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    Old 10-25-2006, 03:21 PM   #1
    penybobeny
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    Question TENS unit, Neurountin and lidocaine cream

    I had my first PM appointment at the UVA Pain Management Clinic yesterday and they placed me on neurountin, lidocaine cream and ordered me a TENS unit to use.

    I cannot take any narcotic pain killers (I get hives with itching so bad that I gouge my skin off, vomiting and severe stomach distress with them all*) and cannot take tylenol, advil or anproxin because of liver issues and no aspirin because of my BP meds.

    (* I have been prescribed and had to stop taking because of my reaction to : vicodine, hydrocodine, oxycotin, percocette, percidan, demarol, darvocette, darvon, methadone, fetenol, morphine, kadian....*)

    This is all due to an ankle/foot injury in 1998 and 19 subsiquent surgeries (the last one in march) with a possible amputation of that foot coming soon because they just cannot fix the problem.

    Can anyone tell me about their experiences using any of the things that I have just been placed on and if it helped them with their pain management?

     
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    Old 10-27-2006, 05:06 PM   #2
    labshark
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    Re: TENS unit, Neurountin and lidocaine cream

    Quote:
    Originally Posted by penybobeny
    I had my first PM appointment at the UVA Pain Management Clinic yesterday and they placed me on neurountin, lidocaine cream and ordered me a TENS unit to use.

    I cannot take any narcotic pain killers (I get hives with itching so bad that I gouge my skin off, vomiting and severe stomach distress with them all*) and cannot take tylenol, advil or anproxin because of liver issues and no aspirin because of my BP meds.

    (* I have been prescribed and had to stop taking because of my reaction to : vicodine, hydrocodine, oxycotin, percocette, percidan, demarol, darvocette, darvon, methadone, fetenol, morphine, kadian....*)

    This is all due to an ankle/foot injury in 1998 and 19 subsiquent surgeries (the last one in march) with a possible amputation of that foot coming soon because they just cannot fix the problem.

    Can anyone tell me about their experiences using any of the things that I have just been placed on and if it helped them with their pain management?

    I've used TENS units in the past and they work to great sucess, some people need to wear them all the time, some people use them for 20-30 minutes at a time, but you will find some relief as they act directly on the nerves in the area that the electrodes are placed (with medical tape, or self-adhesive electrodes), they are very simple to operate and use.

    In regard to the medications you are using, they are all opiods. Has anyone tried giving you drugs such as Klonopin, Xanax XR, Elavil, which are not in the opiate family. However they do have similiar pain relieving qualities when used at high dosages. For instance Klonopin, at 10mg, is equal to a moderate to high dosage of oxycontin.

    In terms of neurontin, this is a drug that is now outdated. It has been replaced by Lyrica. Neurontin has never had much sucesss, and has many lawsuits surrounding it. Lyrica on the other hand has been a miracle drug for many. It works wonderfully for nerve pain, and has been a blockbuster sucess.

    I would try switching from neurontin to Lyrica. Your doctor should agree with this choice, as long as he knows what Lyrica is (and he will as long as he has any common sense at all.)

    In terms of amputation, save this as an absolute last resort. Make sure you have serious nerve blocks in the area, of long acting nerve blocking agents such as Markaine, or Septocaine, in order to make sure that you do not have phantom pain if the foot was removed. Remember, just because the foot is removed, does not mean the pain will go away. So be VERY careful and well informed prior to giving consent to this.

    Do what ever it takes, remember there will be new technologies each and every year. But, if you have no foot to be worked on, you'll be out of luck.

    One other drug you can try is Ketamine, is becoming more popular over time. It is not an opiate, but has signifigant analgesic qualities.

    Seach and Search and make it your goal. Travel to a different city if you must, but do what ever it takes to keep that darn foot.

    Much luck to you,
    Eric

     
    Old 10-27-2006, 06:19 PM   #3
    msswank95
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    Re: TENS unit, Neurountin and lidocaine cream

    amputation should only be done if your foot is actually dying, not to treat pain, especially nerve pain. that won't solve the problem. you will still have pain and it may make it worse if you cut off the nerves conducting the pain to begin with. phantom pain happens because the body believes the foot is still there and still transmits pain.

    i would consider switching doctors. i don't think they sound up to date at all.

    i also agree with switching to lyrica, although it too has side effects. you need to be sure it is safe with your blood pressure problems and don't take it if you have any heart problems. but lyrica is great for nerve pain - one of the best out there. you might also want to try it with cymbalta, an antidepressive that has had some effect with nerve pain.

    klonopin isn't in the same class and is not comparable to morphine. it treats a different set symptoms and also has a lot of side effects, including false memory syndrome. i don't recommend it at all. it is more along the lines of a sedative. it is like comparing apples to oranges.

    oh, and the lidoderm patch might do wonders for you or the cream. ask about the patch

    Last edited by msswank95; 10-27-2006 at 06:23 PM.

     
    Old 10-27-2006, 06:54 PM   #4
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    Re: TENS unit, Neurountin and lidocaine cream

    Quote:
    Originally Posted by msswank95
    amputation should only be done if your foot is actually dying, not to treat pain, especially nerve pain. that won't solve the problem. you will still have pain and it may make it worse if you cut off the nerves conducting the pain to begin with. phantom pain happens because the body believes the foot is still there and still transmits pain.

    i would consider switching doctors. i don't think they sound up to date at all.

    i also agree with switching to lyrica, although it too has side effects. you need to be sure it is safe with your blood pressure problems and don't take it if you have any heart problems. but lyrica is great for nerve pain - one of the best out there. you might also want to try it with cymbalta, an antidepressive that has had some effect with nerve pain.

    klonopin isn't in the same class and is not comparable to morphine. it treats a different set symptoms and also has a lot of side effects, including false memory syndrome. i don't recommend it at all. it is more along the lines of a sedative. it is like comparing apples to oranges.

    oh, and the lidoderm patch might do wonders for you or the cream. ask about the patch
    I am going to have to disagree with you on Klonopin. As, I am sure many others on this board will.

    Klonopin is a benzodiazepine, while it is normally used for social anxiety at dosages of 0.5-1mg per day, it is also WIDELY used and highly sucessful in the treatment of NERVE PAIN.

    The correlation between Klonopin and it's nerve-pain-reducing function is nothing new. It was discovered in the mid 1970's at the University of Arizona by Dr. Harkins.

    It is widely precribed for ALL types of nerve pain. It has a long history of sucess, unlike neurontin, and has a low side-effect profile, even when compared to Lyrica which is relatively safe.

    A bit of research will show the multitude of published studies on the pain relieving effects of Klonopin at higher dosages such as 6 to 8, to 10 mg's per day. This is a dosage that is far higher than what would be normally used for social-anxiety or agoraphobia.

    However, Klonopin has a much higher sucess rate at treating nerve pain, than does Lyrica as most patients are not resistant to benzodiazepine drugs.

    As a testament to Klonopin, it is used for nerve pain at some of the most prestigious pain clinics in the world: Cedar Sinai Hospital in Los Angeles, which is run by Dr. Graff-Radford, The Mayo Clinic in Scottsdale, AZ: Dr. DeLu <spelling>, Columbia Presbyterian: Dr. Brown (one of the worlds leading experts on nerve pain, if not the leading expert on nerve pain, after having invented and patented several new generation neurostimulators that far surpass the capabilities of the medtronic units on the market today) etc.

    Any Board Certified Pain Specialist will be the first to admit that Klonopin is a great nerve agent. It works on the chloride channels of the nerve, in a similiar fashion to Lyrica, but it also has anti-anxiety effects, and hypnotic effects which slow the action potentials of the nerve.

    After 30 years of trials, Klonopin has certainly proved it's worth in the treatment of nerve pain.

    You are correct though comparing Klonopin to Morphine is comparing apples to oranges. But, in the case of nerve pain, using an opiod is a "second line of defense" when drugs such as tegretol, lyrica, Klonopin, and other nerve agents fail to deal with the peripheral or sympathetic nervous system's issue in shutting down the nerve which is generally the cause of nerve pain syndromes.

    Thus, when such measures fail, opiate analgesics are prescribed which only act on the CNS, and are a "back-door" approach to the treatment of nerve pain.

    But please do not take my word for it, ask your Pain Management Doctor.

    Good luck,
    Eric

     
    Old 10-27-2006, 07:14 PM   #5
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    Re: TENS unit, Neurountin and lidocaine cream

    i wasn't saying it wasn't good. i just wanted to point out a bad side effect and why i don't recommend it. i have seen it happen with patients. i never even said it didn't treat nerve pain. i just said you couldn't compare it to oxycontin (i think i said morphine, but you know what i mean). here is your quote and why i responded as i did:

    Quote:
    For instance Klonopin, at 10mg, is equal to a moderate to high dosage of oxycontin.
    also, my only point in posting about it was that you said it was more potent than morphine and i said it isn't in the same class of drugs or targeted to the same type of pain and thus comparing apples to oranges. that is all.

    can i be nosy and ask what is causing your pain? you had mentioned that it is rare and i was just curious. i am glad you have found so many great doctors and are close enough to some great centers for study, or that is my impression anyways. i am so sorry, though, it has you bedridden and hope you are able to get the relief you need soon.

    Last edited by msswank95; 10-27-2006 at 07:19 PM.

     
    Old 10-28-2006, 05:03 PM   #6
    msswank95
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    Re: TENS unit, Neurountin and lidocaine cream

    i want to reply more to you, but am limited in time. i am so sorry for what you have been through.

    may i ask how much of those agents is too much to cause that damage. my pain comes from nerve damage to nerve roots and my spinal cord due to a botched epidural. the doctor flat out told me he put way more lidocaine in than the normal person because he couldn't get my numb (he was putting it in the wrong place and tore my dural sac and several nerves and ripped a nerve root sac). i am wondering if maybe the lidocaine also could have dissolved some of it.

    due to wording, we are having difficulty figuring out if we can do a lawsuit or not. when i had the epidural (for the birth of my last child), of course i had to sign all kinds of consents and acknowledgements of things that can go wrong. i swear you sign your life away. we have never tried to contact a lawyer, but now that we know i have a chronic and incurable condition, it is tempting to try to get some kind of compensation. it has cost us a fortune and me my company (i owned a company i had to shut down). plus, i have to get a lot of help with my home, as i can't clean. i am not lawsuit-happy, but i feel i deserve to be reimbursed for some of this. oh, and do you know the time limit to file? a friend said he would do it for us (he is a harvard grad, so i feel pretty good with him) and said we had a case, but it scares me.

    i guess that ended your friendship? oh, and can you file for disability?

    oh, and have you looked into overseas treatments. germany, france, and the UK are more advanced in the treatment of the neurophysical aspects of medicine. we had to resort to that for my daughter, who had a rare birth defect and most docs didn't know what to do with her here (due to some of the damage she sustained neurologically). she is doing great now due to a world-renowned british doctor who helped her and i think saved her quality of life.

    Last edited by msswank95; 10-28-2006 at 05:09 PM.

     
    Old 10-29-2006, 03:49 PM   #7
    penybobeny
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    Re: TENS unit, Neurountin and lidocaine cream

    Hi all and thanks for your replies...

    Actually, the amputation is not being considered because of the pain levels but because the multitude of surgeries have failed to give me a stable foot and ankle, the last one was in March (triple arthodesis, the 19th surgery since 1999 on that ankle trying to 'fix' it) and while the bones have healed the muscles and tendons are completely shot, the posterior tib tendon gave way four times before they did a triple tendon transfer (that has just ruptured for the second time itself) and all the supporting tendons and ligimants on the interior and anterior of my ankle have been reattached, moved, replaced, reattached again... all to no effect. They did a sural nervectomy in 2004 redirecting the nerve into my achiles tendon in an attempt to moderate the pain and now when that place on my foot "itches" I just rub my achiles, so I have a little experience with phantom pain.

    The problem is not having a pain free foot but a stable ankle and foot that is at least somewhat functional... the pain just seems to be a cosmic bonus... I would never consider an amputation on a functional limb that simply hurts.

    As for the neurontin, 5% lidocaine ointment and TENS, they were prescribed by the Pain Management Clinic at UVA and if they don't work we will move on to the next thing on the list of treatment options.

     
    Old 10-29-2006, 03:52 PM   #8
    msswank95
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    Re: TENS unit, Neurountin and lidocaine cream

    i am so sorry for all the trouble you have endured. i would still seek a third, fourth, and maybe fifth opinion before doing an amputation.

    as i mentioned, ask if you can do lyrica rather than neurontin - more effective with less bad effects and it was actually made by makers of neurontin to replace neurontin, improving it significantly.

    Last edited by msswank95; 10-29-2006 at 03:53 PM.

     
    Old 10-30-2006, 02:59 AM   #9
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    Re: TENS unit, Neurountin and lidocaine cream

    I will look into that further, thanks for the info...

    The problem with getting other opinions is that this is a Workman's compensation issue, they have sent me for other opinions in the past and my current surgeon is the Head of Orthopedic Surgery at UVA Medical School... believe me when I say that it is not my first choice in things. I just want my life back... I used to train and show horses, I used to hike, golf, swim, belly dance and take long walks in the park in the fall just to hear the leaves crunching under my feet. My children were 7 and 9 when I was injured and I have not been able to take them to the beach (I live on the coast) or do anything with them that I used to love to do. It all hit home at a wedding last weekend, I sat there watching the Father of the Bride and the Mother of the Groom dancing with the Bride and Groom and I just started crying... my daughter is 16 and my son 14 and I want to dance at their wedding. I want to play golf again and just go for a walk, even swimming is too painful because my foot flops around painfully in the water and getting in and out is dangerous for me. An artificial leg would defiantely not be ideal and I would have pain issues with that as well and possibly phantom pain to deal with, but I could stand it as long as I could just do a few of the things I used to love to do so much... if I could just dance at 2 weddings it would all be worth it.

     
    Old 11-12-2006, 02:39 PM   #10
    penybobeny
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    Re: TENS unit, Neurountin and lidocaine cream

    Hurray... the TENS unit finally arrived and tomorrow I go to PT for them to show me how to properly use it!

     
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