Trying Gabapentin, and asking for your input on med usage. :)

Hi and MisterK and welcome back to the forum. Sorry your so young and dealing with such issues and in saying that your most likely right about your PM Doc and your age. I will say there are plenty here as young or younger then you that do get adequate pain treatment as their individual DX warrants.

I dont know why your Dr continues to beat around the bush if you have documented scans and such of your problems. After 2 years of being with him and he still was not treating my pain adequately or giving me a chance at a better quality of life I would be looking for another Dr and real soon. Has he tried other modes of treatment such as therapy,tens,hydrotherapy,injections,anything other then the tramadol and nerve meds? They generally work in conjunction with other things and dont do well alone.

I couldnt take the cymbalta but did fine on the lyrica and others here have said the same so maybe the neurontin will help some but if your not having any kind of nerve pain I dont know what he is expecting out of it. I have sciatica therefore the lyrica helps alot but I also do hydrotherapy and several rounds of PT every 6 months.

Please dont take offense in the next question as I am trying to look at this from a medical profs standpoint so maybe we can get an idea of what your Docs thinking.

Have you ever been flagged by another Doc or pharmacy for filling too early or too many different scripts from different Docs? Not implying you did any of those but you would be surprised how many times a tech or someone will do that when they think you have filled too many in a short time period,say a Doc, Er, and maybe a dentists,all writes you a narcotic in the course of a month and an unsuspecting eye it looks hinky so they flag you and this will folllow you from pharm to clinic to Doc to ER.

Thats just an example and again not implying anything here towards you but this happens everyday and another example is you go to a Dr and they chart they are seeing you displaying "drug seeking" behavior and that gets documented and every other Dr that gets that record sees it and assumes that DR knows what he is talking about and maybe all you did was ask about a specific med and it happened to be a narcotic,see where I am going with this?

Is it possible this could have happened to you along the way somewhere as this being in your charts anywhere can make it really really difficult for any Doc to prescribe to you as then the DEA or whatever watchdog sees it wants to question why he gave you a narcotic when you had been flagged by others.

Its a very unfair way to do things and I have never agreed with charting something like that in a patients chart especially in the ER when I have had only 1 occasion to meet and see this person,didnt feel I had the right to chart something knowing so little that would follow them forever.

Here is a example of my own self, went to the beachside hospital to have an EKG done my Dr ordered and at intake or rather triage the nurse says "what kind of substance abuse do you have" I was kind of stumped for a minute and asked her what she was talking about and she turned my intake sheet around so I could see it and right there in print it stated I had a substance abuse problem? I then made her pull my entire record from the medical record dept to see where they got this from and when so it could be corrected immediately!!! This is NOT something we need as CPers and I have never even drank must less do rec drugs well since the 70s anyway, hehe

One time when I was processed thru triage the nurse asks for a list of my meds and she sees the methadone and assumes(the 1st thing they teach in any med class not to do) I am on it for substance abuse even though right at the top it lists my Neuro as the prescribing Doc and all my spine and knee surgeries she assumes I am on for drug addiction!!!

That is how things like this happen and it is a medical record and therefore cannot be erased ever but I made them write an amendment and enter it into the chart stating what she did and why I am taking the methadone.

Long story short take a look at your records read them good maybe someone wroe some such and maybe if not you need to look for a new pain Doc soon.

Good luck to you and again welcome back

Vickie

Wow,it has been awhile since we have heard from you. Gabapentin can be very effective for some that have nerve pain, but one pill at bedtime is not going to cut it. Off the top of my head I cannot remember the max daily dose but its up there. So unless he starts you out taking it at least twice a day and slowly titrates the dose you will never know if its going to work or not. Something else, if this is nerve pain, narcotics/opioids will have little effect on the pain. It just sounds like your dr is not familiar with these nerve meds & does not know how to prescribe them. You can go to drugs.com & look this up to find the max dose a day. Like I said its a life saver for lots of folks with nerve pain.

What dose did the dr start you on? You may have some side effects but they will go away in time.

If you have to find another PM dr, be prepared to possibly start all over with injections the whole bit,some of them do that, so it may be a possibility. You have been more than patient with this dr, I know that. I know its hard to find a new dr but that may be your best bet, we have talked about this before. Pain mgt is really getting tighter, stricter, drs are really skiddish because the DEA is calling the shots. I am afraid PM is going to get a whole lot worse before it gets better. So,this may be the time to scout out a new dr.

Take care....Susie

Thanks everyone, and thank you too Straydog. I haven't been on in way too long. :)

I actually ended up being unable to pick the medication today, and since it was faxed to my pharmacy I don't know the actual dosage. I do know however that he said that in a couple of weeks if I have no adverse effects, that he wanted me to go ahead and double the dosage. So whatever he's starting me on x2. So I guess it really depends on what he's starting me on to see if it makes sense.

The reason he wanted me to take it at bed time, I think, was because of how I said the Lyrica made me sleepy all day and increased my brain fog and stuff. So yeah, I don't know. Guess I'll understand better once I get the med filled and start taking it.

Oh, and he still wants me to take the Tramadol as needed as well. So I'll be taking both.

just able to get on the computer after 15min of waiting on it to find the site! Grrr!

Gabapentin?…yes I have tried it, and up to the higher doses with no luck. However!…my Dr started me on a med called Nuycnta, (at my request after much research) and finally we have had some relief. In fact, I believe it is the most effective med I have taken to date, and my sister also takes it with the similar success.

So what is so special about Nucynta you ask? It is a duel purpose med, in that it has both narcotic and nerve damage qualities. The narcotic med in it is said to be similar to Morphine. Currently I'm at 200mg ER x1, and 100mg IR x2 …for a total of 400mg a day. I believe you can take up to 700mg a day of this med.

It may be that you suffer from both acute and nerve pain, so it may be a med that could be tried if the gabapentin fails to give you relief. If you do try it, and your PM/Dr starts you out on the lower dose of 50mg, make sure you give it at least two weeks to get into your system, and work your way up from there.

When I first started it, I did not think it was working, but after a couple three weeks, I noticed a huge change, and had little lumbar pain if any at all. Lately though, I have began to experience lumbar pain again, and we are currently adjusting the dosage. I absolutely love this med as it is very smooth in how it works, and the side effects are minimal in my own case.

I hope you have good luck with the Gabapentin, and again if not, then ask your PM/Dr about this med.

Take care,

SE

The max for Gabapentin is up to 3600mg....Most people have success between 1400mg and 2600mg...

And yes, most of the nerve pain meds can cause fatigue, headache, and dizziness but for many people it will subside within a few weeks to a month so as mentioned...just be very careful. As well as the key is staying very well hydrated. I drink 12-14 glasses of water a day because of all the medications I take. And then watching your salt and simple carb intake as these types of meds can cause more "cravings" which can lead to weight gain.

But my Dr. has always said that when this is known up front, then there are easy ways to keep this from happening with eating healthy, drinking water, and exercising each day.

If someone isn't actually "allergic" to this med, it's really worth getting through those first weeks as it's a very good nerve pain medication.

Another medication that people have been having success with is Nucynta so if for some reason the Gaba doesn't work out.

Good luck!

you are most welcome!

Someone with more knowledge can correct me if I'm wrong, but Nucynta is a fairly newer med and I'm pretty sure there is no generic.. But I don't personally have any experience with this med so I'm not completely sure..

Anyways, I tried the gabapentin at one time for a couple months and it made me into a walking emotionly unstable zombie mess! Lol, but everyone's different.

Good luck!

The problem with the nucynta for you is it contains an opioid as well as med for nerve pain so your DR seems reluctant to give you opioid for whatever reasons and will likely shy away from that too. If the neurontin turns out to not work for you and he still refuses anything but tramadol I would seriously be on the lookout for another pm. You have gone the mile and did other things,injections,alternative meds and still no relief and no help.

As of this moment there is no generic for nucynta,still too new and I'm not sure as to the cost.

Keep us informed and as SB give it a fair chance as it takes a good month to get any accuracy in dosing.

Vickie

There is no generic at this time for Nucynta, it is fairly new, and the Nucynta ER is newer. I went to fill a script at Riteaid a few months back, and before work comp went through on it, they were going to charge me a little over $800. This was for 180 count. They ran it through with their discount card and it would have been about $470, thankfully the insurance came through on that one. It's a good medication, but it's a C II. It's said to be approximately the equivalent of 10 mg of oxycodone or somewhere around there. I liked it a lot better than oxycodone though, it was far superior in relief in my opinion.

My husband is on this (Gabapentin) and from what I have seen with him & others here at the forum it takes a bit on this medication to sort of build up in your system to know if its working, its not an immediate thing. Some have thought it was not working only to go off of it to find out it was working after all. Thats why you really need to give it a few months.

Susie

Hey Patrick,

Just wanted to jump in and say hello.... and that I hope you can find the right meds....

I'm on gababentin (1800mg) daily... on top of narcotics and so forth. It does help relieve the tingling nerve pain in my hands... but that's about it.

No side effects for me....

I'm w/ Susie - you need to give it a few months to see about it (unless you have really bad side effects or something).

Re: your question about oxycodone 10mg... it's all perspective - obviously 10mg to a opiod-naive person is going to be "alot".... but in the bigger scheme of pain management, 10mg is a low dose.

Hang in there.... and keep posting and letting others support you during this time.

--Tina

Mister....you don't mention the Robaxin...Are you still taking this? I would think that after all this time that you all would try and find another muscle relaxer to take as needed. This is also a great supplement to the Gaba and the Tramadol.

There are many other choices....so this is something I would ask your Dr. about and see what they think...

Good luck with the Gaba!!!