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Thread: Central nueropathic pain solutions

  1. #1

    Exclamation Central nueropathic pain solutions

    Hi,

    My husband is a c5/6 singe '92, age 17. Fine until 2006 when he Had an emergency surgery is right ureter and right Kidney to remove a large kidney stone. They also inserted an indwelling cath. He woke up from that surgery with burning searing pain. After years of many doctors, test, procedures, nonnarcotics, and narcotics the pain is only gotten worse.
    He had an SP tube inserted in '08 and has a colostomy in '09. Urologist suggested an illiovesacostomy instead of sp tube...but not for pain:/

    We don't know if it is spinal tap during that is responsible for this that are praying that it is not. Due to his level of injury he is not a candidate for the dorsal root end nerve procedure. Hypo gastric plexus nerve block (12-4-12) INCREASED the pain. It now ranges from a 8/10 to a 13/10....before it was a 6/10 to 10/10.


    Tried your typical cocktails. Hydrocodone (norco) and Xanax, neurotin (GABA), lyrica, oxybuntin, pot...
    Any ideas?

  2. #2
    How much neurontin did he take? Has he tried Lyrica?

  3. #3
    He has tried to 900 mg of GABA Along with Xanax and hydrocodone. Then he replaced hydrocodone With oxycodone. However the oxycodone causes him to nod out. Since the pain has gotten so much worse since the nerve block, he has doubled his dose of Xanax. This but knocks him out. Any suggestions are certainly appreciated. If you struggle with the same thing please let me know.

  4. #4
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    David would have better knowledge. But, I have avoided oxy by taking the max dose of Lyrica, Tramadol ER and normal Tramodol and now cymbalta. Together they help enough most days. Others have to take stronger drugs.

    I think the 900 mg is not near the max dose. Lyrica worked much better for me.
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  5. #5
    You can go up to 3200 mg/ day of Neurontin. So if he is tolerating the drug, go up in dose until the side effects are annoying or the increasing dose isn't increasing efficacy. I , too, like swh2007 had better luck with Lyrica and take 450 mg/day divided in 3 doses. The max of Lyrica is 600 mg /day. I know it helps. Add a tricyclic like Elavil 25 mg or Nortriptyline 30 mg at night. It is been shown to help. Consider Clonidine 10 mg twice a day to reduce the stress of pain (it cuts down 'sympathetic outflow'). Then there is opiates, nothin' wrong with them. Then some here use Valium or other benzodiazepam drugs that somehow helps , I have no idea how. Of course all these in combination have side effects, but some will deal with the side effects to get out of constant unrelenting burning torture of neuropathic pain. You have to keep trying different combinations of meds with a caring Pain Specialist who understands the magnitude of your problem. Unless you have had this pain, even if you are a physician, you have NO CLUE how brutal it is.
    Good luck.

  6. #6
    Quote Originally Posted by arndog View Post
    You can go up to 3200 mg/ day of Neurontin. So if he is tolerating the drug, go up in dose until the side effects are annoying or the increasing dose isn't increasing efficacy. I , too, like swh2007 had better luck with Lyrica and take 450 mg/day divided in 3 doses. The max of Lyrica is 600 mg /day. I know it helps. Add a tricyclic like Elavil 25 mg or Nortriptyline 30 mg at night. It is been shown to help. Consider Clonidine 10 mg twice a day to reduce the stress of pain (it cuts down 'sympathetic outflow'). Then there is opiates, nothin' wrong with them. Then some here use Valium or other benzodiazepam drugs that somehow helps , I have no idea how. Of course all these in combination have side effects, but some will deal with the side effects to get out of constant unrelenting burning torture of neuropathic pain. You have to keep trying different combinations of meds with a caring Pain Specialist who understands the magnitude of your problem. Unless you have had this pain, even if you are a physician, you have NO CLUE how brutal it is.
    Good luck.
    Jon, isn't it 3600 mg that is the recommended max of neurontin? Either way, I've seen posts from various people over the years who have gone above that when using it for neuropathic pain. A dose of 900 mg is pretty low for folks with serious neuro pain.

  7. #7
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    Quote Originally Posted by swh2007 View Post
    David would have better knowledge. But, I have avoided oxy by taking the max dose of Lyrica, Tramadol ER and normal Tramodol and now cymbalta. Together they help enough most days. Others have to take stronger drugs.

    I think the 900 mg is not near the max dose. Lyrica worked much better for me.
    I couldn't tolerate the lyrica but the Tramadol/Cymbalta worked a long time for me. When it stops working...it stops.

    I take a 200mg ER in the morning. She (pain clinic doctor) won't let me go any higher than that.

    What dose of Tramadol are you on? I know they make a 300 mg ER pill. My doctor is like a woman on the rag...you never know what kind of mood she is going to be in. On the day she said no increase, she wasn't feeling the rainbows. So I just let it go.

    The clinic really like the cocktail of Cymbalta and Tramadol it seems. But everyone cannot tolerate the Cymbalta well. My head shocked for a couple of weeks after going off of it. But it really wasn't helping the neuropain anymore.
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