More "Red Sense" - A Post I Didn't Want to Lose from Awhile Back - Posted in ATN group

Red Lawhern, Phd, is one of our members who has worked with many chronic pain and facial pain advocacy groups. I wanted to keep this post of great info available to all of the NEW MEMBERS. Thanks for caring, Red.

Comment by Richard A. “Red” Lawhern on January 30, 2011 at 5:10pm

One additional thought for Stef, in answer to your original question. I’ve talked to many patients over the past 15 years who have received opioids or Methadone as elements of a pain management “cocktail” administered by pain specialist. Oxycodone and other NSAIDS do not work for everyone. But it would be a basic malpractice to claim that they work for nobody.

Likewise, be aware that although NVD probability of success is low-ER with atypical TN than with classical TN, “lower” is not zero. No less an expert than Peter Janetta once told me in a personal conversation that if a patient has ever had a “component” of typical TN pain (volleys of lightning-strike electric shock stabs), then they should be considered candidates for MVD, even if the character of their pain is no longer that of classic TN. The probabilities of successful outcome are more limited in ATN, because other pain mechanisms (or perhaps additional mechanisms) than direct nerve compression are probably operating in ATN patients. But for some patients some of the time, even a 50-50 crap shoot is an acceptable chance,

A key consideration in choosing MVD with ATN is the care that the neurosurgeon has exercised in doing follow-up surveys of long term patient outcomes. If it were up to me, such follow-ups would be legally required of all neuro-surgeries by all doctors ALL THE TIME. But it is obviously not up to me. For the patient who is concerned about making a decision, reliable measures of past success are highly important. It is never out of order to ask "how many patients have you treated who have presented as I do, and what has been your record of documented successful outcomes? How do you know?"

Just my two Red cents, for whatever they’re worth…

Good evening…