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Re: VestibulitisFrom: mark decker (mhdmd@wi.rr.com)Sat Mar 17 11:13:55 2007
gabapentin start low dose then up to 300 tid or so - see dosing schedule blocks allodynia and hyperalgesia nicely amitriptyline. also helpful - i see a lot of it - need to treat the substance p and calcitonin gene related peptide neuroinflammation that sends high level - very obnoxious - pain signals to the brain in the face of milder stimuli - the local inflammatory response including the aforementioned chemicals and tumor necrosis factor - several interlukins and the like aggravate the nerve relay system and in the spinal columns increase signalling across the wide dynamic range neurons and cause pain sensation to be sent up the dorsal horn ganglia in response to stimulation of touch fibers and pressure fibers - allodynia - eliminate scents dyes chemicals - new soaps detergents body products use good hydration with plain water sitz bath a great idea - no pads just change cotton - loose fitting underwear as need be crushed ice peas or corn frozen in ziploc bag helps cool it down topical 5% lidocaine helpful - topical steroids not helpful usually takes some time but i get good response to tca's or gabapentin and the topical lidocaine and other general recommendations as listed hope this helps mark
At 11:46 AM 3/17/2007, you wrote:
> A 61 year old patient presented with a 3 week hx. of introital
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