Hi and welcome,

I am so sorry your wife and you are going through this. Ketamine is a good option and one of the few that show good efficacy in studies. There are indeed different protocols and the one I am getting is an atypical outpatient plan. I started out with infusions every two weeks for 8 sessions, now at one a month for 3, then I will go just quarterly. It has made a big difference for me even without the more expected ten day outpatient plan.

One thing you might consider is how much ketamine is being given overall. I always feel the lowest dose that brings relief is a good place to start for any med. ketamine is a heavy medication and though quite safe does have side effects and can make the liver a bit unhappy.

My PM has made the analogy that the pain is like a ball of yarn and we are pulling out the thread a little each time. This is in keeping with how my infusions have gone. No one infusion has been earth shattering but the effects cumulatively are noticeable over time. One really important factor has been making sure all pain contributors that could be ameliorated were addressed. I had substantial scar tissue compounding my pain so I have had steroid injections for that. My latest improvement has been a result of dovetailing infusions and injections.

If your wife has anything treatable go after it. Nerve impingment from her fall may be found by a competent chiropractor or physiatrist. There may be something to be done that might help the ketamine work better by relieving some of her pain on a mechanical level.

I wish I had sage advise on whether to go in or outpatient, but I can only say to make the choice that she feels comfortable with. I hope that your wife finds relief soon.

Sending thoughts of healing and comfort,