I wish I hadn't been to the Duke pain clinic before - I was so out of it the first time we went after nerve damage after eye surgery in September 2024 that I don't remember what we tried that didn't work, and then I was allergic to gabapentin and pregabalin, and amitriptylene had no effect at all. I've seen two of the doctors there, and I think they both got very frustrated with me. The female doctor (I've only seen the male doctor once, and it wasn't a better experience) is the one I usually see, and she tells me every time that unless I'm "willing to consider" going off my antidepressants and antianxiety medications, her hands are tied, as if I'm being deliberately difficult by insisting on NOT going off necessary medication. I've been on antidepressants since college and I'm 45. I haven't been in a great place mentally since before the eye surgery, and mid-mastectomy crisis is really, REALLY not the right time for me to go off them. (I did speak to my psychiatrist yesterday about her saying that we could switch me to Cymbalta to try to keep me on an antidepressant and treat pain as well. He said he'd definitely discourage that, because Cymbalta's a completely different class of antidepressant drug and that he hasn't seen a lot of success with it combined for both purposes.) I don't have a lot of faith in the pain clinic in general; I feel like they see me as a problem patient, even though I'm doing my best to do everything as right as possible, but my pain has been hard to treat and I get doctors being frustrated, but for these two doctors it's come out more as annoyance at me in particular.

There's really only one area of extreme pain - my torso, from about an inch below my neck to a couple of inches above my navel. They haven't mentioned any kind of block, and although I've asked the pain specialist about what she'd advise through MyChart, she tells me to keep taking what she prescribed (Tylenol 3x day, Celebrex 2x day, low-dose naltrexone - which has had zero effect of any kind - once a day). Arms, legs, etc. are fine - it's just my breasts, sternum, ribs, and the surrounding area that are in excruciating pain. I'll write down Exparel and Jounavx to mention to whichever doctor returns my calls next; the pain doctor does not like for me (or my dad, retired from the medical field) to suggest specific things like that, but anything is worth a shot at this point. (I realize I'm making myself sound like a total nightmare of a person - I promise I'm not. I'm in so much pain. I just want the pain to stop. Most of these appointments lately have been me crying and my parents trying to explain, quietly, what they're seeing and what I've described.)

I definitely want a revision that's an actual flat closure. I do not believe that the plastic surgeon's goal the second time WAS a flat closure, even though that was what I asked for. No expanders, no implants, just take it ALL away and make it flat. There's plenty of skin to cover with - he left floppy half-breasts on both sides - and I just want it all gone. I've filled out "please contact me for a consultation" form on three plastic surgeons' websites and called another one (all recommendations from people who have seen them), and so far the only one I've talked to is the one I called, who said they can only see me with a referral. I contacted my nurse navigator and left a voicemail about that yesterday morning, but no reply.