Worsening Pain 10 Months Out

I think we have to agree to disagree on this. Even assuming that at the age if 28 I went from no arthritis to, in 10 months, developing severe arthritis, it wouldn't explain why it is out-pacing any benefits I should have been receiving. All of my pre WLS scans (X-ray, CAT, MRI, injection X-ray/flouroscopy) showed no bulging discs, fractures of the spine, no arthritis, no soft tissue damage--just a 1/4" bursa tear and my original femur fracture. I just cannot see how it would go from where it was to three times the severity (judging by pain medication) in ten months when all of the other tests were absent. I am not saying that WLS will do this to everyone. What I am trying to figure out is what has happened to other people so I can have a productive and intelligent conversation with my doctor when the time comes. I am glad that for you, like many, the WLS has not resulted in worsening problems and you have found relief. But even if someone could come on here and tell me that they experienced something similar and that it went away would be helpful. Telling me that the only thing it couldn't be is the only changed cir****tance I had is not helpful. I am glad that you are enjoying your surgery and it's effects but what o need is information from people similarly situated or people who know someone who went through something similar.

My team of docs and I believe I have SIBO, IBS, adrenal insufficiencies , food allergies, .inflammation ..etc tec...  issues, ... I am not sure if I had all of that prior to RNy or if RNY made it all worse.  

Unfortunately - SIBO can cause all of the issues... leaky gut - allergies-inflammation- adrenal issues - and pain...lots of pain...

but- as long as I control the SIBO  - the rest is manageable most of the time..  

SIBO - is gut bacterial flora gone wrong.  Even the "good bacteria" if they are in a wrong place - can cause issues.. major issues.  add candida.... and "the fun" really starts ...

SIBO and Candida can be responsible for most if not all of my other issues... they can cause leaky gut that will cause food allergies and inflammatory response in the body...including joints pain, bladder issues, rosacea, seborrheic dermatitis, autoimmune issues...

unfortunately correcting that is very difficult...   and healing of the gut may take years if not decades...in a meantime the things what I take to  deal with the secondary issues (allergies, pain, inflammation) may make the SIBO worse.. it is vicious circle - darn you do - darn you don't...  

lately I developed GERD- so now on top of everything else I am on Rx (very $$) PPI... that helps only if I follow a very very very strict diet... I am not sure if the diet or the pills are working... and even a small deviation from my diet can cause a horrible GERD -pain- that may last for a couple of days...

I am sure that finding out what I was allergic to and elimination that from my diet helped with a lot of pain and issue.... I just need to dig deeper... 

have you been tested for food allergies? SIBO? Autoimmune? 

Hala b,

I have not heard of SIBO before today. All of my pre-GB WLS testing came back normal so I'm assuming everything was okay. Except for the six months that ultimately had me in and out of urgent care and on/off antibiotics because of an undiagnosed problem with gluten, I have never had many problems with food that I have noted except that walnuts make my ears itch so I've avoided them for a number of years. (Upon reflection, I should have known about the gluten, though.  I had thrown up several times a day for six solid months and in addition to wearing supportive underwear was having to punch my stomach in just to walk. It got so bad I lost feeling in my lower limbs because it was impinging on my spinal nerves. I never slept better, though haha.)  I will add a SIBO test to my wish list!

You said you have had problems with inflammation. Since we can't take NSAIDs, is there anything you have found that helps? My massage therapist told me yesterday my lymph nodes were inflamed in both of my legs (and I only have metal/trauma in the one) so I'm trying to find something/open to anything.  I have mid-weekly homework to do self massage on those lymph nodes now. My other ones are fine. The last thing I need right now is another pill but if it could help get this all under control I would be willing to give it a go. 

I do have a diagnosis of a very high reaction to gluten--85% as of 6 years ago--and the one time I ate gluten since my surgery (on accident) I almost went to the hospital. I couldn't eat or drink anything for a week I was so sick! So I don't know if I'm allergic now but I do know that my doctor and endocrinologist told me my reaction will get worse as my thyroid does For that reason, everything I buy is certified gluten free which feels justified after the disproportionate reaction I had a few weeks back.  I don't believe I have had any other food allergy testing done but it sounds like I might need to from what you're saying. Both times I have had almonds since the WLS--but not other nuts, even thoigh walnuts make my ears itch--they put me off food for a day so I am very careful to check for almonds as an ingredient for the last six months.  I think it's mental but I can't do eggs in any form anymore--they male me gag at the very least. (I miss eggs =(. )  Everything I eat now is extremely bland--no salt, no seasonings, no sugar or chile... Just in case I have switched to lactose free milk for my soaked oats (since it is supposed to help get rid of the pythalates when you do it that way, causing less discomfort) as well as taking lactase for anything that might possibly remain. At first I thought it was just portions, etc. from old habits so in January (month 4) I went back down to scratch. As I reprogressed out of the initial diet when trying to isolate the cause I discovered I can't have meat more than twice a week unless it is fish, all fruit/veg not stewed is out and must be strictly limited in quantity, and I MUST dissolve my vitamins and minerals to drink. .For the longest time I couldn't get out of the protein drink phase but very recently even they have started making me physically ill for the first time. Everything makes me nauseous, though, so there must be something I'm not seeing, right? I can't eat chicken and rice like a normal person on elimination diet (the rice gets stuck and I can't have meat more than twice a week) so I don't even know how else to approach it at this stage.

I only had acid reflux temporarily after being hit by the car and after learning what a hiatal hernia is I think that is where mine came from. Even though I gained weight, it eventually went away after a few months and I haven't had any acid-reflux like symptoms since.

Now that you say autoimmune, I am wondering. We have a history of Rheumatoid Arthritis in my family that manifested itself as Type 1 Diabetes in my older brother and Hashimoto Thyroiditis in me. When I had the test for RA done before my insurance switched over--after all of the xrays, MRIs and CAT scans--the doctor didn't think the results were conclusive. Do you think the WLS could have been a trigger for an auto immune disorder? Maybe I didn't have it then but maybe I have it now (diathesis-stress model)? God, I hope that isn't true. I watched what RA did to my grandfather before the treatments for that had to cease to give way for his cancer treatments.

I do know that I need to go in and I really do appreciate your help. I am trying to make sure that my visit is going to be as productive as possible because between student loans, rent, remedies, and insurance I just can't afford for it not to be. I am definitely adding SIBO, food allergies, and autoimmune. I don't know if the pain clinic can order any of those but he might be able to code it in a way that can get me some help for it, otherwise I have to pay the full cost. That will be in November, though, but if the doctor can't and if I am still working where I am now my plan will vest in January so hopefully at most I will only have to wait another five months. 

Thank you again for taking my question seriously! ^.^

Unfortunately it is very difficult to test for SIBO. From what you describe - antibiotic use long term, gluten intolerance - and pain, inflamation , etc - all indicate gut flora imbalance. Opiate will make it worse. 

I tested positive for dairy allergy. Soy allergy and a few others. 

Milk and milk products are very proinflammatory. I know I could not eat oatmill - since I do have gluten and milk sensitivity. I can't eat so many things, and when I do - my pain and inflamation the next day is so much worse. 

Google SIBO and SCD diet. I follow low FODMAP diet with low carbs. 

With food sensitivity, leaky gut - not only what I eat but food rotation is important. I try not to eat some foods I tested allergy positive to more than once a week.. 

Gut health is about gut bacteria - proper combination and placement of the bacteria. Even good bacteria - if they colonize small intestine can cause a lot of issues. I was dealing with a lot of bloating and gas and severe gut pain until I drastically changed what and when I eat.  

I make sure I get complete BM every day. That means taking Miralax daily in my coffee... And I started IF - intermittent fasting. I limit my eating window to 8 or 10 hours within every 24 hours. I push non caloric liquids during the rest of the day to "flush" my small intestine.

Currently I take some opiate as needed...(typically before bed). That helps "reset " my pain.. 

I have some limph nodes that are swollen - I do try to massage them and use poke root salve to help to pull things out. I get acupuncture once a month..and massages 1 or 2 x a month.  

My muscular / joints pain are not horrible. 

I do take high dose of good quality probiotics every day ...I take Rx Candida pills when I realize my Candida supymptoms are getting worse...

Treating SIBO is tricky.  Taking antibiotics help initially ...but the antibiotics are what most likely caused issues to start with...and rebuilding gut flora can take years... So darn you do - darn you don't.  

First time I got treated for SIBO - my sciatica pain went from 4-5 -9 daily to 2-3 and mostly in evenings... Huge improvement.  But the next one did not reduced the pain further. Keeping good diet after the treatment and adding probiotics worked better... 

To heal the gut with need good nutrients like glutamine, collagen, and good proteins. I take glutamine - 3-6000 mg per day...I use gellatine, and try to "feed" my gut flora.  I avoid grains.  Any grains. I try to avoid most starches and some fiber... I rarely deal with abdominal gas and distention. Both Miralax and my IF with Keto style eating works well...I get more fat than carbs in my diet. Coconut oil, ghee, olives, avocado.. 

I tolerate meat and eggs...

My reset diet is chicken cooked with carrots, Cellery and leak...I use the dark meat..and also cook bone broth and drink that. Homemade egg drop soup with added avocado can be my meal. I use Apple cider vinegar (organic) and lemons to help digest some foods. 

I know I should give up coffee ..but that is my last "guilty pleasure". (coffee irritates my pouch...but I am not ready to give it up).

Unfortunately- changing diet takes time. Good Results with diet change - are slow.   But when I follow a good for me diet for a few weeks...then add some food that irritates my gut - I can feel that the next day...but it may take a week for the irritation - inflammation to go away after I resume a good diet... That's why it is so difficult to be consistent in following very restrictive diet... One "mistake" can cause pain that can last for a week or longer..

I am dealing with that now - on Sunday I ate some dates and rice crackers - it was way too much sugar. I did not dump but my body pulled water from my muscles into my gut. That caused horrible muscle cramps in my left leg - the sciatica leg....they were so bad that it probably cause some muscle damages in my lower leg. Even today that part is swollen, inflamed, and Very hot, painful to the touch. I try to massage it and apply oils and herbs to pull the inflamation out... I know I messsed up.. It probably will take 1-2 weeks before my muscle stop "being angry" with me... In a meantime - I deal with it... 

The elimination diet list rice - post op RNY I can't do rice. So I don't. Or potatoes, or bread or oatmill...

I do tolerate organic chicken, with organic carrots , Cellery and some leak. I use good quality sea salt (i like my pink salt) . Aspartame and splenda irritates my system. I try to use that sparingly. For now - I tolerate organic liquid stevia. For now - I take allergy drugs every day. Alklegra and zyrtec together every morning and benadryl at night. Not ideal - but that keeps my body from overreacting to some stuff. 

I don't - can't use any SA. Even small amount gives me horrible gas and pain. 

If I do protein shakes - they are organic - vegan (not soy) and only once in a while...if I need to.

I manage my condition... I get bad days but only when I stray from my strict diet.  I can "cheat" once in a while..but need to keep that to small cheats... 

Check also AI paleo diet..http://autoimmune-paleo.com

That one is next on my list to try... One day..

You need to find out what works for you...you need to identify "safe food list" then incorporate them in your diet...then add more variety and watch how you feel.. No test can tell you what will - will not work for you. 

Also - Google histamine oveload...that is a very interesting read... 

HALA B,

I hate to say this but I am so glad to know someone out there is going through something similar.  Almost everything you're talking about is what I'm going through and if it really is something I should be on antibiotics for I might be able to get my regular doc to just prescribe them.  If they're specialized antibiotics it'll probably be an extra cost so I may have to wait until my insurance benefits vest with my new employer or maybe I'll get enough saved up.  It's worth a shot, though, to see if my current exchange provider will cover it under the plan I have now.  My previous antibiotic use was only twice six years ago (and once since last summer for a sinus infection I got in London from a professional conference that would NOT die) but it sounds like any antibiotic use could set it off.  Man, that's a scary feeling!  I had never heard of SIBO or Candida before so I'll be researching them more after I take the bar next week.

The oats I eat are gluten-free (Bob's Redmill) and they never gave me problems prior to the surgery.  I quite missed my morning porridge when I had the surgery...I've only been eating them the last couple of months trying to take my nutritionist's words of wisdom to defy my nausea.  Maybe I need to switch off of milk altogether, even though I get the lactose-free and do lactase with it.  I soak 1/4 cup of oats in 3/4 cup of milk but I split it down the middle with my dog (haha) because I can never get through all of it.  It's supposed to get rid of the pythalates which can upset stomachs.  I also drink about 1 cup of Lifeway Organic Plain 99% Lactose Free Kefir which has all of the recommended probiotics from the bariatric advantage chewable that I mix with 1 packet of GoLive Probiotics that has an additional 15 billion CFU.  But, again, even though it is lactose free and I take lactase with it, from what you're saying it might still be too much for my system.  That would make sense because the whey powder has made me nauseous since almost the beginning--after two weeks of getting sick I stopped drinking it.  You mention later in your post that the imbalance of gut flora can cause all of these problems--do you think it is possible I am taking too many probiotics?  My nutritionist, the last time I spoke to her, didn't seem to think there could be too many and I'm taking at least 15 billion CFU every day.  What has been your experience? 

I never had leaky gut before the GB WLS but from what I'm reading based on what you have told me to look up, I definitely do now.  I sit for the bar next week so maybe after that I will try the low carb FODMAP diet and look into the Paleo diet.  I was told after going to gluten free to go paleo and I really like paleo food, it's just that I haven't had enough time for that amount of plan-ahead.  I'm afraid to change anything in my diet until after then in case it makes me worse but I'll have time after next week.  I'm not looking forward to putting eggs in my mouth--they make me wretch now--but if it fixes what's wrong with me and eventually brings the nausea down I'm definitely willing to give it a go.  I don't have to be back at wor****il mid-August (after I take the second half of my boards) so I'll know by then whether or not it's at least improving things.  I'd hate to give up my morning porridge but you do what you have to do, right?  When you do your reset diet, how well do you cook your veg on the side?  Right now I cannot eat any vegetable or fruit that isn't stewed to pre-digestion without it ending in disaster.  God I miss carrots, broccoli, cauliflower, peas, brusselsprouts...  Sometimes I hate watching other people eat.  I never resented watching people eat treats when I had to go gluten free but I really hate watching other people eat now with all of their chewing and enjoying of normal things...  Does it change the reset diet if the chicken and the veg are heavily stewed?  I can't eat non-fish meat except two times a week now without getting really ill but I could probably stew it down and blend it or something.  I mostly use liquid aminos or flavored balsamic vinegars now to spice my food.  (Pepper if I want to go buck wild haha--but absolutely no chile, no matter how pureed.)  I can't really spice up my food, honestly, because it just reinvigorates whatever demon is living in that stomach.  I have no added salt, maybe a dash of minced garlic or liquid aminors or balsamic vinegar but usually just plain.  I don't add any sugar, Splenda, aspartame, Stevia or other sweetener to my food (including my porridge).  I was doing honey for awhile but with all of the sugar in that I took it out in case it was contributing to the problem.  You and I are on the same page with rice and bread--it's gone forever.  I've had rice three times since the surgery and have massively regretted it.  I had one full and complete sandwich over the course of a full day (I just cut it into fours and ate a section every couple of hours) a couple months back--that, too, was a mistake.  I guess it's just as well, I really only wanted what was inside of it anyway.  No big deal, I already had to give up bread once when I went gluten free.  I seem to be okay with sweet potato (or, at least, it isn't making things worse) but regular potatoes are also out.  I don't have allergies except in the fall and when I took a Zyrtec last fall I got really sick so I it's probably better for me to just sneeze it out and concuss myself at this point.  Benadryl historically did nothing for me but I might take your suggestion to see if it is a histamine overload.

I never really have gut "pains," though.  Any time after eating non-fish meat or the three bites of rice that I have had in the last six months, my stomach kind of "plunges" up and down.  It doesn't hurt worse, though.  Of course, with me being on the pain killers that may be masked.  When I took the month off of the opiates, though, it wasn't hurting--just constantly nauseous, bloated, and full--in addition to the plunging motion.  I avoid adding any flavorings to all of my food so unless they're already in my tuna, salmon, meat, sweet potato, oats, or milk I literally cannot be doing less.  There is a very small amount of real sugar in my probiotics, a small amount of real sugar in my kefir, whatever is in my up to one half of a small sweet potato, 7 non-fiber carbs in my protein bar every day, but a massive 27 non-fiber carbs in my oats everyday but they're slow-releasing.  I never had a problem with sugar or reacting to sugar before GB WLS but the change in anatomy may have changed that.  As far as I can tell, I'm chewing everything adequately enough to prevent undigested food from appearing in my stool.  Without my twice-weekly meat allotment I get a minimum of 57.5 grams of protein, and I add a couple of scoops of fiber to my warm soup to ensure I get a minimum of 25 grams a day.  I am trying very hard to keep as good of a diet as I can because I have been reading that people do have increased pain when they go off-diet, especially when they are able to eliminate.  However, regardless of how well my stomach is or isn't doing or whether or not I have managed to eliminate or how on or off diet I am, there isn't a change in my pain ratio that occurs with enough regularity for me to attribute it to that.  You say you tolerate meat and eggs.  I can't tolerate eggs--they absolutely make me wretch.  Not their beautiful taste but something about the yoke sticks to my throat every time now and I am immediately sick.  It's not as bad scrambled but my stomach still doesn't like them.  I can only do meat twice a week now--any more and I am sick regardless so I eat up to 8 ounces of non-fish meat a week.  I did three protein drinks a day for three months because when I tried not-drinks at the 6-week mark I got massively ill.  I didn't go buck-wild and eat the worst things, but you would have thought I was rotting from the inside out.  I went to 2 drinks a day in December since I had time off between semesters, and went down to 1 drink a day at Spring Break in March.  About a month or so ago, though, they started making me throw up so I stopped drinking them.  I get my daily minimum of protein, vitamins and minerals without them, though, so it's not the worst situation.  I have to plan cheat days hardcore--I can't be anywhere near a human populace for days after a cheat day.  And a cheat is anything that isn't the bland life I'm living now--not even going as far as eating gluten.  I have up to 2 hours to get myself quarantined because on top of being unfit for human association, I am just absolutely miserable.  Even though the pain doesn't get worse my body feels like it is going to explode.  I will forever miss sushi.  And it doesn't matter if the whole amount or part of the amount is a cheat--it goes from 0 to f*** you once that switch flips.

It hasn't always been possible for me to eliminate every day with or without laxatives.  The longest I have gone without a BM is three weeks but generally speaking I get it all out twice a week.  If it goes longer than three days I do mineral oil before bed and it usually helps but I am reticent to take it because I don't want to be dependent on it.  I do get my minimum of 64 ounces of water in a day in addition to the 8 ounces of kefir (and until recently my 11 ounces of protein drink).  Other laxatives just make me even more gassy and bloated without any benefits so I just stick with the mineral oil.  Ho****er in the morning is supposed to open up your stoma or something according to my surgeon so I've been doing it twice a day to help facilitate things.  My eating schedule is fairly regular and for the last month (with no change in symptoms) has been: 07:00 8 ounces of ho****er, 08:00-08:30 1/4 cup porridge, 09:00-11:00 16 to 32 ounces of water (it used to be 5-21 ounces of water, 11 ounces of protein drink), 12:00-12:45 1 pouch or can of tuna or 6 ounces of smoked salmon with up to half a small sweet potato, 13:45-14:45 16 ounces of water, 14:45-15:45 8 ounces of kefir with probiotic mix, 16:45-1745 high-fiber protein bar, 17:45-1900 6 ounces of some sort of pureed vegetable soup (and meat two nights a week), with 8 ounces of ho****er again after 20:00.  I can't eat after 8PM because of my thyroid medication or I have to adjust the entire next day's eating schedule and it just isn't worth it.  I keep water by my bed at night so I can take my levothyroxin with a full 8 ounces of water when I wake up about midnight, which has to be done for the 4 hours after eating / 8 hours before taking vitamins.  My vitamins do dissolve in water--they're dissolved into that first cup of ho****er every day (which for as disgusting as it tastes I feel is necessary because my doctor suggested they may not have been digesting in my stomach) and the liquid vitamins at $60 a month is just too expensive. I was doing pu-erh tea in place of water for several months because it was warm (again, keeping the stoma open) but after reading that the caffeine could have been causing some of my problems I switched to water full-time.  There really has been no change except that I'm more tired. 

I don't take opiates to go to bed anymore--I only take them during the day at 1/2 pill every 2 to 3 hours starting at 07:00.  I take 2 extra strength Tylenol (since that's all we can have post-GB WLS) at 06:00 with some water to help me get out of bed, another 2 at 14:00, and then two Tylenol PM around 22:00.  Maximum dose is 6 per day with permanent liver disfigurement at 8 per day so my doctor doesn't want me to take more than the 6 per day.  I apply my patches after showering in the morning and put my analgesic creams around them every three or so hours (sometimes more often on worse days) unless I'm using the TENs unit in which case I just use that--no creams.  My pain can't make up its mind about being muscular or joint--some days it's both, other days they take turns.  My mother suffers from sciatica but from what I can tell my pain isn't the same.  When it's skeletal, it starts deep in the hip but closer to the front of my leg and radiates out until my lower back, quad, and hamstring hurts--but only on the injured left leg.  On bad days it will get as far as my knee, cause swelling, and sharp pains in my foot.  That was true pre-GB WLS surgery, it just happens more often and more severely now.  When it's skeletal, it starts in my lower-mid back on my injured side, crawls into my ribs, cuts across to the right, then just works it's way up and down until I don't want to move.  Nothing appears swollen until I start getting pain in that hip, though.

My lymph nodes in my legs are only recently getting swollen.  They were not swollen when I went for my massage last couple of weeks so this is new (hopefully not permanent).  I have a very restricted salt and fat intake so I can't imagine that is leading to it.  I haven't felt cold- or flu- ill, and at 145 pounds, age 29 as of this morning, I am seriously hoping that it's not something like congestive heart failure.  I will be seriously upset if it's congestive heart failure.  I never had any heart or sugar problems prior to this so I will also be seriously upset to find out that is what it is now.  I just recently moved a couple of months ago 400 miles from home and am re-establishing my care providers.  I found a massage therapist (I go for 2 hours every week) and am looking for a new acupuncturist and chiropractor.  The massage always helps and I was actually down to once a month until the GB WLS.  As soon as I was able to lay on my stomach and sides, though, I have had to go more frequently which has devolved into every week the last month.  I had been off of chiropractic for almost a year and acupuncture for almost 3 years but I undoubtedly need to go back in light of these developments. 

Thank you again for your help.  I hope you're getting stronger every day, too.  One food in front of the other, right?

A few thoughts...as said by the RN the ever increasing opiod use maybe they are no longer working for long term pain. I had two large surgeries this spring and the surgeon prescribed not only oxy but Valium for muscle spasms and pain. I was surprised at how well it worked. And as someone with severe arthritis and can't take NSAIDs I am glad I now know about this. 

You also mention your lymph nodes, I highly recommend lymphatic massage. You need to go to someone certified though. It really helped me after surgery and even though gentle is very relaxing. 

I have absolutely no doubt that they become less effective the longer you take them.  I actually watched my grandfather take percocet several times a day for years until he died in order to manage his diabetic nerve pain.  I didn't want to go out like that, which is part of the reason why I had the surgery.  (I can't take percocet, though, it shuts down my lungs and I can't breathe--there's too much of the oxycodone component in it at one time for my system.)  When I was responding to another post I realized that after I "dried out" for a month in February, it really has only been 4 months since I went from 0 to 15 mg a day which means it is ramping up quickly. 

I have taken the oxycodone with baclofen in the past for muscle spasms.  (I wa**** by a drunk driver in 2013 on my way to school that spent my pain out of control for almost three months, and then again in 2014 by a young girl who just got a really nice car from daddy which put me through another loop.)  I had to do that immediately following my GB WLS surgery for over a month.  I may need another course, though, because maybe it's just that I'm in spasm and it has just crept up on me?  I will talk to my doctor and see what she thinks because if it could be as simple as I didn't get the back spasms under enough control, heck, I could be done with this long before November!  That would be amazing!  I didn't think about it.  In my mind I had already treated for it, got back to the business of life, and therefore it must be done, right?  I have never taken Valium before but I know others who have had success with it for muscle spasms.  I like the baclofen, though, because I can break those in half and not be so...unconscious all day, haha.  (Law school is not as much fun when people catch you sleeping, let me tell ya.) 

The lymphatic situation is fairly new and is really only in my legs from what my massage therapist is saying.  It has only been the last couple of massages she has noticed it.  Do you think I should see someone outside of my massage therapist for just the lymphnodes? 

Thank you so much! ^.^

Lymphatic drainage massage is a very specific technique. I just passed on what my surgeon said to me "Make sure you go to someone certified"

I thought it was great, while gentle, it was the most relaxing massage I ever had...and helped. I ended up going for 6 or 8. The woman i went to had a package deal. That being said i found 2 near me and the difference in price was drastic. The one I used had a room in a chiropractor office. The other one was attached to a spa and was almost twice as much.

Wow! I will definitely look into it! My current insurance doesn't cover my regular massages  (it doesn't cover any normal massage) but I never thought to ask about lymphatic massage. I will definitely look into it! Thank you! ^.^

There is some research and opinion showing that opiates may increase pain after long-term, high dosage use.  This doctor Dr. Nancy Sajben is using some new, cutting edge techniques to get people with intractable pain off of traditional pain relievers.  Her website has a large amount of technical information, but has helped me with my pain issues.  I hope this helps.