I have a question regarding LDN, Surgery & Pain management. This coming week I have dental surgery scheduled. There will be at least 1 tooth removed and almost every tooth will have some type of restorative work done to fix a years worth of damage caused by horrible medications i have been on. In my Pre-Op appt, the docs were cautious and recommended that I be able to take pain medication because of the amount of work that will be done. ( positive note, I will have a ketamine infusion while under to hopefully decrease the flare reaction to the surgery).

The problem is: I am on LDN, which counteracts with opioids. I love love love the LDN because it really has decreased my nerve pain with little to no side effects. I was at the point of needing a wheelchair when the LDN kicked in and made my mornings tolerable.

For me the LDN took 6 weeks to start working. I am so worried that if I stop it to take the pain meds that I will go back to feel horrible and it will set me back again... 6 weeks is a LONG time to be in excruciating pain If I don't stop the LDN and refuse the pain meds, the CRPS in my mouth and my feet will continue to flare.

Anyone had experience with this?

That does sound tricky! No wonder you are concerned.

I can't speak from experience but intuitively it seems that avoiding a really noxious pain stimulus is a good idea. Having noxious pain seems like more of a risk to me than going off LDN temporarily. It has a short half life, so should clear your system pretty quickly before surgery and the worst surgical pain is in the first 4 days usually. So maybe a week off it?

The LDN is working by modulating your immune system and down-regulating glial cells. It took it a while to do that so I would think relapsing back might take a bit of time. If your doc is game they could put you on the antibiotic minocycline 100mg 2-3 times a day for a week. It is also a glial cell modulator and is given post-op to decrease neuroinflammation. I could dig up an article on this if you need.

As far as pain meds, regular opiates increase glial activity and sensitization and should only be used short term. If you do okay with tramadol it will act on both opioid and NMDA receptors (ketamine acts on NMDA). When I had my surgeries I took opiates less than 4 days then switched to tramadol.

These are just my thoughts for what they are worth. Sweet deal on the Vit K infusion during your procedure. That's a great plan.
Sending hugs and healing love for procedure day,

Thank you Little Paw. That makes me feel better. I am going to suggest that with the med with the dr. I'm also wondering if anxiety meds such a ativan or Klonopin would help with pain short term or at least help with sleep. I have a high pain tolerance but when it interferes with sleep, that really kills me.

Thank you for your expertise.

Anytime! I'm glad to help when I can. I got the minocycline tip from my peripheral nerve surgeon who trained at Stanford and Washington U. He gives it to all his patients. There have been several studies on its efficacy.

If your doc thinks it safe to give you something for sleep short term and you know you tolerate benzos it could certainly help you rest and heal. We all know being sleep deprived makes pain worse.