Hi, just read your post and wanted to let you know that I have often wondered the same thing?? It is so infuriating, frustrating, maddening and so on to know that you need something but be denied it for no apparent reason I am taking a lot of the same meds as you, nac, sublingual b-12, etc. I do seem to be having a definite decrease in pain but cyanosis continues as does the cold hand and muscle "tics" from head to toe. Please feel free to pm me anytime and i hope things go well for you with your pain doc!! Best wishes, Jennyk