Dear Mike,
My migraines are from my RSD. Getson did an occipital block in May which helped a lot. My RSD spread from my right shoulder (brachial plexus) UP instead of down - it went into my cervical spine and the back of my head. My PT gave me some stretches to do which I don't do as often as I should. And the pain gets worse as my infusions start to wear off.
My doctor in RI told me what my dose was with Getson when he got my records. He said Getson told him he generally doesn't disclose dosing because patients tend to compare notes and get upset when they discover that their dose might not be the same as someone else's. I guess if I persisted in wanting to know what I was getting he would have probably told me. I don't know if Dr. S. has the same policy or not. The 150 mg worked for me - I didn't need as much at first, I was about 10 - 15 lbs lighter than I am now and hadn't built up any exposure to it yet. Now the 200 mg. works well for me, too.
I get a line placed in my hand for my infusions - Getson used a smaller needle than my RI doc uses (he has more experience with this stuff!!). Because I am active I still have decent veins. I saw some central lines at Getson's in NJ (there were always more than one of us at a time), but no picc lines. I don't think they use them for ketamine. I'm not sure how big the needles are, but you can request a child's size if you like to minimize the chance of spreading. I've had a lot of pain with my left hand since I've so many needle sticks in it (the blocks, lidocaine infusions, and now all the ketamine). The smaller the better. Ketamine is also very easy on the veins.
Take care, Sandy
Quote:
Originally Posted by fmichael
Sandy -
Thank you for that marvelously complete answer. And wow! 28 infusions since April is much more than I would have guessed. But then you don't know what was exact the dosage. (FYI: that wouldn't fly in many jurisdictions, including California, where the patient is generally entitled to as much information regarding his or her care as s/he wants: otherwise it's not "informed consent.")
I guess the big question that comes to mind pertains to your headaches, where I seem to recall them being directly associated with ketamine. But you suggest - as I read it - that the migraines came to town with the CRPS and not with its treatment. Is that correct?
And on a more prosaic level, do you recall the gauge of the needle that was used with your IV? I'm hoping this can be done through a 22, because due to neurogenic vasoconstriction I haven't been able tolerate a 20 since at least 2004, and the thought of being in a "dissociative state" for the better part of two weeks with a PICC line implanted in my arm 24/7 lacks a certain aesthetic appeal, to put it mildly.
Thanks again.
Mike
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