Discussions that mention lidoderm

Pain Management board


[QUOTE=Shoreline;332***3]Hi Sandy, I tried the short acting version last year. I had been on 30 mg roxi 0ne or two twice a day. U usually take a halfa pill in the morning and then a whole pills through a long nights. I was impressed with the pain relief with Opana ,but it did seem a little more impairing, forgeful, etc. It was also tough to compare the pain relief because the impairment was so new. Although I felt stupid, 5 mgs wasn''t really replacing 15 mgs of oxy. The right dose, and some time to adjust to the side effects and I probably could have been happy if the stuff wasn't so expensive. If you have good insurance, that won't be a factor, But because the difference in strength varries so greatly compared to IV use of oxymorphone and oral use, it;s going to take time for docs to figure proper conversion rates and time for patients to adjust to side effects. Oxymorrphne is 10 times stronger than morphine when used IV but only 3 times stronger when taken orally. Dilaudid is pretty ineffective orally but worked great after each surgery I had..

As far as treating your pain goes, nerve pain and treating back pain are very different. It would take way more pain med to manage the nerve pain. So that's why docs look to other classes of meds you have tied..

I'm a spiney with 14 years of PM experience and 3 failed back surgeries iand still have broken hardware crunching and grinding when I walk. I have an internal; pump and use oxy for BT so comparatively, your doses aren’t high. However even at much greaterdoses, I’m having a great dayy if half the pain is relieved. Nortiptaline was like the first of about 15 different anti depressants used to decrease substance P. The drugs in the anti seizure class disrupt the pain signal at a different point and so do the opiates. The more points your attacking that pain circuit that becomes ingrained into nerve tissue and inflamed by substance P the more likely your going to find a combination that works. Giving up on one or two drugs from the anti seizure and antiD class would be no less ridiculous than giving up on opiates after a couple meds at a couple doses failed to relieve your pain.

Everyone responds so differently and just like opiates, antiD’s and anti Seizure meds have sub classes that are very different and have different side effects. What works for one may not another. If you said you spent 2 years tring 10 different anti D's and 12 different antidepressants, That would be thoroughly exhausting a potwential source. Opiates may offer a guarantee of pain relief, but there are lots of other guarantees that aren't so benign. Just don't rule out all the other meds. If you have nerve or leg pain, it's going to take more than opiates.

I don't know what totally sho tmeans to you, I've had the horrible burning radiculopothy and now I'm numb from my hips to my knees. Numb is better in sme ways, but has disadvantages too. Your certainly not on wha t I call a high dose and 50% irelief is a reasonable goal. To expect to find andmaintin in in 1 year may not be. You may get 10 opinions bethat say opiates are bad before you find a doc wiling to look at the alternative to what they were tought in scholool and worked just fine up untill 96 when OxyContin hit the market. Nothing stronger than 5 mg percocet was used for post op pain prior to the big change in the late 90's. The 10 mg percs and 30 mg oxycodone tabs came out,. But 2 years to deal with something that effect you the rest of your life isn't abnormal compared to my experience. Everyones is different but you should be open to anything that might possibly help even if you had a bad experience with a couple versions of a particular class of meds.

2 year is and does seem like a long time, but when your talking about getting something under control for the rest of your life,

Welcome and good luck, Dave.

Hi Shore,
I've read your posts before. You're quite knowledgeable! Thanks for your help.
I was also on Lyrica 600 mg total a day, Zanaflex in the beginning for muscle spasms and the cramping that hits me behind my knees, the tops of my thighs and the back of them all at once but when that failed to keep things in check, they put me on baclofen instead, which is currently 15 mg three tiems a day. The Lyrica I did pretty well on as far as nerve pain goes, but the side effects of weight gain and the effect on my blood sugars forced me to have to go off that. Then we tried Topamax, but that ate a hole in my stomach in days and killed off any appetite that I had, so that had to be stopped as well. Now, we are trying Pamelor but it's still at a low dose, my PM prefers to raise one med at a time to see if it is going to be effective and right now, that's the Opana ER and IR.
You are right, it is expensive but he did give me some discount cards that help with my portion of the copay.
He suggested this or methadone but last time we tried methadone, we jumped into it at 30 mg a day, along with a decrease in Oxycontin ( but I was still at 30 mg, three times a day, so I think it was too big an initial dose, with the Oxycontin and it made me extremely dopey, which I don't want. I want to be able to function as much as I can without the halo/fog around my head. I really dislike feeling drugged. Manage my pain , and allow me to function as best I can.
I've had back problems since a motorcycle accident almost 16 years ago, but it is the last two years that I have had had two failed spine surgeries , CES, and now arachnoiditis on top of it.
My latest surgeon (neuro, first was an ortho), is recommending a scs, which I am not keen on having done. After much research on them, I am hesitant to let anyone near my spine again. Although I did agree to go and talk to the anesthesiologist about it, with the understanding that my inclination is not to do it.
My hardware was backing out of the vertebrae, and bent, and loose. They replaced two of the screws and added a crosslink, along with bmp due to the failed fusion from the first surgery. They also did hemilaminectomies, foraminotomies and attempted to clean up some of nerve encased scar tissue, but so far I am not seeing any improvement. He did tell me that it was extremely unlikely given the extent of the damage to the nerves that I would.
I haven't ruled out other medications, as I said above, I have tried several. If not for the impact of the Lyrica on my diabetes, I would have stayed on it despite the weight gain. My endocrinologist insisted that I come off it due to the impact it was having on raising my blood sugar levels, which in turn makes control all that much more difficult. I also have used lidoderm patches, a TENS unit, which I can't use because of the extensive nerve damage ( it literally drops me to the floor if it is used), and ice, heat, along with just about any other non medication modality you can imagine, including chiro care.
I didn't want to wind up on pain meds, and fought against them for some time, but have also come to realize that without them there is no quality of life , for myself or my family, other than sitting or laying down all day, which is not what I want for my own life or that of my family.
For me, 150 mg of Oxycontin a day was alot, while I realize it may not be for others. I don't like the drugged feeling, and thankfully on that dose, I didn't have it, but what little bit of relief there was in the beginning, was not there at the end, and it seemed pretty pointless to continue to raise the dosage and not get even the small amount of relief that there once was.
One of the reasons that I took myself off it before switching to Opana was to find out what my pain levels were like without it. If it would be possible to go to a short acting prn type medications instead of long acting, round the clock type medications. Unfortunately, that didn't work.
I have the horrible burning, electric shock type of pain and numbness from the hips down as well, including the soles of both feet and toes. My left foot is a complete foot drop which requires the use of an afo to walk, along with a 5 prong cane.
I'm not new to pain management either, I have RSD in my right shoulder, arm and hand.
Sandi