[QUOTE=Susanne C.;1050308]
almost any doctor would agree to trying Gabapentin. It is considered to be very safe and they are comfortable writing a prescription for it.

The primary doctor, podiatrist, and neurologist that I saw regarding burning pain on the soles of my feet all seemed not only comfortable, but even eager to give a prescription for gabapentin. With my pain being limited to one specific area, I found it disturbing that their solution was to offer a systemic drug that is effective for only a minority of patients, and has a lot of potential side effects. From info gained on this forum, I asked the last doctor for the lidocaine patch, which turned out to work adequately. There are various topical creams, lotions, and patches, which you can read about by searching the forum.

Hi Grant,

On one hand, many doctors won't prescribe any kind of treatment unless asked, because they feel if a patient doesn't ask then they don't need it.

OTOH, if/when it comes to pain medications, doctors are hesitant/reluctant to prescribe if asked because they may think the patient is 'drug-seeking'.

IMO, the time to ask/seek treatment is when pain/symptoms interfere with your ability to function—inability to sleep, do your job, take care of self & family.... In these cases, it's best to talk to your doctor about the symptoms and the effects they are having on your day-to-day life, and ask the doctor if there's anything that can be done to help. Then a variety of options are open to discussion, and any decisions about prescribing are left up to the doctor.

How to talk to your doctor about pain

One thing to be checked (if they haven't already) are certain vitamin levels—in particular, B-12 and D. With neuropathy, you want your B12 above 400 pg/ml (regardless of what they say is normal) and preferably much higher.

In a perfect world... Most everyone coming here wants to know that same thing (self included). Unfortunately the reality is that somewhere (depending on how the counting is done) between 40-60% of neuropathies are deemed idiopathic. Hopefully a cause can/will be found, but regardless, you still have to live with & treat what you've got for now.

As has been pointed out distraction is often the best pain med.
distraction pain medication
but distraction can only go so far, and isn't very helpful at night while trying to sleep.

IME, the numbness, tingling, jabs/shocks are going to be difficult to treat (at first, anyway). Some of the prescription meds can alter your brain chemistry and be as difficult (or worse) to get off of as narcotics. So for the burning (and other pain if applicable), I think the preferred route is trying the supplements first, and save the prescription meds (gabapentin, pregabalin, antidepressants, pain meds) for 'plan B'. I've had really good results with R-Lipoic Acid (killed the burning completely) and then adding Pantothenic Acid (vitamin B5) later, which along with the RLA helped most of the zapping. But like the anti-seizure meds (gabapentin & pregabalin) RLA doen't work for everyone. If there were something that worked for all of us, you can bet we'd probably all be on it.

Doc

Did your neurologist talk to you about trying any of the meds like Neurontin or even since you stated you deal with depression Cymbalta which can help with nerve conditions but depression too? When I first got dx my neurologist started with meds like Neurontin etc. Then I went to see a pain management doctor and have seen many since then. For myself the pain management doctors have not only tried to treat the pain but also tried to identify why I have this and other diagnosis that could have been missed.
Often pain doctors work not only with meds but encourage you to see a therapist/psych to deal with the mental impact the pain has, physical and occupational therapy, other therapies that could help too.

Having doctors you trust and know over time also helps. I live rural and our DR knows us quite well. They also know we normally use medication as a last resort and expect to be told the facts even if it is we are being paranoid so we often get told to take it before it gets to the point where we can't stand it. My DR pointed out with a back injury that waiting just meant that the pain relief couldn't block the pain requiring a higher dose.

If you can't talk to your DR then they are not for you and if possible finding one you are comfortable with makes all the difference.

I would agree if you don't need the meds keeping them as plan B is worth it but not at the cost of quality of life.

I grew up with a chronically ill mother and watched her deal with heavy medications for 17 years. She had to go through the trouble of her body getting used to the pain meds and sometimes addiction requiring them to have to switch her medications. We did have the best medicine cabinet I ever saw though. Even the paramedics would be amazed when they came to take her to hospital as we were better equipped than them let alone an 8 year old being capable of pulling the right drugs out and laying out bandaging, catheters and so on in order they would be required. We were never allowed to prep the injections.

:Good-Post:

Doc

Grant,
One bad thing about starting on drugs is that, if they give you relief then you become complacent about trying to pursue actually healing your condition. There is the temptation to go back to life as usual.

If your symptoms are 'tolerable', whatever that is for you, then I urge you to continue pursuing a cause for your PN and attempt to reverse it, or at least manage it, with exercise, a healthy diet, stress management, supplements, and maybe certain foods that you find to help. And for me, a healthy diet does not mean switching from beef to chicken, or eating a smaller portion of pizza, it means eliminating animal products and loading up on fresh vegetables (especially leafy greens), fruits, legumes, and whole grains.

If you get to a point where you cannot function normally (school, work, etc.), you are just miserable, or your relationships are suffering, then I think it is time to get on some medications.

You have found a good group here, so just keep posting your thoughts and you're sure to get some good feedback. Good luck down there.
Ron

Oh don't worry my neurologist is still running tests and stuff, we'll see what happens in that regard, i'm praying that it's something simple! not sure how i'd be able to handle something progressive