I anymore no matter how bad the pain is do not go to the ER as the hospital around here is filled with asshole doctors which have no clue what RSD is and no idea of what to do. The stress and trouble i get from the ER just makes everything worse. And there little things they try are nothing to the meds i am on so i don't bother with them anymore. Methadone & Oxycontin you really can't get any higher than that combination. I was on dilaudid the 2mg pills and than the top 4mg pills as well neither worked and i was on dilaudid for good while. But if it helps you than that is good and am happy for you. The harder part for me is most of mine has gone internal and trying to explain RSD and having internal to people that don't understand at all just goes way over there head of even understanding, that's one part it miss about mostly external at least than you had color and sensitivity to show them with internal its a 360degree angle to look at from external. Hope you are starting to feel better and wish you all the best.