I have neuropathic pain conditions. From stress and a bad

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Posted on Sun, 18 Nov 2018 in Pain Management
Question: I have neuropathic pain conditions. From stress and a bad case of Lyme s disease. What type of pain medication do you recommend. I have UTI like pain conditions. No infection.
doctor
Answered by Dr. Matt Wachsman 1 hour later
Brief Answer:
rather a good question.

Detailed Answer:
the location and movement of a pain gives clues as to what is going on. And different processes producing pain would be a reason to go with a different medicine. There is an irony here, both UTI and neuropathic pain are treated with novocaine like drugs. OVER THE COUNTER AZO, is a XXXXXXX derivative with novocaine like effects that just goes right through you into the bladder. It doesn't have many other interactions other than making the urine orange and treating UTI feelings.
THere are a lot of drugs that work on neuropathic pain but it depends upon the specific condition. Zoster is very close to the surface and is ONE nerve, therefore a lidocaine patch or lidocaine creme works the best. Diabetic pain is the hardest to treat and is deep in the feet. Gabapentin, pregabalin, amitryptiline, and several others are generally tried. While each has a dissapointing 30% success rate if you go with 3 or more tries, the majority will have ONE drug that does SOMETHING. Those are the extremes. Post zoster pain and post trauma pain are 90+% successfully treated. Diabetic pain is 30% successful but about 50/50 for any nerve pill to work on it (gabapentin and pregabalin are anti-epileptic pills that work on neuropathic pain). All the other causes of neuropathic pain 1) are intermediate in how likely they are to work and 2) have specific treatments for the underlying condition.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Matt Wachsman 8 hours later
The Uristat pyridium does not ameliorate the UTI symptoms (pressure, urgency feeling). It obscures at home testing for urinary tract infection and I use a a ten parameters test strip to screen for other health problems. So I don't use that. I take a lot of gabapentin which helps. I have topical lidocaine which I combine with other things and apply like yeast infection preparations. I had a bump on my head and now a contusion on my belly, and pieces of toilet paper when I check for cervical mucus, appreciate the general region. I live alone and I might have been attacked because I keep to myself and complain about the noisy private club which upsets a nature sanctuary and Bald Eagles. It was relatively quiet until I renovated my cottage to a family sized home which is across the street. I'm separated from my husband, who helps with the dogs. The police know what happened and if Rufalin was involved, then maybe it is part of a larger investigation.

So, Lyme disease neuropathic pain and something that looks like an rufalin attack. So plural effusion healing with shortness of breath and a panic attack. I was seen in an ER, but I they didn't help with the pain, and I developed Tachycardia and was monitored. My pulse oxygenation saturation level was 97percent, and I thought I needed a beta blocker and a few lorazepam, but no. And maybe Tylenol three. It had a forensic component to it. I do phone sessions with my regular psychiatrist, and I keep away from doctors and hospitals - My insurance company is okay with my approach.

Anyway, a heating pad helps, and a Tens device. But it causes rashes - and flat warts. Yuck. I must have vital infections in my system. Lyme disease is caused by an unusual microbe.
doctor
Answered by Dr. Matt Wachsman 32 minutes later
Brief Answer:
ok, thank you for the explanation.

Detailed Answer:
Lyme disease is caused by a bacteria in the spirochete family. It attacks particular locations. Problems in particular spots (one spot on the bladder or urinary system) would produce these symptoms. There might not be a way to tell BUT, a bladder biopsy for interstitial cystitis would be one step to look for possible problems and there are partricular treatments for interstitial cystitis.

A tens unit would cause neither rashes nor warts by the electricity. The adhesive in the pad often causes rashes and this is fixable by using a different adhesive (paper tape being one of the mildest).

I noticed that lidocaine, gabapentin (and tens) are already being used. These are some of the best. There is amitryptiline. Cymbalta overlaps in mechanism of action with elavil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Matt Wachsman 9 hours later
My guess is amitriptyline has the side effect of urinary hesitancy, like nortriptyline. I don't like this side effect because I'm trying to fill and void my bladder normally. I like to completely empty my bladder. I worry I was injured in my yard, I told the police everything I remember, so I'm covered. A police car arrived when I called 911 during that panicattack-, before a police ambulance, and my history was taken by an EMT who suffers from ne naturopathic pain alao.
He said non narcotic drugs are better and just need to 'ride it out.'. Which I have - I used a hearing pad on my chest and back and Vicks vap o rub - which eased any subsequent panic attack symptoms, now I'm fine. I use Wellbutrin for depression and anxiety, which works well and doesn't need a blood level.

A bladder biopsy is an okay idea, but like a young single mother, I can't leave my dogs unattended. I also have risk for a Cryptic pregnancy, which although very durable - navy seals and special ops personnel are born from these pregnancies. But it gets attacked in medical settings. Acities, false pregnancy, cancer, and just a lack of knowledge. Anyway I was raised in mainstream XXXXXXX and my best feature is my abdomen. I like swimming at the beach, not a swimming hole or quarry at night. I enjoying night swimming, and I'm very brave and durable. My mom is more externalizing and then calm. She says we are scottish. I think we are Chinook biologically and from Northern Finland, where they ironically speak English... So you see we both win. Anyway, I feel better when I use lots of Gabapentin. So it's probably neurological as opposed to an infection that needs to be better underatood. Anyway, I have hair the color of XXXXXXX Zeverev, the APT tennis player, and have met both Pekka Rinne and Henrick Lundqvist, the NHL hockey goalies. We all have the same hair color and similar genetics. They wanted to know what I was doing here... I think there was a famous kidnapped baby from Finland at the turn of the century. He ended up in an orphanage near the XXXXXXX piers and learned English, and worked his way up to train conductor, then farmer, found a bride from a prominent family in XXXXXXX and well, they are still investigating it. I think it happened outside of a wave of immigration. With the name XXXXXXX So he might have gotten free from his captors during the voyage, and found safety. A cute story, but the genetics express themselves more robustly three generations later, to help explain and my pulse oxygen saturation level is higher than someone who can control detonate nuclear weapons. We met in college, and he is a displaced person too, Native XXXXXXX royalty from Syria, and Chinook. With a dispensation to work in the regular United States. Anyway he needs to shelter with me here, which is a XXXXXXX Revere house and near native XXXXXXX tribes that used their chiefs son to do the bravest work. For our safety and survival. Let's just say there is some resentment. Cryptic pregnancy should be safe to have in this country, but it isnt. Nuclear weapons disposal intelligence workers need an eight year pregnancy, minimum. With the mother over the age of 40- 45. How do you get past resentful people when you get heavy and keep to yourself and don't go to the doctor. In mainstream XXXXXXX life and the way medicine is practiced how is this possible. Where i live is actually southeast Asia in nautical charts and you used to need a passport to visit here. Part of Vietnam war was fought here. It wasn't nuclear, because of people like the ones who live here. My point is that I'm quasi repatriated, but still believe in this country, and some access to healthcare... I don't have the scars yet, but I was not treated in an ER for a panic attack, and cystitis pain, and tachycardia. They heard about the Cryptic pregnancy risk and released me, seven hours later, still in pain. My dogs were left unattended, and seen diatressed.. So maybe you can help, which you have.



doctor
Answered by Dr. Matt Wachsman 7 hours later
Brief Answer:
glad to have helped.

Detailed Answer:
There are very good agencies that can temporarily house pets. Thank you for your interesting question.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Matt Wachsman

Addiction Medicine Specialist

Practicing since :1985

Answered : 3661 Questions

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