Trestment Options for several conditions

[Inspirations]

Hello all,

I suffer form several chronic conditions that I’d really like some advice about if possible.
I have Temporal Lobe Epilepsy, Ménière's Disease, Osteoarthritis, Degenerative Disk Disorder & a pretty severe Trigeminal Neuralgia in my face. I also have what has been termed as “non-specific myoclonic seizure activity of the abdomen”. My thyroid has also been a little off in the past, but not enough to require that I take medicine, which I opted not to because I already take a lot of meds.
I was involved in a pretty severe automobile accident when I was 16, most of these conditions stem from this, as well as rendered me blind in one eye, partially deaf in one ear. The Degenerative Disk Disorder came from an incident where a machine malfunctioned on me at a place I was working, which resulted in 3 amputated fingertips & a broken back.
My epilepsy is well controlled with Keppra (Levetiracetam 1000 milligrams 2x’s daily). I also take Lexapro (Escitalopram Oxalate 10 milligrams 1x daily) to elevate my mood, as well as a multivitamin/multimineral supplement, Acai Berry extract, B-Complex, a joint complex that consists of Glucosamine Chondroitin Complex  (Glucosamine Hydrochloride, Chondroitin Sulfate, Methylsulfonylmethane, Vitamin C & Hydrolyzed Collagen), as well as a Magnesium/Zink/Calcium supplement.  
I also have pro re nata (PRN) medications that I take on a semi-regular basis as needed, these include: Lortab (Hydrocodone APAP 10/500, as needed for pain), Ativan (Lorazepam .5 milligrams, as needed for breakthrough seizures & sudden onset myoclonic seizure activity), Phenergan (Promethazine 12.5 milligrams, as needed for nausea), & Antivert (Meclizine, 12.5 milligrams that I take while having a bout of Ménière's). I also have mild insomnia, which I treat with a very low dose of Valerian Root, or Melatonin. I rarely take any of these meds, except for the Lortab, which I find myself taking about 3-7 days out of the week.

[Inspirations]

I work out when I can (which hasn’t been enough in the past year), I do yoga & I weight train at the gym, as well as work on the elliptical whenever possible. I can’t do these things as much as I’d like, because of time or because I’m having an episode or flair up, but I do my stretches everyday & I take my vitamins & try to eat right.
Recently I have gathered a group who is interesting in learning the performance art that I use to be very involved in, so I’ve been trying my best to get back in shape, but once again, something hit that made all my conditions seem to flair up at once. We got a flu. My son & I have been suffering from nausea, diarrhea, & runny nose & my other conditions all decided to start in the middle of it all.
My ears are still killing me & although I don’t think I’ve had a simple-partial, or a complex-partial seizure, I’ve had a pretty bad aura all week. My vertigo is driving me crazy & I feel completely restless & my muscles & joints ache. Even with the medications, I feel these symptoms, but I know they would be worse without them. I’ve seen my doctor & we are treating it right now, I think we’re getting better.
I’m so frustrated! I am so tired of having so few options to treat my problems! Every time I any of my conditions act up, it’s the same thing: Cortisone Shot, Antivert (Meclizine), Ativan (Lorazepam) & an opioid, which one is usually depending on what is going on & how severe it is. I have Lortab (Hydrocodone APAP) 10/500 all the time, but sometimes they bump it up to Percocet (Oxycodone / Acetaminophen 10/325.
Day to day, my pain doesn’t get me down & the Lortab 10’s do just fine. I can carry out my day, work on writing, take great care of the family & even practice my dance, gymnastics & fans. The Lortab even help the pain in my hand with the amputated fingertips!
The problems arise when any of my conditions flare up & I have a choice, be in severe pain, with nausea, vertigo, & any myriad of other symptoms, or take my meds & feel ok, but be completely sedated.
I’m not interested in increasing the dose of any of my pills, nor am I interested in changing up for anything more potent. I really don’t want to add any medications either.
I just want to live a semi-normal life, get back into shape so that I can perform as well as I once did (if not better than I was), & live day-to-day without worrying about one of these conditions getting me down.
I would also like to go back to school. I’ve had to put my education on hold so many times because of my problems that I find myself forgetting vital information! I really want to be a nurse, but I’ve decided to start out as a Phlebotomist/Medical Laboratory Technician, because the degree is much less strenuous. Even with the lesser 2-year degree, I’ve had to take a yearlong break.
It’s all I can do to maintain as a mother & a wife, which I do keep up with. There was a time when I only had the epilepsy & I did very well! I held down a job, I did well in school & I made it to the gym everyday.
I understand that there is no way to cure any of the conditions I am diagnosed with, but is there anything, at all out there to help me reduce the frequency of my flare ups, or to reduce the severity of them when they come?
I’d love to be able to STOP taking the opoids completely, but everything else I’ve tried for pain has either been ineffective, or has had an adverse side effect. I am lucky in the sense that I have developed a tolerance to the Lortab just enough to avoid the dizziness & loopy feelings, but it still helps with the pain. I’d also like to work on my balance & coordination, as well as my memory & cognitive function.
I don’t want to live the rest of my life taking a handful of pills every 12 hours & feeling disabled! I’m at my wit’s end here! Any advise or suggestions would be GREATLY appreciated! I’m so desperate here! I just want to be a productive person & not spend the rest of my life as a housewife, who feels useless & ill.


Thank you in advance!

[J T Junig, MD PhD]

I am sorry to hear about your health problems, and don't know if I have much to offer from afar. There are a couple things that come to mind that may help how you are feeling and functioning.  First, it is not uncommon to add a small dose of stimulant when a person is taking chronic narcotics;  the stimulant would cut through the sedation and help with your energy level. Vyvanse is my favorite because it has a long, slow release pattern and doesn't 'drop off' at the end of the day.

The second thought is to consider buprenorphine for your pain medication;  it tends to cause less sedation than other opiates.  On the other hand it does lead to tolerance, but all pain medications do that.

Other ideas from readers?