Alan's podiatrist gave him an injection in his toes
 

This was a first. It was dexamethasone sodium phosphate lidocaine. I looked it up and the first three words are a cancer treatment or an anti-inflammatory treatment. In fact, there's so many things that this injection is for, and the side effects are nasty. But Alan explained to the doctor about the pain between his toes (and I've asked him this question before about trigger point injections) but he always said "it would not work in Alan's case), so why he did it today is beyone me but let me tell you, ALAN WAS A DIFFERENT MAN when he walked out of that office. For the first time in 20 years he had no pain in certain toes.

He said "OMG, can I do this all the time"? and the doctor simply said "Let's start with this and see where it takes us.

Well, as I watched him give Alan the injections, he asked him which foot is the worst and Alan said "the right foot", so he gave him more stuff in the right foot, than in the left foot.

The right foot was fine until 9:30 p.m. He got the shot at 2:30 p.m. So for those hours, he was a happy man. The left foot wore off sooner. Maybe 2 hours or so, but the right was fine until a few minutes ago. I just asked him "is your right foot very bad right now and he said 'no". So maybe the effects are still going on.

But today was his first real pain free day since he was on the Fentanyl pain patch 10 years ago.

I'm not finding that much info on this injection. And obviously it's not a permanent solution. But what if......? Wouldn't that be something?

Melody

The lidocaine in there numbs everything, and then wears off.

The steroid, will continue to work for a while.

I've had 2 of those shots over the years for my sesaomoids, and one for my left ankle. I found them temporary.

If inflammation is present, then the steroid will work some over time. But the numbing of the Lidocaine does wear off, that is to be expected.

Well--
 

--I imagine the lidocaine by itself would deaden the pain for at least some hours. It would be like getting a injection for dental work.

Dexamethesone is itself a very potent anti-inflammatory, and is often used in podiatric practices for foot and toe injuries. It's notoriously difficult to reduce inflammation in that area, as the blood supply is not very good--and gravity doesn't help with the circulation; moreover, we ARE constantly using/putting pressure on that part of the body.

There are a considerable number of side effects to using injections of this regularly (the Wikipedia article on it lists a lot of them), so I suspect whatever regimen the doctor decides will have to be spaced out and carefully monitored.

Thanks Mrs. D and Glenn:

I told Alan as much. I knew he wasn't going to be getting these injections 3 times a week. I immediately saw the side effects.

So here's my next question.

Why can't they just inject lidocaine 3 times a week into his toes?

Not possible?? or even feasible??

thanks much Mrs. D. and Glenn

Melody
P.S. The right foot continues to be much better (he had more meds in that way) The left foot (while not as good at the right foot), is cooperating more today because the weather is cooperating. So we really don't know what's happening with his left toes, but we do know that the toes in his right foot are REALLY good and he's very happy with this.

Did you ever try the Lidoderm patches?

Placed over the instep they numb the nerves going to the toes.

YEARS AGO. He would cut them and wrap them around each toe. (I just asked him ) and he just said "It didn't do a good a job as the lidocaine cream that I use every night).

So he has tried compound creams, etc. but the better thing now is the lidocaine cream and even better is the shot.

But I just looked up some info about the shot and I just found this.

(Alan was once told (because of his allergic reaction to Celebrex) that he should not have anything in the same family. So he always tells his doctors "I can't take sulfites). We told this doctor yesterday and he said "No sulfites ).

Really? Read this
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Injection dexamethasone sodium phosphate-lidocaine HCl contains sodium bisulfate, a sulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. The overall prevalence of sulfite sensitivity in the general population is unknown and probably low. Sulfite insensitivity is seen more frequently in asthmatic than nonasthmatic people.
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Now I'm going to go and look up Celebrex and see if I got that wrong about the sulfites.

Thanks, Melody

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UPDATE. Just read about how many people are confusing allergy to sulfa with allergic reaction to sulfites and sulfates.

Common confusion. Alan had no bad reaction to this injection.

I think the steroid would block any allergy.

If he placed the Lidoderms in the wrong place, they wouldn't work.

Placed on the top of the foot (instep) the patches hit all the nerves going to the toes.

I just asked Alan if he placed the patches exactly where you said and he said "yeah, I wrapped my whole top of the foot with those things".

I don't think he did. I remember watching him cut the strips and wrapping each toe.

I think he should ask Dr. Fred about getting some more patches and see what happens. The ones we used to use (and stopped using YEARS ago) expired in 2008 so we threw them out.

Thanks very much Mrs. D.

Melody

You only need a 1/2 patch on each foot.

Melody, I receive lidocaine infusions for 90 mins every 6-8 weeks, they go some way to improving my quality of life. I always get immediate relief and then that night the pain increases for 24 hrs and then a noticeable improvement creeps up on me. This improvement lasts 4-5 weeks and then I am likes a battery winding down until the next time.
This treatment isn't offered routinely in the US but is quite popular in the UK now.