Hi Cindi!  My biggest concern is that you are not taking care of yourself...eating 2-3 bowls of cereal a day and not taking the time to sit down and eat are clear indications that you are not getting the care you so desperately need.  The only person who can put this plan into place is you and YOU have to put yourself into your own life plan.  I have had fibromyalgia since 1996 and was in a serious car accident in 2003, which has caused me to have severe and unrelenting back/neck pain, paresthesias, and now have been diagnosed with gastroparesis (they don't have any idea why but neuro is working on a dx.  May be due to post concussive syndrome?)  I have been on both Lyrica and Cymbalta and both of them gave me a foggy feeling so I stopped because I have a young autistic son.  I also have a suspicion that Cymbalta was responsible for a jaundice episode although the doctor couldn't say if it was that or the Valtrex I was taking for shingles (ouch!) so I stopped taking both of them.   I have been taking the Xanax to help me with the gastroparesis and tremors but it is very low dose (.125 mg to .25 mg)  The Xanax dose you are on is exceptionally high and your body has probably developed a tolerance and dependence which requires for you to be weaned off very slowly.  Your shaking hands are probably just one symptom of withdrawal, and the high dose is because your body needs more of the med year after year as it becomes used to it.  I don't know the nurse practitioner's background, but perhaps a better option for you would be to go to a big city hospital pain clinic where they will have more options and be eager to understand your pain.  The biggest fear for all of us with med changes is the same.....how will I deal with the pain if the new therapy doesn't work....what will I do then?  How am I supposed to cope with the pain AND my life's responsibilities?  I had much better response from the pain clinic and they had some therapies I hadn't even considered that are helpful.  I am planning a trip back there in a few weeks to be seen again.  (Cleveland Clinic)  Hope this helps!