Stellate Ganglion Blocks for Full Body CRPS RSD? Efficacy?
 

Hi.

I have had full body CRPS RSD for 23 days and 79 days since likely onset of RSD. My doctor at the moment Moskowitz Michael, MD suggested Stellate Ganglion Blocks and seemed very confident in them although Dr. Robert A. Savala, MD who did the injection said that if I didn't feel much or any change from the first injection he can't suggest more. However I am not sure of his experience with RSD CRPS. My reading on the subject seems to indicate that people who have it in one limb at my stage - 30% or 40% may have relief?

I have pain at the injection site and it has traveled a little and gotten worse with the days. The injection was done last Wednesday and it is Sunday now.

Should I get another injection Monday or skip it and head down to LA to see Joshua Philip Prager MD MS? I have an appointment Wednesday but maybe he could see me Monday.....

I suggest you consult with Dr. Carden in Marina Del Rey or research the pain clinic at USC, which Michael has highly recommended here on NT in the past.

Praeger will push for a spinal cord stimulator in all likelihood, and many of us that have gone to him for consults were unhappy with the experience... Just do some searches on patient reviews and you'll see what I mean.

Dr. Carden offers out patient Ketamine, as well as other blocks and the SCS (but isn't pushy about it at all!) If you're willing to go further south there is also Dr. Sajben in La Jolla.

I will travel anywhere. I am pretty sure I want fast 10 day Ketamine. Thank you for your response.

Praeger does perform inpatient Ketamine, and outpatient as well. If you're willing to go out of pocket for outpatient he'll probably be interested... I don't trust him after my experience with him... I went to him seeking outpatient K and he made it sound as if he only offered inpatient--something I couldn't afford to go out of pocket for. He knew my insurance would cover the SCS, so that was what he pushed for. I was stunned when I was contacted by one of his patients telling me he performed her K infusions.

Dr. Leverone is in Torrance, but travels around the state, so he might come to you.

http://neurotalk.psychcentral.com/sh...light=Ketamine

I am sorry to hear that. A doctor shouldn't push something because it will be profitable for him.

However I am without insurance so everything is out of pocket anyway. It doesn't matter to me -I just want whatever knocks this devil off my back. I tell you without insurance everything is hellishly expensive. Maybe he pushed for the SCS because he thought that was what you could afford?

[QUOTE=LIT LOVE;899717]Praeger does perform inpatient Ketamine, and outpatient as well. If you're willing to go out of pocket for outpatient he'll probably be interested... I don't trust him after my experience with him... I went to him seeking outpatient K and he made it sound as if he only offered inpatient--something I couldn't afford to go out of pocket for. He knew my insurance would cover the SCS, so that was what he pushed for. I was stunned when I was contacted by one of his patients telling me he performed her K infusions.

Dr. Leverone is in Torrance, but travels around the state, so he might come to you.

I emailed the doc at USC and he said I should see Stanford or UCSF. But as far as I know they don't do Ketamine. I was not impressed by the UCSF pain department, at least the doctor I saw. And I have an appointment at Stanford but it's for August 17.

SCS runs at least 50k for the operation. Plus, he has a 30 day inpatient program. Plus, whatever fees are charged over the lifetime of a patient.

I went to him, seeking a specific treatment. I had the cash ready to pay for a series of treatments. (I was willing to spend 10k or more out of pocket.) And it's been long enough where I can't remember the exact number he quoted, but it was in the tens of thousands and well beyond my option unless I settled out my case. (Something I considered.)

I also asked how many of his patients with RSD, that have had a SCS, has it caused spread. His claim? Zero. This is just dishonest.

Prior to meeting with Praeger, his resident warned me not to be offended by him and his ego...

He belittled something my doc had recommended, (actually laughed and was very condescending) and although my doc was unknown in the field, it turned out that he was not only correct, (verified by Carden) but that the research was several years old and verifiable online.

While I agree it is important to be aggressive asap when dealing with RSD, you also need to find a doc you can trust, and YOU must do your own homework. SCS does work well for some, but it can be a nightmare as well. Learn to use the search button here on NT, as well as some of the other respected RSD sites found in the stickies on this forum. Start with "Praeger" and you will see that he leaves a trail of unhappy patients...

I've had RSD 10+ years. My care has been well managed for several years, so that I'm working towards the goal of remission, or a continuing of lowering the effects of the disorder. I have had multiple brushes with developing spread, and have figured out what works for me to keep it from happening. (Steroids, Lidoderm, massage, warm water with Epsom Salts, an increase of meds when responding to a fresh injury.) I'm unwilling to undergo an invasive treatment like SCS at this point.

If I were in your shoes, I'd probably see what Praeger has to say. It doesn't seem you even have a clear diagnosis at this point. If you're not happy with him, I'd fly into San Diego and consult Dr. Sajben.
http://painsandiego.com/

An appointment in August is not so very far away, btw. You can often get in earlier by calling to fill someone's cancelled appointment. In the meantime, start reading--there's a sea of important info about RSD available. Starting with how diet can effect RSD http://www.rsdrx.com/four_f%27s_diet.htm

Check out HBOT. Research Ketamine. Start swimming in warm water asap.

I see this is an older posting but I hope that you opted to see Dr Prager ;)
_ S.