Question
Cosmetic surgeon damaged forehead muscle/nerves and have taken eight Tylenol daily for more than three years.  Pain is now more severe and hardly adequate.  Neurologists say codeine is addictive/dangerous and give no further advice. But Tylenol is dangerous with alcohol and I may have couple cold beers at the beach and wine before/with dinner. That's not intoxication for this senior but....
 
Do email with two others who have tried accupuncture, anesthesiologist pain mangers, nerve block shots, nerve drugs, other medications, and even remedial surgery. One  managed to see chief at U of PA Neurological Dept who had no help. There are pain management clinics here.....

Any advice would be greatly appreicated.

Answer
Hi Joan

Thanks for your question. Three years is a long time to be struggling with this, so I know you must be very frustrated.

Tylenol is actually not that good of a solution regardless of alcohol; as you know, it doesn't work very well, and there have been some studies that show that it is hard on the liver if taken over a long period of time, even if taken at a reasonable dose.

Pain due to nerve damage is one of the most difficulty to treat in my opinion. A medicine specifically for neuropathy has been approved by the FDA (Lyrica). Lyrica is a non-narcotic medication and might be an option if you have not had a good trial of it yet. Another medication used for pain and depression is Cymbalta.

Other than these medication possibilities, anything in terms of lifestyle management that helps the body relax and decompress can have a beneficial effect on pain by sort of turning down the volume on your nervous system.

This would include relaxation training, breathing techniques, hypnosis, and meditation. They also help the mind not react so strongly to the pain and can improve your peace of mind. These need to be tried over a period of time with some consistency to begin to have an effect.

Let me know if I can provide more information on any of these.

Best wishes

Barry Hughes, Ph.D.

http://www.chronic-pain-alternatives.com