Riding Through The Woods

September 17, 2009

Thanks folks for all your kind wishes last week for my trip back to see the surgeon. I’m sorry to take so long to report back on the outcome. While the day in Nottingham went smoothly, I was totally exhausted following it. With the arrival of our late summer, Connemara beckoned and I joyfully obeyed the call. I’m now suitably revived.

Since finishing all the treatment for the osteomyelits, I’ve been having recurring headaches along with episodes of acute bone pain. Despite taking strong pain killers plus an anti-inflammatory medication, the headaches have continued intermittently leaving me to wonder if the bone infection had really cleared. A recent blood test did little to allay this fear as it confirmed that the inflammatory marker (CRP), is markedly raised again.


(Image credit: Display at entrance to Nottingham Castle – photo taken on my mobile phone)

In Nottingham, the surgeon carried out an endoscopic examination of my head and and the report back was encouraging. The bone which was exposed by the surgery, has healed well despite the set-backs. However, the surgeon agreed that the abnormal blood test was a cause for concern. I had another blood test before leaving the hospital and a radioisotope bone scan has been requested, to check for any residual infection in the bone.

Due to the nature of my ongoing symptoms, the surgeon has advised that neuropathic pain is the most likely cause. This type of pain occurs as a result of damage to nerves following surgery/bone infections. Neuropathic pain is difficult to treat but can be eased by ‘tricyclic’ antidepressant medicines, by an action that is separate to their action on depression. Treatment is usually long term.

“Neuropathic pain (‘neuralgia’) is a pain that comes from problems with signals from the nerves. There are various causes. It is different to the common type of pain that is due to an injury, burn, pressure, etc. Traditional painkillers such as paracetamol, anti-inflammatories, codeine and morphine may help, but often do not help very much. However, neuropathic pain is often eased by antidepressant medicines – by an action that is separate to their action on depression. It is thought that they work by interfering with the way nerve impulses are transmitted. There are several tricyclic antidepressants, but amitriptyline is the one most commonly used for neuralgic pain. In many cases the pain is stopped, or greatly eased, by amitriptyline”.

I was sent home with a prescription for a low dose of amitriptyline. The side effect of this medication is increasing drowsiness so I’ve been advised to take it only at night and to persevere with it as it can take several weeks to get maximum benefit. If, after 3 weeks,  I’ve not experienced any relief from the pain, I’ve been instructed to double the dosage every week until benefit is achieved. So… if my blogging becomes more sporadic with words slurred, you’ll know why!

The surgeon’s parting words to me were “you’re not out of the woods yet but there is light at the end of the tunnel”. That sums it up nicely.

(Information Source: WebMD and Patient UK)