Simple little Loretab. Why did my GP get roghon thigds NAND not neurologist?
Phoebe, there seems to be a garble in your question. Would you mind re-phrasing or expanding please?
Regards, Red
Hello, Phoebe.
Apologies, I do not understand. Was is your General Practitioner, or your Neurologist who prescribed the Lortab?
There is a school of thought that says that medicines, such as Lortab, do not help with pain which of a neurologic origin. However, many patients who deal with chronic daily, intractable neurologic pain differ in opinion.
I'm glad that you found a treatment which is helping to control your pain! I have spoken with many TN and ATN patients who find this medication helpful as a part of their treatment.
Since Lortab is a combination of Hydrocodone and Acetaminophin, doctors and patients must be careful to stay within the limits of Acetaminphen which can be processed by one's liver to prevent toxicity.
I am in no way saying that your dose is high enough for this to be of concern. Since it is a starting dose, this is unlikely a concern for you. Also, the fact that Acetaminophen is hard on one's liver may be something of which you may already be aware of.
It is simply something I throw out there whenever Hydrocodone, Lortab, or Vicoden are being used for pain control. All of these formulations contain Acetaminophen.
When you get the chance, can you please clarify your question? Are you asking why your General Practitioner prescribed you this medication and not your Neurologist, or is it the other way around?
I am not sure if any of us will be able to tell you exactly why. All doctors are different in what they believe to be appropriate therapy for this condition. I did want to reply to your post, and to congratulate you on finding some relief!
Best wishes!
The neurologist in the hospital that diagnosed me prescribed vicodin (aka loratab) as well as the tegretol. My GP then changed to the gabapentin and vicodin. Like stated above, there is some school of thought that narcotics are not effective for this type of pain. I am here to say for me it is.
As for the acetemenephin aspect. My doctor said the lower amounts 500 of vicodin contain MORE acetemenophen, then the higher doses. He thought so that it would compensate for better pain coverage. I can have more tablets at the higher dosage, than the lower.
My GP told me that this is a lower level narcotic that they will use to help control the pain while trying to get you leveled off. These are addicting.
Personally, if it were not for these, then I would be in an insane asylum by now.
For me, I have to take one right when I feel a flare coming..... or I will be in pain for some time. Not sure why that is, but that's the way it works for me.
Good luck.
Yah know, when I went back and re-read what I wrote I was afraid someone would think I was stoned beyond belief. Actually, for a while there I was tired beyond belief. I was working on a medical history for my mother's friend the neurologist. The 8 millionth revision of course.
Anyway, my GP prescribed it. She said she didn't understand exactly why my neurologist hadn't prescribed ANY pain medication. She was concerned about prescribing something I could become addicted to but she didn't want me to suffer either.
It seems she made the correct choice, at least for now. It didn't totally take away the pretty much on schedule pain. But it sure put a damper on it. It is so strange how I am amble to start to "predict" the timing of these things. I am not always doing the same thing. And sometimes the timing is off, but not always. Just enough time in between attacks to make me thing I'm not going to have them.
Hey, have a question. You know the ole "If it was you or your family" question? How many of you have tried that one? I did and I believe them. But maybe I shouldn't?
Oooh, I'm garbling quite a bit. tee hee.
I don't care if the pain is low or gone! Ya know, if all the anecdotal results out there were put in one big "real" study there sure would be some changes I tell you. My GP said the Loretabas would kick in pretty quick and she was right. If it means my liver goes so be it, just keep the pain away. Now I realize that is a pretty stupid thing to say but at the moment I don't care. I'm sure if my liver goes I will feel differently about things but not having pain at the moment is a peaceful feeling. I can appreciate the cicada, the train whistle in the distance, the wind in the trees, the little dog of min rooting around in the yard, ahhh...the peace of it all. :) :)
A couple of thoughts for Phoebe and Lisa.
(a) While opioid medications don't work for all facial pain patients, they certainly do for some. And the use of these meds is well within prevailing medical practice for the treatment of neuropathic pain of all kinds. That practice standard has prevailed for over 20 years. Getting doctors to adher to it and prescribe has been another matter because of those who abuse opioid pain relief, and the DEA folks who are engaged in an all out war of persecution against doctors who over-prescribe them.
(b) There is evidence in medical literature that with chronic neuropathy patients (of whom, TN and ATN patients may qualify as a sub-p0pulation), the opioids are HABITUATING, rather than addictive. The distinction is meaningful. Pain patients tend to use medications to control or reduce pain, and to become dependent on the meds to accomplish that result. They do NOT commonly engage in the cycle of accelerated drug-seeking which is observed in addicts.
(c) Narcotic meds can, however, become less effective as the body acclimates to them. Thus maximum dose levels must be carefully managed, and the patient may need to periodically be withdrawn from a med or switched to another med in order to maintain this management. Taken in high doses for chronic pain, narcotics can create a body reaction called "rebound" pain, that is as bad or worse then the base condition being treated.
(d) I believe the practice has become general, that when acetaminophen is one element of a mediation like Vicodin, the specific pill dose of acetaminophen is marked on the prescription label separately from the opioid content. If it isn't for some reason, you can still look it up at sites like drugs.com or rxlist.com. Maximum recommended dose of acetaminophen is also listed at such sites. People who are hyper-sensitive won't be able to take as much of it. Thus you may wish to discuss with the prescribing doctor, the use of a liver panel blood test every 30 to 60 days, to monitor for effects of excess acetaminophen.
In all of these issues, FIRST CONSULT YOUR PHYSICIAN, before you accept my assertions of principle. I am not a licensed medical doctor.
Regards and best,
Red
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Thank you Red. I shall bring all these issues up at my visit at Mayo. BTW, Red and anyone else who would like to chime in: I located the Email address of the Dr. I will be seeing. I find it fascinating that he is a psych doc and brain doc. I want to write him a letter before the appointment pointing out that we tend to buy cars with more investigation than trusting our bodies to drs. and I have some things I'd like to go over BEFORE seeing him for the first time. Has anyone done this and would it be a big no-no?
Thanks,
Phoebe
I think it is a YES-YES-YES
I don't think he'll go over anything with you before the appointment. (They really are busy) But it's a good idea to let him know that an informed patient is on the horizon. I suggest a concise, firm yet friendly letter. Please keep us up to date on this
Bill's advice is appropriate. Stick with your medical history and present pain patterns. Best to leave out any concern for his credentials in Psych. Likewise advise you to go lightly on any concerns not directly related to treatment per se. You don't want to be labeled a "difficult" patient before you're seen.
Regards, Red