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Recently diagnosed
Hi my name is Dan and I'm a 20 year old male who was in good health until a work related injury followed by a injury playing basketball caused a bad bone bruise and a tear in my illiotibial band. After the doc realized I was in much more pain than I should be and noticed how sensitive my skin had become to touch, he referred me to pain management.
Yesterday I had a sympathetic nerve block done on my L3 vertebrae (feel free to correct me if I'm getting that wrong) and the back pain has become unbearable, they plan on doing 2 more next week but I'm afraid.. From what I've read this isn't always the most effective treatment and the back pain seems to be spreading to my entire lower back, and is quite severe, I can barely bend or twist and riding in a car (even a whole day+ after) is incredibly painful. Could this be a sign of RSD worsening? And what other treatments are most successful? I am currently on lyrica and endocet, which help somewhat but not entirely.. I also am on anti-anxiety meds which help calm my brain a bit cuz I'm kind of freaking out. Any suggestions/advice is much appreciated. -Dan |
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I'm a huge advocate of ketamine infusions...the sooner the better.
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The fact that you are young, and were diagnosed reasonably fast are on your side.
It sounds like the book 'Break Through Pain' by Shinzen Young may be of help. fmichael recommended it to me years ago... He is one of our most informed forum posters. It has a small book and a CD and is around $20. Shinzen explains how to use Mindfulness Meditation to help with the pain. I have had RSD ten years now, and it has helped me more than anything else has. For some reason, most medications have not helped me much. I think when you first get RSD, it is darned scary, and this book really helped me take the fear away from being in pain. Juli |
Many will disagree probably, but I do believe in SOME cases blocks can and does cause spread. I have seen it!!!. If I were in your shoes (if i could wear shoes lol) I would run away FASt from any more blocks. Just my opinion. Fondly-Carol
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Hey Dan,
Anytime you feel those "freaking out" and "afraid" emotions it's time for a 2nd opinion. If you don't feel right about a treatment or procedure, take a time out and try to get to another doc. I think repeated SGB may have caused my RSD to spread to my right leg. But I will never know for sure. The RSDSA has a link to board certified anesthesiologists and PM docs. Jim Broatch (the Director of the RSDSA) also is maintaining a list of ketamine docs. Do your best to get to highest quality PM center in your area. This is a good place to start your search for another doc: http://www.rsdsa.org/4/resources/spe..._websites.html RSDS.org also has a ton of other great info on CRPS. Also - if this is a work related injury, make sure that you have a lawyer. Worker's Comp can be a real hassle. Good luck and keep us posted. XOXOX Sandy |
Hi Dan
Having been diagnosed with RSD almost 6 years ago (feels like 100:() the one thing I've learned is that when the pain tries to overwhelm me it's time to stop the cycle. One of the other replies mentioned Mindfulness Meditation. Let me tell you that above all the meds, docs, and procedures this type of meditation has saved my life. Getting to the point where you are, you need to get in touch with yourself. As someone else said, when it doesn't feel right, it isn't. RUN. Getting diagnosed early is critical. I had nerve blocks done on both my ankles and it was a nightmare--won't go into that now. See if you can get someone to mix up a batch of ketamine and amytriptaline cream to put on your back. Or if that doesn't work, try lidocaine patches. These both are topical. Please let us know how you are doing. I look back on that first few months and remember how scared I was. We are all here to help. :hug: Teresa Marie |
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Have you had an MRI to rule out lumbar disc hernia or other axial pathology? When you hear stampeeding hoofbeats, think horses not zebras.... I'm not say'in....I'm just say'in... |
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------- Unfortunately I used to have an opiate problem after a car accident last summer (which hurt the same knee, opposite side of the knee though and the kneecap). I was prescribed percocet 10's for 2 months and the dr did not ween me off at all and I started withdrawing badly (and was still having knee pain anyways) so I turned to a friend who could get some roxicodone and headed down a slipperly slope. I went to rehab in Calif and really turned my life around and got myself into incredibly good shape and continued that when I got back home to NY. That's why this injury has been so frustrating as it has killed my physicality. I also have no desire to be an opiate addict again but my tolerance is so high that I have to take the maximum prescribed dose or more just for pain relief as it seems to be the most effective pain reliever for me at this point. But honestly I'd rather be on them than experience this raw gnawing burning pain. At least on them I can walk around without too much pain. Although lyrica seems to help or at least the mix of the two with anti-anxiety meds. This seems to be at least a percentage of a mental issue, as I can have sex in a couple positions that don't hurt and when I'm doing it (or receiving fellatio) the pain is almost non-existent or only a 2-3 instead of the usual 6-8 (that's including meds). Thankfully I have an amazing girlfriend who is an angel and is really helping me through this. Sorry for rambling I'm just very confused and a little scared as I really want to get back to the gym and working physically as that's 75% of my work duties. -Dan |
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So sorry to here you are suffering with RSD. It's a really tough disease to get under control but many do and early intervention is very important. From my experience with Lumbar Epidurals and what I have been told by my doctors is if you don't get relieve or your pain is worse then maybe it's not the correct treatment. But it is only the first one sometimes it takes a few. I just want to ask you a few questions if you don't mind. First I hope you are bringing one of your parents with you when you have your PM Appointments, I've seen the good, bad and the ugly you always should have someone with you especially at your age, I also have a 20 yr. old son, does your doctor when administuring the epidural use flourosopy guidance which is a type of tool that allows the doctor to see on a screen exactly where the injection will go , what does your doctor say when you say "you can't twist, or bend or ride in a car" and last how long have you been going through this? My personal experience with spinal epidurals is as such: I had 4 over the last 4 years. The 1st was great total relieve but 6 months later I needed another which didn't work at all, then I switched doctors same office my insurance changed and this guy did the last 2 and it was absolutly complete relieve, my last one was April 2010,so that's pretty good. So, yes it can go up and down and each persons situation is different. Most doctors don't like to sedate a patient when doing an epidural, they like the patient awake so he/she can ask if the injection is hitting the area of discomfort, but truthfully I have asked to be sedated and yes they do sedate me when I have them done, but I have known these doctors for 7 years, I would never do sedation unless I felt comfortable with the doctor and facility. Try not to let it get you down. It's a tough road and if you read on this site many go into complete remission and you are young which gives you so much more of a chance of remission. I have read for some reason young people are more likely to go into remission then someone like me who was 43 when I got hurt. Keep positive this is a great site with many people who are going through the same thing and there are some young adults like yourself on here also. Gabbycakes |
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And thank you for the questions I don't mind at all it's relieving to know that someone who gets what I'm going through can ask constructive questions. Yeah he uses some kind of x-ray thing or something to see where the fluid is going. He doesn't ask if I can twist or bend but the sheet they leave me with after says not to ride in a car for 8 hours after. The first one was pretty clinical I was kind of in and out, they gave me lyrica then I had to call back and wait a day of terrible pain for a script of percocet to be filled (god forbid they give me something that actually works) since I'm technically not a patient until tuesday when I sit down with the Dr himself as the they think the Dr who referred me is my Dr, but he is just a family friend who was helping out and rushing me in there so I could be seen as he couldn't take me on as a patient for 2 weeks. It's confusing I know I don't really understand it either, as I thought time was of the essence with this. They used a local anesthetic last time but it only lasted for maybe 45 minutes then my back killed on top of my knee & calf still killing me. And all that has happened since the first one was an increase in pain in my calf muscle and the feeling that it's spreading. To be honest I would rather be sedated as it's not like I could feel anything there at the moment of impact, and once I saw the size of that needle my only thought was "Holy $#*1, you're sticking that big thing in my spine?".. Now I know that most people go through this, I just hate needles and this was no IV needle, unless you're sticking a grizzly bear. Thanks again for your support I'm trying to stay positive it's just tough going from being 6' 185 in excellent shape to under 175 and skinny as hell. It also sucks when you had a small drug problem that you're over with but caused you to have a high tolerance. So they act like they're doing me a favor by giving me perc 5's which don't touch the pain unless I take at least 2, usually more like 3-5 when I'm really flaring up, but then I run out and spend a day or two in excruciating pain. And those don't even touch the muscle spasms. Sometimes I feel like I'd almost be better off saying &%& it and canceling my health insurance saving that money and getting meds that actually work. I know that sounds stupid but it seems more pro-active than this useless stuff. The first one didn't help anything and if anything just made it worse, so I'm pretty disenchanted especially when I read so many people not getting relief or it even making it worse with these spinal things. I understand the whole "we don't want people hooked on meds" stuff but honestly I'd rather be hooked on something that works so I can go back to work and at least exercise in some capacity, instead of being 20 and walking around with a damn cane like I'm 92 yrs old. /rant |
You can get ketamine in NY. Call the RSDSA for a list of doctors in NY. 877-662-7737.
Insurance paid for my daughter's and many others. Sometimes you have to appeal but the FDA has approved ketamine for breakthrough pain so it is getting more and more acceptable all the time. Can't hurt!!! |
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It all comes down to clinical indications as whether or not your insurance will spring for another MRI or if it's even ecessary. If your exam findings are suggestive of a disc issue, for example in your lower back, then your doc may feel compelled to order a lumbar MRI. It's not so much that your insurance counts how many per your you have and basis a decision on that merit. |
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I'm so glad I was apple to help. I would be lying if I said I don't take any pain meds. but I have come from 35 pills a day in 2003-2007 to almost nothing. I have done ketamine 3 - 5 day inpatient infustions which did help tremendously. But I had to do 3, which was a drag, believe me. As I think I mentioned I have been with the same group of doctors for 7-8 years and I was always preached to "once all this is over you will be getting off the medication" and I did. My doctor would always tell me to much of pain killers will actually make you worse in the long run you really have to keep it in check. So, please don't say "I'll cancel my health insurance and buy from someone else", thats really not a solution.. Remember I have a 20 yr. old college student and he tells me everything, sometimes I don't even want to know. But we where all 20 at one point so I get it. I actually have never seen the size of the needle, I'm a big baby. What part of NY do you live? Are you close to Manhattan? I hope you appt. goes well today . Keep us posted. Gabbycakes |
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I wish I could just do it myself cuz honestly I can get ketamine easier than a pain patient seeking a legitimate route. Now I'm not going to do it cuz I don't know how to do the procedure, but just goes to show how stupid this country is. |
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Basically long story short I sat in a hot waiting room for way too long, got funneled in like a dog being put down, then accused to dr. shopping even though I have had a prescription to anti-anxiety meds for 2+ years now, and they help tremendously with my anger and anxiety (often related, and when I say anger I don't mean swearing I mean breaking thousands of dollars worth of **** and beating the **** out of people that cross me). He then goes on to say that if the first block didn't take, that I shouldn't have another, something I thought all along but everyone else including his own employees said I should stick with. And then, he says in order to get another script of percocet (pretty much the only thing keeping me from the street right now), and a consult with him tomorrow, I have to submit to a drug test. So whatever, I already wrote cannabis on my check in paper, so I **** in this cup just so I can meet with him tomorrow to tell him how much of a f*****g c***s*ck** he is. He said all of this in a very domineering tone as if I'm not a man. And yes, my mom was there, but I wish she wasn't I woulda stabbed that *** **** with his own horse needle. And sorry for my language edits but that's the only way I can convey my emotion here And I live in Albany. |
Hang in there Dan
So sorry for what you are going through....
I have a 20 year old daughter. it sucks that you are faced with this are your age. on the other hand, remission is more likely when you are young and when it has been caught early. the street version of k may not give you the same benefits as the k that's administered by a medical facility. You should be REAL careful thinking that you can duplicate the effects...the dosages need to be titrated at a certain rate over a certain period of time. And side effects can be nasty, I get terribly nauseous without Zofran added to my IV. in addition, the most effective treatments have been demonstrated to be the multiple day protocols. For instance, I started out at 10 days in a row. You really should have good medical care when doing a drug like k for that long... Most of us have experienced arrogant, egotistical docs who don't listen to us and don't care about our pain. Try to bring someone with you to your appointments for support - a parent or a sibling or a dependable friend. The RSDSA has a list of pain Mgmt doc on their website. Go to RSDS.org. I really hope you get the help that you need quickly. keep in touch.... Good luck, Sandy |
I'm so sorry to hear this. I had a block done on January 31st this year and I now have terrible, severe pain in my entire upper body. It has been a nightmare with things just getting worse and worse and worse. We're still looking for other explanations besides a spread of the CRPS...but I am really scared that CRPS may be the explanation for the new pain...especially after so long with no answers yet. But so far I am hoping I have just had incompetant doctors and that there is another explanation besides CRPS spread.
I really wish I had not let this doc convince me that blocks were the answer. I was doing so well before with meds and physical therapy. Not pain free...but functioning. I'm a stubborn person and will do anything that I need to do to keep that function...but this latest stuff has been a major setback. physical therapy was probably the best thing for me...but without the meds I wouldn't have been able to DO the PT. I was on Lyrica, Mobic, Ultram, and Doxepin along with Lidoderm Patches when I was doing well. Even once I 'finished' physical therapy I still continued to do all the exercises every day at home. It was hard...but totally worth it. I got hurt at work when I was 25 (am now 27) and I am not willing to let this thing get the best of me. I wouldn't continue the blocks if I were you. I would try the meds, physical therapy, and possibly using a TENS unit and see how those treat you. I've heard good things about Ketamine...but haven't tried it myself so I can't really speak to it. There is so much information here on the board and it's been a great resource for me. I hope things start looking up for you soon. :hug: |
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Sorry to here you felt treated so badly. PM is a funny business it can be a great help and or it can make you worse. You want someone who is going to watch out for you in regards to medications. To me thats a smart doctor anyone can write a script. So my advice to you is to take it down a notch and try and work with this doctor if you and your Mom think he's good and can help you. There's not a respected PM Doctor who will work with anyone who is arrogent and nasty. They are to affraid of losing there license. Unfortunitly, many abuse there medication, use it recreationally try and get in sooner, thats not what PM is. You stated you where an athlete, if I where you before you go to your appt. today move your body if you can even if you walk 25 feet in front of your house/apt. and try and relaxe. As an athlete you know how good your body can feel when it moves. Exercise for me is something I have to do everyday to beat this beast. I go to gym 3 times a week and walk the others I can't do everything but if I didn't do it I would be misreable. I could not do all this when I was going through 7 surgeries, 3 ketamine procedures etc. when I first had my accident. My problem in upper extremety so it's easier but I do have a slight spread of RSD to my back like I stated in my first post. I told you before I have a 20 yr old son he was also a althete from 7-18, played ice hockey. We traveled around the Albany area all the way to Lake Placid. He hasn't picked up his stick but for 1 time since his last varsity game he just had had it. But the point is he feels the effect on his body from not working out all the time, being on the ice 7 days a week blah, blah. The point is excercise helps RSD. When you get time today look up Dr. Sherry in Philadelphia. He is a pediatric RSD Spec. He has a very interesting take on RSD and how to cure it,especially for young people up to 18. I believe the University of Chicago is working on a simular treatment for adults. Just read it. I see alot of my son's friends who I have heard display behavior such as you described in your post.Again my son's know angel but never displayed that kind of behavior. Its tough for young adults today I definitly get it but there's no excusse for that kind of behavior. First it increases your stress which will flare any kind of medical condition not just RSD. So like I said before take it down a notch, try and get some kind of body movement so you feel a little better before you see this doctor today. If he is willing to work with you,you need to show him you are responsible. Dan, good luck today. You need someone to work with you so you have to work with them. KEEP US POSTED. Gabbycakes |
ketamine infusions
Don't know where you are in NY so I am posting what I found:
New York: Durkin 631-638-0800 Waldman 212-606-1015 Haider www.killpain.com Hertz 212-523-6357 Northshore Hosp 516-496-6506 New Jersey Getson (worked with Dr S and has great rep) Zampella 973-285-7800 Camden (no doc name) 856-983-7246 As a word of warning.....prob not a good idea to mention your previous use of ketamine!!! They probably will not want to take you on. The K infusions are a little diff anyway. If you do the outpatient they will give you a three hour infusion mixed with Versed and prob Ativan. In patient is 5 straight days. I know a doc that is not on there that does in patient. Richman in NYC. Good luck to you...I hope you consider trying it. Liz |
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Gabby is right on. My message wasn't strong enough...try to behave yourself!! Sorry to sound like such a Mom, but we all care about each other here and don't want to see you get blacklisted by all the docs in your area. I also have the latest list of ketamine docs from the RSDSA (the info that Betsy gave you) - from what I can see they are all in and around NYC and Long Island. There are a few in New Jerrsey. I don't see any in northern NY. But the treatment is worth traveling for, I went over 300 miles from RI to Marlton, NJ to Dr. Getson for my first 22 low dose ketamine infusions almost a year ago now, it has changed my life!! I returned to my full time job after a year's sick leave from my RSD. Please take care, Sandy |
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Richman is with Waldman at the Hospital for Special Surgery. The Camden, NJ number above is actually the number for Getson in Marlton, NJ He used to also be at Cooper Hospital, which is in Camden. |
Dan,
We all get very frustrated when doctor's "don't act like we want them to". Be mindful that they deal with all walks of life daily and need to protect their license to practice medicine. My doctor's always tell me they wish they had more patients like me who are afraid of and wont take narcotic medications. My sister was labeled in all local hospitals as a "drug seeker", so they know her game....me complete opposite, maybe seeing my family struggle with addiction has steered me the other way, not sure. But any how, if you truly feel there is going to be a problem with this doctor, try and find another one first. It is hard to find doctor's to treat this beast and throwing F*** bombs around will not make it any easier. I currently treat with a PM Dr. who is very rude however, I am trying to overlook it and get some relief. Could I switch? Sure, but saying she was rude probably won't get me far with a new Dr. They stick together and usually won't go against another Dr., so think of that for future medical treatment needed. We can all get pissy and hot headed, but remember, we are only hurting ourselves, causing flare ups and causing our doctor's to be extra guarded when treating us. If you have a legitimate, medical complaint that is another story, by all means run and run fast. Hang in there, we are here for each other!!! |
My daughter is in Syracuse. I think you will see ketamine there before you know it. Also...this is only ONE list. There are plenty of other doctors who do it.....you just have to search. I would join a bunch of the RSD groups on FB if you want to learn more.
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I wish I knew where there was a more comprehensive list available of ketamine providers. I have heard that there are more docs in New England other than those that are included on the RSDSA listing that Jim Broatch has so generously provided every time I have requested it. There are many southern New Englanders who would love to try ketamine for their RSD, but cannot afford the price that the only RI doc charges. And the Beth Israel in Boston shut their doors to new patients several years ago.
Thanks Betsy. XOXOX Sandy Quote:
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first of all, go to a teaching hospital. they are trying newer things. second of all, get admitted for pain control. that is the easiest way to get it done. and really, do go to FB and join some groups. I see names on their all the time. the bad thing is the list is not complete. the good thing is it is not complete because more and more doctors are using it!!!! |
Hi I am sorry about your pain. The block I had increased my pain but it did settle back to where it was which was hell but not as horrid as the flare as the block gave. My pain doctor said that the pain probably is not stemming from the spine then. I have had very little success with meds and I take no narcotics now but even ones like neurontin. I have gotten a few opinions from pain docs. I always encourage others to as well.
As for ketamine I think if one does it and I have not but have read a lot and same with my mom that it is important to see someone who deals a lot with rsd. I feel that way about pain docs in general and treatment providers be knowledgable about rsd. When I went to a day program for pain at Cleveland Clinic some had issues with med addiction. I really feel for people who do. I think regardless if this is or not an issue therapy can help in general to cope. As for the doctor I am sorry that you were treated that way. I agree that one no matter how upset they are must remain calm in front of them. It is ok to say how you feel but must be done in a proper way. Most of us have heard things from docs that make us want to scream but taking a deep breath and having a plan either to see someone else or explain to the doc in a calm way how you feel is important. Hang in there and I hope you can find a doc to help you |
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The appointment was ok, although at the beginning I told him I would be going back to my original neurologist and (Dr. Argoff) who referred me in the first place. I also told him I was displeased with his attitude and treatment towards myself, a patient and his customer. He responded by saying he wanted to make sure I was not drug seeking, and then went on to say that he would like to still try and work with me in some manner. He then went on to say that he would not prescribe me any narcotics or muscle relaxers as I had tested positive for THC (no **** sherlock, I had stated that I am an occasional user of cannabis from time to time on your little sheets and before you even gave me the **** test, so what was the point?). Not that I want to be on these things forever but they help a little for now. He did give me a script for pool physical therapy which I asked for and know I need. At least I have an appointment with Dr. Argoff and he has enough time now for me to be a regular patient, and he also is a friend of my mothers and her boyfriend (who works in oncology at the same hospital, Albany Medical Center). This guy is also a lot more reasonable and friendly, and doesn't wear oakley reading glasses and $7,000 suits to work like that other @$$. Thank you all for your help and support it has been a real life saver, I wish I could comment on all your posts and reciprocate a little more right now but I have to go, thanks again. -Dan |
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Sounds like you accomplished a lot. Hope all continues well and keep us posted. Gabbycakes |
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Thanks again, Sandy |
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I went back and read you post and just 2 more things. Be carefull with the klonopin it's a benzodiazapan and can do more harm than good, trust me. And 2 I wouldn't worry about cannabis on a urine sample. Most if not all test new patients just to make sure there not doing other drugs. Cannabis is being percribed in NJ and about 15 other states as treatment for RSD and other medical conditions. Dan like I said I have been in PM for 7 years. I have seen some crazy things just while sitting in the waiting room and I can see why these doctors are paranoid. Some people just act crazy when after they tried to get over and lost. If someone walked into my office and behaved in such a manner I would just call the police they end..... Gabbycakes |
I am newly diagnosed
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Plus I don't have to take it every day if I don't feel like I need to. I know there's concern for psychological (and physical) addiction. But you gotta understand you're talking to someone who's tried almost every drug you can try, has lost control, and regained control. I know what's best for my body and what's not. If it weren't for all this country's stupid laws I would be an excellent pharmacist, I'm a strong advocate for self-teaching especially when it comes to putting substances in your body, I never take a drug from a doctor before thoroughly researching it, same goes for when I was in my experimental stages. You're a kind lady Gabby, your son is blessed to have you as a mother. |
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I totally agree with you I would take a klonopin before all that other medication you mentioned if I needed to again. The SSRI, SSNI's etc. is a crazy line of medication and I would not take it either. That kind of medication is percribed so recklessly it unbelievable. Just wanted to follow up. Hope your feeling better today. Thank you for that very sweet compliment, you made me cry. That was very kind. Keep us posted. Gabbycakes |
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