Posted by ed_uk2010 on April 30, 2010, at 13:57:06
In reply to Neurologists stumped; medication side-effects?, posted by Daphna on April 30, 2010, at 11:37:19
Hi there Daphna,
I have no idea what is causing your attacks, but I'd like to make a few comments anyway.
>Twice I was unable to take my daily dose for 3 days, and in both cases I had an attack. If the illness is unrelated to the medication, why does going without it cause an attack?
That's very strange. Missing doses of Klonopin after long term treatment would be expected to cause withdrawal symptoms, but I don't know why that would lead to another attack.
>As I write I have taken 4 oxycodone pills and the pain in my upper back is still at a 6.......
It sounds like your pain is caused by a disorder within the central nervous system ie. central neuropathic pain. Opioids are usually only modestly useful for neuropathic pain.
Have you tried pregabalin (Lyrica) for the pain? In the UK, Lyrica is approved for the relief central neuropathic pain as well as for peripheral nerve pain. Amitriptyline is another drug which is widely used for neuropathic pain.
>.....anesthesia is always a nightmare (I don't go down)
You need to avoid total IV anesthesia techniques (TIVA). TIVA is very reliant on opioids, which you are clearly very tolerant to. You may also have some tolerance to the IV sedatives due to the long term use of Klonopin.
In this situation, inhalational anesthesia with volatile agents is likely to be much more reliable. Sevoflurane and desflurane are popular at the moment, due to rapid recovery. Both drugs can be quite nauseating after you wake up, but it's better than being awake during surgery.
poster:ed_uk2010
thread:945727
URL: http://www.dr-bob.org/babble/20100425/msgs/945746.html