I need advice and help....I just got a phone call today from a nurse from a dr's office that is affiliated with the neurologist office that I see. I was just diagnosed with tn a few months ago although my pcm has suspected I have had for awhile. I only have seen my neurologist once since I live almost 4 hrs away but have called his office a few time needed help for pain they are not good about calling me back and I have had alot of problems with them. Anyway I had an mri with contrast a few weeks back and my neurologist was due to get the results last week the nurse from this dr's office that called today said that my neurologist had referred my case to this dr last week and that after this dr had looked at my case he had decided to refer me to another dr in the partenership and that they would be calling me if they took on my case. I looked up this dr that they are referring me to and he is a neurosurgeon. My question is why would they be sending me to a neurosurgeon so soon did they see something on my mri and nobody told me? Is it because I called and told him that that I was having breakthrough pain with the neurotin? I am so confused and I don't want to call my neurologist's office because they are also so mean to me and I am just so fragile everything makes me cry
Several things can be going on in this medical practice, Emily -- and it may be unhelpful for anybody to jump to conclusions on what those things are. It is entirely possible that the neurosurgeon to whom you were referred is more expert in trigeminal facial pain than the neurologists also on staff in the practice. Alternately, the MRI results may reveal a vascular compression, which the neurosurgeon is better equipped than his practice partners, to interpret. In any event, you can and should call the practice and REQUIRE them to provide you with a copy of the radiologist's report and comments. If you have trouble reading and understanding the report, we can correspond by email and I'll help you translate.
If you're having breakthrough pain with Neurontin, then you need to be evaluated for an increase in dose levels, or possibly for transition to a different medication such as Trileptal, or addition of a booster med such as Baclofen or Phenoytin. Given your emotional fragility, you might also do better and have better focus under a low-dose prescription of one of the tricyclic antidepressant meds (Amitriptyline, Nortriptyline, 8-10 others).
Go in Peace and Power
R.A. "Red" Lawhern, Ph.D.
Resident Research Analyst, LwTN
Red thank you for the response that helps and makes more sense I am freaking out a little because it just seems like it is a little soon to already be talking surgery...I am on 1800 mg of neurotin 1-2 5/325 of percocet up to 80 mg of baclofen a day and I am getting ready to start cymbalta 20 mg twice a day I also take ambien cr 12.5 mg every night and 100 mg of topamax for migraines
Neither Cymbalta or Ambien have much of a record of effectiveness in neuropathic pain, HC. Please talk to your neurologist about being tried on one of the tricyclic antidepressants. There are about 12 meds in that category and none of them are exactly the same in their effects. So you may need to try more than one before you see the effects you want.
Regards,Red
Ok I will thanks and I am going to get a copy of my mri tomorrow I will let you know what the report says
Hi,
Red has already done a great job of answering your questions but I just wanted to add my support and send you a cyber hug.
I’m always intimidated ringing a specialist but one of the things that helps me is to write out what I want/need on a piece of paper so that when I call I don’t get flustered.
Best wishes
Trish