Steff,
One of the neuro's I saw precribed PLO gel which is a mixture prepared by a compounding pharmacy. It's a combo of neurontin, ketamine, tegretol, amitriptyline and magnesium chloride in a cream which is used for pain. It can help w/ severe burning and lancinating pains in my feet and toes.
Alkymst

Hi Alkymst:

I have a question. Alan sometimes has the pain between his toes. Two on the right and three on the left (maybe I have it backwards), but these are the toes that are affected. No place else.

Are you saying that he can go to a pharmacy and they can make up a compound that he can rub into his feet and he will be pain free.

He has used the blue stuff, the capsaicin (forget about what that did to him), and bio-freeze but honestly, none of that stuff does a thing for him.

So exactly what does he ask the pharmacist to do?

Thanks much.

Melody

Great for Alan being able to walk somewhere! It is so exciting...I went to a grocery store last week and was able to shop WITHOUT a motorized cart for the first time in a while and was so proud! It feels so good when you are able to do something again that you thought you would never get to do.

a doctor has to write an RX for any of those compounded creams.

I don't know if Tegretol, or gabapentin is necessary for Alan ...
as he can get around pretty well.

Perhaps just lidocaine in ointment form would work for him. That requires an RX too. Is he still on Lyrica? So no gabapentin is necessary (that is Neurontin).

You can ask the podiatrist next time you go...you find out if your insurance pays. Many compounding pharmacies do not take insurance. They make you pay, then submit your own claim.

No, he's not on lyrica. He took it a long time ago for about a week. Did absolutely nothing for him. He can't take neurontin because it made him deathly ill. We did ask the podiatrist about the trigger point injections but he said "that's not my field, you need to speak to your doctor, or a pain management doctor".

When Alan asked his doctor, he was told to "ask the podiatrist".

If you think he's going to start playing musical chairs with these guys, you don't know my husband. He'll just go back to the gym because that's what got him better in the first place. And now that the ulcer is healed, he'll think he's Rocky Balboa except he can't go on treadmills.

I will ask about a compound cream Just for when he sleeps. Even with the sponges, cotton balls, whatever, there is still a residual pain there. Over 15 years now. But it's much better. It would be so nice if he could be completely pain free when he goes to bed at night. But it is better with the sponges or cotton balls between his toes. That much I know.

Right now, he is sitting in the kitchen looking at a Harriet Carter Catalogue.
His recliner broke last week so he has to sit on the couch when he watches his programs.

He just sat up in the kitchen and shouted "I've found it, I've found it". I said "you found what??" and he showed me in the catalogue this blow up mattress (kind of like an aerobed). I looked at Alan like he lost his mind and I said "Have you lost your mind?" "You want to buy a blow up mattress and put it in the living room to watch tv?, why on earth do this, just go and sit on the couch". He said "no, this is nice, it's only $19.95 and we can blow it up, and I can put pillows and lay down and watch tv".

My response: "over my dead body".

Don't know about Dunkin Donuts tomorrow

lol

comments re: the compounding pharmacy, she's absolutely right the gel requires a prescription and most compounding pharmacies do not take insurance. They require payment up front, then you submit on your own, at leas tthat's bene my experience. The advantage to the compounded gels is that the drugs are absorbed locally and not taken systemically so much of the side affect profile can be reduced but you'd realy need an in depth discussion w/ your PCP to konw if this is reasonable for Alan. I was told the gels generally weren't prescribed for use between the toes because of the possibility of providing an environment for a fngal growth like athlete's foot.