<s>[INST] I have a chronic pain condition known as disfuction of the sphincter of oddi. I was being treated with IV dilaudid that I did on my own at home. I felt being on the dilaudis all the time was not good for me. I came off the dilaudid. Started on gabapentin 600mg 4x/day and cymbalta 60mg bid Welbutrin XL 300mg bid. I went from 133 lbs to 180 lbs in about a month. I was so blown up and full of fluid I went to the ER. The ER doctor said I was toxic from the gabapentin and needed to come off slowly so I dont have seizures. As I have decreased the gabapentin and the welbutrin XL.  I have developed a rash. My FP doctor believes the rash is from stess. Also, she no longer feels comfortable treating my chronic pain issue. I am having trouble getting a pain Dr. to see me. [/INST] HAI.your really into a chronic and troublesome problem. Already u have taken the maximum dose of gabapentin ALS,, which brings you down. Please go for a TSH (thyroid stimulating hormone) to check out the levels duet the chronic problemPlease reduce your stress. The ultimate relief for pain u can go for is with the neurotic blocks., fentanyl patches under supervision taking care of respiratory depression. Take care good luck </s>