Tag Archives: Neurologist

The Journey Continues – Life With Burning Mouth

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The great news? The combination of 1 mg of Clonazepam ODT and 40mg of Duloxetine is still working. I am still experiencing a tingle of the tongue rather than burning, and it has been liberating.

The not-so-great news? I still have Burning Mouth Disorder, and there is no cure or even a definitive diagnostic test on the horizon. In nearly seventeen years of burning, the best we can hope for is remission. Still, the second best is a combination of medicines and coping strategies (Stay hydrated, my friends!) that allow us to function and avoid descending into depression.

We have talked about depression before and what a sneaky and destructive beast it can be. Please stay aware, and if you have people around you who care for you, ask them to be aware if your sleeping, eating, moods, or general behavior change dramatically. Sometimes those around us notice before we do because we are already in the woods.

If you haven’t seen a Neurologist, I encourage it. I find that of all the specialties out there, Neurologists are a bit more likely to have heard of or seen BMS/BMD and also seem more open to trying different therapies. Mine has had my migraines under control for over six years, and the current BMS/BMD therapy has been working for nearly a year now. Fingers crossed, right?

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Cymbalta and Burning Mouth

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Photo by Tara Winstead: https://www.pexels.com/photo/illustration-of-a-head-and-butterflies-around-the-scalp-and-inside-the-brain-8849272/

As promised, here is an update on my Burning Mouth Journey and the latest thing I am trying.

You may remember my experience with Effexor XR/Venlafaxine and the muscular tic side effects that forced me to abandon it even though it had been very effective at reducing my burn to a tingle.

My primary Doctor suggested that I talk with my Neurologist about compounds similar to Effexor XR but that may have fewer side effects. My Neurologist listened, did some research, and we decided to try Cymbalta/Duloxetine at a very low dose and see if it made a difference. This was in addition to the Klonopin/Clonazepam ODT at .50 to 1 mg daily that I take to control the burning escalation.

I must admit that at 20 mg per day of Cymbalta/Duloxetine, I noticed no change at all. I passed this information back to my Neurologist and he prescribed 30 mg per day.

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Not So Sweet Sixteen with Burning Mouth

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Photo by solod_sha on Pexels.com

Every year in May now, I join Great Strides for Cystic Fibrosis, fundraising and supporting my oldest grandson in his fight with CF.

I celebrate Mother’s Day with my family…

And I mark off yet another year of Burning Mouth Syndrome/Disorder. This year marks the sixteenth anniversary and the beginning of the seventeenth year because there is no cure or even a reliable treatment in sight.

Sounds a bit melodramatic, doesn’t it? Believe me, if you felt what we feel every single day, you might slip a bit into the dramatic side yourself!

I have described Burning Mouth Syndrome/Disorder in this blog several times over the years, so I won’t make you read that again, but you can definitely find the definition here in prior posts.

Today I made my yearly pilgrimage to the Neurologist to check in, renew my Aimovig prescription (For migraines – VERY effective), renew my Clonazepam ODT prescription (helps me deal with the daily burn), and to talk about any other options that may have come up in the past year.

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Another Med Bites the Dust – Burning Mouth Disorder

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In recent posts, I have shared with you that Effexor XR has been helping my burning become tingling most of the time. Unfortunately, the dose that was most effective had too many side effects including a very noticeable muscular tic that made it look like I was shaking my head “No.” I had no idea I was even doing that until my husband showed me a video. So weird!

My Neurologist was on top of it, reduced my dosage by half and most of that went away. But not all of it.

Over time, I realized I was having excessive sweating after taking my dose each day, the muscular tic was still there, but with less movement and it became intermittent. I was also starting to develop muscular spasms in my feet, ankles, and quads. Some were quite uncomfortable and there didn’t seem to be any action on my part that brought them on.

At first, I thought it was a shoe issue. Inserts, new shoes, and a couple of different styles of shoes made no difference, and I had to look elsewhere. Effexor XR seemed to be a likely suspect, and I discussed it with my Neurologist. I told him the side effects were outweighing the partial relief I was getting and that I thought it was time to discontinue.

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Why You Should Do Yearly Checkups – Burning Mouth

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Photo by CanstockPhoto-Ankabala

Yesterday, I spent some quality time with my Neurologist at my yearly checkup. We discussed my medicines (Effexor XR and Clonazepam ODT) and discussed how the mix had changed and whether I should continue on them now that I have begun my sixteenth year with this disorder.

Our consensus together was yes. Effexor XR has lessened my need for the Clonazepam ODT with minimal side effects at the dose I am taking. I start tingling within an hour after breakfast and that sensation increases in the normal cycle of primary BMS until late afternoon/evening when I take one low dose of Clonazepam ODT.

This serves two purposes. It interrupts the cycle of intense tingling so I get through my evening when it would usually be the worst, and it allows me to fall asleep easily and quickly. Sleep is painless for primary BMS sufferers and my body gets the rest it needs. The more rested and hydrated I am, the less pain and tingle I experience.

All of this routine can be completely upended during a flare (You folks with BMS know what I am talking about!), and I have the go-ahead from my Neurologist to increase my Clonazepam ODT dosage up to 2 milligrams if necessary. Even my worst flares have not required that much Clonazepam, but it is nice to know it would be okay if it did.

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No Free Lunch with Burning Mouth Syndrome

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Neurologist and Medicines
(c) Can Stock Photo / everythingpossible

I shared the good news with you in one of my last posts that the Effexor XR at 150 mg per day had lessened my burning into a tingle that did escalate through the day but was easily tamed with .50 mg of Clonazepam ODT around dinner time.

I was so happy and just waiting to see if this would hold or if something would change.

As with nearly everything I have tried against this burning neuralgia, something did change.

My husband started noticing a couple of weeks ago that I had begun shaking my head in little “no” movements when I was engrossed in a TV or computer show and it increased as time went on. He mentioned it to me and I truly had no idea I was doing that. It only happened when I was watching TV, whether on the big screen or my computer or reading at night and I felt nothing unusual. He videoed me when I wasn’t paying attention and I agreed, it was a definite involuntary movement.

Weird, right?

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Effexor XR and Burning Mouth – An Update

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I reported in a previous post that my Neurologist had suggested that I try Effexor XR (Venlafaxine) in addition to my daily dose of Clonazepam/Klonipin ODT.

He started me with the lowest dose, and it didn’t seem to do anything so as we had agreed, he doubled the dose and I started taking it once a day.

I immediately came down with a head cold that turned into bronchitis and set everything on hold for a while. Now I have had a clear month at the higher dose and I have noticed something interesting. My daily dose of Clonazepam ODT has always been subject to some fluctuations due to flares in pain after dental work, abnormally dry air, or those elusive good days when the pain level isn’t too high, so it took about a week to notice the pattern.

I was not burning so much as tingling at the beginning of my pain cycle. I had been able to get by with one dose of Clonazepam ODT a day for a week.

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Cannabis, Virtual Reality, and Another Option – Burning Mouth Syndrome

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(c) Can Stock Photo / Ankbala

I had my yearly sit down with my Neurologist yesterday and after discussing my migraine treatment with Aimovig (100% effective, BTW, but getting very pricey with my husband’s new insurance.), we moved on to Burning Mouth Syndrome.

He asked how my pain was, and I said, “The same as usual. I achieve tolerable levels with 1 mg of Clonazepam/Klonopin ODT spread between two doses, and if I have a flare, I take an extra .50 mg to deal with that and try to get a nap.” He shook his head and said, “I have reviewed your file and you have tried just about everything out there, but there is one that I noted you haven’t tried and I think it might help. It went generic in 2006 so it isn’t outrageously expensive and you can safely try a low dose with your present meds and see if it has a good effect. I would like to get you out of pain if it is at all possible.”

Well, to be frank, this is what you want to hear from your specialist. I said I had some questions about other treatments before I jumped into another drug tryout and he sat back and listened intently.

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Breaking In a New Doctor – Burning Mouth Syndrome Challenges

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Photo by Shopify Partners from Burst

You can find yourself with a new doctor for a variety of reasons. New insurance, moving to a new town, a referral to a pain specialist or Neurologist…these are just a few. In all of these cases, you will need to bring your new doctor up to speed about a chronic neuropathic pain syndrome they may never have heard about.

A Neurologist or pain specialist may have dealt with BMS before and if you have a choice in the matter, try to find one who has. Their experiences may be to your benefit.

However, many of us are caught in that somewhat awkward position of educating our medical professional and it can be daunting if you aren’t prepared. Continue reading →