Hi Everyone, I haven't been on in a while. I have had a lot going on. My son got married. It was wonderful and then our family took a vacation.
For those who don't remember me or are new. I have been diagnosed with idiopathic small fiber neuropathy. I currently take,
Cymbalta 120 mg once a day
Tramadol 100 mg three times per day.
Synthroid 1.0 mcg once a day
CoQ10, Sublingual B12, R-Lipoic Acid, L-carinitine.
I have had SFN for just about 6 years now. I have had every test you can imagine. Every doctor says auto immune even though my antibodies all come back normal.

Ok now to my questions. I am prescribed Tramadol 100mg 4 times a day but have never gone that high. Until 1 and 1/2 weeks ago then I cut back to 100mg in Am and 100mg in PM. That seemed Ok. So a few days ago I went to 50mg in AM, 50 in afternoon and 100 at night. I have done this for two days and I'm not feeling for great. A lot of pain and numbness and tingling and twitching and really tired. Is this because I need that much Tramadol or are these withdrawal symptoms?

I have also decided to cut back on my Cymbalta and took that from 120mg to 90 today. I think I intend to stay at 90 of Cymbalta. Question is should I do this together or get through one and then do the other?

I was on vacation and realized that I don't have a lot of emotions. That is when I decided the meds may be too much. I cry sometimes when I think about the turn my life has taken but that's about it. I guess the real problem is I feel like I can't experience real joy.

Don't worry I know I have to wean off the tramadol just not sure if these are withdrawal symptoms.

For those of you who have had IVIG. I have been receiving them for about 8 months now. It seemed for a few months I got relief from them. I was getting RX one day a month. My neuro wanted to take it up to 3 days in succession each month. The first time I tried I was so sick rheumo said no and decided on 2 days/month. By the wai I received no relief from the 3 days. I then tried the two days before my son's wedding and had no relief.
Is it possible for IVIG to work in the beginning and not continue to work?

Sorry, for the long thread just looking for some answers.
Thanks, hopeful

Depending on how long you have been on tramadol...and the dose if high for a long time.... there will be a withdrawal.

Tramadol has serotonin effects like the Cymbalta, in addition to the opiate mu receptor dependency, so I wouldn't taper off both at the same time. Do one and then the other. If you do the tramadol first, don't change the Cymbalta yet.

Serotonin withdrawal is different for everyone. Some have severe symptoms and others less so.

These are some of the symptoms of tramadol withdrawal:
http://prescription-drug.addictionbl...awal-symptoms/

Hi Mrs. D. Thanks for the answers. I met with my neuro today and he said he thinks it is probably the Cymbalta that is causing my affect. He recommended going back to 90mgs. I told him I cut back on tramadol. He laughed and said he was not surprised. He knows I hate taking meds. I am still not certain if the pain I am experiencing is withdraw from lowering the dosage of tramadol or just that I need the dose I was on to alleviate the pain. I'm going to stay at the lower dose for a while and see if it stops. If not I suppose I will have to increase it again. I Hate Medications.
Since I lower the dose of tramadol and the twitching etc has returned also. I am thinking of beginning a Mg supplement. What do u think? When you apply the lotion to your inner arms and wrist is it systemic? Thanks again Hopeful!

Yes, it goes into the systemic circulation for me. It lowers my blood pressure!

I apply it on the backs of my hands, wrists, and inner arms.

You can apply it where the twitching is, and see if that helps, also.
If it is a thick area with fat and/or muscle...less will be absorbed systemically.

My hands still swell with this angioedema...but not when I use the mag lotion on them. Areas with thin skin and visible veins, are best for systemic effects. Large muscle masses, I'd expect the mag to stay in that area only.

Thanks again. Would you know which of the sites I may be able to find more people who have had IVIG Rx's on.

Hi, the withdrawl from Ultram is horrible. Its a nightmare. And I became very depressed. Eyes glazed over and I could not get off the couch. It was horrible. I stayed like this for 5 days. Then my Neuro put me back on it. I am on 200mg a day. It does help with the nerve pain and twitching and pins and needls. I would much rather stay on it at a low dose and be comfortable than be miserable.

Hi and thanks for the answer. What was your dose before you cut back? I have cut back to 50mg in AM and afternoon and 100mg at bedtime. I have to admit that my pain level has increased since I lower my dose. This disease is so terrible. For me the meds that help take away my real personality. It is so hard to make a decision what to take. I think I have decided I am going to stay on the lower dose and put up with some of the pain.

I have also lowered my dose of Cymbalta after speaking with my neurologist. He thinks that the Cymbalta is the cause of my lowered emotions. I do feel since I lowered both I feel more with it. Hopefully, I can stay with the lower dose of Cymbalta.

Hi Hopeful, I was on 200 mg before. When the pain is real bad even with takeing the ultram I will take a Norco( the lowest dose). Recently I got put on Norantin( probably spelled that wrong)and its helping. My feet are not burning at night. But I do get bad stomach aches from it.

Hi, I did try that medication before. I was not able to take it. It really made me out of it. I hope you can tolerate. A lot of people here seem to do well with it.