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pain from nerve regeneration (what is a peripheral nerve specialist??)

      Re:  Re:Re: pain from nerve regeneration (what is a peripheral nerve specialist??)

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Posted by CCf Neurology MD on February 03, 1998 at 12:42:34:

In Reply to:  Re:Re: pain from nerve regeneration (what is a peripheral nerve specialist??) posted by Shawn Bland on February 02, 1998 at 23:42:25:

: : : my mother has CIDP (Chronic Inflammatory Deyelinating Polyneuropathy), her
  : : nerves are regenerating which is causing her to be in excruciating pain, her
  : : neurolgist tried several medications, including Tegretol, Amitriptyline, Tylenol
  : : #3, and Emla cream, she is currently seeing a pain specialist, he initially started
  : : with Neurontin and then tried Duragesic patches, the patches were the first thing
  : : that really provided any relief and she had her first pain-free 24 hours in MONTHS,
  : : however, she soon developed severe itching and nausea, her doctor recommended
  : : reducing the dose, the symptoms decreased in intensity, but the pain also came
  : : back, my question is WHAT that has not been tried MAY work for my mother, we would
  : : prefer to find a medication that works, is there something similar to the Duragesic
  : : patch?, would some sort of local anesthetic work?, other than the Emla cream which
  : : has already been tried, we would appreciate any advice on what other options/medications
  : : exist, her pain specialist is recommending a nerve block but the neurologist
  : : does not think it will work for this type of pain, the only thing the neurologist is
  : : recommending is giving acupuncture a try, we would be so appreciative if you
  : : could answer the above questions and give us some advice on what else to try, the
  : : pain is so intense and it is hard to get doctors to understand just how bad
  : : the situation is
  : =Dear Mrs. S. Bland, The treatment of such pain is always difficult for both the patient and the physician. Standard
  :treatments for such pain would include NSAID's, Anti-Depreswents (Tricyclics and SSRI's), Anti-epileptic Drugs and
  :Narcotic's. With such medication, only experimentation with various combination of medications can lead to pain relief
  :(and often only partial). Less standard would include accupuncture and herbal remedies which are much more variable
  :than medication in their ability in supplying pain relief. Also, since this is an inflamatory process that is chronic, the
  :question arises if your mother is having a relapse that is manifesting itself as primarily pain and thus a course of SAID's
  :(such as prednisone) shoud therefore be considered. I would discuss such issues with your neurologist and pain
  :specialist. Finally, I would consider an evaluation by a peripheral nerve specialist if this has not already been done.
  :"This information is provided for general medical education purposes only. please consult your physician for diagnostic
  :and treatment options of your specific medical condition."
  THANKS for the info., one thing though, what is a peripheral nerve specialist?, could they possibly help the pain?, could they
  better diagnose the extent of nerve damage and stage of recovery?, my mother has a neurologist at OSU who specializes in CIDP,
  her main problem right now is the painful nerve re-generation, anyway, please let me know what exactly a peripheral nerve specialist
  is, where one could be seen, and how they could possibly benefit her, Thanks in advance.
=Follow-up from CCF Neurology MD. A peripheral nerve specialist or neuromuscular specialist would be one who deals with medical conditions such as CIDP. Therefore, your mother is being followed by the correct specialist. "This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options of your specific medical condion."

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