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06-29-2008, 10:35 AM | #51 | |||
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Wisest Elder Ever
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The subject of patches has just come up.
Here is a short explanation of what is available now as of 6-08 for pain relief: Okay... this a good time to explain patches, I guess! There are several types. 1) Fentanyl (Duragesic) RX ONLY--this is a very potent narcotic and effective but has alot of warnings with it to NOT use in people who are not already using high doses of another narcotic. (the term is opiate naive). There can be severe side effects and even death if it is improperly prescribed and monitored. But for severe pain...it is effective. http://www.duragesic.com/duragesic/ These CANNOT be cut or severe results will occur including death. 2) Lidoderm patchesRX ONLY -- these contain lidocaine which is a numbing agent. They were designed specifically for post herpetic neuralgia, but they have been shown to work very well for other chronic pain issues. I started these right when they came out.. and really like them. They help me tremendously. (placement can be tricky, and failure with them may reflect where they are placed). Their website: http://www.lidoderm.com/ These MAY be cut to fit any size placement. 3) Salonpas OTC-- These are over the counter pain patches with different formulas. I use the ones with methyl salicylate in them. They are more effective than BenGay or IcyHot patches which only have menthol in them. Salonpas(R) Pain Relief Patches & Sprays for Powerful Pain Relief When and Where You Need It. These MAY be cut to fit fingers and toes. 4) Flector--RX ONLY these are new in USA, and I am trying to get some. It looks like I will have to wait until September, since my doctor is leary of new things... These have the NSAID diclofenac in them. I expect them to work like the Salonpas. However the Salonpas cost pennies each and Flector costs mega DOLLARS! They have been in Europe for about 15 years, and have just been approved for "short term pain" here around January 08. FLECTOR(R) Patch (diclofenac epolamine patch) 1.3% | Safety Info These may be cut (but the doctor I talked to at their website says the FDA has not approved cutting them however, yet, but that may be in the future approved) 5) There is an antidepressant in patch form, called Emsam. RX ONLY However, as of now, the company that makes it is not targeting it for pain. That might change in the future, as many drugs become commonly prescribed off label. 4 4 - File or directory not found. This is an MAOinhibitor, and requires careful supervision. These MAY NOT be cut. I personally like the patch idea. I use both Salonpas and Lidoderm with great success. (Lidoderms are expensive if your insurance does not cover them). Salonpas are extremely INexpensive. Edit to add: as of Oct 2016 there are two new topical patch types that are OTC now. Salonpas has introduced a stronger patch with ingredients more like their arthritis one.. but still called "original". They are available at WalMart now in a 60 patch box. But Costco still does not have them. The other small ones are no longer in stores but some Ebay venders are still selling them. Read the ingredients on the box to see if you are using the old original or the new product (which has 10% methylsalicylate in it) Aspercreme is now offering a 4% patch (this is the same strength as the lotion with Lidocaine the offer. The RX form of Lidocaine patches are 5% in comparison and much more expensive than the new Aspercreme 4% ones.
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All truths are easy to understand once they are discovered; the point is to discover them.-- Galileo Galilei ************************************ . Weezie looking at petunias 8.25.2017 **************************** These forums are for mutual support and information sharing only. The forums are not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider. Always consult your doctor before trying anything you read here.
Last edited by mrsD; 10-02-2016 at 11:13 AM. |
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11-21-2008, 08:54 PM | #52 | ||
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Magnate
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It appears to ba a primer for Family Practice docs, so the viewpoint is in doc-speak.
If you go to the bottom of the page and back to the index, it too is interesting. http://www.aan.com:80/familypractice/html/chp3.htm - j |
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12-20-2008, 09:29 AM | #53 | ||
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Magnate
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01-22-2009, 02:29 PM | #54 | |||
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Junior Member
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This is interesting; skin biopsies of healthy skin and skin with peripheral neuropathy. Imo this link wasn't posted yet, but I hope I searched well
http://www.nature.com/ncpneuro/journ...neuro0630.html
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Diagnosed by small fiber neuropathy. I am a little insecure about my English . so please ask me if you think . What the **** is she talking about . . |
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02-04-2009, 06:40 AM | #55 | ||
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Junior Member
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Quote:
thanks... |
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02-20-2009, 10:14 PM | #56 | |||
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Junior Member
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thanks i hope this can help
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02-27-2009, 09:24 PM | #57 | |||
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Member
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LYME is a not uncommon cause of what is usually diagnosed as idiopathic pn. Ordinary lab tests do NOT detect all the antibodies which help make this diagnosis. I highly recommend everyone with an undiagnosed neuropathy to have their blood sent to a lab which specializes in tick-borne disease.
These are three: Top 5 lyme/tick diagnostic labs in USA: 1. Igenex, Calif.; 2. MD LABS, NJ; www.mdlab.com 3. Central Florida Research Florida . In NY, Igenex is used a lot, even though it's in California. Independent labs will draw your blood, usually on a Monday or Tuesday, and mail it to the tick lab. Here's a link to the international lyme association for more information: http://www.ilads.org/ This is from their site: 1. Lyme disease is transmitted by the bite of a tick, and the disease is prevalent across the United States and throughout the world. Ticks know no borders and respect no boundaries. A patient's county of residence does not accurately reflect his or her Lyme disease risk because people travel, pets travel, and ticks travel. This creates a dynamic situation with many opportunities for exposure to Lyme disease for each individual. 2. Lyme disease is a clinical diagnosis. The disease is caused by a spiral-shaped bacteria (spirochete) called Borrelia burgdorferi. The Lyme spirochete can cause infection of multiple organs and produce a wide range of symptoms. Case reports in the medical literature document the protean manifestations of Lyme disease, and familiarity with its varied presentations is key to recognizing disseminated disease. 3. Fewer than 50% of patients with Lyme disease recall a tick bite. In some studies this number is as low as 15% in culture-proven infection with the Lyme spirochete. 4. Fewer than 50% of patients with Lyme disease recall any rash. Although the erythema migrans (EM) or “bull’s-eye” rash is considered classic, it is not the most common dermatologic manifestation of early-localized Lyme infection. Atypical forms of this rash are seen far more commonly. It is important to know that the EM rash is pathognomonic of Lyme disease and requires no further verification prior to starting an appropriate course of antibiotic therapy. 5. The Centers for Disease Control and Prevention (CDC) surveillance criteria for Lyme disease were devised to track a narrow band of cases for epidemiologic purposes. As stated on the CDC website, the surveillance criteria were never intended to be used as diagnostic criteria, nor were they meant to define the entire scope of Lyme disease. 6. The ELISA screening test is unreliable. The test misses 35% of culture proven Lyme disease (only 65% sensitivity) and is unacceptable as the first step of a two-step screening protocol. By definition, a screening test should have at least 95% sensitivity. 7. Of patients with acute culture-proven Lyme disease, 20–30% remain seronegative on serial Western Blot sampling. Antibody titers also appear to decline over time; thus while the Western Blot may remain positive for months, it may not always be sensitive enough to detect chronic infection with the Lyme spirochete. For “epidemiological purposes” the CDC eliminated from the Western Blot analysis the reading of bands 31 and 34. These bands are so specific to Borrelia burgdorferi that they were chosen for vaccine development. Since a vaccine for Lyme disease is currently unavailable, however, a positive 31 or 34 band is highly indicative of Borrelia burgdorferi exposure. Yet these bands are not reported in commercial Lyme tests. 8. When used as part of a diagnostic evaluation for Lyme disease, the Western Blot should be performed by a laboratory that reads and reports all of the bands related to Borrelia burgdorferi. Laboratories that use FDA approved kits (for instance, the Mardx Marblot®) are restricted from reporting all of the bands, as they must abide by the rules of the manufacturer. These rules are set up in accordance with the CDCs surveillance criteria and increase the risk of false-negative results. The commercial kits may be useful for surveillance purposes, but they offer too little information to be useful in patient management. 9. There are 5 subspecies of Borrelia burgdorferi, over 100 strains in the US, and 300 strains worldwide. This diversity is thought to contribute to the antigenic variability of the spirochete and its ability to evade the immune system and antibiotic therapy, leading to chronic infection. 10. Testing for Babesia, Anaplasma, Ehrlichia and Bartonella (other tick-transmitted organisms) should be performed. The presence of co-infection with these organisms points to probable infection with the Lyme spirochete as well. If these coinfections are left untreated, their continued presence increases morbidity and prevents successful treatment of Lyme disease. 11. A preponderance of evidence indicates that active ongoing spirochetal infection with or without other tick-borne coinfections is the cause of the persistent symptoms in chronic Lyme disease. 12. There has never been a study demonstrating that 30 days of antibiotic treatment cures chronic Lyme disease. However there is a plethora of documentation in the US and European medical literature demonstrating by histology and culture techniques that short courses of antibiotic treatment fail to eradicate the Lyme spirochete. Short treatment courses have resulted in upwards of a 40% relapse rate, especially if treatment is delayed. 13. Most cases of chronic Lyme disease require an extended course of antibiotic therapy to achieve symptomatic relief. The return of symptoms and evidence of the continued presence of Borrelia burgdorferi indicates the need for further treatment. The very real consequences of untreated chronic persistent Lyme infection far outweigh the potential consequences of long-term antibiotic therapy. 14. Many patients with chronic Lyme disease require prolonged treatment until the patient is symptom-free. Relapses occur and retreatment may be required. There are no tests currently available to prove that the organism is eradicated or that the patient with chronic Lyme disease is cured. 15. Like syphilis in the 19th century, Lyme disease has been called the great imitator and should be considered in the differential diagnosis of rheumatologic and neurologic conditions, as well as chronic fatigue syndrome, fibromyalgia, somatization disorder and any difficult-to-diagnose multi-system illness. Disclaimer: The foregoing information is for educational purposes only. It is not intended to replace or supersede patient care by a healthcare provider. If an individual suspects the presence of a tick-borne illness, that individual should consult a healthcare provider who is familiar with the diagnosis and treatment of tick-borne diseases.
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LizaJane . --- LYME neuropathy diagnosed in 2009; considered "idiopathic" neuropathy 1996 - 2009 ---s/p laminectomy and fusion L3/4/5 Feb 2006 for a synovial spinal cyst |
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03-15-2009, 04:12 PM | #58 | |||
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new member
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An Algorithm for the Evaluation of Peripheral Neuropathy
http://www.aafp.org/afp/980215ap/poncelet.html I think this one lists a good view of Peripheral Neuropathy!
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GanaQ - living everyday by the grace of God . . Take care and be well! |
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05-15-2009, 06:39 PM | #59 | ||
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New Member
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Thank you for this thread, it's full of great information.
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08-21-2009, 10:25 PM | #60 | ||
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Magnate
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This is a good paper I came across again that does caution and outline the diagnostics......http://theoncologist.alphamedpress.o.../full/11/3/292
While seemingly scary? It really isn't? The two, neuropathies and cancers CAN occur separately. I am an example, and am still here? - j |
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