Lidocaine Infusion (I'm afraid)
 

Any opinions on this?
2 wks. ago at last consult my P.M. Dr. is pretty sure the CRPS/RSD is spreading to my left foot. Of course I've suspected it but have been in partial denial.
So, she ordered a lidocaine infusion (IV) done in hospital but outpatient.

Well, as with most things with this disease I had never heard of this before and did not know what to ask, she was in a hurry, she was training a new assistant etc. etc.....
I figured she thought it would deter the spread but now from what I've read it seems like just another temporary (few hours) pain reliever and it may be diagnostic as well? Can have dangerous side effects that's why in hospital. She rattled that off in a hurry like a drug commercial. :rolleyes:

Now, I have questions and I'm scheduled to go in for this on Thursday.
Love & Hugs to you all!

As far as I know the spreading cannot be altered. Where it stops nobody knows.

I've never had this done but may consider it someday. I'm sorry I can't offer any advice. I hope that whatever you decide, that you feel better soon. My thoughts are with you.

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I've also never had it done. My RSD spread pretty far, far enough. Nothing can stop it, unfortunately. Pain is the only thing that can be relieved by all the types of procedure's. The doctor should go into GREAT detail about it. Information is so important. The pros, the cons are important. She should tell you step by step what will happen before that day comes NOT when you're there for the procedure. I've never been rushed like that.

The most important thing to me (because I've had everything under the sun done) is research!

Good luck :)
Heather

you need to primt this out and insist it is followed.

Hospital ProtocolRSD/CRPS Patient: Handle With Care!
The Joint Commission on Accreditation of Healthcare Organizations has man-
dated the healthcare institutions that they accredit to assess and treat your
pain. Pain is now to be assessed as the fifth vital sign. Patients have the right
to demand pain control and to be pain free.
Reflex Sympathetic Dystrophy(RSD) also known as Complex Regional Pain Syndrome (CRPS) is a chronic condition characterized by severe burning pain, pathological changes in bone and skin, excessive sweating, tissue swelling and extreme sensitivity to touch. People afflicted with RSD/CRPS are extraordinarily sensitive to certain stimuli, such as touch, movement, and injections.


Patient Tips

1. Bring a written copy of your medication regime. It is important to verify whether your medication regime can be taken care of solely through use of the hospital's
pharmacy. Some medications may not be part of the hospital's formulary.
2. Avoid having ice applied to the RSD-affected limb
3. Instruct all hospital staff to always ask before touching you!
4. Request that the surgery protocols be adjusted so that the pre-op shave be done after anesthesia
(catheter is in place for epidural or whatever). It feels like a lawnmower has been run over your legs when they shave without anesthesia.
Patient Room

1. Whenever possible patient should be in a quiet part of the hospital
2. In a semi-private room, patient should be in the second bed to avoid inadvertent bumping
3. A Zone-Air bed should be used (adjust mattress pressure to patient preference)
4. Heat and air conditioning should be well regulated
5. Standing orders should be issued for patients to have warm blankets
6. Foot Cradle to hold bed linens off body area (will diminish tactile stimuli)
7. Frequent linen changes may be necessary due to hyperhidrosis (increased sweating).
8. Allow family members to bring in clean sheet and pillowcases for patient. Hospital sheets are not soft and can irritate the skin.
9. Place a sign above bed designating affected limb
Procedures

1. Perform a phlebotomy on unaffected limb only
2. Use Pediatric needles (any trauma can cause the spread of RSD to a new site)
3. Warm Alcohol or Betadine wipes with warm running water on outside of package before opening package (these wipes can be very cold to the patient)
4. If PICA site is available, see if blood can be obtained from PIC instead of using vena puncture technique.
Blood Pressure and Pulse Rate

1. Use cuff on unaffected limb only
2. Use thigh cuff if both upper extremities are affected Transport

1. Ask what kind of help the patient needs when transferring to a stretcher or wheelchair (simply touching arms or legs may cause hyperalgesia)
2. Use extreme care over bumps, such as elevator doorways
Feeding

1. Be careful not to touch patient extremities with bedside table
Patient Identification

1. Place red bracelet on unaffected limb
2. Place red dot sticker on patient chart
PO Box 502
Milford, CT 06460
Toll-free: 877-662-7737
info@rsds.org
www.rsds.org

This info is from the pamphlet my doctor gave me on them. I think you should really research any treatment before you do it. There have been times that I have been so desperate for any relief that I just let them do what ever they recommended and regretted it later.
Good luck. I really hope it works for you.

"An intravenous lidocaine infusion is used to assess the potential benefits of lidocaine (a numbing medication) and related medications to manage your pain. Depending on the specific cause of the pain some patients report immediate, temporary relief of pain during the lidocaine infusion.

Other patients report sustained relief for one to four weeks after the infusion. If you notice an improvement in your pain during the infusion, please take note as to how long the beneficial effects of the medication last and report this to your provider at the time of your next scheduled office visit. Although extremely uncommon, side effects may include agitation, fainting, seizures, cardiac arrhythmias or arrest during the infusion."

I haven't had a lidocaine infusion, but I have read about them, and they do seem to be mainly used as a diagnostic tool. I don't think any possible benefits will be long-term...:rolleyes:

The main red flag for me is the rush/haste/slapdash/can't-be-******d attitude of your doc. There are significant risks invoked in the procedure, and you as their patient should be completely informed as to WHY they think you would benefit from doing this, and most importantly WHAT THOSE RISKS ARE. It is completely negligent for any doctor to try to sleep-walk their patient into doing a procedure.

It happened to me with my knee :( and is the reason I now have CRPS in my entire left side, and my right foot. I believed every word the surgeon said when after physio wasn't improving my pain, he declared he would just have a quick look around in my left knee and "fix whatever's wrong in there". I didn't ask enough questions, didn't research the procedure and the risks enough... I know I was just darned unlucky to get CRPS from it, but....:rolleyes:

My point is, ESPECIALLY if you already have CRPS, do not go into anything without all the information you need. Of course they are pushed for time, and as a patient you do have to research lots aout it yourself, but any remaining questions and concerns - if your doctor won't make the time to talk you through them, then don't let them do it. Our lives and bodies and futures are far far too important to put them at risk without a darned good reason.

Sorry to rant. But your whole post really flagged to me that you are confused and scared and a bit lost - and it's your doc's responsibility to help with that, and to do their best for you. You deserve no less than that.

My left foot is now my worst affected place, and I was in denial for as long as I could too :rolleyes:. It's horrible to accept that this can I just take over some other part of you... Keep it moving and flexing, massage it, do the warm epsom baths, and use it use it as much as you can.

Good luck with everything, I hope (whatever you decide) that the future is brighter than it probably seems right now!

Bram.

Thanks everyone as always!!
I highly value all of your advice! So often medical people treat patients
all the same as if we're practice specimens in medical school.
Thanks Kevscar for the protocols reminders too!

I'll let you all know how the proceedure went after tomorrow.
Hope I have a good report.

My thoughts and prayers are with you AZ-Di. I hope the procedure works for you. Take care. From Renee.