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Dr. Natasha
Dr. Natasha, Doctor
Category: Medical
Satisfied Customers: 11698
Experience:  American Board Certified in Emergency Medicine and Ivy League trained. Medical Review Officer trained in Drug Testing
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My husband 88 years old has PHN ongoing pain in his left mid

Customer Question

My husband 88 years old has PHN ongoing pain in his left mid back close to his armpit for the last 4 years that has made him completely dependent on Vicodin and laying on his back as pressure relieves the pain..also uses heat at the same time. He sleeps better part of the day and all nite. He has been seen by his physicians with "nothing we can do about it". I have suggested a local at the site of his pain and the answer if "NO". He's too old..... I would like to have any type of info that can help this mans' last few years of life fruitful and with minimal pain. He does have moderate to severe kyphosis stemming from being a tile setter. Thank you. Arlene V
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Natasha replied 1 year ago.

Doctor Cameron : hello
Doctor Cameron : welcome to just answer
Doctor Cameron : are you seeing a pain management physician?
Doctor Cameron : hello
Doctor Cameron : please type and hit reply
Customer: HE WAS SEEN BY PAIN MANAGEMENT WITHOUT RESULTS...THEY HAD HIM GOING THRU YOGA TYPE EXERCISES AND HOW TO CONTROL HIS DISTRESS. HE HAS BEEN SO WRAPPED UP IN PAIN ITS BECOME HIS EXISTENCE TELLS ALL HE'S SICK. HE ALSO HAS LOST WEIGHT, DOESN'T WANT TO EAT--HAS RX FOR MEGESTROL ACET 40 MGM/ML SUSP. 2TSP BID. HASN'T HAD TIME ENOUGH TO WORK. FYO...I AN A RETIRED RN. FIELD WAS OCCUPATIONAL HEALTH..
Doctor Cameron : Thanks
Doctor Cameron : Well, they do do nerve blocks for post herpetic neuralgia- these are sympathetic nerve blocks
Doctor Cameron : Have you discussed this? the local at the site of the pain doesn't help as much as actually blocking the nerves further up
Customer: AM FAMILIAR WITH SYMPATHETIC BLOCKS,HAS BEEN DISCUSSED..RESULT WAS NEGATIVE AS HIS X-RAYS HAVE SHOWN THE SPINE IS COMPRESSED/FUSED THERE WAS NO WAY, THUS THE PRESENT SITUATION AND MY ASKING IF LOCAL CAN BE TRIED WITHOUT COMPLICATIONS.
Doctor Cameron : got it. thanks
Doctor Cameron : Sorry about the miscommunication
Doctor Cameron : Yes, you can use local injections.
Doctor Cameron : But another 'hot' option is the injection of botulism toxin
Doctor Cameron : This has been shown to markedly decrease pain
Doctor Cameron : http://www.ncbi.nlm.nih.gov/pubmed/21134121
Doctor Cameron : It is subcutaneous and pretty easy to administer
Doctor Cameron : It is offlabel, but many physicians are doing it
Doctor Cameron : http://www.medpagetoday.com/MeetingCoverage/AAPM/18345
Doctor Cameron : Now, yes, you can do local injections of lidocaine too
Doctor Cameron : and triamcinolone
Customer: WOW!!! YOU HAVE NO IDEA WHAT YOU'VE JUST GIVEN ME...AM SITTING IN TEARS AS NOT ONE "KAISER" DOCTOR HAS EVER SUGGEST OR STATED THERE WERE OPTIONS FOR INJECTALBES.
Doctor Cameron : you are welcome.
Doctor Cameron : I work for KP- lol
Doctor Cameron : if you are not happy with your provider, switch
Doctor Cameron : the problem is, people often look at the age and not the patient
Doctor Cameron : I have seen 99 year old women grocery shop and take care of them selves and ride the bus around San Francisco
Doctor Cameron : And then a 43 year old can do anything for themselves..
Doctor Cameron : anyway, I hope that I provided you with excellent service ? :-)?
Doctor Cameron : *43 cannot do anything for themselves
Customer: I TOO KNOW THAT AGE IS A PAIN, HAD TO FIGHT FOR MY MOM..I WON!
Doctor Cameron : :-)
Customer: FYI..AM A 1953 KAISER DIPLOMA RN.
Doctor Cameron : :-)
Customer: MANY MANY THANKS. KEEP HITING THE WRONG
Doctor Cameron : you are welcome.
Dr. Natasha, Doctor
Category: Medical
Satisfied Customers: 11698
Experience: American Board Certified in Emergency Medicine and Ivy League trained. Medical Review Officer trained in Drug Testing
Dr. Natasha and 6 other Medical Specialists are ready to help you
Customer: replied 1 year ago.

Thank you so much..your information has provided me with a way in which I can assist my husband without throwing a temper tantrum. Am waiting now for Chronic Pain Dept to call in order to set an appt. Will let you know what happens...


 


Again many thanks


 


Arlene

Expert:  Dr. Natasha replied 1 year ago.
Yay!! Thanks for the feedback

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