What Should My Next Steps Be?
I am a female weighing 130 pounds, who vapes and smokes. My current medications include birth control, vitamin D, Zyrtec, omeprazole, and I'm taking amoxicillin, though that is not connected to my current health issue. I have a long history of mental health challenges, but those are under control now. The main concern I am dealing with has persisted for over four months. For the last four months, I've been suffering from a pinched nerve on my left side, which has impacted my dominant hand. Initially, I encountered issues with my insurance, as a former foster youth, being incorrectly denied coverage. After contacting them, I was advised to visit the emergency room due to the severity of my symptoms. There, I received three steroid injections along with muscle relaxants, and I underwent a course of each. The steroids provided significant relief, while the muscle relaxants were only moderately effective. Despite my PCP denying requests for scans and referring me to physical therapy, which I've diligently attended for six weeks now, there hasn't been substantial improvement. I have a physical examination scheduled for the 23rd, and I am eager to learn about the next steps, as I feel overlooked in my situation. Due to a previous severe case of H. Pylori, I have developed extreme sensitivity to NSAIDs, which makes ibuprofen out of the question as it puts me at risk for ulcers. I even experimented with liquid gel after taking famotidine with food, but now I'm also dealing with anemia as a result. The recommendation has been to use Tylenol, which my physical therapist confirmed would not be beneficial, and the diclofenac cream I've received has had minimal effect, resembling more of a scented lotion than a solution. I find myself largely bedbound outside of work, as staying upright exacerbates my discomfort. Even while at my job, I am greatly limited in my activities, but have received generous support from my colleagues. To alleviate the strain, I use a soft collar while sleeping, adhere to my therapeutic stretches, and do my best not to aggravate the injury, yet the pain and muscle spasms are relentless. Would it be considered inappropriate or viewed as drug-seeking behavior if I were to request a protective medication for my stomach, like sucralfate? Additionally, might low-dose naltrexone (LDN) be a suitable alternative to high-risk medications such as gabapentin or stronger muscle relaxants? Unfortunately, regular use of Tylenol is not an option I can rely on.
Answers (1)
9/14/2025, 1:20:37 AM
OpenHealth AI
It sounds like you're dealing with a challenging situation regarding your pinched nerve and managing multiple health concerns. Your experiences are completely valid, and it’s important to find solutions that prioritize your comfort and well-being.
Main Points:
- You're experiencing persistent pain from a pinched nerve without satisfactory relief from current treatments.
- You're cautious about medications due to past health issues, and you’re looking for alternative options to manage pain and protect your stomach.
Explanation:
A pinched nerve can cause significant discomfort and impact daily activities, especially when it's affecting your dominant hand. Given your history with H. Pylori and sensitivity to NSAIDs, it’s essential to approach pain management carefully. Steroid injections can help reduce inflammation, but if you're still struggling after physical therapy, it may indicate a need for a reassessment of your condition and treatment plan.
Prioritized Next Steps:
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Documentation and Communication: Prepare for your upcoming physical examination by keeping a detailed record of your symptoms, the effectiveness of treatments you've tried, and how your condition has affected your daily life. Bring this to your appointment to provide a comprehensive view that can guide discussions.
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Discuss Medication Options:
- Sucralfate: Requesting sucralfate for stomach protection, given your sensitivity and previous history with H. Pylori, should not be viewed as drug-seeking. It can be a legitimate concern, considering your risk for ulcers with pain medications. Clearly explain your concerns about NSAIDs and Tylenol, emphasizing your need for a protective option.
- Low-Dose Naltrexone (LDN): Talk to your doctor about examining the potential of LDN as a treatment option. Research shows some promise for chronic pain management, but it’s essential to have an open conversation about its appropriateness for your specific condition.
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Alternative Pain Management Techniques:
- Consider Non-Pharmacological Approaches: Explore options like acupuncture or chiropractic care, if suitable, as they can be complementary to physical therapy.
- Mindfulness and Relaxation Techniques: Techniques like meditation, gentle yoga, or guided imagery can help manage pain to some extent and may provide relief from muscle tension.
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Seek a Second Opinion: If you feel your concerns are still being overlooked after discussing these options, consider seeking a second opinion from a specialist, such as a neurologist or pain management expert, who can evaluate your situation with fresh eyes and may offer new treatment avenues.
Supportive Suggestions:
- Keep ensuring that your workplace environment accommodates your needs as much as possible.
- Stay consistent with your therapeutic stretches, as they can aid in recovery.
- Reach out to support networks for emotional well-being during this challenging time.
You deserve effective pain relief and proper management of your health concerns. Don't hesitate to advocate for yourself in discussions with healthcare professionals, as your comfort and quality of life are paramount. Let me know if you need more information about any specific points!
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