Continuous cervical epidural
 

Hi there,

I’m new to NeuroTalk and for that matter CRPS. I was diagnosed four months ago due to break to my right wrist. Within two weeks of being casted unfortunately things were compounded by separate injury to my left hand, thus the symptoms have now spread to include both arms, both legs, the back of my neck and my face. Though my orthopedic surgeon was prompt in suspecting CRPS, the spreading of symptoms has made it very difficult to treat. I’ve had numerous nerve blocks in both my upper and lower extremities with no lasting results, so I then flew to Florida to have a 4 days of Ketamine infusions followed by heated pool exercises 3 – 4 times a week. The infusions did provide some relief, however they didn’t put me into a remission as I’d hoped they would.

Because I live in a small city in Alaska the nearest pain management clinic is a 45min plane ride away, so needless to say I am feeling very alone. My pain management doctor is pretty vigilant about treating things very aggressively in the first 6 months and is now suggesting I have a continuous cervical epidural by means of a pump for 1-week in order to knock this down. I’ve discussed this with my doctor in Florida and he said that the procedure is very risky and to keep with the heated pool exercises and get a Ketamine booster when needed, but that means another plane ride across the country! With that said I am now really unsure. I really don’t have any doubts as to the capability of my PM doctor in Alaska, but I’m really scared about the possibility of spreading things further and possibly having a new source of pain. Therefore I was wondering if anyone out there knows anything about this procedure?

In the event I don’t do this procedure, I am contemplating doing a second 4 – day infusion with hopefully better results than the first, but was also looking for any information on this as well.

Thank you for your time,
Denali

Unfortunately, this is a difficult decision. I guess the question I would be asking myself is did I get any relief from the Ketamine? How long did it last? If I did get some positive results I would try it again if you are allowed to do it this early.

A pump can give you some could relief as well but it is not a cure.

Just a suggestion, post your thread also on scs/pain pump site. They can possibly give you more details into the painpump issues.

I hope you can research and make a decision. It is so hard with CRPS because there is no road to follow for pain relief, it is always a "try it and see what happens" Good Luck to you. I have read good things about both Ketamine and epidurals. My daughter had both and had some relief with K and had a 5 day epidural, she was pain free for the 5 days in hospital and 3 days after. She is facing the same thing as you as the PM doc wants her to decide to do one of the treatments again. It is never easy with CRPS. Good Luck!!!

Thank you for sharing your daughters experience, I do appreciate it, as I've really had a difficult time getting any feedback at all with regards to this treatment.

If you don't mind, may I ask if she had any issues with spreading of this disease i.e. to the back due to the epidural being a surgical procedure?

The one may PM doctor is suggesting is also a continuios epidural, that will be connected to a pump that I ware, as I won't be staying in the hospital. Additionaly, someone from home health is to come and check on me daily and adjust the meds.