Hi Numb,

I use the term centralized because I think it better describes the progress of the how RSD seems to manifest in many of us. I have a friend here who has been seeing Dr Schwartzman for a few years now and he diagnosed her as having centralized CRPS. It was because of her relationship with Dr. S that our doctors here in Vancouver set up the protocols and started giving lidocaine infusions to many of us RSD patients.

I honestly don't know what people mean by full body RSD as I've never come across any literature that explains what full body RSD is. If I had RSD all areas of my areas of my body I might describe it that way too. The latest information I came across seems to support my understanding of what happens as our disease progresses. I believe that there is a centralization of the pain that occurs in most of us probably right from the beginning. The RSD manifests itself differently in each of us depending on many many individual factors.

Here are a couple of quotes from the most current copy of the Medifocus Guidebook on Reflex Sympathetic Dystrophy:



The continuous peridural block I had for 1 week is very similar to a continuous epidural block, it's covered under regional anesthesia so I'm sure there are many well qualified doctors in the US who know how to do them. The question is do they perform them specifically for RSD/CRPS patients experiencing chronic pain. I was told that this is a gold standard treatment for newly diagnosed patients in Germany but I've never come across any translated research to qualify that statement made by my doctors. Just to be clear there was no doubt that the peridural block would provided me with any long term pain relief because I'd already had RSD by 6 years at that point (despite the fact that I hoped it would), it was specifically given as a precaution to help prevent further spread of the RSD following my surgery.

How is that different form Ketamine you ask? I'm just a patient like you so I may have this wrong but from what I've read and experienced so far this is how I understand it.

Ketamine belongs to a class of drugs that is a sodium channel blocker, the preferred method of delivery is intravenously in various doses depending on weather they keep you awake or put you in the coma. Lidocaine is also a sodium channel blocker and Mexiletine is the oral version of lidocaine. Many people seem to do very well with sodium channel blockers. It's the hot topics amongst many researchers and in Kiel they've been studying the sodium channels in the skin of RSD patients.

Personally until now I have done very well with Lidocaine infusions every 3 weeks or so for the past few years. I prefer IV infusions to the subcutaneous delivery method but most people seem to do well on the subcutaneous treatment option.

The continuous peridural block is a local anesthetic delivered through a catheter that is positioned either in the neck or positioned just beside the spine. The exact position of the catheter depends on whether you are blocking an upper or lower limb. The risks of infection can be high with this type of catheter and complications can be serious. I was lucky that nothing bad happened except for some allergies to medications prescribed to me orally after the fact. The hospital protocols there are superior to anything I've ever experienced so i would go back in a heart beat. Plus the German food is a real delight from the rubber food served in our hospitals here. It's real healthy food.

We paid the hospital about 5,000 Euros for a week long stay, not including the actual surgery, which really was a minor procedure just to remove screws that could normally be done in an out patient clinic, that was additional. Plus our travel costs and we were well into about $12,000 CND.

I'm a bit tired tonight so i hope my answer makes sense.

Hope you are doing well.

MsL