... breakthrough medication other than gabapentin, lyrica, lidocaine patch, etc. that might help my father?
YES! I have had PHN pain from shingles for almost 10 years & tried all of the first-line treatments (gabapentin, tri-cyclic antidepressants, Cymbalta, etc). Finally, I went to a pain specialist who prescribed Tramadol, and for the first time in a decade, I am completely pain free!! Tramadol is technically not a narcotic, but it does have dependecy characteristics... I feel unpleasant when I miss a dose... BUT, it has truly saved my life. You may also try looking into having a nerve block injection for the area of pain in question. I had 3 nerve blocks, and it has allowed me to reduce my tramadol dose by half :)
I also tried oxycodone, which was also perfectly effective, but I ultimately opted for the safer, less addictive tramadol, and it has completely alleviated my PHN pain. By that, I mean the pain is completely GONE!!
Be aggressive with the physicians & request an immediate consult with a pain specialist or a neurologist :)
I have suffered PHN for 3 years following Shingles that severely damaged the nerves across my chest, inner side of the entire arm, and my hand and fingers. Since then, I have lost strength in the hand due to muscle wastage, while the fingers have recovered 80%. However, the chronic pain remains. I've tried most of the common drugs to treat the condition, however, for me, most offered little sustained relief with harsh side affects. I was recommended "Targin" (Oxycodone/Naloxone slow release - started at 40/20 now 20/10) and "Panadol Osteo" twice a day. While this isn't the magic bullet, I've found it provides the best results overall. Hope this helps.
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