5/31/14. The post where I am reminded that things aren't completely back to normal.

5/31/14:  woke up earlier than I wanted this morning with nausea again, but again it faded away pretty quickly.  Back to a 4 this morning, so I did not regret yesterday's shoe experiment.  After doing some chores, I went for a walk and made it two miles!  Sure, it was slower than my "normal" pace and completely on flat ground, but it felt like real exercise for the first time in a long time.  It.  Was.  Awesome.

After my patient, long-suffering husband returned from his bike ride, we went to the farmer's market and then to a wine tasting at a local wine shop.  Still feeling great.  Next stop - grocery store for dinner fixings and a few things to tide us over until we leave for vacation.  As we stood n line to check out, things went downhill.  Quickly.  Suddenly my foot was screaming and by the time we got home, it had shot up to a 7 and was red and swollen.  

After 30 minutes on the couch with my foot elevated, the color was back to normal and it felt much better.  I spent the rest of the day at about a 5.  So maybe I overdid it a little today.  "Consistently moderate activity."  Why do I have such a hard time remembering that on good days?

We had a delicious dinner with our house guests (courtesy of my patient, long-suffering husband) and watched "To Catch a Thief" (the Grace Kelly/Cary Grant version, of course).   Tomorrow I will back off a little on the exercise and see if I can stay in the 4 range all day.  Wish me luck...

5/30/14. The post where I may get a bit overly ambitious.

5/30/14:  went to bed a little nauseous and woke up a little nauseous, but it passed quickly.  I was still at a 4 and since I'd been cycling all week, I decided to take a longer walk this morning instead.  One of  the friends staying with us joined me on the walk and we had a lovely stroll as the sun came up.  

Since I felt good all week, I decided it was time to try a little experiment and managed to sneak past the shoe police (aka my patient, long-suffering husband) wearing these:

Risky, I know, but I figured it was Friday and even if things went badly, I would have the weekend to recover.  Sometimes you just have to take a chance.  Things went very well at work and while shoe shopping at lunch.  The biggest issue was that the buckles made it inconvenient to try on shoes.  (I balanced my temporary insanity by selecting two pairs of extremely sensible but cute shoes for the trip.)

Filled with optimism, I wore them to my book club tonight, too.  It was a very enjoyable evening with friends - a good book with interesting discussion and a nice meal.  But I probably pushed my luck just a bit.  I took my shoes off about halfway through the evening and drove home in bare feet.  My little piggies were pink and swollen, but I still ended the night at a 6.  Progress.  All the same, I'll go back to the sensible shoes tomorrow.

5/29/14. The post where I don't go shoe shopping.

5/29/14: so much for my resolution to get more sleep last night.  I went to bed at a decent hour, but woke up at 1:30am to discover that my patient, long-suffering husband was still awake working on a project downstairs.  After going down to check on him, chatting for a few minutes, and then returning to bed, I realized that my stomach was churning.  I worried for a minute that I had food poisoning or a virus.  After thinking about it a little more, though, I recognized it.  It was the nausea from my Cymbalta.  I remembered that when my doctor suggested taking it at night instead of in the morning, it was because he said I'd sleep through the nausea.  I had convinced myself that it was gone for good.  But as I told a friend today, even if it never goes away, I can live with it as long as it continues to make my foot feel better.

Eventually I was able to get back to sleep, but I barely managed a C on my sleep score and woke up at a 6 again this morning.  I prepared for a rough day.  But it didn't materialize.  I had a little redness after my PT exercises, but it disappeared quickly and by mid-morning it was back down to a 4.5.  Great news, but I give up on trying to predict what is going to cause good and bad days.  (If only that were true, for your sake.  I have no doubt I will be making predictions again tomorrow.)  I remembered that I needed to leave work early for a haircut, so I nixed the lunchtime shoe shopping until tomorrow.  I was wearing sandals and I could see that my big toe turned purple a few times today, but I never got above a 5 in the afternoon or evening.

I came home from my haircut and my patient, long-suffering husband declared it to be "sassy". (He's a good judge of sassiness, so I believe him.)  We have some good friends staying with us for a few days while their new house is completed, so we went to dinner and had a nice visit.  Once again, I am resolved to get more sleep tonight.  Maybe I should resolve to stay asleep instead.  Or at least to make sure my patient, long-suffering husband goes to bed early.  But I'll take sleepy and nauseous over a pain level 9 any day.

5/28/14. The post where I go shoe shopping.

5/28/14:  didn't start off the morning quite as well as the last few days, but still just a 6.  (Well below my goal of seven hours of sleep last night.  Could it be related?)  The weather looked threatening again, so I biked instead of walking, but about the time I got off the trainer, the sun came up and it turned into a beautiful morning.  C'est la vie.

Speaking of which, our vacation is just over a week away, so I decided it was time to get cracking on shopping for those last-minute necessary items.  There will be quite a bit of walking on the trip, some of which could probably qualify as hiking, so good comfortable shoes will be a must for my foot to have any chance of surviving.  I set out at lunch to look for shoes that were comfortable and sturdy, could hold my orthotic inserts, looked at least fairly fashionable, and would match all the clothes I am taking so I can pack lightly.  Easy, right?

I went to several nearby local shoe stores that specialize in comfort shoes, with no luck.  I saw lots of cute pairs, but didn't find anything that met all my requirements for this particular trip.  I found several pairs of black Mary Janes that I considered briefly just for general purposes, but I managed to restrain myself.  How did I exercise such self-control, you ask? Because:

Yes, folks, read 'em and weep.  Six pairs.  I love Mary Janes.  And I can tell you the different purpose each pair serves.  At least, I could at one time.

I went back to work empty-handed.  I'll try again tomorrow.  I feel certain the right pair exists out there somewhere.  And if it is out there, I assure you I will find it.  It's kind of a specialty of mine.

I stayed at a 6-6.5 most of the day, with a couple of unexplained episodes of redness.  I will try not to read too much into it and do my best to get more sleep tonight, just in case it matters.  I have to be in good shape tomorrow.  There is more shoe shopping to be done.  

5/27/14. The post where it continues to rain.

5/27/14:  we were awakened at 3am by thunderstorms, which continued through most of the morning.  Even with the storm-related sleep interruptions, I woke up at a 5.  Since a walk outside was ill-advised this morning, I cycled for 20 minutes on the trainer instead.  A little redness afterward, but it faded quickly.  

It was a relatively quiet day.  It rained on and off, so I wore my rain boots to work again, this time with no apparent consequences.  I guess it's time to officially admit that the Cymbalta is making a difference.  I've been warned that it is not a long-term solution, so I am trying not to get my hopes up, but I sure am enjoying it right now.  

As lucky as we've been to have the rain, I wish I could have done my hike today.  I'm getting a bit superstitious these days, and when I have a good day I want to replicate it as closely as possible.  There is a chance of rain for the rest of the week, so presuming I have no after-effects from the training bike, it looks like that will be my activity of choice.  I'm up slightly to a 6 this evening, but nothing I can't handle.  And I'm more confident these days that I'll wake up feeling better.  I'm starting to sound like an ad for Cymbalta.  I wonder if they read blogs?

5/26/14. The post where I am surprised by how good I feel.

5/26/14: another pretty good night's sleep, with a sleep score of 89%.  I promise I won't subject you to my sleep score every day.  My health monitor is a shiny new object right now, but I'm sure I'll get over it at some point.  

I remember my PT telling me that when I try new physical activity, the best indicator of whether the level was right is not how I feel immediately afterward, but how I feel the next day.  Even though I felt good after our hike yesterday, I was concerned about how it would affect me today.  I needn't have worried, because I woke up feeling great.  Like 4-4.5 level great.  I don't think I ever got over 5 today.  Woo-hoo!

We were forecast for more storms today, so we decided to get in another short hike this morning.  Still slow and steady, but with a few more hills.  Just like yesterday, I came home with a red foot and just like yesterday, a short period of elevation did wonders.  The sky exploded shortly after we got home and while it poured outside, I finished a good book.  This was great for my state of mind, but my health monitor was not impressed with my two hours of "inactivity".  Guess I need to learn how to read while walking around the house. Or my health monitor needs to chill out.

It was an active, but relaxing, holiday weekend and put me in a good enough frame of mind to get through the ten days before my real vacation.  I will keep hiking a little each day as well, so I can also be ready physically.  And I will try to remember my new mantra - "consistently moderate activity."  

5/25/14. The post where I take a long walk.

5/25/14: got to bed much earlier last night and had a sleep score of 91%.  Which I learned doesn't necessarily mean I won't still be tired all day.  I think I have yawned for two days straight.  But my foot felt much better this morning - back down to a 5.

I made it through the last handbell performance of the spring season with no problems, then had a fairly lazy afternoon.  I had not done my PT walk this morning, so my patient, long-suffering husband and I decided to take a walk this afternoon.  A long walk, at least compared to the distance I've been walking recently.  Our upcoming vacation will involve a lot of walking, so we decided it was time to see if we are up to it.

We walked to a nearby park and wandered around the trail for awhile.  We stayed away from the big hills, but did a little (slow) climbing.  We were probably only gone for 30 minutes, but it felt like a victory.  My foot was pretty red when we got home, but it cleared up quickly after I sat down for a bit.  I think if I take it slow, I will be able to get through our vacation without any major damage.  Now all I have to do is figure out a way to lose 10 pounds in 12 days and I'll be ready to go.

5/24/14. The post where I am glad it's a three day weekend.

5/24/14: what do you get when you entertain guests until after 2am and then wake up at 7am? A 65% sleep score, that's what you get.  Boy, am I glad it's a three day weekend with very little on the calendar.  I started the morning at about a 6.5 and never got below that.  It was another rainy day, and we have at least some chance of rain every day for the next week.  Great for our plants and area lakes, not so great for my foot.

We did some chores around the house this morning and then ran errands this afternoon.  While getting ready, I had a strange and unpleasant episode.  My foot turned red, but not in the usual places.  It was more confined to one long, thin strip coming down from my big toe. The color was very intense and it felt like it was on fire.  I don't mean a burning sensation.  I mean a "stop, drop and roll" kind of fire.  At least, that's what I would imagine it would feel like to be on fire.  While I have burned myself on stoves, ovens, car seats, curling irons, and just about anything else you could imagine, I have never actually been on fire.  And for that I feel very, very fortunate.  I put some cream on the red strip and elevated my foot for about five minutes, and it began to feel better, but it sort of did me in for the rest of the day.  I was still able to get out and do errands, but I've spent most of the rest of the evening lounging on the couch and shaking my fist menacingly at my foot. 

I read an article about CRPS yesterday by a doctor who used the phrase "consistently moderate activity."  The theme was very similar to the pep talks my PT would give me during my appointments.  Don't overdo it on days you feel good and don't underdo it on days you feel bad - either one can aggravate it and decrease your chances of getting it into remission.  While you might not believe it from reading my posts, I really am trying to do better at following this advice.  But clearly I have more work to do.  

One final note - I failed to mention yesterday that I had a manicure.  My bad.  I know some of you can't stand the suspense of not knowing what color my nails are at any given time.  I am now wearing "I Think in Pink" from OPI's "The Sophisticates" collection.  There, now you can sleep tonight. 

5/23/14. The post where I remember that I have another tool in my arsenal.

5/23/14: didn't quite make my seven hour goal, but slept much better. My sleep score was 94%! Now that's the kind of grade I am used to receiving.  (Yes, Dad, I know.  An A+ would be even better.)  Apparently no one told my foot, though, because I woke up at a 6 and was at a 6.5 by the time I was done with my PT exercises.  

It was a fairly quiet day at work, with many people already out enjoying the holiday weekend.  The afternoon brought some unexpected rain, which might be responsible for my pain level.  We had a concert tonight, so I was on my feet quite a bit preparing for it.  By the time we were ready to open the box office, my foot was scarlet and swollen and I was up to a 7.5.  Not the best circumstances for counting money or being hospitable to guests.

Then I suddenly remembered my prescription cream.  I haven't used it much for the last week or so because I was having good luck with the Cymbalta and I had sort of forgotten about it.  Fortunately, I had some stashed away in my purse.  I managed to apply it just before the first guests arrived at the venue and I don't think anyone noticed that I only had one shoe on as I sat behind the ticket table.  Or if they did, they were too polite to mention it.

By the time the concert started, the color was nearly back to normal and I was back down to a 6. I think I've figured out the best way to use the cream. If the Cymbalta is a starting pitcher, the cream is more of a middle reliever.  Now, if I could just find a closer.  

5/22/14. The post where I resolve to get more sleep.

5/22/14:  so much for my caffeine theory.  My alarm woke me up in the middle of a dream and I was completely disoriented.  A check of my health monitor explained why.  I was in the middle of REM sleep when my alarm went off.  (REM is the sleep stage where your brain processes information and stores memories.  Not to be confused with the rock band of the same name.)  My sleep score was even worse than last night - 77%.  My parents are going to ground me when they see my report card.

Even with its optimistic definition of "light sleep", my health monitor still only measured a little over six hours sleep each night for the last two nights.  I'm no expert, but I suspect I should be getting more than that if I want to beat this thing.  While I can't control how well I sleep at night, I can at least control when I get to bed, and I intend to try.  I resolved today to try to spend at least seven hours in bed each night.  And now I have an objective way to measure it.

The good news was that I started the day at a 5 and stayed there much of the day.  Unfortunately, it didn't last, and when it ramped up, it wasn't messing around.  Tonight my foot swelled up again, turned red and purple, and is up to a 7.5.  I have it elevated right now for the first time in several days.  I don't think I get to count this toward my seven hours...

5/21/14. The post where I find out how many steps I walk in a day.

5/21/14: didn't sleep very well last night (more on that in a minute), but was feeling pretty good this morning. My pain level had eased back down to a manageable 5 and it never got above 6 today. Woo-hoo!

Last week my patient, long-suffering husband and I ordered some wrist health monitors like all the cool kids are wearing, and they arrived yesterday.  He set them up for us last night and we started using them immediately.  It looks like we are wearing big ugly matching watches.  

One of the things they measure is sleep patterns and I was anxious to see the results from the first night.  I have always been highly affected by caffeine, so for years I have stayed away from it.   But yesterday, in a fit of poor judgment, I ordered a cola-flavored Icee at a convenience store during our trip.  Caffeine and sugar - a dangerous combination for an already hyperactive overachiever insomniac.   I felt certain I would pay for it last night.

The first thing I learned about the health monitor is that it records lying quietly in bed staring at the clock as "light sleep".  So it is an optimist, just like me.  It gave me some pretty detailed stats and an 84% sleep score.  I was hoping for an A, but based on the stats and how I felt this morning, I think I was lucky to get a B.  I'm back on the caffeine-free wagon today and hoping for a better score tomorrow.

My health monitor also records, among other things, the number of steps walked.  My current morning PT walk is approximately half a mile.  I recorded about 4,400 steps over the course of the day today.  Before CRPS, I walked two miles every morning at a much faster pace and was much more active the rest of the day.  I guess that explains why I can only fit into about one-quarter of my clothes.  

The health monitor is providing interesting information, but there is not a lot I can do to change any of it right now.  Maybe it would be better not to know, but now I am committed.  As things improve, and I am sure they will eventually, at least I will be able to quantify it.  And besides, who wouldn't want to wear a big ugly watch all day every day?

5/20/14. The post where I am officially determined to be neither crazy nor a terrorist.

5/20/14: slept pretty well again and woke up at about a 5.5.  A good start to a busy day.  After a few hours of work, I left for a doctor appointment.

This was not the usual type of appointment.  Because the spinal cord stimulator is a very expensive piece of equipment and has about a 50% success rate, insurance companies want to ensure you are a good candidate for it and have no other issues that might impede its success.  Prior to approving me for the stimulator trial, my insurance company required me to undergo a psychological evaluation. 

I showed up at my doctor's office and completed a questionnaire.  Then I met with a psychologist who also specializes in pain management that they bring in specifically for patients who are contemplating spinal cord stimulators. The purpose of the meeting was two-fold: to ensure I understood how the stimulator worked and what it would do, and to determine whether I had any related psychological issues that needed to be resolved prior to receiving the stimulator to increase its chance of success.  After discussing the questionnaire, my medical history, and the procedure, she determined that I was a good candidate.  And that I know the difference between my foot feeling like it's on fire and my foot actually being on fire.  

I'm not sure if she made a determination regarding my ability to exercise good judgment, but after the appointment, I immediately got into the car with my patient, long-suffering husband (fresh from his epidural injection yesterday afternoon) and made a six-hour drive.  We decided several weeks ago to apply for the global entry program that allows travelers to go through expedited security and customs processes when flying commercially.  Part of the application process includes an interview with customs personnel.  The closest airport with available interview times prior to our upcoming vacation was three hours away, so off we went.

It was a relatively easy drive with little traffic and we arrived well before our interview time.  Fortunately they were running ahead of schedule, so they got to us almost immediately.  It was pretty anticlimactic.  First, they showed us a short video that briefly explained the program.  Then they looked at our passports and driver licenses, took our fingerprints and photos, and explained in more detail how the program works.  The entire interview process took less than ten minutes and we were back on the road prior to our scheduled interview time.  So I was two for two.

The trifecta would have been another sub-7 day, but I didn't quite make it.  I think the events of the last few days finally caught up to me.  By tonight, I was at a 7.5, although I'm surprised it wasn't worse and the color is still much better than it has been.  Two out of three ain't bad.

5/19/14. The post where I (just barely) keep my winning streak intact.

5/19/14: different day, same pattern.  Woke up early with my foot around 6.5, but it got better as I got up and started getting ready and the color was pretty good.  I spent much of the day sitting in a meeting without being too uncomfortable.

After the meeting, I made the three hour drive back home.  It was an extremely windy day, as I discovered when I stopped to get gas.  I stopped at a large truck stop/convenience store and was surprised to see everyone staring at me as I walked inside.  Are they that surprised to see a woman in a business suit?  When I walked into the ladies' room, I discovered the real reason they were staring.  The wind had blown my hair completely straight up in the air on one side and plastered it to my head on the other side.  I looked like I had walked out of an avant garde foreign film from the '60s.  I would have stared at me, too.

I made it home just in time for handbell practice, which was abbreviated because my patient, long-suffering husband was recuperating from his epidural injection.  While my foot did not feel quite as good as it has the last few days, it stayed under 7 all day, so I am going to call it a win.  Tomorrow is my last travel day before our vacation, a six-hour round trip.  If I can make it through tomorrow without a meltdown, it will be a good sign.  And if I can't, at least I had three good days in a row. 

5/18/14. The post where I survive a long drive.

5/18/14: slept pretty well last night.  Although I woke up at about a 6.5, once I got up and started getting ready, it went back down to a 5.  I went to church, had lunch, then packed up the car and took off for my parents' house.

Something I had not really considered before today - there are about...oh, let me think...maybe...1,000 colleges between my home and theirs.  And apparently all of them had graduation ceremonies this weekend.  There were three lanes' worth of families returning home and u-hauls filled with graduates' belongings.  Which is fine, except for the fact that most of the freeway between my home and my parents' home is only two lanes wide.  Traffic was at a crawl for much of the trip, which took an additional 45 minutes.

I made it home just in time for dinner.  Mom and Dad teamed up to make a lovely meal and my brother, niece and nephew were able to join us as well.  We went for a short walk after dinner to enjoy the cool evening.  I'm glad circumstances worked out for me to sneak in an additional visit before my vacation.  My foot was slightly red and swollen by the end of the evening, but still only about a 6, and after my drive I would have expected much worse.  The winning streak continues.

Tomorrow I will spend much of the day in a work meeting and then make the drive back home tomorrow evening.  My patient, long-suffering husband is having an epidural injection tomorrow afternoon that we hope will bring him some relief.  With any luck, he'll start his own winning streak. 

5/17/14. The post where I start a winning streak.

5/17/14:  woke up early, as usual, and spent a lazy morning with our guests.  On the spur of the moment, we decided to make a trip to nearby wine country.  It was a beautiful sunny day - perfect for a drive through pretty country and a leisurely lunch outside on a patio.  A little too leisurely, perhaps.  While I keep sunscreen in my car for days like this (because, of course I do), we were in our friends' car, so my shoulders are now a light salmon color.

Sunburn aside, it was a nice trip and a lovely day. The best part was that my foot felt pretty good again today.  This makes two days in a row spent mostly in the 5-5.5 range.  I was even able to wear some sandals with a slight heel without any apparent ill effects.  Don't get me wrong - under normal circumstances, if I had suddenly woken up one morning with my foot at this pain level, I would have called in sick to work and gone to the doctor for x-rays on the assumption that I had really injured it.  And if I continue at this level for an extended period, it will get old pretty quickly.  But right now, it is a real relief.

Tomorrow afternoon I will make the drive to spend the evening with my parents before a work meeting  and a return drive home on Monday.  If I do as well for the next two days, I may start to believe the medication is working.  I'm trying not to think too far ahead, though.  I'm just enjoying each day as it happens.  Now, if you will excuse me, I still have a little day left to enjoy.

5/16/15. The post where I get some relief.

5/16/14: started taking my full dosage Cymbalta Thursday night.  I woke up a little nauseous, but nothing unmanageable.  I was concerned that my recent trouble might be a result of overdoing it with my PT exercises, so I made a conscious effort to be more careful.  I use a pedometer app on my phone to record my walking speed and it is usually around 3mph.  A glacial speed compared to my usual gait, but three times as fast as the speed dictated by my PT.  I was very deliberate during my walk and managed to get my speed down to 2.5mph.  A little progress, but I don't think I can get it down to 1mph without being on a treadmill.  I was also much more careful with my pedaling on the bike.

And I think my effort was rewarded.  I had almost no color in my foot and spent most of the day in the 5-5.5 range.  It seems too early to be seeing results from increasing the medication dosage, but who knows?  Regardless of why I was feeling some relief, after the last week, it felt absolutely decadent.  I did not have to do much walking at work and had a nice pedicure break at lunch.  ("Thanks a Windmillion" from the OPI Holland collection.)  We have friends in town visiting for the weekend and went out with them for a delicious dinner.  All in all, a really pleasant Friday.  Fingers crossed that Saturday will be just as good.

5/15/14. The post where I tell you about the next step.

5/15/14: the good news - for the first time in quite awhile, I did not wake up long before my alarm.  The bad news - because my sleep cycle is completely off schedule, I was in the middle of a dream when my alarm went off.  I woke up completely disoriented and felt slow and groggy all day.  (I can just hear my brothers saying, "and how is that different than any other day?" Very funny, guys...)

I managed to get ready in time for my doctor appointment.  First, we talked about the Cymbalta.  I have been taking the "half dosage" (my words, not his) for two weeks and it is time to ramp up to the full dosage.  He suggested I take it at night rather than after breakfast to help with the nausea and assured me it would go away after a few weeks. 

Then he asked me the million dollar question: after thinking about it for a few weeks, had I decided if I wanted to pursue the next step?  Yes...yes, I am.  The next step is a spinal cord stimulator.  For those of you who, like me until a few weeks ago, have no idea what that is, I'll try to describe it briefly in non-medical terms.  (Hope I get it right.)  It is a small battery or generator attached to wire leads that are threaded into the epidural space of your spinal cord.  It sends electrical impulses to the brain that are intended to mask the pain signals coming from the damaged nerve.  It does not "fix" the nerve, it just provides pain relief.  Or at least, it does in about half the people who try it.

It is surgically implanted in the back and adjusted using a small remote control. The good news is that there is a one-week trial that can be done without implanting it to determine whether it will provide any relief.  During the trial, the leads are implanted using a tiny needle, but the generator stays outside of the body and is worn like a pager.  (The younger folks reading this will need to get on the Internet and find out what a pager is.)  If you experience relief during the trial, the generator will then be implanted.  It can be removed in the future if you no longer need it or if it ceases to provide relief.

While having what sounds like a tiny set of jumper cables in my spine is not my ideal scenario, nothing else has worked so far, so I am ready to try it.  The scariest part is the thought of trying to keep up with the remote control.  And hoping I don't get a shock every time my patient, long-suffering husband changes the channel on the TV.

The one-week trial will be scheduled after we return from our vacation.  If it works during the trial period, I will schedule the procedure to have it implanted.  If it doesn't...well, let's cross that bridge if we come to it.

5/14/14. The post where I make it back home.

5/14/14: after a rough night, I was a little improved this morning.  My foot was stil red, but a much lighter shade, and the pain level was down from a 9 to about a 7.5.  It was still cool and windy, but the sun was out and I was able to finish my conference and drive back to the office to get some work done in the afternoon.  I even made it to choir practice.

I came home to find that my patient, long-suffering husband was in nearly as bad a shape as me.  He has a periodic back problem that has flared up recently, and it got much worse while I was gone.  He already had an epidural scheduled in about two weeks, but now he is trying to get it expedited.  We make a fine pair right now. At least we have each other.  And a good sense of humor. 

I go back to the doctor tomorrow morning to talk about the most recent attempts at pain relief. Anesthetic cream - minimal and brief relief when I use it.  Cymbalta - nothing yet, but I've taken it for less than two weeks, so it may be too early to tell.   Our vacation is three weeks away, and he said he may have a couple of other short-term options to get me through the trip.  Which is fortunate, since I may have to carry my patient, long-suffering husband if his back doesn't improve.

The color of my foot is much better tonight and I'm down to a 7.  Tomorrow is a busy day, but it is forecast to be warm and sunny.  I have four days before my next road trip, so my foot will get a bit of a rest from driving.  Between that and sleeping in my own bed, I'm hoping to be back down to a 6 tomorrow.  Hope springs eternal, right?

5/13/14. The post where I talk about garlic and Nutella.

5/13/14: it continued to rain quite a bit through the night.  So much so that when I looked out the window this morning, I felt like a genius for packing my rain boots.

I slogged over to the convention center for day two of the conference, the envy of all my non-rain boot packing co-workers.  It was cold, rainy, and windy all day today and my foot was very angry about the whole situation.  I came back to my room at lunch time and elevated it for awhile in a vain effort to calm it down.

One of my co-workers had a birthday today, so after the conference several of us went to dinner to celebrate.  The birthday boy is a fairly finicky eater, so when the waiter brought the obligatory free birthday dessert, Nutella mousse, he was skeptical.  He had never had Nutella (heresy, I know), so another co-worker and I assured him that it was delicious and he would enjoy it. He took a bite off one end and exclaimed, "Yuck! It tastes like garlic!"  Who could possibly think Nutella tastes like garlic?  A second co-worker, who (inexplicably) had also never tried Nutella, then tried it and agreed with his assessment. What is wrong with these people?  My Nutella-eating co-worker and I each tried a bite off the other end and assured them it did not taste like garlic.  Finally, the fifth member of our party tried it and agreed that it did, in fact, taste like garlic.  Exasperated, I took another spoonful out of the end they had tasted, just to show them it was fine.  I got it halfway to my mouth and...holy stinking rose, Batman! I was overwhelmed by the smell of garlic.  I didn't even attempt to taste it.  

When the waiter came over, we told him about it and convinced him to try a bite.  He was horrified and, after offering us a replacement dessert, took it back to ask the chef to taste it.  He came back out and told us the chef's reaction after tasting it: "Well, that's odd."  Oui chef, Nutella mousse that tastes like garlic is, in fact, odd.  And is not going to help our finicky friend become more adventurous in his eating habits.  At least he'll have a good story to tell.

I had to call it a night early because my foot was particularly red and swollen and the pain level was getting out of control.  I suspect it may be a combination of all the walking and the storms, which have continued tonight.  Tomorrow, I have one more half-day of conference and then a drive back home. The weather is supposed to improve in the morning and I'm hopeful my foot will improve with it.  Otherwise, the drive home is going to be worse than garlic flavored Nutella mousse.

5/12/14. The post where I brave the conference.

5/12/14: slept terribly last night and would have liked to have stayed in bed this morning.  But today was a travel day, so I got up early and packed instead.  Made the two hour drive and got into town in time for the opening of the conference.

It was a tough day for my foot. Even though my hotel is across the street from the convention center, there is still a lot of walking involved and by fate, most of my co-workers could rival the Harlem Globetrotters in terms of height.  Since I am closer to a jockey in terms of height, I did a lot of fast walking.  Despite the summer-like temperatures, I wore pantyhose and I don't think anyone noticed that my foot was red and swollen.

The conference started well and I had a good dinner with co-workers afterward.  With all my recent travel, it is getting harder and harder to leave my patient, long-suffering husband behind each time.  Luckily, we have a great, long vacation coming up in a few weeks, so I can look forward to it.  

I am watching and listening to the biggest thunderstorm I've seen in some time while I write this post.  I'm on the 16th floor of my hotel, so while I feel safe, it is quite a show.  Hoping to get some sleep so I will be ready for day two of the conference.  Don't worry, I packed a raincoat, an umbrella, and my rain boots, so I am prepared for the one-block walk to the convention center.  

5/11/14. The post where I take a nap.

5/11/14: Woke up at about a 6.5 this morning and stayed between there and 7 all day.  Fortunately I didn't have a busy day ahead.  

After church, we had a nice lunch with my patient, long-suffering husband's parents.  Then we came back home and settled down to watch a baseball game.  Baseball has long been my favorite sport and my favorite team was playing a rare afternoon game.  I can tell you about innings 1-4 and the 9th inning, but I have no idea about innings 5-8, because I fell asleep.

Historically, I am not a napper.  Besides the fact that my days are usually filled with activities, I've always had difficulty sleeping at night and I don't want to make it harder by napping during the day.  Even in the last few months when I've spent more time than usual sitting on the couch with my foot elevated, I have not napped.  But today I did.  Not on purpose.  One minute, I was watching the game and then suddenly it was the 9th inning.

I'm sure I needed the sleep, but I already regret it.  I've been groggy the rest of the day and I feel certain I won't be able to sleep tonight.  On the flip side, my team lost the game, so I didn't miss much.    I have to travel tomorrow for a three day conference, so there won't be time for naps.  Thank goodness.  I'm not cut out to be a napper.    

5/10/14. The post where I have a pretty good day.

5/10/14: boy, did I sleep well last night!  Even waking up for a small stretch during the night, I bet I got seven hours of sleep, which felt decadent.  And it was good sleep, too.  You can always tell how I slept by looking at my hair in the morning.  If it looks just like it did the night before, it means I slept poorly, but if it's a wreck, it means I slept well.  I looked like a dandelion this morning.

I felt rested and my foot was also behaving pretty well.  I woke up at about a 5 and stayed there much of the morning.  I skipped my PT exercises, which probably helped.  While in the long run, it's important to keep up with them, it's nice to have a break every now and then.  While I was still slightly nauseous, it was definitely better than it had been most of the week.

It was a hot, sunny day and we made a lovely afternoon trip out to nearby wine country.  I continued to feel good most of the afternoon.  This evening has been a bit of a different story.  The nausea is back and my foot has turned red again and is inching back up to near 7.  At least it happened tonight and not while we were out today.  I'd love to take some kind of credit for it, but I guess it was just good luck.  I think I will go to bed early and hope for dandelion hair again in the morning.

5/9/14. The post where I wear ugly shoes.

5/9/14: improved a little last night before going to bed (maybe it was the cream?) and slept pretty well.  Woke up back in the 5.5-6 range even though it is still wet and humid, which I took as a good sign.  

For casual Friday, I decided to wear the lone pair of prescription sandals I bought at the end of last summer, which haven't been back out of the box in almost eight months.  I picked out an outfit to match and then got out the shoes.  Yuck.  I had forgotten how ugly they are.  Since I didn't want to change clothes again, I wore them anyway. At least they will be comfortable and maybe they'll save me a couple of days of increased pain.

I wore them all day at work and guess what I found out?  They aren't that comfortable anymore.  While I'm sure they won't aggravate my foot for days like the wedge heels did, there is a strap that goes right across the top of my foot, which was not a problem prior to the CRPS, but which was now at least mildly irritating all day.  So, they are ugly and uncomfortable. A winning combination.  I wonder if bare feet are appropriate for casual Friday?  Ironically, I wrote my employer's dress policy, so I know the answer is "NO."  That will teach me to be more flexible in future policy writing.

Today is the last day of a work week that would probably seem normal to most people, but is pretty rare for me. No work travel or off campus meetings.  No doctor, PT, or other personal appointments.  I just came to the office for five days in a row and worked at my desk.  While it is somewhat of a relief and I was able to catch up on some nagging paperwork, I feel a little unsettled, like I've forgotten or missed something.  I go back into whirling dervish mode next week, starting with a three day out of town conference.

For now, though, I will enjoy the weekend.  Dinner tonight with good friends, a day trip to nearby wine country tomorrow, and a Mother's Day lunch with my patient, long-suffering husband's parents on Sunday.  I'm looking forward to it.  Even if I have to wear the ugly sandals.

5/8/14. The post where I find out if warm wet days are as bad as cold wet days.

5/8/14: awake early again this morning, but pain level was only about 5.5-6. I was worried it would be worse, because a large storm front was going to move through today.  While I've had more experience than I'd like with cold wet weather, this was the first time I have encountered warm wet weather, so I wasn't sure what to expect.

No repeat of the green light luck I had yesterday.  In fact, every light was red today, which happens fairly often.  And I was stuck behind a dump truck most of the way.  But it still only took 15 minutes, so I guess I shouldn't complain.

I wore my cowboy boot galoshes to work since we were forecast to get quite a bit of rain.  In case you've never seen cowboy boot galoshes, here you go:

They are very comfortable and as you know, cowboy boots have tended to work well for me.  I felt pretty good all day and they kept me dry when I got out to get a manicure at lunch. ("Where Did Suzi's Man-Go?" from OPI's Brazil collection.  Although frankly, it looks more like orange sorbet than mango.)   So far, so good.  In fact, good enough that I started to wonder if the Cymbalta was working.

I came home, took off my boots, and sat down at the computer to work on some email.  After awhile, I suddenly noticed that my foot felt worse.  I looked down and all my toes were completely purple. Holy eggplant, Batman!  I hadn't seen that color on my foot in awhile.  My patient, long-suffering husband immediately ordered me onto the couch to put my foot up and we stared intently at it until the color started subsiding.  Now it is back to red and the pain level is inching up above 8. Maybe I should have kept my boots on.

I wish I had an explanation that made sense.  Maybe it's the weather, or maybe the boots.  Or maybe it's just random.  The only thing I can say for certan is that the Cymbalta is not working yet.  But it's too early to give up on it.  Besides, if I did, what would I do with all these saltines and cans of ginger ale?

5/7/14. The post where I string together a bunch of random thoughts.

5/7/14:  woke up early again this morning.  The recent pattern has me waking up between 3:30-4:30 every morning.  Not my favorite pattern.  Stayed at a 6 for most of the day, although it ramped up slightly this evening.  I have plenty to say today, but I'm not sure it comes together as a coherent story. Maybe because of my tired state.  So, here are some random thoughts.  Or, as I prefer to call them, "vignettes".

I had an interesting phenomenon this morning after I did my PT exercises.  Usually when my foot turns red, it starts around my big toe and the ball of my foot.  This morning when I took my tennis shoe off, the only place on my foot that was discolored was my fourth toe (aka the little piggy who had none), which was bright magenta.  Later, the color spread to the usual spots, but this was a new one on me.  Not sure what it means, if anything.

As you know, I've been wearing the same prescription shoes to work most days.  After a few shoe fails, I'm trying to be more careful.  This morning, I was sick and tired of the black prescription Mary Janes, so I replaced them with...another black pair of May Janes.  I owned these before "the troubles" and they used to be my go-to comfortable work shoes.  They did not seem to irritate my foot any more than the prescription shoes and it was nice to wear something different, although I suspect no one else could tell the difference. Maybe it's time to go shoe-shopping for something besides black Mary Janes.  (Cue my patient, long-suffering husband beating his head against a wall.)

I have driven basically the same route to work for nearly 20 years. This morning, for what I believe is the very first time, I caught every light green and made it to work in 7 minutes.  Since it has never happened before, I assumed the lights were set in a way that made it impossible.  Now that it has happened once, I don't understand why it hasn't happened more often, and I'm curious to find out if it will happen again.  I assure you, though, I do not intend to work another 20 years to find out. 

It struck me today that this is the first full week I've spent at home in more than a month.  My suitcase finally went back in the closet for awhile, although it comes out again on Monday.  It's nice to sleep in my own bed. Or, at least, to lie in my own bed wishing I could sleep.

5/6/14. The post where there's nothing much to report.

5/6/14: wanted to check in, although there isn't much to report.  A pretty "normal" day.  Stayed in the 6-7 range all day.  Still pretty nauseous from the medication.  This was day 4, so I think it will be a few days before I can start to assess whether it is working.  Fingers still crossed...

5/5/14. The post where something fun and unexpected happens.

5/5/14: fitful night again, but stayed in the 6-6.5 range.  I had a dentist appointment this morning and you know what that means.  Yep.  An hour of music I hear only at the dentist office.  Kenny Loggins, Phil Collins, George Michael - all the usual suspects.  I went to work afterward feeling very mellow.  I got a clean bill of health, so regardless of any other medical issues I have, at least I have good teeth.

I had a pretty normal day at work.  A musician friend was staying with us tonight and we planned to have a late casual dinner with him and his girlfriend before they went tomorrow to meet her parents, who live about two hours south of us.  Just before I left work, I happened to check Facebook, where I found a post from our friend saying he had just GOTTEN ENGAGED!  Whaaaaaaat???  I immediately called my patient, long-suffering husband, who was unaware of the big news.  

I came home from work to find them all at home and immediately asked for the details.  "Where did you ask her?" "Right there," he said, pointing to our balcony.  Wow!  Someone got engaged at our house today, and I didn't even know.  Pretty exciting. The casual dinner turned into champagne and then dinner at one of our favorite Italian restaurants in town, outside under a big oak tree.  

Still feeling pretty nauseous today, but it's much better if I keep something in my stomach.  I have it on good authority that this will subside eventually.  On a today like today, it's easy to forget.   We'll see what happens tomorrow, presuming there are no spontaneous engagements.  

5/4/14. The post where I get used to the new medication.

5/4/14: shortly after I wrote my last post, I took my first pill.  Just before breakfast.  Not a good idea.  I should know better.  I always have to take medications like that with food.  And by "with", I mean after, not before.  I spent the rest of the day rotating between antacids, saltines and ginger ale trying to settle my stomach.  But I was not alone.  In a show of solidarity, my patient, long-suffering husband came home from a bike ride with a stomach bug and a low-grade fever.  Luckily there was enough ginger ale for both of us.

Everything I've read about Cymbalta indicates it can start working in "as little as a week", so I am not expecting anything yet.  It's a good thing, because I would have been sorely disappointed.  The evening and night were really rough, in the 8-8.5 range.  The cream did not make any appreciable difference either.  I slept in shifts and took it easy most of today, and it is back down to a 6 this afternoon.  I was smarter today and took my pill after breakfast.  I still feel a little nauseous, but it's much more manageable.  I drove to church without any issues this morning, so I think I can continue to take the Cymbalta for the next two weeks and I am determined to try.  Guess I'd better stock up on saltines and ginger ale.

5/3/14. The post where I feel ridiculous.

5/3/14: had a productive meeting yesterday and then made the three-hour drive home in terrible, Friday afternoon, everyone-leaving-early-for-a-weekend-getaway traffic.  Fortunately, I got home just in time to accompany my patient, long-suffering husband to the home of some friends for a wine tasting event, for which he had just made a delicious goat cheese and roasted vegetable tart.  Yes, I am a lucky girl.

Another sweet thing he had done for me while I was out of town was pick up my allergy medication prescription, which had been sitting at the pharmacy for almost 10 days and was about to be reshelved.  I had gotten a call from the pharmacy when the prescription was originally filled, but it was right after my doctor appointment and I was preoccupied with filling the prescription for the cream, which was coming from a different pharmacy in another city, and thinking about the doctor's longer-term recommendation and it just slipped my mind.  Besides, I still had plenty of time before I use up my current supply of allergy medicine, so it just wasn't on my list of priorities.  Patient, long-suffering husband gets the rebound...he shoots, he scores!

Had a great time at the wine tasting, but my foot started swelling about halfway through the evening (or, as they say in my part of the country, "it got all swole up") and I had to take off my sandals.  When it was time to leave, it was a struggle to get the sandal back on and refastened.   I've noticed an alarming trend recently.  The pain level is not getting higher, but the amount of real estate affected by the pain is increasing.  I sprained my right ankle more than 15 years ago, and since that time it has ached and swelled periodically, usually with weather changes.  Now it hurts and swells nearly every day.  Is it related to the CRPS, or is it "legitimate" pain because I'm putting too much pressure on it trying to stay off the inside of my foot?  I don't know, and I'm not sure it matters.  I just want it to go away.

As we drove home from the event, I thought more about my recent conversation with my doctor friend.  He's right, I need to consider some other medications that might provide at least temporary relief.  After my Lyrica experience, I have been hesitant to try anything else, but it's time.  My next doctor appointment is two weeks away, but I resolved to call Monday morning and ask for a new prescription.
I picked up my allergy prescription bag on my way upstairs to bed.  I guess I should at least make sure my allergies stay under control.  I opened the bag to find...not my allergy medication, but a bottle of Cymbalta, which I suddenly remembered my doctor said he was going to prescribe.  I had previously remembered every detail of the conversation: my concern about side effects, his assurances that it was in a different family of medications than Lyrica and likely would not have the side effects that concerned me. The only thing I had not recalled was the last part of the conversation: "...and I will call in a prescription."  You would think the call from the pharmacy would have jogged my memory, but you would be wrong.

So, I should have started taking this 10 days ago.  Now I officially feel ridiculous.  I read up on Cymbalta to be sure I was comfortable with it.  While it is used to treat depression and anxiety, it is also prescribed for chronic nerve pain and it is used with some success by CRPS patients, although the relief appears to be temporary ("temporary" meaning months).  There are some potential side effects and driving is not recommended until you know how the medication affects you.  I have nothing on the calendar today, so I started taking it this morning.  Everyone cross your fingers!

I still have two weeks before my next appointment to see if it is going to work, although I'm sure it would have been preferable if I had started taking it right after the last appointment.  It would have been even more embarrassing if I had let the prescription be reshelved and then called the doctor Monday morning to ask him for a prescription.  My patient, long-suffering husband now gets credit for a three-pointer.  If the Cymbalta works, it will be a game-winning shot at the buzzer.

5/1/14. The post where we have a good day.

5/1/14: slept a little better last night.  Still in the same pattern - mostly in the 6 range with a few periodic spikes and the cream helps a little for awhile.  All in all, pretty tolerable.

Mom also had a pretty good day.  This morning I took her for more lab work and afterward, she felt well enough for us to do a little shopping for some things she needed and then have a fun girlie lunch.  Finger sandwiches, anyone?

In the afternoon, we took care of some chores around the house and then decided to watch a movie before Dad got home from work.  The idea of watching a movie was a good one.  The execution of the plan was a different story.  The movie we picked? "August: Osage County."  Quite possibly one of the most depressing movies I've ever seen.  Dad got home just in time for the end of the movie and then 15 minutes of the two of us in tears.  (My patient, long-suffering husband is nodding knowingly as he reads this. Another thing he and Dad can discuss during their support group meetings.)  One would never have imagined from seeing us then that we had a good day.  

Tomorrow I have a work meeting in the area and then I will drive home.  I won't be able to be at all of Mom's chemo sessions, but I feel a lot better now that I know how the drill goes.  One down, 11 more to go.  Next time, we'll make sure we pick a comedy to watch afterward.  For Dad's sake.