Just so you know, I’ve become totally enamored with the services and user interface at squarespace.com and have committed to locating my blog here on a permanent basis. I’ve laid down my money and made the move. The new domain name will be technomonksmusings.com. (Yep, I’ve finally got my own dot com location!)

The really frustrating part now is that I still am unable to log into the Blogger system to let my readers at technomonk.us know about this transition. Sooner or later, I suppose, I’ll be able to get back into the system long enough to notify everyone of my new address. In the meantime, folks’ll probably start to get worried: my last post there indicated that I was “back” – and then I disappeared again. Hey everybody: are you out there?

Welcome!! My old Blogger-produced blog was good for my first year of online journaling, but I ultimately discovered I was desirous of a cleaner, more-professional, and up-to-date look. So, here I am with a new address and a new blog. Thanks for traveling this journey with me!

I’ve talked off and on here about my diagnosis of chronic myofascial pain, provided some thoughts about surviving this disease and the treatment process, and most recently, discussed the trigger-point injection therapy I began a couple of weeks ago.

Here’s a little addendum to the story that I’ll now share with you…

During the first appointment at the doctor’s office where we performed trigger-point injections , skittish-(around-needles)-person that I am, I allowed only four injections. The second time, a few days later, was a session with 19 injections. That extremely-intense ordeal was on a Monday morning, and, as it followed a weekend of suffering through some intense back and foot pain, I experienced some much-needed relief during the course of that day. However, by that evening, I had pretty much returned to “normal.” (This was not a good thing, of course…the pain had returned!) In fact, by the end of the week (on that Friday), I was hurting so much that I made and kept an appointment with my chiropractor in Eugene, where I obtained some pain abatement with the (for me, usual) treatment modes of ultrasound, light massage, and a small chiropractic adjustment.

My injection-therapy doc was going to be out of town for a bit, so the first chance I had to return to him was Monday morning of this week. While there, I reported on my status, including the few-hours-only relief I obtained as a result of the 19 injections last time.

Of course, I had been discouraged at not experiencing more relief as a result of that previous visit, but, still, was rather unprepared for the assessment that injections were not going to be the preferred treatment for me. The “typical patient” tends to respond much more positively than I did, apparently.

I had been warned that this (injection) path might be more problematic for me than others, though. In reporting my medical history, I of course had disclosed that I had been taking lorazepam (“Ativan”) during the last several months in an attempt to cope with the anxiety-factors of my life (job loss, interviewing, moving…that kind of stuff). As it turns out, and as I had been informed, taking a drug in the bezodiazepine class can sometimes (oftentimes) seriously get in the way of having a successful outcome from trigger-point injections. And this doctor, while having treated only a few individuals who were taking (or had taken) this type of drug, had first-hand experience in seeing such cases as mine “fail.” I had been off the drug for a full three weeks at the time of my injections (and, now, as I write this, it’s been over five weeks), but the effect that the drug can have on the body (at least as far as trigger-point injections go) can be much longer lasting than would typically be predicted from the elimination half-life .

So, what to do now? (was the question) I had been studying the Trigger Point Therapy Workbook and doing my own self-massage of trigger points (with the help of a variety of massage “tools” that I now own). But this approach seems to have yielded little progress, especially regarding my back pain. (It’s possible that the condition in my left leg and foot is somewhat improved.)

I asked the doc what we could to do to pursue an alternative treatment path. Fortunately, he had some ideas (several of them, actually). One possible approach that emerged was to take small doses of a drug, naltrexone , once a day (at bedtime) for thirty days. Naltrexone is an “anti-narcotic” usually prescribed to manage alcohol and opiate addiction. However, in low doses (3 mg vs. the typical 50 mg), the drug has been found to be advantageous for a variety of ailments. The hypothesis regarding this drug’s biochemical mechanism (magic?) is that it produces an increase in endorphin levels in the body, which positively impact muscle tissue (and myofascial trigger points, in my case). In people with diseases that are partially or largely triggered by a deficiency of endorphins ( CMP and fibromyalgia are thought to be in this category), or are accelerated by a deficiency of endorphins, restoration of the body’s normal production of endorphins is believed to be the major therapeutic action of (low-dose) naltrexone.

Now, I had never heard of this drug prior to two days ago. But, I admit, this theory and approach are fairly attractive: a low dose of a drug purported to have “no side effects” and that does not involve frequent, multiple and painful needles in my body. Further, the success rate of this approach for individuals with my condition is supposedly quite high (the pharmacist said that, in his experience, this approach works “about 90% of the time”).

I took the first dose last night at bedtime, after discovering that “low-dose naltrexone” (LDN) has its own website and listserv on yahoogroups . I have started to do the reading and the research, though it may be several days before I have any “results” of this experiment to talk about.

Stay tuned for further updates on my naltrexone experience...

Here is a mildly disturbing development in my life...

I drove into town to run an errand during the noon hour today. While there, I decided to have lunch at the Subway shop closest to my apartment. As I was at the register to pay for my turkey sandwich and chips, the young man said, “that’ll be $4.70...or do you do the senior discount?” To which I stammered, “ excuse me ? Uh. No .”

Holy craperino, Batman! This is the first time such a thing has happened to me, and it caught me completely off guard. What, I wondered, about my appearance today , merited this promotion to senior status?!?

Yeah, yeah…I know. I’m 59. I’m an AARP member. I have some gray hair. But, geezzzz. He had to SAY IT OUT LOUD?

Now, I hadn’t had a bad day to that point, and the rest of day went mostly ok too. There is just this one little blip that sticks with me.

Senior discount? Moi?

The popular TV show Grey’s Anatomy is filmed in Seattle, and maybe its Pacific Northwest roots are part of the appeal for me. (This season the show made a move to 9:00 p.m. on Thursdays, so it is on ABC an hour before ER airs at 10:00 p.m. on NBC; I tape them both and watch them on the weekend). Aside from its obvious (and frequent) quirkiness, the show has real and touching moments that occasionally tend to unearth some truths about life and relationships.
 
Last Thursday’s Sometimes a Fantasy really caught my attention. Most episodes are filled with several different story lines, with some, not uncommonly, continuing from week-to-week. And the story of Izzie’s loss resumed this time. She had fallen in love with a heart-transplant patient who had asked her to marry him. However, shortly after he popped the question (and after Izzie had made an ethically-questionable call about his care), he died. Izzie’s story was juxtaposed with one about Megan, a young girl who came to the emergency room with multiple injuries. Although she was bruised, beaten, scarred and had stapled a wound on her arm with an office stapler, she claimed to feel no pain. The ultimate diagnosis for her was “chronic insensitivity to pain.” (Who knew there was such a thing!?)

So, he we had: Megan, dramatically physically damaged, who claimed to “feel no pain.” And Izzie, who stood immobilized outside the hospital, unable to motivate herself to return to work, when asked where it hurt, said “everywhere .”

The array of possible human experiences always tends to amaze me. In this dramatization, one person feels immense, debilitating, chronic, paralyzing pain, and the other, none at all.

During the operation on Megan, the surgeon observes that “everybody wants a life without pain. What does it get you? She needs to be on a poster somewhere to remind people that pain’s there for a reason.”

I know, I know. This is a TV show. But the writing this week seemed incredibly good…and provided a degree of wisdom than one typically does not encounter during prime time.

Of course, these observations extend my previous commentaries. You know that I think about pain a lot ; and an episode of a medical drama focusing on the topic is bound to attract my attention and dwell in my thoughts. Six days ago, in an attempt to address my chronic myofascial pain issues (including my long-standing chronic lower-back pain), I allowed a doctor to inject me 19 times with small amounts of Marcaine in my first major attempt at trigger-point injection therapy. Although I experienced some short-term relief that day, by the evening I was back to “normal.” And, as my back pain has been the predominant factor in my existence the last couple weeks, I drove to Eugene to see my chiropractor on Friday.

If “pain’s there for a reason,” I ask, “what is it ?”

I struggle with this question.