I didn’t sleep last night. My elbows were killing me, and I had a very acid stomach. As a matter of fact, sometime around breakfast time I figured out there might be a common cause – if I didn’t take enough water with my evening Aleve, it doesn’t go down all the way and gives me acid and doesn’t help my joints. On top of that I’m tired as hell. I couldn’t get comfortable all night – my legs were always cold and my trunk was always too hot. And I had a bunch of stuff running around my head.
Right now I’m not 100% sure if I’m going to have explosive diarrhea or vomit. So I’ve come home. Maybe I can get some sleep.
A few weeks ago, I had a sleep study. They wire you up with a bazillion wires and tubes, put you in a sterile room on an uncomfortable bed, and then say “sleep normally”. The reason for the study is that sometimes lack of sleep, especially because of apnea, is sometimes related to sensitivity to pain.
Today, I got the results. Highlights include
- It took me only 14 minutes to fall asleep, but over 180 minutes to first get to REM sleep, and I didn’t get very much REM sleep over the course of the night
- I experienced “arousal” (not sexual arousal, they just mean I wasn’t properly asleep any more an average of 38 times per hour
- The “arousals” were closely correlated to snoring and some apnea, and are the probable reason for the lack of REM sleep
Upshot is that I’m going to get a “CPAP” machine for a few weeks to see if it helps.
I probably should have read tthis post of mine from 2005 before today’s doctor’s appointment. Then I would have been ready when it happened again. Or not. I never seem to learn.
Today, I got my second appointment with the new neurologist. After spending 3 hours absorbing the magic healing rays that are evidently given off by an empty exam room and a rack full of magazines that don’t interest me, (broken up by 15 minutes answering questions from a different PA than last time, most of which were already in my file), I got to see the doctor. And he did the physical exam that I’m already too familiar with, having had it more times than I can count, involving moving my kneecap around, pressing on my legs and knees, and all that shit, only to hear the all-too-familiar word “chondromalacia”. Yup, the same diagnosis that I’ve had since I was 15. And since we’re on the endless repeat cycle, I know what’s going to come next – some barely effective anti-inflammatory pills and some physiotherapy that makes the problem far worse.
I might as well forget it – I’m never going to be pain free, and even a reduction in pain or a reduction in the amount of increase in pain over time is too much to hope for. Trying a new doctor has been a complete waste of time, and used up even more of my ever dwindling bag of hope. It’s times like this I wonder how much more of this pain I can stand before I just have to end it all.
Meanwhile, I took some drug that he wanted me to try last night, and woke up feeling sleepy, mildly nauseated and headachy. The PA referred to it as a “hangover”, I assume in a medical sense just meaning a side effect that carries on the next day, but that’s exactly what it felt like, like I’d tied one on last night. And after the 3.5 hour doctor’s appointment (plug half an hour travel time each way) made me two hours late for lunch, I was really feeling sick. I was seriously considering just going home and lying down on the bed and crying for the rest of the day. But instead I grabbed some lunch, and after a few hours I can almost look at a computer screen without feeling like I’m going to barf. I still feel like crying.
 Wikipedia says “chondromalacia” isn’t a diagnosis, just a description of the pain. Big fucking deal – it also says the usual treatment is anti-inflammatories, physiotherapy, and “treatment of any underlying cause of the pain”. Well, since nobody has ever discovered the underlying cause of the pain, after X-Rays, MRIs, and arthroscopic surgery, that comes back to the same treatment plan that’s been tried and failed a dozen times already.
(No, this isn’t an Obama post.)
I went to see a new doctor yesterday. This was the first time Vicki has managed to convince me to convince a doctor to give me a referral to a neurologist. I’ve asked before, and the doctors always said “no, it’s not neurological”, and then given up on finding an orthopeadic or other cause. This time, I got my doctor to promise that after his idea failed, he’d refer me to a neurologist. And it did, and he did.
I hate to get my hopes up, but this guy (or rather his physician’s assistant) outlined a multi-pronged approach to figuring out how much of it is orthopeadic, how much is neurological, how much is caused by sleep apnea (evidently apnea can make you more susceptible to pain – who knew?), how much is due to rheumatoid arthris, etc. I’ve got a blood test script here (Comprehensive Metabolic, CBC + Platelet, Sed Rate, Protein Electrophresis, C-Reactive Protien WR, Creatine Kinase (CK), Angiotensin-1-Conv Enzime, ANA, Anti-Cardiolipn Ab, Lyme Antibody), then I’m going to have three days of a powerful steroidal anti-inflammatory (can’t remember the name, but I’ll never be allowed to compete in the Tour de France now), and three days of a powerful neurological drug. All I have to do is figure out how to accurately compare one day’s pain to another, something I’ve never been able to do. They’re also talking about various tests of nerve function and sleeping with a pulse oximeter and maybe even a sleep study.
Anyway, keep your fingers crossed for me. I would give my left knee to be able to cross country ski again.