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RE: DO I HAVE ANOTHER DIAGNOSIS IN ADDITION TO MC THOMSEN

Had my visit with the Rheumatologist at the Siteman Center for Advance Medicine - St. Louis. It lasted 15 minutes, approximately. The doctor does not believe that there is any inflammation - no signs of Rheumatoid arthritis. Diagnosed with Myofasical Pain Syndrome and possible Fibromyalgia. I already had scripts for Skelaxin and Tizanidine which the doctor stated should help me with muscle spasms/pain. The doctor could offer no other help and did not need to see me again.
So - there - you -go

Thanks for responding Lois and Mcboarder. I will look up Quinolone drugs.

It is nice to talk to others and that you all understand and talk back. Feeling very tired and stressed out. Talk more later.

Re: RE: DO I HAVE ANOTHER DIAGNOSIS IN ADDITION TO MC THOMSEN

Judy, that's pretty good progress for a 15-minute appointment :-) My husband has myofascial pain syndrome and has had good results seeing a physiatrist. He had trigger point injection therapy which seemed to help for a while but he still had to give up his career (had been a jeweler for 20 years).

The things that help him most are 5-HTP at night for sleep, heat including hot packs and the warming mattress pad I mentioned, and Flexaril occasionally when the pain gets really bad and he needs a good night of deep sleep. He also did acupuncture which helped a lot but we no longer have insurance that will cover it.

MPS can be VERY painful and debilitating but at least there are treatments that can help. Your myotonia will be exacerbated by it since the muscles tend to overfire, but it shouldn't be progressive...just responding to the pain from the nerves screaming and muscles tensing.

This is Lois' area of expertise and we also have a pharmacist, Anne, who checks in and can give some input. At least you have another piece of the puzzle!

Jan

Re: RE: DO I HAVE ANOTHER DIAGNOSIS IN ADDITION TO MC THOMSEN

Hi again ... The only thing I would add here is that everyone's input is so valuable, and adds dimension and depth and potential leads for each person to follow. But each person needs to know themselves as well as possible, and be able to make decisions and "game plans" based on their own individual histories and manifestations. I want you to know that, since I never officially knew I had a "condition" until I was 54, I have never taken any medications for it at all - once I learned what it was I'd been begging doctors to identify all my life, I had become so accustomed to living with it and dealing with it that I had (and have) no intention of trying any medications - at this point, I'd rather stay as far from meds I can live without as possible! The doctors offered Mextil, and a few other things - but when I researched them, I decided the risks, as I perceived them, were not worth whatever potential comfort the drugs might offer. I did take Bactrim once - in 1999 or 2000, I was diagnosed with a sinus infection, and while I preferred good old PCN, the doc rx'd Bactrim. After about a week, I developed a generalized rash, and some mild shortness of breath, and so now have sulfa drugs listed as an allergy... and I'm pretty fussy about what I'll take. I also do a gall bladder flush and detoxification routine about every year or 2, and sometimes a liver flush - I figure since I'm an obese old bag, I better do what I can to stay spunky and healthy. lois

Re: RE: DO I HAVE ANOTHER DIAGNOSIS IN ADDITION TO MC THOMSEN

Judy,

You have mentioned taking tizanidine and Cipro in previous posts. Since I don't know whether you took them during the same time periods, I'm not sure how applicable my comments will be to your situation. Since you are a nurse, you may already know some of what I am going to say. As a pharmacist and a patient, I have had considerable experience with tizanidine.

There is a dramatic drug interaction between tizanidine and ciprofloxacin (Cipro) Ciprofloxacin is a strong inhibitor of the CYP1A2 enzymes that play a significant role in metabolizing tizanidine. The AUC of a single 4 mg dose of tizanidine was increased 10-fold in 10 normal subjects when administered after a three-day course of ciprofloxacin 500 mg twice daily. Common side-effects of tizanidine, decreased blood pressure and drowsiness, were also increased. Therefore concurrent use is contraindicated. Other quinolones such as norfloxacin and ofloxacin may also interact with tizanidine since they are strong inhibitors of the same enzymes.

You mentioned that you have developed cognitive problems. While I have no idea if this is true in your case, tizanidine can interfere with cognition. Tizanidine's considerable sedative effect is dose-related. My dose has had to be gradually increased because I developed tolerance to the drug. After one of the increases, I wasn't able to make change for a couple weeks. Then as I developed further tolerance I regained that ability. I am now taking the maximum recommended dose. During all the years I have taken tizanidine I have felt that I am not as mentally sharp as I was before I started it. If you were to take tizanidine and ciprofloxacin together, the effect on your cognition could be extreme.

Tizanidine is a close chemical relative of the antihypertensive, clonidine. While tizanidine is supposed to have a much lesser effect on blood pressure than clonidine, 16 to 33% of patients who take it do experience drops in blood pressure. When I first started tizanidine, it reduced my blood pressure so much that I had to discontinue the antihypertensive I was taking. As my dose increased my blood pressure went lower and lower. What I didn't realize is that I was getting rebound hypertension during the night while I was asleep because I wasn't taking the drug while asleep. Tizanidine's cousin, clonidine, produces rebound hypertension if it is discontinued abruptly. Tizanidine increased my blood pressure to as high as 200/120. I eventually realized what was happening when I took my blood pressure in the morning because I didn't feel right. Since tizanidine has a short half life, two hours, when I went without it all night it was as if I had discontinued it. The fact that I am taking a high dose probably makes this effect more dramatic. Someone taking it only occasionally or with the doses spaced far apart may not have these problems. However I do suggest that you check your blood pressure periodically if you are still taking tizanidine. Blood levels are greatest about 1.5-2 hours after the dose. Therefore you could check your blood pressure at that time and just before time for the next dose.

I'm sorry your visit with the rheumatologist wasn't more productive.

Anne H.