Thoracic Outlet Syndrome Thoracic Outlet Syndrome/Brachial Plexopathy. In Memory Of DeAnne Marie.


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Old 10-03-2012, 02:15 PM #1
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Default What medicines have people found effective?

I am returing to pain management on Monday. I may ask for a reboot of medicine as my meds are becoming less and less effective. I am taking 5mg methadone 3xday, 7.5mg hydrocodone 0 - 2 times a day, and 5mg baclofen about 2 - 3 x day. At night I take a cyclobenzaprine muscle relaxer for sleep. I also take 150 mg Wellbutrin to combat the depression.

I hate the narcotics and I really do not want to go up in dosage. I have tried Neurotin and Lyrica but they did not help very much. I really beleive the muscle relaxers help more than anything but they feed depression and they seem to not work as well after taking them several months. Perhaps I should switch to another form of muscle relaxers? I am trying Calcium and Magnesium as well but just started.

I am likely to have the surgery before the end of the year but need to survive until then. Any advice is greatly appreciated.
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Old 10-03-2012, 04:29 PM #2
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It's normal to need a med overhaul every once in a while. Yes, try switching the type of muscle relaxer. I have gone from skelaxin to (cant remember ) to valium to Flexaril. Had to stop valium because it was increasing my depression. Flexaril seems to do it, 10mg at bedtime.

Switched up many times on anti-inflamatory meds. Too many side effects, so now I'm liking Aleve for swelling.

For pain, percocet works best for me (can't tolerate the synthetic meds). I use this only when needed.

For my depression, nothing. I am too afraid to add these to the mix! I see a psychologist 1-2x a month and work on my cognitive distortions.

Best of luck to you!
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Old 10-04-2012, 11:37 PM #3
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Take a look at this thread Advice on Nerve Meds

I recommend asking your pain management doc about Cymbalta or Pamelor. These are anti-depressants that also offer pain relief. They can also enhance the effectiveness of Neurontin or Lyrica.

I've tried almost all the muscle relaxers but I would build up a tolerance rather quickly. Zanaflex still works for me but only lasts 4-5 hours and gives me strange dreams so I wake up in the middle of the night (it also is not fully covered by my insurance). The benzodiazepines/anxialitics such as Valium or Ativan have worked better for me (I take Valium).
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Old 10-05-2012, 12:01 AM #4
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Sometimes a Medrol Dosepak (steroid taper) or a course of Toradol (cox-1 and 2 inhibitor/NSAID) is necessary to stop a major flare. Toradol has been the most effective for me (can only be taken continuously or a max of 3-5 days).
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Old 10-05-2012, 06:40 PM #5
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Like Marc said, Cymbalta might be a good choice for you. It helped my pain, but it made me really, really angry - like wanting to punch people in the face angry - so I had to stop taking it. But Wellbutrin did that to me, too and since you're okay on that, you might do well on Cymbalta. And that might help enough with the depression to let you better handle the muscle relaxants that you know help.

I found Lyrica did not help me on its own, but combined with other drugs it has been a lifesaver. It also takes a few weeks to really "kick in," so don't give up on it too quick. It'll give you crazily realistic dreams, though. ;-) I've not gotten much relief from steroid regimens - well, for TOS pain, anyway. It's great for the old allergies, though. - but I know some people do.

You're already taking a fair amount of narcotics to not be getting relief, which makes me suspect you probably need to add a nerve drug to the mix. I really hope your pain doc can find the right combo for you.
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Old 10-31-2012, 10:47 AM #6
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Post my meds

Hi ...I used to take Methadone 5mg 3x daily but could not cope with being sedated and having problems srtinging sentences together. It was far better to have increased pain and be off it tho' it made me quite ill from withdrawal effects. I even reduced the dose but ended up quite ill with hideous body pain for about 6 weeks. I was basically in bed for two weeks. I stayed on and continue to take 100mg oral Ketamine 2x, 600mg Lyrica tho' was up to 900mg a wee while ago but have got it back down. I take Venlafaxine 75mg in morning and 27,5mg at night. Have to take anti emetic and gastro protection. As an add in to help me go out or do something I take Meptazinol 200mg up to 3x daily and then switch out with Nefopam to reduce tolerance effects...
I have a lot of drugs and manipulate them according to cut of dose given. My docs are great. Tried cutting Ketamine down but get more pain.
It is trial and error and a good doc. Also have Migraines to boot.

Don't think there is an effective combination that can be prescribed as we are all different.
Best wishes and find some relief soon.
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Old 10-31-2012, 12:13 PM #7
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I was prescribed Tramadol, 3x a day but only take one pill a night and almost feel no pain the next day. I stopped taking it for my marathon and my pain returned although not as severe as before.
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