My PM doc wants to begin Ketamine treatment...
 

I posted this first on the RSD site, but I wanted to take advantage of the knowledge that is present here, as it would be hard to overstate how valuable I've found this site. It has been both extraordinarily informative and most beneficial psychologically.

Along those lines, I hope I can hear from anyone who has any experience with or knowledge of Ketamine infusion.

My Pain doctor, who is good and who I trust, wants to do this as our next step. Last week I had my first Stellate Ganglion and Lumbar blocks. I had some, not much, pain relief for a few hours, and then the burning came back, a little stronger actually, in a rebound effect. The burning, by the way, was first present in my abdomen as a result of a surgery, thus the RSD concern, and is now spread to my arms, legs, upper back and forehead. But I don’t technically have RSD as I am absent the other markers for the condition, having just the full-body small fiber neuropathy and pain at the surgical site. My hands and feet, unlike most I have spoken with at support groups, are just fine (if I could just trade in a foot for a new body...)

For medication, I'm at 600 mg Lyrica, along with Tramadol and am now titrating up with Cymbalta, giving me some relief, basically enough to keep from climbing the walls day and night.

My concerns with Ketamine are with the side effects. I realize it is for many the best, strongest form of treatment, a 'rebooting' process that works. But, ah, the hallucinations (!!)...

You know the person who, when, let's say, a joint was passed around, ended up paranoid on the floor? I'm that guy. Also, I have a minor but present underlying manic condition that is very sensitive to psychoactive drugs. I'm wondering how beneficial a single, four-hour infusion treatment is that first time. Does one see immediate positive effects (if there are to be any)? My reading on Ketamine led me to believe that it takes a ten-day treatment to see improvement, but my doctor (Dr. Joshua Prager in LA) said that he pretty much could tell after the first infusion if there are going to be any benefits.

Anyway, I'm in desperate need of relief, but I'm dreading the possibility of four hours of disassociative hallucinations (especially if I'm paying $2000 for such pleasures....)

Thanks to anyone who replies.

I'm very interested in the results if you decide to take the treatment as my diagnosed as idiopathic symptoms are very similar to yours. My pain extends from below the ribs to midway to my knees, both sides, front of my body only. Started at the waist and spreading slowly in both directions at first only skin deep but now feels to be going deeper in a few places.
I'm on the same dosage of Lyrica as you plus the maximum dosage of Tramadol and a two Vicodin per day. Seems the only time I'm not in pain is when I increase dosages but this is short lived. Considering medical marijuana but don't see how that could work. A good night's sleep has been 3 hours lately. Can't stand wearing clothes or a blanket touching my torso.
I really feel for the folks who have PN in their feet and hands from which I'm spared, That would be the worst.

Good luck to you no matter which course you chose.:)