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My mom's prescription coverage has recently changed. The NH was able to get approval for the first med challenged, but when a letter arrived saying that they would no longer cover the lidocaine patches used for her spinal compression fractures, the NH proposed to switch her to neurontin. I have a call into the APRN to discuss this, but i wondered if anyone has any experience with this med for back pain.

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She could also take neon tin at night time. It will help her sleep as well. The new news is that many nh Are now using neurotin as a sedative for patients who don't sleep well anyway. An investigation is being done
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I have also use the Neurontin and Lidocaine patches for post shingles neuropathic pain. My only comment is that it could be worse without either. I do actually like the local anesthetic ointment as I have a severe painful itching at times and that seems to soothe it. Neurontin has a very drowsy side effect which may not be helpful.

I also have spinal stenosis and a crushed vertebrae so if the pain gets too bad i will be in line for some narcotics.

It is important to get a steady dose prescribed as low as possible so that the pain never gets out of control. Hospice and palliative care are very good at titrating doses of narcotics till they get the right blend.
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I've used both. Personally I did not get much benefit from the neurotin and the potential side effects from it are very scary. As someone else mentioned it was originally developed for seizures. I've used lidocaine patches and creams - preferred the patches as it's less of a mess - getting the cream on cloths and bedding can cause a grease-like stain. In the long run neither were helpful and I've returned to opiate pain relief - but that is so problematic for the elderly as well. My mother also went the neurotin route and didn't get much relief from it either.
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My mother has neuropathy and has taken both. Drug plan also will not cover the patch. We have tried the cream with lidocaine with some success. She has been on the gabapentin for years, so we think that it has cut down the pain somewhat, and she could not go without it. My father tried it but said it made him so sleepy that he could not take it. It acts upon your nervous system, so many pain specialists prescribe it. The price we were given for the lidocaine patches was over $200, so the cream will have to do instead.
If she does take the gabapentin, start at a low dose and make sure that it does not cause her to be unsteady on her feet ( like it did for my dad)
My mother was also prescribed Tramadol for pain - so I wonder why they didn't mention a pain medicine?
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Be very careful with neurotin. It affects the central nervous system. How many Milligrams does your mom tAke. To take someone off is Avery slow process and if you were to search neuontin and dementia you would go with the oTch if it helps your mom. I weened my mom off her gabaprntin due to her dementia very slowly. The last 300mg cant be weened OFF.
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I had a long talk with the APRN the other day; what mom has IS nerve pain from nerves being compressed by what is going on in her spine.

The NH staff have been more than willing to write letters of medical necessity for other meds; the fact that they want to change this one appears to be driven by a sincere belief that the Neurontin will help more than the lidocaine can. thanks to you all for your helpful opinions.

Mom's new problem? she says she "can't hear". Of course, this is while she's having a conversation with you. What I've learned is that with stroke/VaD patients, the real message is somewhere buried in the text. "I can't hear" might mean, "my ears are bothering me". when my FIL, years ago said "I can't eat", the speech therapists eventually figured out that he'd lost his ability to swallow.

Anyway, they are doing ear wax drops for mom; stay tuned!
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Neuron ton is for seizures and nerve pain. If her pain in the back is not from pressing on a nerve it will not help her at all she will need the patches. My moms insurance company did the same and all it took was the doctor to write a letter of medical necessity explaining such so the patches would be covered. Yes the generic type doesn't stick well but you will have to secure it with gentle tape.
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Ack! should have finished reading first , my mom doesn't have the health problems like your mom does
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my mom uses them for her back- she loves them except she cant get them on really well and the mylan brand (generic) is really thin and don't seem to stick will. Her insurance is raising heck as well
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eeeek! don't stop the pain killer!! Contractures are sharp! And compression fractures are painful as well. Put the two together and I understand why they picked the gabapentin. The pain now goes beyond the area covered by a patch. Please focus on comfort care. Consider roxanol for both the pain and the breathing, if they offer it.
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I was wondering about the neurontin being effective vs the patch.
Pam is much more experienced and wiser than I am, and in light of her comments I would consider holding off on starting the new drug and see what happens, perhaps her other pain meds are doing the job and the patches were more harmful than helpful?
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No, the lidocaine came much later☺. The pm was back in Aug 2014. Early in 2015, she fell and a really dangerous recurrance of her pleural effusion happenened. They drew off fluid but she went into septic shock because there was a patch of unresolved pneumonia. ( I'm hoping this is making some kind of sense, medically). She was in terrible pain after 10 days in the hospital; they finally figured out that she had some compresion fractures in her spine. Thus the patches. She also had contractures of her leg muscles, but we got her back on PT and they walk her every day. No bed sores. The beginnings of one that occured about a year ago, the woyld care doc jumped on and cleared it up.

She is not in pain. But she also can't communicate when she's in pain, due both to the aphasia and the dementia. You ask if she's in pain and she says "no". But if we see her face scrunched up, we know she is. So she's on scheduled, not prn, pain relief.
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Please don't tell me she was on lidocaine when they added the pacemaker. That would tell me they were too stupid to stop the lidocaine and let the heart rate return to normal. Honestly.
Are there other pain issues? Bedsores? Muscles contracting?
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Pam, she has chf and recurring ( not lately) pleral effusions. Pacemaker for low hear rate 18 mos ago. Stroke july 2013 with aphasia and vascular dementia. She's in a nh in Connecticut.

My sister in law gets the mail and I run interference with the nh. Called today and talked to the unit manager who is an RN but was clearly very busy today. I'm going to call the APRN tomorrow and find out what their thinking is.

We're just worried because mom gets every side effect known to mankind and a few that aren't listed! Thanks to you all!
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Lidocaine can significantly lower heart rate. Was that a concern?
Neurontin (gabapentin) is both a pain reliever and anti-seizure med. Are there neurological issues?
Finally, is your state being restrictive about lidocaine? Patches are sometimes sold on the street, diverted from patient's supplies.
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Cw, you mean you would question the effica y of the patch, or of the neurontin?
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Baba, I have no experience either, but it seems that the lidocaine patches are commonly prescribed for neuropathic pain. I can see why they would consider the neurotonin as something similar as it also treats neuropathy, but your mom needs the patch for an off label use, and in her case I would question it's efficacy.
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None, other than understanding that Neurontin has been used for diabetic neuropathy. Sorry.

I would think though neuropathy is a different type of pain than back pain.

I do hope it works out well for your mother though.
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