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"A Little Advice, NEVER Discontinue Meds Abruptly!!!" Topic


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1,109 hits since 6 Oct 2018
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Cacique Caribe06 Oct 2018 4:05 p.m. PST

After my sixth lumbar surgery last November, on top of all my other pain issues, I developed very deep severe chronic pain on my right hip, leg and foot. Basically, the two 5-inch long screws going from my S1 joint out into each hip bone caused me to have "sacroiliac joint dysfunction" on the right side. Not fun at all.

So a couple of months ago my orthopedic surgeon had me see a pain management doctor, who put me through another barrage of tests. And he also put me on something called Gabapentin (Neurontin) for a month, to see if it would help with some of my other nerve pain issues.

I took the Gabapenting for almost a month exactly as directed and, a few days before running out, I called for a refill. The pharmacy didn't get approval for the refill, but I didn't worry too much since my appointment with that doctor was going to take place this coming Monday (day after tomorrow).

HOWEVER … this week I becan to experience periods of sudden intense perspiration and anxiety, my hip and leg/foot pain came back with a vengeance and i went unable to sleep for two whole days on TWO occasions. All of it in the space of a week. And, according to my wife, my typical irritability reached new levels.

I confessed my symptoms to my wife a few minutes ago and she asked if I felt any chest or arm pains, or any other symptoms mentioned in a typical heart attack checklist. Nope. Then she asked if I was still taking "that new medication" (the Gapapenti). That's when we looked at each other and had an eureka moment. We immediately looked up the symptoms for those who discontinue it abruptly:

"The symptoms are generally similar to those of benzodiazepine withdrawal. The most frequent ones are anxiety, insomnia, nausea, pain, and sweating. But symptoms vary a lot. Confusion, disorientation, tremor, tachycardia, and hypertension can occur, and are the next most frequent"

It was so simple. We should have thought about the new medication first.

Good thing I only took it for 30 days. That's probably why I didn't get the other worse symptoms.

Lesson to be learned:

Don't stop any meds abruptly, without checking with the doctor. The moment the refill didn't get approved I should have immediately spaced the last few pills to make the stop more gradual. I should know better than just stop.

Anyway … we are both sorta laughing about it now, but I was really starting to freak. I thought I was coming down with something completely new, on top of all my other crap.

Oh, well. Live and learn.

Dan

Private Matter06 Oct 2018 4:17 p.m. PST

I'm glad to hear you're alright.

Actually, Dan, I would advise that instead of spacing out the pills when you get low I would recommend that people contact their doctor and seek the doctors advice about modifying the dosage of any drug being taken. If the dosage instructions are not specific about stopping get the information clarified by an expert. The drug you mention behaves one way, whereas, other drugs could have differing effects. Seeking advice of a medical professional is always the best course of action. (my son-in-law is a doctor who specializes in pain management)

Cacique Caribe06 Oct 2018 4:37 p.m. PST

Good points!

Dan
PS. The older I get the more I've come to believe that the best profession for any son or daughter in law to have is being a pain management physician. Pain is not a fun thing.

Private Matter06 Oct 2018 5:58 p.m. PST

Agreed.

Personal logo Editor in Chief Bill The Editor of TMP Fezian06 Oct 2018 9:35 p.m. PST

Always beware of the possible side effects, too.

Lisinopril is a great blood pressure medication that's based on snake venom and very inexpensive. But for a small percentage of people, it gives them an annoying cough they can't get rid of. I had a family member with that problem, she had to figure it out herself, the doctor didn't know what was causing the cough.

Ed Mohrmann Supporting Member of TMP07 Oct 2018 3:42 a.m. PST

Dan, my wife suffers constant pain from a very minor
surgical procedure she had almost 10 years ago.

It can be very minor or *very* major pain (she typically
runs a 4 t 5 on the 1-10 scale, but can spike to 10
very quickly).

She was briefly on Gabapentine but could not handle the
side effects. After several consultations (including one
with Cleveland Clinic's pain management folks) she got
a referral to Duke, one of three hospitals in the
country which will do Lidocaine infusions for pain.

She also now has a neuro specialist ('pain doctor') as
her PCP and since then she has gone from non-functional
to semi-functional (she's active about 30 % of her
waking hours). Her infusions are covered by insurance
(Medicare) and generally are scheduled at 4 to 6 week
intervals (depends upon time of year, since her condition
responds poorly to cold weather and low atmospheric
pressure).

Good luck and glad you didn't experience any of the
other side effects of the G.

Roderick Robertson Fezian07 Oct 2018 8:58 a.m. PST

Hell, starting new drugs is always a roller-coaster ride as well. "Are these symptoms I'm feeling just a bad burrito, or the new drug?"


My dad and I both had/have gout, and were prescribed Colchicine for it. Well, we both were so sensitive to it that a "normal dose" was enough to overdose us, and we both ended up with peripheral neuropathy (screwed up nerves in our feet).

Gunfreak Supporting Member of TMP07 Oct 2018 9:29 a.m. PST

Always beware of the possible side effects, too.

Lisinopril is a great blood pressure medication that's based on snake venom and very inexpensive. But for a small percentage of people, it gives them an annoying cough they can't get rid of. I had a family member with that problem, she had to figure it out herself, the doctor didn't know what was causing the cough.

Lisinopril is an ACE inhibitor, and that cough is quite common to all ACE inhibitors.
If neither the doctor or the pharmacist knew that, then I would get a new doctor.

Bowman08 Oct 2018 5:54 a.m. PST

Dan,

I'm sorry about the situation with your sacroiliac joint pain. But it sounds like the gabapentin was working for you. I guess you just can't afford to run out.

Perhaps pharmacies aren't allowed to give emergency does of prescription drugs in the event the MD is tardy getting them the OK for a refill in the US. Many times I've inadvertently run out of one of my meds and the pharmacy can legally give me a weeks supply while they contact my physician. There is a computerized system that updates all my refills and MD authorizations, but like all computerized systems, there are errors.

Regardless, I hope things eventually improve for you. I take it you are continuing with the Gabapentin?

Old Wolfman09 Oct 2018 6:48 a.m. PST

I know that situation some. Myself,I accidentally left my diabetes,BP,pain,and cholesterol meds at home last weekend while I was at a con.A brief moment of "what to do" ,and then I remembered to stay calm,eat regularly,ask folks if I looked OK,and all. After returning home,I had spiked for about 36 or so hours,but am now back to my normal readings and dosage schedules. BTW,Lisinopril is what I take for my BP too. My wife,however is allergic to it,and is on another brand.

Gunfreak Supporting Member of TMP09 Oct 2018 4:13 p.m. PST

In Norway you can get emergency prescription if you run out, but only for certain medications.(insulin and other stuff you can't just stop using) you'll only get the smallest package and strong recommendation to renew the prescription. But if you ran out of your codine on Friday, you'll just have to survive the pain on paracetamol until you can get a new prescription on Monday.

Old Wolfman10 Oct 2018 6:42 a.m. PST

Yep.definitely back to normal,such as it is.

Garand19 Oct 2018 9:31 a.m. PST

I'm bad. I was on Gabapentin becaue I have 2 bulging disks in my spine that put pressure on my spinal nerve. This was a big deal. I had cortisone injections & the Gabapentin. After a while I decided to discontinue the Gabapentin because I was afraid I was becoming dependent. No ill affects whatsoever. My back sometimes aches, or I get nerve pain in my sides or chest, but not often. Some people react differently than others.

Damon.

Bowman20 Oct 2018 5:27 a.m. PST

Gunfreak, I'm sure you have acetaminophen (what we call paracetamol on this side of the Atlantic) with some codiene sold over the counter in Norway. Just take a few of those at a time and it is the same strength as the prescription versions.

But your point is taken. Drugs with a huge abuse potential, such as oxycontin, have more controls. That being said, Gabapentin is not a narcotic and is not a controlled drug, at least in Canada and the US. It is not addictive in the physical sense. However, that doesn't mean it can't illicit withdrawal symptoms in some users. Dan's and Damon's differing responses illustrate that.

By the way hope you're feeling better Dan.

Old Wolfman04 Dec 2018 7:38 a.m. PST

And now I always keep my stuff w/me or close at hand within reach.

Gunfreak Supporting Member of TMP04 Dec 2018 12:28 p.m. PST

Gunfreak, I'm sure you have acetaminophen (what we call paracetamol on this side of the Atlantic) with some codiene sold over the counter in Norway. Just take a few of those at a time and it is the same strength as the prescription versions.

Actually no, the strongest pain killer your get over the counter is paracetamol/Caffeine

Codine/paracetamol is by prescription only and locked away with the ritalin and valium etc. Any drug with a high chance of miss use and addiction is schedule B at minimum.

Bowman05 Dec 2018 7:24 a.m. PST

In Canada the formulation known a s "Tylenol #1" has 325mg acetaminophen (or paracetamol), 15mg caffeine and 8mg codeine phosphate. This is available over the counter. The next formulations contain 15mg and 30mg respectively. These are prescription only.

However, the Canadian government is considering removing the over the counter status due to abuse issues.

link

Gunfreak Supporting Member of TMP05 Dec 2018 1:50 p.m. PST

Regular painkillers are 500mg paracetamol from various manufacturers.
You also have 200mg ibuprofen in various forms.
The 1g paracetamol and 400mg ibuprofen are prescription only. You can also never buy more than one 20pack of paracetamol without prescription.

Drugs are extremely regulated in Norway.

And pharmacist are held to a much higher standard than say doctors when it comes to personal missuse of drugs.
While doctors can have documented substance abuse problems and not loose their license.
For pharmacists it's a zero tolerance policy.

And those working at the depots packageing schedule A drugs (mostly opiates and synthetic opiates) have to go through special background checks.

Bowman05 Dec 2018 3:11 p.m. PST

Mmmmm……acetominophan and ibuprofen really don't have any potential for abuse. You can OD on them at high or prolonged doses but they are not addictive or mind altering.

Gunfreak Supporting Member of TMP06 Dec 2018 3:28 a.m. PST

You can overuse them, leading to "withdrawal" symptoms if you don't continue to take them(in paracetamols case you get a headache)
The daily max for paracetamol unless prescribed by a doctor is 3 grams, and maximum use 3 times a day.
So either 3 times 2 pills for three 3 grams or 4 times 500mg.
You can get toxicity at a little as 6g a day and you will get mild poisoning at 12g a day. With 20g being a serious health risk.

Hence you're only supposed to use it for 3 days, if the pain lasts longer, you should contact a doctor.
Hence you get one pack of 20 500mg, as that's about 3 days worth of 3 grams a day.

I personally overuse paracetamol as I have migraines.
I do have my own migraine medication, but those are rather nasty, and should never take more than 8 a month and even that is a bit…

So it's better to use too much paracetamol.
My mom has had pains for decades, and get bottles of a 100 1g paracetamol and paralgin forte(paracetamol/codeine) But she takes semi-regular tests of her liver.

Bowman06 Dec 2018 6:05 a.m. PST

Have you tried caffeine derivatives for your migraines? Like Cafergot or other Ergotomine derivatives? It might be the caffeine helping you and not so much the acetaminophen. Long term acetaminophen causes hepato-toxicity as you probably know. Be careful my friend.

Of course ibuprofen is also effective but then you get bleeding disorders.

Wolfhag29 Oct 2019 5:03 p.m. PST

My L4 and L5 vertebra were misaligned and I had severe nerve pain through my glutes, legs, and feet, sciatica. It got so bad I could walk only about 50 yards before I had to sit down and I had to practically pull myself up the stairs. On top of that an old knee injury from Rugby flared up and an Orth Surgeon said I'd need a knee replacement in about 5 years.

A friend introduced me to a Chiropractor Neurologist, I was very skeptical. After the exam and him telling me everything wrong I got with his program. It was electrotherapy for my lower back and that and deep laser for circulation on my knee, no medication, no invasive procedures and no chiro adjustments. After 6 weeks it's like new and no pain in my back, glutes or knee. I thought I'd never be the same again.

The pinched nerves were playing havoc with my muscles and tendons pulling my knee out of joint. He said he's treated over 1,000 patients that were told they had bone-on-bone and needed a knee replacement but only 2 out of the 1,000 he treated needed it.

Wolfhag

Asteroid X29 Oct 2019 5:56 p.m. PST

Thank you for sharing that! I will have to remember that (about the very few needing replacement surgery). Whether I remember to have them see a Chiropractor Neurologist or not, is another matter …


Bowman, the bleeding disorders can be quite frightening, to say the least.

I had been using ibuprofen for ankle swelling (long-term training and fighting in full-contact martial arts and kicking with the instep instead of the ball of the foot in turning kicks/roundhouse kick).

After seeing every sports-medicine specialist I could find and undergoing various MRI's, etc the consensus was the small capilaries had been damaged from the extensive full-contact training and fighting they were not returning the blood as effectively. Hence the swelling.

Taking ibuprofen led to hemoraging from the bowels (I know I'm making a longer, edge-of-the-seat story not as exciting, but I want to get the information out there, not entertain). I immediately went to get checked and a colonoscopy revealed a colon that resembled bad Crohn's.

Immediately going off the ibuprofen, I returned in 6 months for a follow-up to find the issue had cleared up!

It was not Crohn's (or similar disease) but CAUSED by ibuprofen.

2 lessons to learn.

– 1 kick with the ball of your foot on the heavy bag (rules stipulate kicking with the in-step in competition due to the greater chance of killing an opponent with the ball of your foot, but don't train like that – you WILL regret it after years of doing it!)

– 2 do not use ibuprofen – especially for extended periods of time – as it CAUSES Inflammatory Bowel Disease (IBD-Crohn's Disease and Ulcerative Colitis). They don't tell you that on the bottle!

link

NSAIDS may also cause a non specific type of colitis and small intestinal inflammation with associated complications of chronic blood or protein loss [8]. … A possible association between the use of NSAIDS and the onset or relapse of IBD has been repeatedly suggested.

There are many other studies that can be researched, if one needs to.

Wolfhag29 Oct 2019 8:01 p.m. PST

Has anyone tried CBD derived from hemp, not marijuana? I have some friends that said the ointment works great but is expensive.

Wolfhag

Old Wolfman31 Oct 2019 6:33 a.m. PST

Also,Aetna's making some changes in the meds they cover,some of which I take.

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