Got to meet my new NP (Nurse Practitioner) this morning. She's wonderful!! She even knew about Neurontin depleting B-12 and that the test used isn't accurate as well as stating that if the B-12 level even hinted at being a bit low she'd give B-12.

We discussed treatment options for the PN and I expressed my concern about becoming addicted to Tramadol. She said that the risk is there but it's small. We discussed alternate treatments and I asked about Lyrica. She said she wouldn't give me Lyrica because Neurontin made me suicidal. Lryica is related to Neurontin. I never knew this. Instead we've agreed to try Mirapex. She stated that if I don't have any weight gain in the first 6 weeks with Mirapex I'm not going to. If I do gain weight we simply stop the Mirapex. I told her I was sensitive to meds and she said to stay at the initial loading dose of 0.125 mg. She also gave me samples and said to give her a yell when I needed more, that she has plenty. She even knew about the problems with Statins and PN issues as well as other problems with the Statins.

Get this, my last NP, the one that I was having issues with never documented that Neurontin made me suicidal. And she told me she would make a note of it in my chart. Guess what...no documentation so Jennifer (the new NP) made a point to document it under drug allergies. My last NP was simply lazy and sloppy. Apparently I wasn't the first one to comment on problem's with Beth to Jennifer.

Can you all tell I'm just tickled pink about this new NP?

I had to look this up....the reference I use didn't have this in it:

http://www.peacehealth.org/kbase/cam/hn-1390003.htm

This site is really good... when you start to click on things, you get more and
more information.

The B12 effects involve the CNF..spinal fluid....
B12 is also low in spinal fluid of patients with fibro.

I am bookmarking this site, BTW... it has alot of new information on it.

That is wonderful that you found a health care person who knows these things.
I guess there is still hope on that frontier?

That's a great site! Thanks for finding it. I'm bookmarking it also.

I am happy for you, she sounds great
I was on Tramadol for a few years and just stopped taking it one day a few months back, no side affects and defiantly no addiction problems for me anyway.
Actually i have never heard of a nurse practitioner, i don't know if we have them in OZ, perhaps , i don't really know for sure.
all the best,
Brian

NP is a Registered Nurse that's gone on in school and can perform as a doctor as long as they're working under a doctor. They can do almost as much as a medical doctor. I prefer a NP because nurses learn medicine and such in a different way than doctors. To me they're better all the way around. Well, except for Beth... Sigh.

ETA: Duh, I seem to have a problem today with not finishing my thoughts. Thanks for the info on the Tramadol. I'm worried about addiction especially now because one of my daughters has a SO that's addicted to pain killers and God only knows what else. She's been with him for 14 years and they just had a baby 6 months ago. It's scary and heartbreaking. I don't want to go there.

I can't take tramadol....severe reactions, but if you can take it, that is good because you don't get the 'looks' from the pharmacist that you get when you have other narcotics.

As far as neurontin (gabapentin) and Lyrica...I can take lyrica but neurontin makes me really crabby, but yes they are related.

Did they put you on Mirapex for restless leg....I have been on that for almost 10 years, recently haven't been taking it, as the RLS calmed down, but now that we are dinking with pain meds, I am sure it will rear its ugly head. I had to grab for the bottle a few nights ago after my go around with fentanyl that didn't work out so well. I have issues from a 55 mph head on 'kiss' with a truck, so no the fentanyl isn't for PN. It is for what is left of my trunk, no, not the one on my car....that would be my thoracic spine and rib cage. It has missing parts and is rearranged.

It is good you have a nurse to have some rapport with. It is refreshing to get decent providers....I found an internal medicine person I really like too. What a relief.

The Tramadol is very effective for nerve related pain and it really mutes my symptoms. I also have symptoms of RLS that preceded the PN symptoms. I've heard good things about the relief drugs like Mirapex can offer and I'm willing to try it. At times I can't differentiate between what's PN and what's RLS symptoms. So maybe this will help me identify the differences a bit more clearly if there are two different things going on.

Neurontin made me suicidal. It was really terrible. Within a few days of discontinuing it I felt myself again. This happened *while* I was taking Effexor for anxiety and depression. So that was *not* a good sign.

I don't think my pain is bad enough to ask for the fentanyl patch. Although I'm not sure what the criteria would be. I supposed if Tramadol at 100 mgs a pop wasn't working that would be a good option.

I have found that at times when I have breakthrough symptoms that three aspirin usually smothers the pain. The only time this happens is when I'm almost asleep and get woke up or startled awake. Maybe something to do with a sudden increase in BP or perhaps a surge in adrenalin? That and 37.5 mgs of Tramadol was no longer enough. She switched me from the "Ultracet" (contains Tylenol) to plain Tramadol. She was concerned that when I had to double up on the Ultracet dose that I was getting too much Tylenol. That and there's no point in me taking Tylenol as it doesn't do squat for the PN pain.

When I read stories like yours I'm grateful for having only the level of PN and pain that I currently experience. I don't think I'm strong enough to endure what you have.

What was your experience with Mirapex? Did you have problems with being tired or weight gain? Anything I should know straight from the horses mouth, so to speak? I'll be staying at the lowest starting dose unless it has no effect. Even a reduction of 50% in the symptoms would be a big deal to me.

Jarrett,

I can't take any of the meds you mentioned as well. I have tried for years so I finally said I give up on anti-convulsants and anti-depressants types. The SE's are just too much.

As for the Fentanyl patch I just started it. The MAIN thing is...you CANNOT be opioid naieve. You HAVE to be taking opiates. My PM started me off on the lowest dose...12mcg. The standard used to be or is 25mcg. But when he put me on the 12mcg, it had just come out. I was scared of it so it sat in my fridge for a LONG time LOL! But about a week ago I started it. I love it! So far so good. Of course there are some SE's but nothing that compares to the way I was on Neurontin and all those others. If anything, just slight sedation, some nervousness (that passes) and a lot of energy. And that's about it! I don't have constipation either and ONE of the reasons he put me on it was to help with GI issues I have and that is working well. Sooo...if you ever decide to try it, let the doc decide what mcgs you should be taking. I asked my PM to start me off low.

Oh, and I was a bit worried because I only took ONE Vicodin a day. But my PM reassured me time and time again I would be okay. Additionally, my Neurologist was all for it as well since I am so sensitive to everything else. Oops, forgot to add, you can still take the BT meds. I am...I still take the Vicodin and Klonopin and I am NOT overly sedated.

I'm so glad your tickled pink...I'm tickled pink my Neuro came home,I mean
back to the hospital,her shattered leg is much better..I'm going to
talk to her about weaning off of that darn Neurotin,like C makes me crabby
at least Bob said it did..

Mrs. D thank you for that sight,can't wait to tell oldest son about it,
and hello everyone, And a big J. hugs to all Sue ps. No rain,
and could open the door,I'm very warm but my hands are cold..