Hello all,

I recently had a discussion with an anesthesiologist regarding my PN pain. (I am not a diabetic nor has any other reason been found for my PN so I have been an Idiopathic sufferer for about 4 yrs.)

He asked if I had ever heard of lidocaine infusions for the treatment of PN pain. I had not and so I thought I would bring it here. Has anyone been treated with lidocaine infusions for PN?

Thanks,
Nancy-H

Just did a search on it and the only thing that gives me 'cause for pause' is that there really isn't anything very 'current' on it as a therapy. Most of the research seems to be in small focus specific groups.

WHY hasn't it caught on? would be my big question.... I also feel that it's interesting that your pain doc would stretch and be, essentially, experimental. It's an aspect that can be good or bad.

It it were me? I'd really read the fine print about s/e's of lido infusions in all findable instances and maybe give it a try. I hesitate because when I use patches things go VERY dead and there are times the trade-off is worth it and others when it's not.

Whatever your decision, I for one, am awaiting for what all happens! - j

went through my mind. This is not something he was suggesting that I try at this point in the game but something that he had discussed with a doc at a pain convention. Waaaaay more info needs to come to me before I connect to a drip :-)

There is one machine that they have at the hospital here, which is new and so all the equipment is new. But, dummy me misplaced the brochure so I don't have the correct name to share. It's like a big TENS unit. Anyone heard of such a machine?

My pain has increased something terrible lately and I've not done anything to bring it on. It starts at bedtime and goes until about 3 a.m. or all day the following day. I know you guys are no strangers to pain but this has been going on now 3 weeks. How long do your pain flares last???

My best to all,
Nancy-H

Here's some of what the information says:

"Lidocaine Infusion
Intravenous lidocaine infusion is occasionally administered for diagnostic purposes. A "lidocaine test" may be given in patients with suspected neuropathic pain to predict response to oral mexiletine.[24] If the pain is neuropathic, transient pain relief may occur, lasting for several hours.[24] One study of a small number of patients reported pain relief lasting days to weeks after a lidocaine infusion.[24] Electrocardiogram and blood pressure monitoring are required during continuous infusion of lidocaine, and resusci-tative equipment must be readily accessible.[24]
Contraindications to therapy are hyper-sensitivity to amide-type local anesthetics, Adams-Strokes syndrome, and high-grade heart block.[24] Adverse effects are dosage related and transient. They include paresthesias of the fingers, abnormal taste, tinnitus, blurred vision, drowsiness, and dysarthria.[24] Higher dosages of lidocaine may cause cardiac arrhythmias and seizures. If the patient experiences drowsiness or dysarthria, the infusion should be discontinued immediately.[24] To administer lidocaine intravenously, a dose of 5 mg/kg of body weight should be infused over 30-45 minutes.[24, 41]

Continuous subcutaneous lidocaine infusion may be useful for the management of neuro-pathic pain states. Such use should be under the direction of a pain management specialist."

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Now, I can't tell you how many times I have asked neuros, pain management docs, everybody who wears a white coat, I have asked the following:

"Why can't they just take an injection of Lidocaine and stick it where it hurts (like with Alan, it's between certain toes of each foot, and it drives HIM CRAZY, SOMETIMES") Well, you should see the look the docs give me, a look like "what is she nuts, or something??"

And now I hear about something called a lidocaine infusion. You know, I wonder if they can mix it in with his IVIG, I mean, once they start doing it???

Interesting stuff.

Mel

I have not had regular Lidocaine infusions, but I did have Lidocaine in my IV, when my gallbladder was removed. It was WONDERFUL... I saw a pain management doctor not long after that who was going to try me on this, probably as Melody said, to see if I was a candidate for Mexiletine.

My Neurologist said "ABSOLUTELY NOT." I cannot recall why he was so definite about this..

I do get trigger point injections with Lidocaine and a little Cortisone, which helps in the places that hurt. It is not permanent, but in my case has been a Godsend at times. It varies on how long it lasts. I was leary at first about having this, because an old doc injected my back with this once, and it hurt like the devil-probably because the needle was huge. This doc uses a very fine needle and deadens as he begins. You hardly know you are being stuck... He also does the epidural, which helped considerably with the lower back.

Cathie

Every time I asked a doctor, I was told "No, it's not possible"!!!

And now I hear that you have gotten them!!!

What is wrong with these docs???

Melody

Trigger point injections... Right there in your neck of the woods...

http://www.freeofpain.org/html/painm...retrigger.html

Cathie

P.S. I am not saying whoever this is is good. I am just saying they do these in Brooklyn...

I just told Alan, he ran over to the computer, he took one look at Trigger Point Injections, and said "where do I sign up?" I said 'take it easy'.

We'll give them a call and ask our questions. Now, a long time ago, Alan used to go to pain management doctors for his PN, they had him on Ultram, vicodin, and finally, the Fentanyl Patch. This was around 2001 and 2002. Then he went to get the epidural thing. He did nothing!!!

And why no one ever suggested a trigger point thing is beyond me. You see, I have no idea if this will work on Alan. And if you think about it, he's had 5 rounds of IVIG and soon will (hopefully) begin the home infusions.

Now if he gets a trigger point, and he feels no pain (AND THIS IS NOT A BAD THING, BELIEVE ME), how can he tell if the IVIG thing is working??

He's going to call us this trigger point guy anyway and ask his questions.

Wow, if there's a way to stop the pain between his toes (besides using Blue Stuff and me pounding on his back), that would really be something. He wants to get a part time job so we can at least have a life. Right now, all we do is go to doctors and pay co-pays. I know there are many many people who have a much much worse case of PN than Alan. I do realize this. But for 18 years this guy has been shaking his feet, not able to lie down or sit down for any length of time without resorting to xanax, and other stuff, well it would be a nice change of pace to live normally.

I really don't see this happening any time soon. I guess I'm defeated or something. I have to be happy that we have a roof over our head.

A lot of people don't even have that. I know this.


Will let you know what Alan does with this Trigger Point thing.

Regards and much thanks for the info. You are a special doll!!!

Melody

Melody;

I had trigger point injections and they worked for about 6 months each. This went on until I moved here and my new doc did them as well. But soon the six months started inching back to 4 months, then 3 then 2 and at that point they started to hurt, rather than help me. But, I had success with them for 3 years. So, I'd talk to your doc about them.

As far as asking questions to doctors - I do it all the time for myself and my wonderful husband who has back, neck and orthopaedic issues. I have to ask the questions and sometimes it leads to possibilities!

Good Luck to All,
Nancy-H

I get relief whenever I get them, but I do not get them on a regular basis, only if I just have to have them. They have a little cortisone (cortisol?) in them, and I don't like taking more steriods than I already take. I have been told the injections contain a small amount though.

Along with Prednisone, I try to make do with various combinations of different things I have tried (some prescription, some over-the-counter.) My friend gets injections far more frequently than I do and I don't think she could tolerate her pain level without these.

Injections between the toes sound like a painful area to have stuck, even with deadening though. The feet are very sensitive. I have no idea how that would feel. I had one in the bottom of my foot once for inflammation of the fascia. It was done by a Podiatrist and it was pretty painful, because of the inflammation present. It was very effective though.

Mel, you might want to google up, Trigger Point Injections Brooklyn and call and see if anyone has ever done feet, or the area between toes before.

Cathie