Over the last few posts, I have kept you up to date on my new medication, Effexor XR/Venlafaxine HCI.

My Neurologist initially prescribed a very low dose with no effect. We doubled it and saw the burning neuralgia back off into a tingle for most of the day. We doubled it again and got amazing relief that lasted all through the day, keeping the pain to a very tolerable tingle. Then the side effect of muscular tics began and we had to cut that little honeymoon short.

The upshot?

I am back on that medium dose of 75mg per day and I usually have just a light tingle that escalates. Sometimes I can skip that late afternoon dose of Clonazepam ODT, but other days I need it to blunt the tingle that is becoming too strong. I haven’t had a real flare yet with Effexor XR so I am unsure whether that means it is preventing them, or the stars just haven’t aligned yet. I will let you know because the ultimate test looms ahead!

It is about time to replace a crown on a lower left molar (the porcelain cladding has mostly chipped off and is becoming temperature sensitive) and to crown an upper left molar that has a spiderweb of cracks in it. As you may know from previous posts, dental work is the thing most likely to cause flares for me and I suspect it may be the initial cause of my burning journey.

I am not looking forward to this, but I know it must be done. I will wait until after the first of the year when the holidays are concluded.

Dental care is one of the maintenance items that those of us with Burning Mouth can’t put off. Our mouths can be quite a bit dryer than other folks’ and lower saliva flow means higher bacteria counts. Your gums are a direct indicator of your health and you don’t want gingivitis or other periodontal nasties to take hold. If you haven’t gone to your dentist in a while (I know, COVID got in the way for many of us.) please do it now.

Regular brushing, flossing, professional cleanings, and checks for gum recession can save you a lot of pain.

But what about that flare I fear will happen? What do I do about that?

“The same thing we always do, Pinky.” (Sorry, couldn’t resist a Pinky & the Brain reference!)

I will plan ahead with the coping strategies that help me when my pain is at its worst. I will prepare mentally and will have enough medicine on hand to take the maximum dose for a while if I need it. Most importantly, I will communicate with my family and friends that I may be dealing with increased pain for a while and though I know it will go back down to the previous level eventually, I may need to retreat for a bit and just take care of myself. It is only fair to let them know and they will help if they can or just check in on me if that is what I request.

Things will get better and as chronic pain sufferers, we have to hold on to the image of those better days to get through our worse ones.