Hi, Sandy and everybody:

Thank you so much for your support and information. You are all so kind to me that I consider you all as my friends. My family is not supportive at all, to say the least, and I have no friends in my life. Maybe people are afraid of my RSD. In fact, practically all of the persons with whom I come into contact want to flee me, as if RSD was a contagious disease. This is the reason why I prefer to call RSD a syndrome rather than a disease.

Sandy, you are right; I might be tolerant to Duragesic. I have been using this medication for about eight years and a half, but I have been on the 125 mcg dosage only since August 2010. I read somewhere (I do not remember where) that there are a few medications to help reverse one's tolerance to narcotic painkillers, without that person having to wean off of the narcotic painkiller he/she has been using. I think this type of medications is called NMDA agonist (or anti-agonist) receptors medications; my memory is so bad I do not remember the exact name of this type of medication.

If I am not being indiscreet, what pain medication(s) do you now use to replace the Duragesic you used to use?

If you read all my messages on this thread, you might remember I mentioned that it was my anesthesiologist who forced me, by trickery and what I would call "blackmailing", to wean off of Duragesic in exchange for sympathetic nerve blocks, blocks which I never received afterwards. Fortunately for me, my wonderful primary care physician, who I thank from the bottom of my heart (may God bless him for all the good he does for all his patients, not just for me), prescribed Duragesic again for me. Do you know what this stupid anesthesiologist said to me? He claimed that the fact that Duragesic worked for me meant I did not have RSD. This is just the most RIDICULOUS thing I ever heard from a doctor's mouth.

My insurance company is a public one, not a private one. Their only objective is to save money on patients' backs (except when one of them or of their loved ones is sick). Too bad for them (I mean the public health insurance company's doctors, who dare call themselves "experts") I am not afraid of them. I am willing to go to court, from the lowest level court all the way to the European Court for Human Rights, which already condemned France for several things they did when it comes to not respecting human rights.

Like I said in one of my previous messages on this thread, I tried many, many, many medications from different categories, most of which did not work at all and some of which worked very little or too little. I tried functional knee braces (but mine recently broke after a fall; it is impossible for me to get another such brace because I am not in the USA at the present time). I tried physical therapy (no help at all there; PT was so painful for me it could have just sent me to the Emergency Room and almost everyone knows hos ERs treat chronic pain patients, like druggies). I tried relaxation, guided imagery... (no help there). I tried sooo many different things for my RSD pain it is impossible for me to remember them all.

The only thing I have not tried for my RSD pain is the RSD Ketamine Coma Procedure. I have posted a message about this on the RSD thread. Maybe you have answers to some of the questions I asked, since it seems to be the treatment you tried. Maybe I am wrong? You tried ketamine booster infusions without first going through the coma for a few days or a week?

I am usually doind well with Duragesic, but only if withdrawal symptoms do not kick in between the 48th and the 72nd hours. Fortunately for me, if withdrawal symptoms happen more and more often, they are not usually that strong.

Quote: "There are a lot of high quality time release opioids out there that you DON'T currently have a tolerance for that you could consider that may be really effective for your pain." Like I said in one of my previous messages on this thread, I have trouble remembering to take oral medications on time because of my memory and concentration problems, which I had well before I started using Duragesic. If there is a way to remember taking such opioid medications and if they are as effective as Duragesic, I will be happy to try them.

Is Suboxone not an opioid antagonist? I thought opioid antagonists were supposed to "kick" or "chase" the opioids off of their receptors in the brain and body.

The only medication from the lidocaïne family that I tried is the Lidoderm 5% patches, that can be cut off in pieces to fit one's needs. Lidoderm works for the type of pain that feels like electricity stabs, but it does not really work deep inside my RSD knee.

The last option I can see and that I consider during my saddest and most desperate times is suicide, even though I do not want to die. I just want my RSD and its pain to die.

Thanks again for your help, caring, and information.

Priscilla