Post Lumbar Fusion Pain
 

I am 9 weeks out from lumbar fusion (S1 -L4 and stabilization device L3 - L4).
I have been on up to 80mg Percocet and 1800mg Neurontin per day but have been able to reduce Percocet to about 10mg per day taken at night. I have developed a lot of numbness in both feet. I need a cane due to a problem with stability. I have developed bad short term memory loss and my wife claims I am babbling all the time. I am wondering if others have experienced these problems with Neurontin? Is there a normal amount of time when I can go back to my mostly sedentary job without needing Neurontin? I couldn't do it now as I must bend and lift heavy files and need my pre-surgery mental ability which is not there now. Should my doses of Neurontin soon be able to drop?

Hello fast carbon
 

Welcome to Neuro Talk. Sorry you are having trouble with neurontin. some people just don't tolerate the medication well at all. I am one of those people who tried three times to take the medication. Foggy all the time. Please ask your doctor about it. Also lifting heavy things is most likely something you don't want to do ever after a spinal fusion. I was told not to lift over 10lbs. I do hope you will ask your doctor some questions. ginnie

Ask your doctor to switch you to Topamax. I would BET that you won't have that trouble with it and you WON'T need to be on that high of a dose. I've been on it for years, and I'm only on 400mg per day!! It has taken away ALL the burning, tingling, pain. I occasionally still have numbness but that's because I have severe nerve damage.

Ask your doc about the Topamax. I'm sure you'll like it much better! Neurontin is AWFUL and makes you retain water and makes you LOOPY. God bless and take care! Hugs, Lee ;)

if you took that much percocet, you WAY overdosed on tylenol, get your liver enzymes checked! Are you doing PT as ordered? is the numbness etc only post op?

Neurontin to Topomax
 

Lee: Thanks for the suggestion. I saw the surgeon yesterday and he switched me to Lyrica 75mg twice a day for a week and then increasing to 3 times. I did find that when I took my first Lyrica last night I had to take 20mg percocet as the leg pain came back (had been controlled with Neurontin). I do hope I don't have to return to percocet if Lyrica won't work. Perhaps I have to take Lyrica a week to get the leg pain under control.
If Lyrica doesn't work better than Neurontin I will request Topamax (hopefully it on my carrier's formulary). It sounds like I could return to work with Topamax if it would work as well for me as it does for you. Steve

pabb: Thanks for the warning. I was aware of the red box warning at 4000mg acetominophen so insisted on 10/325 so I would stay considerably under the max. My first prescription was for 5/325 so I immediately called the physician for the change. I am concerned that the Doc's are not up on t5his danger. Steve

ginnie: I appreciate the comments. I am curious as to what med you switched to if any? I see the surgeon about every 4 weeks for a followup and x-ray to see when fusion is pretty complete. The Doc tells me I will have no lifting or activity restrictions and can return to cycling and running (dirt only) after complete fusion but he warned me that I will need a fusion to L2 sometime in the future and if I run, especially on concrete, the need will occur sooner. It sounds like no matter what the additional fusion will be required in less than 10 years. Steve

Hi fast carbon
 

I got off of morphine and Percocet. I now am taking a low dose of hydrocodone. I am allowed to take that as needed. This takes the edge off. I can take the percocet if I want, but I have not done so in a month. I wanted to see what exactly I had left after my two fusions. Also I know better on what my limits are. If you really have to do another fusion down the road, I would take it easy, and not push that verterbre into herniation. Maybe Yoga? I know it isn't the same as running, but for me, I don't want to go through anymore than I already have. I do wish you all the best. ginnie

Hi Steve, Welcome.

There's really no "normal" where this is concerned; each patient and procedure is unique, both in the condition requiring the surgery and in response to the procedure, healing time, and response to medications.

Whether you're given/taking Neurontin/gabapentin, Lyrica/pregabalin, or Topamax/topiramate, the duration will likely be very close, whether a few weeks to indefinitely, depending on how well the surgery went and how you heal. There are side effects associated with all of these meds; it wouldn't hurt to look them all up and become acquainted with them and the side effects so as to know what to expect or look for.

Taking it easy and allowing yourself to heal are of primary importance now, so that you can get off of all these meds. I don't know where 9 weeks fits into the scheme for your particular case; that would better be left to the experience of the surgeon, or a physiatrist (a specialist worthy of considering seeing, IMO, if you or the surgeon think rehab from the surgery is not progressing as it should).

I think it's a good sign that you've been able to reduce the percocet as much as you have. This suggests that you may be able to reduce and eliminate the Lyrica (or whatever) as well. Many pain patients are prescribed a low dose (10 mg) of amitriptyline for nighttime (I've taken this on & off myself) in lieu of either opioids or antisiezure meds. A possible added benefit is that it may play a role in helping the nerves to heal/regenerate.
http://psychcentral.com/news/2009/06...tors/6761.html

Doc

Hi all: Thanks for all the sound advice. I do have a question I didn't ask my Doc when he changed me to Lyrica from Neurontin due to a problem with balance and memory on Neurontin. When you change, as I have from Neurontin to Lyrica or possibly Topamax if Lyrica doesn't work out, do you still take some dose of the old med? I was surprised at how much leg pain came back when I dropped Neurontin at 1600mg to go to 150 mg Lyrica. As you know it forced me back on Percocet. I do get to increase the Lyrica to another 75mg next week. Steve

ginnie: I unfortunately cannot take Hydrocodone (Vicodin) which isn't as strong, at least in the same mg dose as Oxycontin/Acetominaphen (Percocet) as I vomit almost continuously for a whole day. I will probably just go back to cycling although I ride with a guy who had a multilevel fusion 7 years ago who is getting close to getting another level fused. My L2 has stenosis and DDD already so I expect I don't have 10 years.

Steve,

A call to your doctor or pharmacist should get you an answer to that.

Doc

I'm surprised he did't put you on a higher dosage of Lyrica. I'm on 150mg per day, and that seems to work well for me. At first I felt a bit "loopy" on the Lyrica, but that has worn off and I don't feel like that anymore. I don't have ANY side effects from it.

I hope you can up your dosage of it soon. It should work better on the higher dosage. God bless & best of luck. Hugs, Lee :)

PS: by the way, I'm still on the Topamax, 400mg per day.