Shoreline

Hey Jon, As mush mentioned some folks get tremendous relief from the triC's. My mother had a mestectomy in June and she has had a very hard time, she's a bit opiate phobic but has gottten relief rom elevil for the nerve pain and phantom pain of the missing breast. However it does have to be dosed corectly, One dose at night to help with sleep and pain does not work.

Elevill has an 8 hour half life and after discusing the nightime relief she was getting with the pharmacist he explained in order to truly benefit you would need to take it during the day too, He recomended TID dosing and that has worked through the worst of it but she's now weaning herself off the elevill too.

When you say nerve block, are you talking about along acting numbing agent in the intercostal nerve roots? It may be that not enough med was used or the wrong nerves have been blocked, It may be worth trying the blocks again to see if you are a candidate for RFA, Radio frequency ablation or chemical destruction of the nerve. It's an option and it does have to be repeated if succesful every 4-8 months.

There have been complications and increased pain as the nerve tissue regenerates too. It's a major roll of the dice and something that will likely need to be repeated many times over.

As far as alternative therapies for nerve damage and pain, The antisiezure meds are still the top of the list, however the antseizure med Lamyctal (sp?)is believed to speed regeneration of damaged nerve tissue. There are many antiseizure meds to try, just as there are quite a few opiates.

When it comes to cost of meds, I've been doing this for years without prescription insurnace. The peoples prescription plan cost 7.95 a month, It's a discount card . not insurance, But it's managed by Advanced PCS which is a major prescriptin ins providor across the country and the discounts are very real. pays for itself over and over.

Fot the cash patient as far as long acting or continous relief, methadone is the only real cash alternative. When I lost my ins. I went from 1400 a month for kadian paid by ins. to 60 bucks cash for methadone. Another huge factor in cost is where you buy your meds. The buying clubs like Sams and walmart is in line with sams, Costco and the other various ones around the country do not keep their doors open by the profits made in the pharmacy.

You don't need a membership to use Sams either. Pharmacy service is just an added benefit to using Sams. For example, when I first switched I was paying 58 bucks a month for #120 .5mg Klonopin. When I started at sams it was 19 bucks a month and has slowly dropped to 16 and change. Same med, same dose, same manufacturer "teva"

I also lok at the most bang for you buck so to speak as far as strength for price. The two short acting meds that I can afford are generic MSIR 30mg at 30 bucks for #120 tabs or Hydromorphone at 26 bucks for #120 4mg tabs. The newer strengths definitely cost more. I need to take 2 4's at a time, they do make an 8 mg dilaudid but it's a new strength and although generic, it's almost 4 times as expensive as the same number of mgs of the 4mg tablets. 60 8mg tablets even at sams would cost me 96 dollars, I can get the same number of mgs by purchasing the 4mg tablets , quantity #120 for 26dollars. The 10 mg percs are the same way. You could get twice as many for half the price of the 10's but more apap.

Another alternative would be plain old Oxycodone 5mg generic tablets, no apap. They recently have a generic version of Roxicodone. #120 30mg tablets of short acting oxy would cost 126 bucks at Sams, they can be broken in half so you would end up with 240 15 mg tabs for 126 bucks. If your buying club is out of the med you need that day, some of the retailers will match prices. I keep the piece of paper that tears of the insert in my wallet that shows the med,quantity and price.

If you disabled by your condition you ay qualify for medicaid which would pay for it all, or what's on their aproved list. There are patient assistance plans for folks that don't qualify for medicaid that can be chacked out by going to Needymeds.com. Your doctor would have to initaite the program, dcontact the rep, ffill out paper work and he doesn't sound like the most accomadating doc, unfortanetely. But it's worth checking into. You really have to set pride aside and see what programs either through manufacturers or through social services to see what you may qualify for. There is a generic version of the patch coming out the end of the year by Endo, It's new so it's not going to be cheap cheap but it may save a few hundred bucks.

I wasn't imnpressed by the discount on generic OxySR, but it's better than making purdue richer and richer when the canadian govyt prevents the same gouging that goes on in our capitalist country. The same meds, same manufacturer,, made in the US are 1/3 the price in Canada. However the Canadian med programs won't ship C-2's.

Lidoderm patches may be another option.

Methadone works partuclarly well on nerve pain because it's an NMDA receptor blocker. Blocking the NMDA receptor does seem to slow tolrance, It's believed to increase your threshold to pain and suppoesed to make opiates last longer and helps more with neruo pain than than other meds. Compounded long acting Hydro is made with Dex for this reason. Plain Dextromathorphan does the same thing and there is pure dex capsule OTC in 30mg strength. It's not particularly cheap. There is also a new parkinsons med that is called Nemanda, It's also a powerful NMDA receptor blocker. Perhaps if the doc can get some samples to see how it works , the patient assistance programs may open the door for use of that med.

Have you tried a TENS unit to drown out the pain, It's the ideas behind the SCS but the SCS is implanted and electrodes placed directly on the offending nerve or nerves.

I think even with the break in opiates you would quickly find yourself needing the same dose you required before. What you have done is a medication holiday, It's an old school of thought and not effective.

I ned to cal my wife back and give this some more thought, anything you can add as far as therapies or meds or modalities tried would help. As far as suffering, It doesn't build character.

No need for that and no need to stay drugged or groggy when you have choices. Hang in there and good luck. Dave