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Old 08-17-2013, 09:41 AM   #1
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Gabapentine

I'm curious?
I still have significant back and leg pain right side, 8 months post discectomy L4-S1 Left side. After two more ESI the Pain doctor put me on Voltaren 2mg -3 times a day (no help). My Neurosurgeon gave me a prescription for Cymbalta 20mg 1 per day, but I could only try it for 1 month (coupon online and insurance will not cover it [U]YET[/U]).
The solution - I now have a prescription for Gabapentine 300mg 3 times a day. Everything I read and even the pharmacist says that's to high a dose to start, but the doctor is a brain surgeon.
Anyone like to share there experience with this medication.

 
Old 08-17-2013, 10:07 AM   #2
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Re: Gabapentine

I'm not a user but the dosage sounds about right from what I have read.

Let me know if it helps you...I've got the same screwed up discs.

 
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Old 08-17-2013, 10:40 AM   #3
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Re: Gabapentine

Hey Hun ! Sorry to hear about your pain !! I have been on it for almost a year for nerve damage after surgery on my ankle. I take it twice a day or believe me my foot lets me know! My NS also popped mine to 4 a day when I herniated c5-c6. The reason they normally start off low and go up is the side effect of swelling in your extrimidies. If your NS wants you to take it that way I would ! You should notice a difference as early as a day or so but it does take time to get in your system regularly to be most benifical. Good luck I hope it helps!
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Old 08-17-2013, 11:25 AM   #4
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Re: Gabapentine

I've been on gabapentin for 5 years now after failed back surgeries and continued sciatica down my leg, and now also nerve pain (neuritis) from ankle surgery last fall.

I was also started out at 300 mg, 3 times per day, and have now increased to 1,800 mg per day. I was still having bad nerve pain when trying to sleep, and my pain management doc told me to take 300 mg in the morning, 300 in the afternoon, and 1,200 before going to bed, and that made a really big difference in my ability to sleep.

When I first got on this medication, it caused me bad foggy headedness; however, I could tell it was helping with my nerve pain so I stayed on it. If you experience this common side effect, talk to your neurosurgeon about possibly ramping up your dose to make the side effects more tolerable. I still have word recall problems and some foggy headedness, but not nearly as bad as when I first started on the medicine.

Best wishes!

 
Old 08-17-2013, 11:38 AM   #5
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Re: Gabapentine

These are the customary directions: (when given for nerve pain).

Initial dose: 300 mg orally on day one, 300 mg orally twice a day on day two, then 300 mg orally 3 times a day on day three.

The dose may be titrated up as needed for pain relief to a daily dose of 1800 mg.
Maintenance dose: 900 to 1800 mg orally in 3 divided doses.

When you start out too high, it only increases the chances of causing side effects, and giving up on taking the drug before you find out if it is going to help you.

You may want to get a second opinion or a consultation with a spine surgeon. It may be that you have some instability from multiple discectomy without fusion that is causing the continuing pain.

(I'm mostly adding onto your comment about the "brain surgeon..."but truthfully, there could be a mechanical reason for your continuing pain.)

 
Old 08-17-2013, 03:20 PM   #6
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Re: Gabapentine

Thanks for the replies.
This medication actually sounds encouraging. My heads already foggy.....
I'll try the -one -two -three - method as you said teteri.
I hoping it's only been around 7 months an maybe I'm still healing.
I talked with some sisters today at the beach - both had disc replacements in their necks and are doing great. One had surgery from a ortho I consulted with from Norwich and the other one from the head of Hartford's neurosurgery (my brother had bad luck up there).
Things are still bearable I guess and as long as I don't over do it at work.
When is enough enough ??
Funny thing My physicians PA said disc replacement was not an option ?
Anyways This boards great I really appreciate you guys
Thanks again..
The Pharmacist said the brain surgeon comment - Made me laugh -

 
Old 08-17-2013, 03:38 PM   #7
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Re: Gabapentine

Just know going in you might feel a little fuzzy headed at the beginning, but most adjust.

Regarding disc replacement, it tends to be more commonly done in some parts of the country than others -- but even then, you have to have the right set of circumstances to qualify for the surgery. Not everyone has the necessary structure to hold in the new disc, and there are other issues too.

 
Old 08-17-2013, 04:32 PM   #8
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Re: Gabapentine

I hope it works Hun! Lord knows I would be in a world of hurt with out it.
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2006 march- ankle fracture, plate and pins.
2012 sept -Debridement , ligament and tendon repair.
2013 July 3- C5-C6

Ankle replacement to come soon

 
Old 08-17-2013, 07:31 PM   #9
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Re: Gabapentine

I have been using gabapentin for almost 3 years. The pain doc started me on the same dose as you. It was too much all at once in the day. I found out they have 100mgs. capsules. I had the doctor write me for the 900mgs a day but in 100's so I could ease into it in the day and use more at night if I needed to. It truly got me through alot of the burning pain that the opiates wouldn't touch.

One thing the pain doc mentioned was that since it was a mild seizure med, you should never stop taking it abrubtly.

I hope you can get it to work for you if it helps.

 
Old 08-20-2013, 12:10 AM   #10
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Re: Gabapentine

Update-
On three per day (day two), no real difference, just a little loopy.
When should I start seeing results from this med?
I'm having a bad day/night...
Gabapentine and my regular pain meds are not even touching this.
I need to talk with my doc about a higher doses?
Feels like my back was on the other side of a baseball bat
I need Help....

 
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Old 08-20-2013, 07:03 PM   #11
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Re: Gabapentine

My last back surgery was back in 2010 and I was put on Gabapentin at that time. I now continue on it also for my fibromyalgia. My dosing is 1200mg two times a day for a total of 2400mg daily. My pills are 600mg each. I am at the maximum dose according to my primary physician so I can not go up anymore unless I work with a pain specialist. I hope this helps to ease any worries about the dose of your Gabapentin.
Tanya

 
Old 08-20-2013, 10:17 PM   #12
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Re: Gabapentine

Thanks for the reply
When does it start to work if it works? Days, weeks, months??
Everything I read is very encouraging and I would really like it if it works for me.
Had another very,very bad day today. The ESI must be wearing off it's been about 2 months.
I not sure how to approach my doctors about all this pain.
I'm being prescribed pain medication by my neurosurgeon and his PA.
They are surgeons not pain management. [B]Is this normal??[/B]
I'm not scheduled to see them for another six months
My pain management doctor so far only handles the ESI ,nerve blocks and he prescribed a back brace (had a bad reaction to the last ESI).
I'm trying to stay on my prescribed doses of oxy 10mg 4x per day, they are not really working anymore (been on the same doses for almost a year).
Any advice?

 
Old 08-21-2013, 01:56 AM   #13
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Re: Gabapentine

It's common for surgeons to prescribe pain killers for 2-6 months after doing surgery on a patient (sometimes a little longer), and only rarely before they do surgery on a patient.

Typically a surgeon will prescribe lower doses of pain killers than a pain management doc would, as well as weaker pain medicines compared to those a pain management doc would.

Can you describe how bad your pain is? What limitations do you have? Are you able to work at all? Can you walk around your block?

It's very common that you would work with a surgeon to try conservative/surgical methods to reduce your pain first for some time - sometimes for several years, and if that isn't successful, the surgeon will then refer you on to see a pain management doc for ongoing pain management therapies. One thing you don't want to do is see the pain management doc about getting pain meds while your surgeon is still prescribing them for you as they both then could potentially label you as a drug seeker and you could possibly get no meds then. If you are in severe, unrelenting pain that isn't getting better, then you need to either call your neurosurgeon's nurse and talk to them or make an appointment to go see them and talk to them. You will need to be as specific as possible about what you can or can't do. If they feel you are in an unreasonable amount of pain and it's been long enough that they have tried treating you, they may send you on to pain management, or they may adjust your pain meds. Just because you aren't regularly scheduled to see your surgeon for another 6 months doesn't mean you can't see them if there's a problem.

Regarding the gabapentin, it usually works within 1-2 weeks if you are on the right dose. Gabapentin is one of the most effective nerve pain meds on the market, even though it's also one of the lowest costs meds. Again, you may need to talk to your surgeon about adjusting your dose of this med.

 
Old 08-21-2013, 06:02 PM   #14
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Re: Gabapentine

Two hands
Thank you for the reply
I can work with difficulty - I'm a self employed contractor/carpenter who needs to work. When things get real bad I just stop and lay flat then either I'm done or I push on (being busy can make you forget-Till you stop).
I'm lucky I can go for walks but it increases the pain.
Sitting increases the pain
Standing increases the pain
Laying flat ice and using a tens unit gives relief..
Mornings are the best time and things just progressively get worse till I have to stop and be done...
No more 8 hour days,Or 5 day work weeks
Spend a lot of time in bed...
When it's bad it's bad
I'll give it more time. I've tried so many other things

My surgeon and pain management doctors work together so I don't see any real issues there. My surgeon has been prescribing for over a year - Pre surgery post surgery.?


Teteri wrote "It may be that you have some instability from multiple discectomy without fusion that is causing the continuing pain".
I'm starting to think along those lines but I think fusing's not an option.
I'm thinking the other side needs to get decompressed/cleaned out.
Things just don't feel right.
I'm wondering if those steroid injection can damage things, last round was very painful.
I can almost pinpoint the area in my back the pain originates from.
Then down to my butt and all the way down my leg sometimes both(STABING,BURNING)
It's different from last time
I know there are people worse off and I thankful I can still do what I can do.
I just need relief
Thanks again

 
Old 08-24-2013, 06:15 PM   #15
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Re: Gabapentine

I have similar pain, though not from surgery (arthritis). Gabapentin worked at first, but it gave me migraines (as do all medications that list headache as a possible side effect). Cortisone injections never work for more than a few days for me, so not worth the pain. I was very depressed about the chronic pain, and still am somewhat. I think that's inevitable. Right?
Anyway, what has been helping me the most is walking and swimming. Even though sometimes it is painful to walk, if I walk for 25-45 minutes, I really do feel better and can even sit at my desk at work for a few hours without feeling like there's a screw being drilled into my pelvic bone from the seat of my chair.
I still wake up in pain every night, but it is better with the regular exercise.
Maybe you can try that?
In your line of work, you probably don't want the mental fog of most medications anyway.
I find if I don't take any Tylenol for a few weeks, then I can take it when I'm having a bad night and it helps for a few hours.
Actually, that's true with all the pain medications I've tried. After a few weeks they don't work any more.
I wish I could drink wine before bed, but it just makes me gag, and I can't get it down. Probably would just cause more inflamation any way.

 
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