Dear Ali -

I am also very sorry to hear of your current problems. Understand that the NHS is cost-conscious and have assumed that's why ketamine infusions aren't part of the solution-set in the U.K. I also understand the bind that exists for U.K. citizens, where obtaining medical treatment for a non-emergency situation outside of the NHS (as in, anywhere in the world, if one could afford it) could easily result in a lifetime ban from receiving NHS services.

But I do have a question, which may cover ground you've been over too long, if so, my apologies. Have you been seen as an out-patient and/or participated in the full in-patient CRPS programme at the Royal National Hospital for Rheumatic Diseases in Bath, under the direction of Prof Candy McCabe, Consultant Nurse? http://www.rnhrd.nhs.uk/departments/...n_syndrome.htm

I have been impressed by Dr. (she has a PhD after all) McCabe's online talks and publications, and know someone who is fortunate enough to have her as her pain specialist. And if a physician were to submit a referral on you behalf, I would seriously recommend including some of your poetry, noting your age when any particular piece was written, so that your potential cultural contribution to this world is out there. Any health system has a way of taking care of "high value" patients.

Pending that, search the forum for Dextromethorphan. At therapeutic (prescribed) levels, it's cheap and some people have had amazing results with it. It has few side effects, and is second only to ketamine as an NDMA receptor antagonist, or in plain English, can break up the pain mechanism quite nicely. For what it's worth. Again, you may have been there a long time ago.

Finally, in light of your incontrovertible verbal and metaphoric processing abilities, may I suggest a mixture of Existentialism and Tibetan Buddhism? The person I have in mind for the job is Pema Chödrön, an American Buddhist nun and abbot of Gampo Abbey in Nova Scotia, the first Tibetan monastery in North America established for Westerners. And the specific book (although I've gotten a lot out of anything of her's I've read) is When Things Fall Apart: Heart Advice for Difficult Times (2002), widely available in paperback. From Amazon's review:

Much like Zen, Pema Chodron's interpretation of Tibetan Buddhism takes the form of a nontheistic spiritualism. In When Things Fall Apart this head of a Tibetan monastery in Canada outlines some relevant and deceptively profound terms of Tibetan Buddhism that are germane to modern issues. The key to all of these terms is accepting that in the final analysis, life is groundless. By letting go, we free ourselves to face fear and obstacles and offer ourselves unflinchingly to others. The graceful, conversational tone of Chodron's writing gives the impression of sitting on a pillow across from her . . . .

For me, I was struck by how much her treatment of acceptance in the face of the ultimately unacceptable reminded me of the hard-boiled existentialism I had read in a Humanities class in high-school too many years earlier. Then, on the last page, she finally quotes Jean-Paul Sartre in a blinding finale:

There are two ways to go to the gas chamber, free or not free.

As I understand it, we are free if we enter into each moment solely as the present. We are not free if each stimulus in the here and now just plays on a thousand strands of undigested personal history, so that what we are aware of is not the moment itself, but the reverberation of all that has come before.

I hope some of this can be helpful. Bring your talents to bear and it will work out, you'll see.

Mike