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medications question for Dr. Ed

Posted by Debbie on 5/25/05 at 18:02 (175725)

Dear Dr. Ed,
I just got back from both my family doc and a pain management doc, 2 appts today. I left on the neurontin (2700mgs) a day, Ultram (50mgs) every 6 hrs as needed, Skelaxin (800 mg) every 8 hrs, and Nabumetone (500mg) 2 times a day, also Lidoderm patches, 12 hrs on and 12 hrs off. I am afarid of all these meds. My family doc talked to me about coming off work for a bit, but the pain doc said no. How can I function on all these meds and handle money all day? I am worried. Please give your advice, I'd appreciate it. I have neuropathy (both feet), tarsul tunnel(both feet), artritis in my left ankle. I truely love my family doc but this was 1st time to see this pain doc. Didn't care a lot for his bedside manner. I have diabetes also, not sure if you remember me from other posts. Thanks in advance for any input. I am in tears over this pain.

Re: medications question for Dr. Ed

Ed Davis, DPM on 5/25/05 at 23:05 (175740)

Debbie:
Your family doc has prescribed a highly effective and synergistic combination of medications. It sounds like he must have had some advanced training in the area.

I don't know enough about your condition to comment as the only thing that I would be looking to see is for something more definitive to treat the underlying cause, IF that is possible.

That combination may be advantageous for a patient with chronic regional pain syndrome. tell us more about yout symptoms, history, diagnostics...
Ed

Re: medications question for Dr. Ed

Debbie on 5/26/05 at 16:54 (175779)

I have had diabetes for 30 years, I am 49, insulin dependant. I have neuropathy in both feet. In Jan 2000, I had surgery on my left foot to remove a painful, plantar fibroma. I have a lot of scar tissue from that surgery which is quite painful. I have a plantar fibroma on my right foot also, but not going to have it removed, since the pain after the surgery on the left foot is worse than before surgery. I have severe pain in my feet, and walk 8-9 hrs a day for my job at a large retail Super center where I am a customer service manager. I had a PSSD test done, and it showed severe nerve damage, entrapment, etc. The foot doc dx'd tarsul tunnel, and he wants to do a diagnostic nerve block to see if it helps the pain, he said if it did, the surgery would help. All of this medication, makes me very sleepy and makes it very hard to concentrate at work. I am worried about taking it all, and having to hold down a full time job, on my feet. I appreciate any info you can offer. Thanks in advance.

Re: medications question for Dr. Ed

Ed Davis, DPM on 5/26/05 at 17:40 (175783)

Debbie:
If you are a scar tissue former, the diagnostic block is a good idea ut I would consider mixing some hyaluronidase in the block. Also, based on German commission E, you should be taking at least 800 mg. of alpha lipoic acid per day. Finally, Cymbalta, a drug specific for diabetic neuropath ywill be out very soon -- check up on this via a web search...
Ed

Re: medications question for Dr. Ed

Debbie on 5/26/05 at 17:43 (175785)

Dear Dr. Ed,
I tried the cymbalta a few months back, it made me very sick and very weird in my head so had to come off it. What is German comission E?

Re: medications question for Dr. Ed

Ed Davis, DPM on 5/27/05 at 20:25 (175827)

Commission E is the agency in Germany responsible for testing the efficacy of neutraceuticals. Sort of like having two FDA's -- one for drugs and one for non-drug medicinals.
Ed