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Spinal Cord Disorders Message Board

Spinal Cord Disorders Board Index

just another lil FYI when it comes to the neurontin? i don't know if you did this before you upped it, but you ALWAYS need to have this done BY the Rxing docs orders. its just a slower taper is better, and with this type of med too, the doc really does need to be the one to decide to up it. it "usually" is NOT a huge issue to do, but just always make sure to call that doc and ask before upping any doses actually on any meds unless it states otherwise on the bottles instructions. i would "think" he would agree with what you did, but DO make certain he knows about it, esp since this med, once you have been on it for awhile and going up on doses/mgs, you do NOT want to suddenly find yourself without ANY doses left when you DO at that point, need to be taking it very regularly since the brain does get used to it. thats the reason for the tapers up and off of it i mentioned before. just ALWAYS check before.

it may or may not 'always' help with pain. it kind of depends more upon the real underlying generator OF the specific type of pain. what neurontin actually does for nerves by calming them down is why this was originally created for epilepsy patients too. it calms down the "over firing/misfiring" of the nerve synapses within the brain that causes siezure activity. thats why they i guess thought originally it might also help with pain that is also generated by some inflammatory nerve signals as well, and it does for some. tho it is considered as an 'off label use', if it works, it works ya know?

i was on it too back early on when i had my herniated c 6-7 too. i got up to around 3200 mgs at one point and still never ever really felt like it worked for MY radiculopathic pain. but different meds work differently on certain people and how the nerves are actually even involved at particular points too. but since you DID actually have a good response originally, it is more than likely probably helping somewhat? you just may need a good raise in the dosage when you see that doc tomorrow. i had like three different docs all raising up this med on me(over like three years) anytime my pain got worse. it was stupid really, but thats what they do even tho it was NOT actually doing anything for me. there ARE also other anti S type meds other than neurontin too that can potentially help as well if this does decide to stop working on you anymore. but i would try and stay with this since as i said, it actually 'connected' with your pain at all?

whether or not an actual surgery of any type will actually help with pain really DOES involve so many different factors. in the c spine case with ACDF, it can either totally take away your pain, or 'some' of it, but in your particular case, if they do all that really IS needed up there esp cleaing ANY areas where your nerves are being impacted or impinged, it should relieve the pain. and of course just getting that real compression OFF that cord before a condition called myelomalacia can set in over time and pressure on neural tissue. it can sort of 'kill off" certain areas of very direct(usually the smaller the area pressing into the cord is more impactful than a larger more spread out type of compression would be)impact within or on the cord levels if the pressure is just THAT hard or very directly INTO an area.

but back to nerves, its usually the longer you wait to unimpinge ANY nerve pretty much anywhere within the body, the pain CAN 'imprint itself' upon that particular nerve(neuropathic pain vs what you have now as radiculopathic), or losses of sensory that one had pre op may not come back either. it all depends upon how compressed or even closed off any given nerve is and how it may heal as well. as an example, my hubby had a herniated c 5-6 and a severely stenosed c 6 nerve that was making the entire forefinger numb and horrid radiculo pain? after he had his ACDF done, the horrid pain ALL went away(thank god), but he still has a never regained sensory finger TIP only left behind that has not come back in the 15 years or so he had it done? but at least that pain went, god it was awful to watch him suffer like that. but work made him wait way too long. but what you have going on in your lower c spine esp NEEDS to be relieved since your symptoms just ARE appearing to progress into more 'bodywide" than just the like upper torso level now?

once you see that surgeon tomorrow, he will be able to at least give you his overall opinion on what HE feels really needs to be done with that c spine as a whole, since you DO have another area of cord impact too as i recall? soo, now you just see what he thinks and go from there for now. but i can tell you, if my cord were that distorted to what you are now feeling from it, i would go ahead and get that pressure relieved esp that c 6-7 as soon as possible. living with spinal cord damage is NOT fun at all. what he will decide as to what needs to be done really is based more upon what IS really truely being impacted and how much. if any real tracts are being impacted, along with just the overall level of the herniation there too, and IT'S impact alone(nerve and cord), i am sure he would want to go in and do the ACDF. this IS of course only my lil opinion here.

the one really important question i would ask him tho, if this IS going to be done? ask him if he will be using whats called "intraoperative monitoring" on you during the surgery. this just IS the very best and safest way to actually do a surgery when the cord is being decompressed or just even 'involved' at all during a surgery. they just place little electrodes on very key places(arms legs mostly) on your body before the surgery that will monitor your overall possible motor and sensory responses during the surgery so the surgeon simply knows, before they 'do' anything that may actually cause further damage, the monitor screen that the trodes are connected to will tell him that whatever approach he is using, he needs to change BEFORE any real damage gets done to YOUR cord or nerves. this is usually done by a 'neurophysiatrist'(these types of docs DO KNOW about nerve and muscle and what is or is not 'normal with them too) whos ONLY job is to keep an eye on that screen and you during the surgery. this is kind of like an early warning system for the surgeon. and as i said, i can really prevent damage before it could happen. if the surgeon tests an area before they actually go to do anything,and that screen shows anything abnormal, they just try and do things from a different angle, they also DO do a baseline check of ALL of your sensory and motor responses BEFORE that surgery begins so they WILL know if anything as far as your overall nerve flows have been relieved and gotten better or something else may have changed at all. just DO ask him if the surgery is going to take place hon, it really is a good thing to have goin on while you are in the OR with what they would be doing.

good luck with the appt mahoney. hopefully this can be taken care of soon and with no damage done or left behind. but DO ask questions and make certain to write them down in a notebook and also to write down answers too, lol (i forgot sometimes). it may not hurt to try and bring someone else with you for that consult/eval too if possible. sometimes when we are just discussing really critical things with surgeons, we can tend to get hung up on certain things and not always really 'hear' everything they are telling us when we are by ourselves? i ALWAYS bring at least my hubby or my mom, or both when i had to have my cord surgery consults. let us know how things go hon. take care, marcia

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