Dear Sandy -

I'm thrilled that you have hade this level of relief. You speak of all of the travel this involves. From the experience of others, I've heard that the key factor in determining how well this "sets" is aviding as much stress as possible. I wonder, where travel is required, can you minimize stress by going at off-peak hours, taking a mid-day trains the day before the appoinments, etc?

As far as why they don't do this earlier, it's because the basic mindset among terating physicians, as incorporated into any number of "treatment guidelines," is to statrt with the most conservative treatments first, whivh is of course crazy: try applying that to heart attacks, strokes, cancer, etc. In constrast, from what I've heard, in Germany today, as soon as their is reasonable suspicion that someone has CRPS, they are immediately given a continous regional infusion of a cocktail contains ketamine for several days, when It is the most likely to do the most good. Why the disparity here? Probably because the insurance companies call the tune, and with no NIH funding for large scale trials, is hard to generate the "evidence" to tell them differently.

Which is so sad. ;(

May the next few weeks be easy for you.

Mike