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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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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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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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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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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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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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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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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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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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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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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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