I am at a loss and looking for some suggestions. 4 years ago my life changed when at 26 I was diagnosed with late onset type 1 diabetes. Lucky for me I had not experienced any major side effects to date, with the exception of the occasional sore feet and legs. I am very well controlled, but have noticed my pain tolerance has gone way down. Then a year later I tore my achillies tendon and broke my ankle. Days after coming out of the cast my foot started to swell, change color, hurt alot, and burn. After countless tests I was diagnosed by an orthopedic doctor, then confirmed by a pain management doctor, with CRPS. They did a series of nerve blocks, which never worked well, and put me on hydrocodone 10x325 4x a day and various doses of lyrica to try and alleviate the pain. After a few years, the hydro stopped being as affective and we were looking to make the switch to fentanyl patches. Then I lost my job and found a new one in wisconsin. I moved from Chicago to wisconsin and got into a primary doctor right away. He kept me on the hydro and then added ms contin 15mg 2x a day. This actually seemed to do beter, but still left me uncomfortable. About that time I started to feel stiff in every joint, so we ran blood work and found I also had developed rheumatoid arthritis. This doctor refered me to a pain clinic, and the past 2 months have been he'll. The doctor immediately took away my pain meds and said she wanted to try other routes. She tried a ketamine based cream, which hurt to put on and broke me out in a rash. Now she is pumping things like nortryptaline and other antidepressent because they will help me sleep and help the pain. All they are doing is making me feel foggy every day and the pain is almost unberable. AM I out of my mind to ask for fentanyl patches or something long acting plus break through for pain? Any suggestions on what might work better? I am so upset as I can hardly sleep and not only is my foot in excruciating pain, but the rest of my body aches and hurts as well. I'm thinking of firing this pain doctor and going to someone else. Any suggestions would be appreciated on what is worth a try.