Lidocaine patch management on long plane flight

[BaltimoreOriole]

This question concerns post-herpetic neuralgia.

Lidocaine (Lidoderm) patches are to be worn for 12 hours on, 12 hours off.  This will pose a problem for me when I take a 9 hour flight to a time zone 6 hours ahead of my own.  Normally, I wear 3 patches from about 9 AM to 9 PM.  My flight leaves the East Coast of the U.S. at 5 PM and arrives in central Europe at 7:45 AM local time, which is 1:45 AM U.S. Eastern Daylight Time.

My goals: (1) Be as comfortable as possible during the flight.  (2) Be able to go immediately on a schedule in Europe in which I wear the patches during the daytime.  These 2 goals would appear to be not easily compatible.  

If I were to follow my US schedule, I would wear the patches during the first 4 hours of the flight, then remove them, and not re-apply them until 3 PM in Europe.  Then I would wear them for 6 hours, removing them at 9 PM.  The second day in Europe, I would be back on a 9 AM to 9 PM schedule.  This may in fact be the best solution.

Were I to wear the patches for the entire 9-hour flight, I would need to make a schedule adjustment on the day prior to the flight, which is something I could consider doing.  But I would then, upon arriving in Europe at 7:45 AM, be nearly 12 hours away from my normal schedule.  In other words, I would have to be keep the patches off all day on the first day.  Then I would have to keep them off all night, too.  On my second day, I could get back on my regular schedule.

I should state that, without the patches, I need either to wear no shirt or to hold my shirt away from my chest on the left side.  I sleep without the patches; lying on my back and not wearing a pajama top, the pain is muted enough (thanks to Neurontin: 600 mg morning dose, 600 mg afternoon dose, 900 mg night-time dose) that I am able to sleep.  Without patches, I doubt I can sleep well during the flight.  Ergo: I probably will need to wear the patches in flight for at least a substantial part of the trip.

Have any of you confronted this problem?  I would be very interested to know how you dealt with it.

I'm also interested in any advice concerning the management of the Neurontin during the flight.

Thanks in advance.

BaltimoreOriole

[kasbb86]

Hi Baltimore,
Do you use Lidocaine patches for Post Herpetic Neuralgia pain?  If so, do they help?
I was recently diagnosed with PHN and am looking for some kind of pain relief.  I'm on 300 mg of Gabapentin.  Does Gabapentin work for you?  If so, how long did it take before you felt any relief?
Any other advice on PNH pain relief?
Thanks,
kasbb86

[BaltimoreOriole]

Thanks very much for your concern and guidance, Tuck, and for your good wishes.

To answer your question, I will be away for 10 days.  I appreciate your concern for not upsetting the balance I've achieved (which, by the way, is a very recent balance as I've been using the Lidoderm patches for only a few weeks).  However, were I to stick to my US schedule,  I'd have to wear my patches from 3 PM to 3 AM local time.  This would be very inconvenient to say the least.  At 3 in the afternoon, I expect I'll be out and about, and 3 AM speaks for itself.  

So I guess I'll wear the patches on the day of the flight from 3 PM to 8 PM EDT (the flight leaves at 5 PM), then put on the next set of patches at 2 PM local time on my first day, after awakening from what will be a much-needed 4-hour nap I'll be taking upon arriving.  That will have given me the required 12-hour off-time.  

I'll remove the patches at 9 PM.  The morning of my second day, I'll get on a 9 AM to 9 PM schedule.  

At the end of the trip, I'll do something similar, which means making sure not to violate the 12-hours-off rule while sacrificing some hours from the 12-hours-on rule so as to make the adjustment back to the US schedule.

Thanks again!

All the best,

Balt O

[Tuckamore]

Hello and welcome to the Pain Mangement Forum. I am glad that you have found us at MedHelp.

You did not say how long you wil be in Europe. If this is a brief vacation (two weeks or less) I would not disrupt your US schedule. If however you will be in out of the USA for over for an extended periods of time than the second option seems more practical. My concern is how your body will adjust to the changes you impose on it. It seems to me switching back and forth and back and forth in a short time frame may interfere with the good balance you have found.

Good luck to you and have a great vacation. I am hopeful that you will be comfortable and return with many wonderful memories and photos.

Best of luck to you. Happy Traveling,
Tuck