Posted by shelliR on February 28, 2002, at 15:38:13
In reply to Re: Has anyone had costochondritis?, posted by BarbaraCat on February 28, 2002, at 13:37:05
> Hmmm, I've been hearing alot about buprenorphine here, especially from Elizabeth. I never considered taking it myself, but now I think I'll consider it. The hurdle will be getting my pdoc to agree. Is that what you're taking?
If you really think you want to try buprenorphine, it might be best to go to a pain specialist or pain clinic and see what they think. (Your pdoc shouldn't take offense because of your fibro.) Most pdocs will not prescribe it. I am changing pdocs because because my present pdoc will not only not prescribe it, but she will kick me out if I take it. So I called around and talked to pdocs who were recommended to me and specifically asked them if I'll be "allowed" to take bupe. On my fourth try I found a pdoc who said he would definitely not give me an ultimatum about it. And he just seemed open in general, as well as having a specialty in treatment resistant depression. One other thing that might be helpful is to first order it from the internet and see how it feels to you, before you bother to risk upsetting your pdoc. The sublingual pill is so much easier to use anyway, and is still before the FDA for approval, looks positive, but who knows when. Anyway, I ordered it off the internet and asked pdocs if they could accept that (rather than asking them to prescribe it). Doctors have to be concerned about law suits if something happens and because bupe is prescribed for pain and not yet approved for depression, your pdoc would be taking more of a risk than a pain specialist.
>
> The fibro manifests as much more than just pain. Major fatigue, flu-like aches all over, depression, insomnia. I'm usually in bed for 2-3 weeks when it hits, then in remission for a few months. You definitely don't want it.Do you know how you react to opiates in general? I have always had positive reactions to opiates and found I reacted the same way to bupe.
> Your chest tightness is very interesting. I primarily feel my depression in the central part of my chest and upper solar plexus area. It's like a visceral expression of the psychic pain, almost a feeling of a hard emptiness, or a tight black fist is how I've described it. The reason I find it interesting is because of all the recent work being done on vagus nerve stimulation for refractory depression. Stimulating the vagus nerve seems to have the capacity to increase noradrenergic and serotonergic transmission to the brain. One of it's major nerve plexes is in the diaphragm area. My theory is that a spasm in the vagus nerve would translate into disrupted neuroendrocrine transmissions and perhaps vice versa. I've always thought there was a strong correspondence between diaphragm/chest pain and depression, but have never heard of any significant studies on it. - BarbaraThat's fascinating that you have thought all that out. One of the pdocs I talked to from NIMH mentioned exactly the same thing. He said they were not sure why vegus nerve stimulation worked (why that nerve specifically increased transmission), and he was interested that my pain and depression manifested exactly where the vegus nerve travels. It might be interesting to write or call one of the vegus trial centers and ask if they have any data on the type of depression for which the implant has worked the best. It's always best to talk to the researchers themselves and most times they *will* talk to you. The data is showing that it is helping about 40% of the "subjects" 50% or more. Not good enough odds for me if something else works, but if the data was broken down into manifestation of depression, perhaps the odds might be better.
Take care,
Shelli
poster:shelliR
thread:95431
URL: http://www.dr-bob.org/babble/20020222/msgs/95853.html