Lyrica, Gabepentin, and Cymbalta has done very little do treat my allodynia.

Next on the list is Namenda and Nuebexta.

I have tried all 3 of those and the Namenda for the PN in general...with no success. I am now going to try lidoderm patches on the bottom of my feet (which might not work since he feels the pain is coming from ganglioneuropathy in the dorsal root ganglia in the spine). I may try one of the patches (or half) on my leg to see if it settles down the allodynia. I did read on the Wiki site Dr. Smith attached that lidocaine (topical) is helpful for this. We'll see.

Just a suggestion....

I don't think Lidoderms work on the bottoms of the feet.

I'd put them on the insteps instead. That is where both major nerves enter the foot.

A 1/2 patch is enough for each foot.

Also to try:
1) 1/2 patch around the top of the ankle before the foot starts.
2) if you think your issues are ganglion centered, then putting over the affected ganglions over the spine is best. This numbs them at the source.

This link shows yellow nerves...
http://www.northcoastfootcare.com/pa...e-Anatomy.html

hit Ctrl + scroll wheel to enlarge. The 3rd photo (anterior) in the first array shows the main nerve coming down in the instep.

This link shows the nerves in the foot more clearly:
http://www.northcoastfootcare.com/pa...-the-Foot.html

This website is excellent for viewing the feet, anatomy and where the nerves are and go.

Most people see no effects from placement on the bottoms of the foot.

Some experimentation is necessary. For example I find some foot relief when I place a 1/2 Lidoderm behind my knee, on the thigh side of the bend. This hits the peroneal nerve that passes there to go down to the foot.

Thanks for the tips MrsD!!!

We talked about putting the patch on the back. My neuro said that I wouldn't likely have good results on the lower spine (source of the ganglionitis) because the dorsal root ganglia is too deep and protected that the medicine wouldn't reach it.

I can't see where it would hurt to try this, though.

I haven't even received them yet. He wanted my cardiologist to approve the use with all the heart meds I take. I'm hoping to have them by the weekend. I'll try your suggestions with instep and ankle first.

Go easy with them. I know they have a limit of 3 per day.

But I don't trust that. I never go beyond one patch a day.
And even sometimes I just use 1/2.

I've experimented with them for years. Certain placements work and others do not.

Start with the tops of the feet --the instep. With your cardiac issues, perhaps do one foot only for the first experiments.

And consider the knee. I was surprised to find behind the knee worked so well for my feet at times. I know of a study of Lidoderm against Celebrex for knee pain, so that is why I did it there for my painful right knee. The relief goes all the way down to my foot! So now I wonder how much of my "arthritic" foot pain is really referred knee compression?

There always can be an unexpected result when PN is concerned IMO.

Probably a stupid question, but here goes.

Do lidoderm patches even make it to the blood stream? I didn't think so, until my doctor said he need it cleared from my cardiologist due to heart problems and cardiac meds.

I thought it was strictly topical.

All topical things get to the blood stream.

The topical Flector patch is causing liver problems in some patients!

When I first started Lidoderm, I had some rapid heart beats.
That only lasted for the first couple of days or so. That is why I
cut them now in half for some uses. I even found that 1/2 patch is quite effective when placed properly.

But I will caution you....doctors DO NOT KNOW how to use them.
We used to get endless calls at my last job (nursing home provider) from nurses who could not figure out what to do with them. Doctors don't know. Everyone would eventually come me for advice. I even met a drug saleswoman at a pain conference and asked HER about the drug company's advice...and she told me...They don't know either and don't recommend placement!

Kind of spooky isn't it? So start with 1/2 patch, keep the other half in its foil pack fold over tightly and put in a ziploc. They do dry out if exposed to air. Using 1/2 successfully will save you mega bucks too.

Hmmm. I didn't think enough of a "topical" made it beyond the surface.

I can see my cardiologist holding off for a while "IF" he allows it all at. I just had (Monday) a major drug reaction from the Ranexa (which is new for me) and Cardizem. Apparently these two can fight for excretion and in the process increase potency...considerably in both drugs!! It was horrific, and a genuine struggle to stay conscious. Was very scary...not even sure if I want to try ANYTHING for a while...still fresh in my mind. I was under impression lidoderm patch is benign systemically. Only reason I considered it.

IF and when I do try it (big IF now), I will do so with just 1/2 on one foot for starters...placing it at the instep.

I was excited about trying these...the wind is gone from my sail

Lidocaine is a topical anesthetic, meaning it only numbs what it directly touches. So gluing a patch over unaffected skin in hopes it will have a deeper affect will only give you numb skin.

--is just to put "skin biopsy" in the pop up box that appears when you left click on "Search" along the top bar here; that way you'll not only get mine bout lots of others. I have often talked a lot about how the skin biopsy protocols were originally developed at Johns Hopkins and how the cut-off points for "abnormal" intrapidermal nerve fiber densities were determined.