My mom's prescription coverage has recently changed. The NH was able to get approval for the first med challenged, but when a letter arrived saying that they would no longer cover the lidocaine patches used for her spinal compression fractures, the NH proposed to switch her to neurontin. I have a call into the APRN to discuss this, but i wondered if anyone has any experience with this med for back pain.
I also have spinal stenosis and a crushed vertebrae so if the pain gets too bad i will be in line for some narcotics.
It is important to get a steady dose prescribed as low as possible so that the pain never gets out of control. Hospice and palliative care are very good at titrating doses of narcotics till they get the right blend.
If she does take the gabapentin, start at a low dose and make sure that it does not cause her to be unsteady on her feet ( like it did for my dad)
My mother was also prescribed Tramadol for pain - so I wonder why they didn't mention a pain medicine?
The NH staff have been more than willing to write letters of medical necessity for other meds; the fact that they want to change this one appears to be driven by a sincere belief that the Neurontin will help more than the lidocaine can. thanks to you all for your helpful opinions.
Mom's new problem? she says she "can't hear". Of course, this is while she's having a conversation with you. What I've learned is that with stroke/VaD patients, the real message is somewhere buried in the text. "I can't hear" might mean, "my ears are bothering me". when my FIL, years ago said "I can't eat", the speech therapists eventually figured out that he'd lost his ability to swallow.
Anyway, they are doing ear wax drops for mom; stay tuned!
Pam is much more experienced and wiser than I am, and in light of her comments I would consider holding off on starting the new drug and see what happens, perhaps her other pain meds are doing the job and the patches were more harmful than helpful?
She is not in pain. But she also can't communicate when she's in pain, due both to the aphasia and the dementia. You ask if she's in pain and she says "no". But if we see her face scrunched up, we know she is. So she's on scheduled, not prn, pain relief.
Are there other pain issues? Bedsores? Muscles contracting?
My sister in law gets the mail and I run interference with the nh. Called today and talked to the unit manager who is an RN but was clearly very busy today. I'm going to call the APRN tomorrow and find out what their thinking is.
We're just worried because mom gets every side effect known to mankind and a few that aren't listed! Thanks to you all!
Neurontin (gabapentin) is both a pain reliever and anti-seizure med. Are there neurological issues?
Finally, is your state being restrictive about lidocaine? Patches are sometimes sold on the street, diverted from patient's supplies.
I would think though neuropathy is a different type of pain than back pain.
I do hope it works out well for your mother though.