Meds to treat PN
 

After my recent visit to CC, my medication regimen looks like this:
Neurontin 600 mg 3x day
Tramadol 50 mg 1tab 4x day prn
Darvocet n-100 (discontinued because it doesn't help. Replaced with tramadol)


My questions:
How long before the tramadol is effective (if it is going to be)
What was/is your experience using Tramadol?

Looking for the good, the bad and the ugly here. Hoping to find some combo that works. Need to keep myself in the workforce for as long as possible. Thanks

I was on tramadol for a very short time in the start of this for me it did little and then my doctors decided no more of those type of meds for me. On neurontin your dose seems low still is your doctor still having you increase it? I had also tried darvocet and it did little for my pain either. Have you tried any other meds like neurontin such as cymbalta,elavil,lyrica,etc? I know trying new meds and dealing with side effects is draining but I hope in the long run you find something to help

Tramadol really helps me with pain, but I only take it very occasionally. I am very sensitive to it, and have to use 1/2 of a 50mg tablet. It will work well into the next day at that low dose for me. A whole one makes me "hallucinate".. I call it "tripping".
But when I do take 1/2 when I have alot of pain it does work for me. Too much walking or too much gardening, sometimes sets me off.

I don't have severe pain from my PN anymore (it was severe when my thyroid was low). I have aggravating discomfort, and sometimes terrible burning. (but since watching the foods that trigger me, the burning has become less).

I still have Lidoderm patches and Salonpas. And Biofreeze. I used the Biofreeze last night in fact.

For aggravating pain I also use Tylenol or Aleve liquigels for that, but not every day either and I rotate them, so I won't get any long term negative side effects, since Tylenol can affect the liver and Aleve (NSAID) can cause heart attacks or stroke.

I've been on Trmadol for over 9 years.
Doc Rx'd 100mg 4x day, but I usually skip the lunchtime dose.
Along with neurontin for 6 yrs, & now Lyrica - it has helped me a lot.
I don't think that I could function without this combination. I know that if I forget my bedtime meds and fall asleep, in the a.m. I feel terrible until I take my a.m. meds and give it about an hour to take effect.
No side effects that I can think of & I use power tools and drive a small truck at work 6 days a week.

Tramadol not much help
 

I think I am going to go out of my mind. The burning pain is terrible. The tramadol doesn't seem to be doing much, much like the Darvocet N-100. Took the tramadol last night before bed, woke up 3 hrs later itching like crazy. No rash, just itching. I don't see the doc at CC until 7/26. Not sure I can hang in there til then. I sure hope this is not what I will feel like for the rest of my life.......this sucks!!

If you have burning pain, that is localized, (and not all over the body) I'd really suggest you use the Biofreeze. 3.5% menthol completely blocks burning for the whole night for me! I use it on my feet and hands.

Are you using a magnesium supplement? Magnesium is a NMDA receptor blocker, and can reduce pain for some people.
Many are low in this nutrient anyway, and just bringing yourself up to RDA levels which would be 200mg a day elemental, can really help. Estimates are 70% of US is at least 1/2 low in this mineral.

Neurontin, in addition to itching, I had Acid Reflux exacerbation.

Herbs that mimick Neurontin and Celebrex. Bacopa and Gotu Kola for quick releif 2x 100mg capsules daily or more if you need. Holy Basil for COX-2 inhibition. Curcumin is an effective pain releiver as well. These herbals are helpful.

Herbals like tramadol are different. I think the California Poppy can be a minor help.

For a more effective herbal Opiate-like kick for pain releif and Opiate withdrawal,Kratam. Kratam, helps addicts over in Thailand kick the addiction and is supposed to offer excellent releif. I am going to order some soon and will update. Here is a page about this:

Kratam:
http://www.articlesbase.com/alternat...on-954513.html

Burning pain........
 

Will stop on my way home and pick up some magnesium. Is there a particular thing I should be looking for or avoiding? Will also look to pick up some gloves. I have biofreeze but hesitated to use it on my hands for fear I will touch my face & eyes. I have used it on my feet and it does help. Thanks for your help!!

Biofreeze sinks in and is gone in about 10 minutes. I've never had problems with having it on my hands.

I rub it into the feet (mostly the tops and ankle) and then rub my hands together. You don't need gobs and gobs, a little goes a long way. It is a gel, and very easy to live with, IMO.

Magnesium oxide is to be avoided at all costs. It is not absorbed.
SlowMag is good, Magonate (not easy to find), magnesium glycinate.
WalMart has generic SlowMag behind the counter. I get mine at Costco, but each Costco is different. The pharmacy there orders the odd ball items, and it would depend on the location if they had it behind the counter. They must sell alot of it where I live.

If you get SlowMag, start at one tablet twice a day. I take mine with food. I couldn't live without this mineral. I started with it 10 yrs ago!
(before the generics came out).

Hey I am sorry about your high pain. At CC I would call everyday to see if they got a cancelation earlier then your appointment. I did that there and got in months in advance. I take magnesium too the glycinate that I get online. I am not sure so this could be so off but what about an anti inflammatory med to ask about? I am not sure that helps with the burning though. Hope you feel better

kprn, I have tried it all, and frankly, nothing works very well. I can't take Tramadol, so that is out.

I have tried Neurontin and Lyrica and had memory issues, but Lyrica worked the best. My insurance won't pay for it. If I could, I would use Lyrica again.

I have tried the opiates all the way up to fentanyl 50mcg and my pain simply ROSE to the occassion. In a few weeks one gets used to the med and one hurts the same. I have hydrocodone now, after weaning off ALL meds for a while, and I refuse to go any higher on any opiates....like I said, it is a merry go round. This is bad enough, any more and I plug up like some one put concrete in me.

Don't even think Benzos....ugh. They DO make the buzzing and burning go away, temporarily....then BANG.

I wonder if some of the beta blockers, or things like topimax may work? I dunno....neuropathic pain is a witch.:stirthepot:

As far as treatment, will your doc consider IVIG?

I also noticed after two cortisone shots, I felt better, but, I don't want to live on steroids. I had the shots for bursitis, and the cortisone went systemic, giving me some relief.

BioFreeze
 

The BioFreeze definitely helps. I have been using it day and night for the past several days. So much so that I am going to have to replenish my supply. Thanks for the suggestion, Mrs D. and, I did try it on my hands. After allowing it to fully dry, no worries about accidentally touching the eyes.

Good... I think Biofreeze is the most effective for that nasty burning. It works well for sore joints too. The Ilex in it, contains potent antioxidants, which are twice as potent as green tea. I think they also penetrate to do some good.
Biofreeze is a very elegant product IMO. Not messy, no staining, and as you noticed it penetrates quickly.

I found potatoes (nightshade family) really make burning worse, for me. Also highly spiced foods, curry and hot sauces too! As well as MSG sauces. Even A1 Steak sauce bothers me now.

You might want to try grapeseed extract orally. I find it works well at 300mg or more day.

Having a good day
 

I am having a good day....at least so far. It is 8:45am and I am at work. BioFreeze has become my new best friend. :hug:It helps me sleep better at night, and with a good nights sleep, anything is possible. (I keep telling myself that.)
I currently work out of town and only get home on the weekends. While I have a fairly easy job, and am well paid for what I do, I have made the decision to terminate my employment here and find work closer to home. It will mean a substantial cut in pay but I need to be home where I can have the support of my husband, children and friends. :circlelove: I can only imagine that the stress of being away from home is not having a positive effect on my psyche. I will be telling my current boss tomorrow that I will be leaving in 30 days. Pray for me........I hate delivering news like that!!:smileypray:

I too left working, only mine was so stressful...blech!
It is time to retire for me anyway.

I wonder if you drive a Prius? or another electric car?.

I ran into a gal who had been driving hers for about 2 yrs (maybe a little less) and she claimed that the car is not shielded properly and caused her to have immune deficiencies! I am not sure it is the car...but she is convinced it is...emitting EMFs...she drove over an hour each way to work. She said that cars made for US don't have the proper shielding but the European cars do?

These are some of her symptoms, that abated on weekends, and came back during the week driving the long drives:
"bad vertigo, fatigue, nausea, flu like symptoms, and really bad body aches and pain that came and went daily".

I just Googled this keyword search "EMFs from electric cars health effects" and there are quite a few hits about this subject!

No prius for me!!
 

After an auto accident in 2007 that totalled my car, I now drive a Chevy Trailblazer. Something a little bigger and meatier than what I had. Rides like a car and I love it. I have found that I can no longer make the 135 mile trip without stopping mid way. Otherwise I am too stiff and in pain when I finally extricate myself from the drivers seat!!

I wouldn't say you have retired......you spend countless hours on this forum helping others. God bless you for being so caring!!:hug:

Could also try increasing your Neurontin dose by 600mg/day, starting with the nighttime dose. You are not on very high dose and it sometimes requires >2700 mg/day before you notice a benefit. Topical analgesics can work wonders as well. Lidoderm patch over the area may be useful too.

fabdou.....I have thought about increasing the Neurontin but don't have an appt at CC until 7/26. Not sure I have enough Neurontin to get me through. I am going to keep using the bio-freeze for sure. Thanks for the suggestions.

Oh dear, kpRN! Please make sure that you can find another job first! I lost my job last year, and haven't been able to find anything. I'm about to lose my unemployment benefits if they don't pass another extension. You do not want to be where I am for the stress level alone. Most people don't realize how hard the job market is unless they or a family member is out of work.

You are absolutely correct, JoanB. I am lucky enough to already have secured another position with another company. Being that I carry the health insurance, I had to make sure of that before making any moves!! I worry about this even tho I have a job so I can't even begin to imagine your stress level!! I do know that stress aggravates my PN. I hope that you get another extension on your benefits or that you are able to find employment. God bless!!

Hi did you tell your boss? I am glad you had a better day and I hope you have more ahead. Who rx you neurontin? Could you call that office and ask if you should or could increase and if they would refill your rx till you have your appt at CC? Just a thought. I do know for me as I am going through some extra stress right now it does impact my pain. For me it takes all my mental skills to cope with this condition and my pain and when other stresses or things I need to manage in life happen it causes a lot of anxiety, being tense,and brings my mood down. All which is not good for pain. I am trying to be calm and live that life but obviously life throws you curve balls and you can't control them. I guess overall I just try my best to not have to face things I don't have to that may add stress or anxiety. Again with your job or someones family etc you can't always but in ways one can.

*** Thankfully, I am self-employed (although unemployed population base reduces my cash flow and has other effect). My stress comes from dealing with warring siblings about our elderly and declining parents.

*** I am sorry to see that Congress seems to be jumping on the R bandwagon of cutting spending.... hardly the smart thing to do with so many folks like you just hanging out there.

*** OTOH, cash flow constrictions result in me finding the little-known (and therefore cheaper) activities in town. Sitting in a park as the sun goes down and local blues players are working... good-bye to all those cookie-cutter big time acts. This situation is not so bad....

*** I find that I have adopted some good calming practices (deep belly-breathing is always good for a momentary 1 - 1.5 point drop in pain). Stress is just plain bad for me.

Cowboy

Neurontin and Tramadol
 

I took Neurontin and tramadol and learned that they worked well together and I hope that they do for you. Hopefully you can find a good combination of dosages of each one or at least find that both or one either works or doesn't for you. The dose of 900mg of Neurontin was my 1st and just barely took an edge off so I agree with the others that 1800mg could be increased. I worked my way up to 3600mg.

With the tramadol, I took the top amount, 2x50mg, 4-6 hrs (4 times/day). I don't remember my starting dose. Now I can't take it, I've become tolerant but it served me well for a number of years. I gave one to my Mom for a migraine (only time I've ever done that), we were snowed in and she got stressed out, hadn't had one of those for years! She said it was very strong and knocked her headache out...

SlowMag
 

WalMart had to special order the SlowMag so I got it yesterday. Took one tab this morning and will take the other tonight. How long should I give it before I notice any improvement and what benefits should I look for? I am keeping my fingers crossed that this helps in some way. Have a good weekend. :winky:

At one tablet twice a day, you may see easier sleeping.

Less muscle tension, and a reduction in some pain.

In general taking magnesium makes you "feel better" in a vague general way. If you have been having cramping however, that will reduce as you build up the magnesium you were missing.

Magnesium is a global mineral affecting more than 100 enyzme reactions in the body. It helps metabolize essential fatty acids,
and works also in the mitochondria. It normalizes heart rhythm also and dilates blood vessels (may normalize high blood pressure). Taken in high doses it treats some migraine conditions.

If you get loose on one tablet twice a day, then take with food.
Typically it does not loosen much, but some very constipated patients I had at one time liked being returned to "normal"...they noticed this right away. I am very sensitive to magnesium, but SlowMag does not "loosen" me.

3oz of unsalted almonds have 270mg in them. Having almond snacks is therefore a good way to get magnesium naturally.

Yup!
 

Lyrica and Tramadol are the real deal. With it? I almost forget that I have PN. Without? NOT GOOD!

I am sorry you are suffering. :(
It can take awhile to find which options work best and also to get them in place!
You have been given lots of great advice though! :winky:
I sometimes use a prescribed topical lidocaine (5%).
(Something in that makes my skin peel.)
It helps; yet, I think Biofreeze helps me more.

Many may not realize that a high quality Lavendar essential oil, mixed in a carrier oil, like jojoba (parts lavendar to 5 parts jojoba) can decrease the inflammation/pain in the feet and hands. The Lavendar oil does need to be of high quality to work best. (Too much lavendar oil can actually dry out the feet.) Some people report great relief with a mentholated emu oil. (I have not tried this one yet.)

During some of the worst pain, after a sural nerve biopsy, I had to use capsaicin. I, otherwise, hesitate to suggest it, as may get into some worse burning sensations with this. This was the only way I could tolerate that pain at all.

Many of the drugs used are very potent and tend to have many side-effects for many people. The more you can use topicals and gain relief, the better, imo.

I hope you find relief soon!:)
Take care!
~DejaVu

Update on leaving my job and meds
 

OK.....so I told my boss on July 4th (Independence day, no pun intended there) that I would be leaving my current position and the company. After much discussion, on my part and debate on her part,:mf_swordfight: my last day is August 6th. Of course, she wanted me to stay and on-board my replacement but she hasn't even posted my position so we would be looking at September. I know she is looking out for herself and the company, I have to look out for MYSELF. Told her the 5th was the best I could do. I gave her a 30 day notice which is fair, IMHO. Have been living out of a suitcase for 9 months now......it is time to move home.
As far as the meds......Neurontin 600mg 4x day, Slo-Mag 2x day and Tramadol as needed. Oops, forgot the bio-freeze.:Oops: Lots and lots of bio-freeze. Back to CC on the 26th. Will carry COBRA until the insurance from the new job kicks in. Just can't afford to be un-insured. Time for lunch!!:Starvin:

Pain meds
 

I take 600 mg neurontin 3x day and also have norco 10/325 to help with "overload" of pain. Take clonozepam at night to help me sleep thru the pain!!! Tried tramodol a few years ago- did not help me at all.

I have a moderate to severe level of pain which I felt but could not communicate to my Drs. at first. So I was started out with Elavil and Neurontin, then tramadol was added and these dosages were elevated. When the severity of my pain was understood, I was prescribed Percocet which is oxycodone 5mg and acetominophen for "breakthru' pain", the peak pain periods. I was working a full-time job which was 1/2 sitting and 1/2 walking and standing, so I was not without pain. So finally I was prescribed Oxycontin at a low level 10 mg (it's lowest level) 3xday which I still take today, that was 7 years ago. It was raised to 40mg/day for about 2 years but I could reduce it again when I retired. I am not ashamed to use this Godsend to help me with the horrible pain that other patients like me only know about. And both of my neurologists have said it is usual for pain at the top level. I can say it was only the narcotic that had the "heavy punch" to knock down the awful pain that I had. The other treatments only took away small parts of it and added up some help but at least 1/2 of the pain was still there....

However I am excited to come to this website and learn more about supplements than I knew to help me in my search for less pain and healing for my sensory PN. I see that there is much to learn here for me. And maybe I will be able to lower some dosages or even eliminate some meds I take. I only write this for the people who may be new and know their pain is so high that the topicals and lower-level pain-killers are not enough. I know that narcotics definitely have their place in the field of legitimate pain relief for chronic pain. It's what they are made for, plus acute pain, not drug abuse.