Surgery for stenosis, pain persists for now, to lyrica or not

[JRS11]

My surgery went well, it was just a bit over two weeks ago. At my post op appt today I talked to the doctor about the nerve pain, I understand the nerve is irritated and not very happy, which of course makes me pretty miserable as well. I am out of work another 2 months at least and if it goes more I have to consider LTD which is not what I want, I have 2 years until I retire and would like to work for that time. I have really put lyrica on the back burner as something that is not a cure but a cover, but now that sugery is completed and I will have pain for an undetermined time maybe Lyrica would be a good way to control it and get on with my life instead of waiting. I cannot walk much distance, I cannot stand up for long so it is not fun. Today I drove to the doctor, quite a ways and tonight I am paying. As I posted in my post op update, I would like to be able to do some things, walk for one, maybe lyrica for a few months and the nerve will calm down enough to wean off of it and be ok. Any thoughts on this? If this post is in the wrong place please feel free to move it. Thanks much.
Joel

[Justin]

Hi Joel,

Sorry to hear about the ongoing pain. Driving at 2 weeks post-op is pretty risky in my opinion, especially if you are on narcotics. Anyway, Lyrica does help with nerve pain. Did you discuss possibly going on Lyrica with your surgeon at your follow-up appt yesterday? Many Spine Patients use Lyrica with great success. Also, there are some side effects associated with Lyrica (constipation and weight gain are the most common [studies have demonstrated that weight gain with Lyrica is ~1 pound]; just an FYI, as you will hear stories of significant weight gain).

Good luck and keep us posted.

[JRS11]

Thanks Justin, no narcotics since 3 days after surgery. The drive was inevitable as I had to get to the doc and he said 2 weeks no driving, so it is a bit over that. I had nobody to take me and I did pay the piper last night with leg pain, but that was the worst of it.

I did discuss Lyrica with him, he suggested it as a good way to manage the pain until the nerve calms down. He did tell me it could take as long as 9 months, and also much less time, and then we have to wait to see if there is any permanent damage. I called the pain management folks that gave me the samples of Lyrica and am waiting for them to call back before I start, planning on tonight. While I am not thrilled with the prospect of weight gain the pain now dictates I do something. I am a pharma rep and the label scares even me but, and the but is, the pain is not fun after over a year of this intensity. So I will try lyrica unless they feel Neutroton (sp) is a better alternative.

Thanks again, always reassuring to get feedback.

[Justin]

Neurontin will have more "head fog" (memory problems--people often feel "spacey" and can have difficulty with word choice, etc.) than compared to Lyrica. Good luck.

[JRS11]

Justin, that was Dr.Yue's feeling as well. I just got off with pain center, going in in 3 weeks, starting Lyrica tonight. Thanks again

[Cindylou]

Joel, I think this is a good move for you right at the moment. I believe you will be quite pleased with the relief Lyrica affords you. Might have to play with the dosing, to get the most therapeutic amount in your system, under your doctor's instruction, of course. Good luck with this. Cindylou

[Catherine]

Sorry to jump in here, but I have a question. First, Joel i hope things improve for you. My surgery is still in front of me. As I've started on gabapentin a month ago and I'm just beginning the increase in dosage I'm very curious about the "head fog"? Does it go away when you get off of the drug? Is Lyrica a better choice, less side effects? Thanks.

Catherine

[Justin]

Sorry to jump in here, but I have a question. First, Joel i hope things improve for you. My surgery is still in front of me. As I've started on gabapentin a month ago and I'm just beginning the increase in dosage I'm very curious about the "head fog"? Does it go away when you get off of the drug? Is Lyrica a better choice, less side effects? Thanks.

Catherine

Hi Catherine. Once the drug is discontinued and out of one's system the "head fog" goes away. Some patient's find that Neurontin works for them, while others find that Lyrica works. Neurontin is dosed three times a day and Lyrica is usually dosed twice a day (it can be dosed three times a day too). Many of the patients I've spoken with like Lyrica better, as they report fewer side effects and better pain relief.

Neuropathic pain is very tricky. This means that some people respond really well to Neurontin, while others respond to Lyrica better. Thus, one drug is not really superior to the other in my opinion--the best drug is the one that works for you.

[JRS11]

Joel, I think this is a good move for you right at the moment. I believe you will be quite pleased with the relief Lyrica affords you. Might have to play with the dosing, to get the most therapeutic amount in your system, under your doctor's instruction, of course. Good luck with this. Cindylou

Thank you Cincylou. I continue to wait for the effects to be really noticeable. In the morning on my walk I can walk a couple of blocks with minimal pain and then it starts to build up and the rest of the day follows when I stand or walk, but I am only now at 1 50mg in the morning and one in the evening. In another day or so I start 2 at night, and 2 days later 2 at night and increase the morning dose to 2 and I believe by that point I should have a more pronounced positive effect.

[JRS11]

Sorry to jump in here, but I have a question. First, Joel i hope things improve for you. My surgery is still in front of me. As I've started on gabapentin a month ago and I'm just beginning the increase in dosage I'm very curious about the "head fog"? Does it go away when you get off of the drug? Is Lyrica a better choice, less side effects? Thanks.

Catherine

Catherine, others will answer you better. I was told that Lyrica was better about having less head fog than neurotin, but so far I have not had any side effects (and I am concerned like all) except for sleeping much better at night. My surgeon and the pain center I use both feel lyrica is more specific, and all of the research I have done says that both lyrica and neurotin have similar side effects. Time will tell for both of us. Good luck and than you for your well wishes.