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Family Physician
Family Physician, Doctor (MD)
Category: Health
Satisfied Customers: 12816
Experience:  Emergency Medicine and Family Practice for over 26 years
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My wife is suffering severely from Post-stroke pain, a

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My wife is suffering severely from Post-stroke pain, a condition that has gradually worsened considerably since the stroke in 2002. Concentration of the pain has basically been on the left side and medication has basically been Percocet 10-325, 2 tablets 4T daily. For the past 3 months her Neurologist has placed her on Gabapentin (Neurontin), 4 tablets 3T daily. Neither Percocet of Gabapentin has had a large impact on her pain level, so she suffers daily. For the past two days she has encountered numbness in her right leg, increasing to a high level in the last 2-3 hours and posing a huge problem, not just from the pain, but mobility factor. We have no concept as to what action we should take to cope with the right-leg problem. Please advise us as to the direction to take. We are debating as to whether an Emergency Room visit is the answer.
Submitted: 7 years ago.
Category: Health
Expert:  Family Physician replied 7 years ago.
I'm sorry to hear about your wife's problems:

As a primary care physician who works part-time in the ER, I doubt that a trip to the ER would be very useful. ER physicians are not well equipped to deal with chronic conditions, particularly chronic pain patients.

You may want to ask your neurologist to try her on Lyrica (pregabalin), a medication with an action similar to Lyrica, that is often more effective in chronic pain patients than the Neurontin.

Her best long-term option would be a chronic pain clinic. If your doctors can refer her to a multidisciplinary pain clinic, a comprehensive pain management plan can be developed that includes medication, injections/nerve blocks, and in some case spinal simulators.
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