Hi Numb,

I will try to explain this as best I can as a lay person, I hope it makes sense.

A peridural catheter is similar to an epidural. The difference is that the needle of the catheter is slightly bent and when it is inserted it accesses the sympathetic nerves at the side of the spine. Mine was inserted in the lumbar area where I used to to have lumbar sympathetic blocks, I think that is around L12 but I'm not certain. Initially when the catheter was inserted it veered off to my my right side, so they had to reposition the catherer a second time. Unlike a lumbar sympathetic block they did not use an x-ray to verify the position. I found it interesting that the same amount of medication that paralyzed my right leg barely affected my left side, it just took the pain a way and I was able to walk (with assistance in case I fell) for the week. The medications that were used was Bupivacaine 0.25 %, Sufantanyl 25Ml (opiate) and sodium Chloride 0.9%. The maximum flow was 6% but they kept me at 5% so I didn't loose control of my bowl function. As I mentioned my whole pelvis area was numbed during this treatment. I don't know if this is right for you under your circumstances. It cost us 4,000 Euros plus travel costs, fortunately we were able to use points for the flight. The hospital was fantastic, more like checking into a very sanitized spa hotel. They keep sparkling mineral water (flat if you prefer) at your beside and have beautiful crisp white cotton linens and European duvets. They have lots of nursing staff and the nurses aids are either 1st year medical students or doing this in lieu of military service. It is very impressive.

What I meant by "gold standard" is that this is the preferred standard treatment used by doctors their for patients that are newly diagnosed with rsd. The earlier that it done the better success they have. To access the sympathetic for upper extremity rsd they go through a vein in the neck or somewhere in the the armpit . I asked about that because my rsd has already spread to my left arm too, although still somewhat mild.

I am lucky in that my husband is German and he was able to translate everything for me. He knows the orthopedic surgeon personally so he emailed him and explained my situation along with my x rays of my foot. The surgeon offered to remove the screws from my foot and did not charge us for that procedure. He introduced us to the pain management team and the anesthesiologist at the hospital when we arrived. They do not have wait lists and frequently take private patients from Denmark since it is so close to that country. It was a big deal for them to have someone come all the way from Canada and the local newspaper cam and interviewed me.

I see from another post of yours that you have an appointment with Dr. S. in Philly. If I were you I would absolutely keep that appointment! As other say Dr. S is the "Expert" in North America. He can make the referrals that are appropriate for you. That being said I did go directly to Dr Rohr who Dr. S works with in Germany in conjunction with the Ketamine coma treatment. At that time Dr. Rohr told me that I had the potential to become full body rsd. He said that he could refer me to Dr. S if I did not want to go through with the ketamine treatment. He said in all likelihood Dr. S would recommended I first try the IV lidocaine. My husband translated the consult report and rather than going to see Dr. S in Philly we gave the consult report to my PM doctor locally here. My PM doctor has been giving me the lidocaine IV treatments ever since. As one person recommended Dr. S can work in conjunction with your local PM doctor.

That all being said if you want any information or contact numbers to the doctors in Germany I'm happy to forward it to you. As I mentioned language can be an issue as I only speak a little German. Without my husband it would have been difficult for me. Many of the doctor & nurses do speak English but I could sense their relief when they realized that my husband could translate for me.

I hope you are feeling better today.

MsL