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-   -   Ketamine Safety (https://www.neurotalk.org/reflex-sympathetic-dystrophy-rsd-and-crps-/150623-ketamine-safety.html)

betsykk 05-22-2011 12:10 PM

I would be very surprised if they would do the ketamine without bloodwork and an EKG. If you are seeing a regular counselor (as many patients are and should) then he might skip that portion of it. My daughter always has to have work done before the infusion and she has had over a dozen at this point.

DeesRSD 05-22-2011 12:58 PM

hi
 
I am happy to report that my doctor ( Dr. Leverone in CA.) does require prior testing before he even considers doing the infusions. Here is a small blip from his site and I quote:

"In order to schedule ketamine infusion therapy treatment with Dr. Leverone you will need to click on the questionnaire, fill in answers to the questions, and then click "submit". Please note that there are a few exclusionary criteria for ketamine infusion therapy, not everyone can receive the treatment even with a correct diagnosis, and these will be revealed in the questionnaire. You will also need to fax in the completed physician referral form (click on that page and print) and a recent (within 30 days) complete history and physical from your general practitioner. It is very helpful to also fax a copy of a recent workup by your pain specialist.

Additionally Dr. Leverone will need lab work done within 30 days of treatment, to include CBC, Electrolytes, and Screening Liver Function Tests (ALT, AST, Alkaline Phosphatase), and a 12-lead EKG. Chest X-ray is sometimes required, but may be waived in certain patients. This can be determined at the time of scheduling.

All of the above pre-procedure information must be received by Dr. Leverone prior to rendering ketamine infusion treatment."



For me personally, I would never see doctor that I didn't do research/check on first.
I'm getting my next infusion on the 6th so if I'm not posting for a bit, that is why. Oh, I had to have my regular doctor here also sign a statement stating that I am medically clear for this procedure in addition to the above.

Take care,
Dee

gabbycakes 05-22-2011 01:58 PM

Quote:

Originally Posted by DeesRSD (Post 772735)
I am happy to report that my doctor ( Dr. Leverone in CA.) does require prior testing before he even considers doing the infusions. Here is a small blip from his site and I quote:

"In order to schedule ketamine infusion therapy treatment with Dr. Leverone you will need to click on the questionnaire, fill in answers to the questions, and then click "submit". Please note that there are a few exclusionary criteria for ketamine infusion therapy, not everyone can receive the treatment even with a correct diagnosis, and these will be revealed in the questionnaire. You will also need to fax in the completed physician referral form (click on that page and print) and a recent (within 30 days) complete history and physical from your general practitioner. It is very helpful to also fax a copy of a recent workup by your pain specialist.

Additionally Dr. Leverone will need lab work done within 30 days of treatment, to include CBC, Electrolytes, and Screening Liver Function Tests (ALT, AST, Alkaline Phosphatase), and a 12-lead EKG. Chest X-ray is sometimes required, but may be waived in certain patients. This can be determined at the time of scheduling.

All of the above pre-procedure information must be received by Dr. Leverone prior to rendering ketamine infusion treatment."



For me personally, I would never see doctor that I didn't do research/check on first.
I'm getting my next infusion on the 6th so if I'm not posting for a bit, that is why. Oh, I had to have my regular doctor here also sign a statement stating that I am medically clear for this procedure in addition to the above.

Take care,
Dee


Hi Dee,

We are the lucky ones who are getting pre-testing and good medical care. But as SandyRI states the FB site states that there are young people getting ketamine infusions without any testing. I don't want to talk negatively and give names because I have no proof that this is true or not. But better safe then sorry. The FB Site is an "open" so if you have an account you can view all the post. It's really eye opening.

Have a great day.

Gabbycakes

SandyRI 05-22-2011 02:55 PM

Does Leverone require psych clearance?

Doesn't he use REALLY high doses of ketamine in a single outpatient treatment, then prescribe oral k for a week or two after? ( I get nauseous just thinking about it..ugh.)

Everyone is different, but I know that I've never had hallucinations at the low doses that I receive. They are also infused over a 4 hour time period with a lot of Versed. (But my doses also don't last anywhere near as long as Leverone's.). I did have really bad vivid dreams for the first several months after I started getting my treatments, I used to dream about my shoulder getting sliced up in pieces or yanked apart, probably because I had some pretty awful PT sessions after my surgeries that I was traumatized about.

psych clearance was standard at all the ketamine docs I went to a few years ago in Boston, NYC, and NJ. I know Dr. S requires it, too. a doctor from NYC told me that one of his patients that was injured in the collapse of the World Trade Ctr just could not tolerate ketamine at all - as soon as they began his first infusion he started hallucinating about 9/11 and they had to stop.

Interesting topic...

keep smilin 05-22-2011 05:32 PM

Quote:

Originally Posted by SandyRI (Post 772772)
Does Leverone require psych clearance?

Doesn't he use REALLY high doses of ketamine in a single outpatient treatment, then prescribe oral k for a week or two after? ( I get nauseous just thinking about it..ugh.)

Everyone is different, but I know that I've never had hallucinations at the low doses that I receive. They are also infused over a 4 hour time period with a lot of Versed. (But my doses also don't last anywhere near as long as Leverone's.). I did have really bad vivid dreams for the first several months after I started getting my treatments, I used to dream about my shoulder getting sliced up in pieces or yanked apart, probably because I had some pretty awful PT sessions after my surgeries that I was traumatized about.

psych clearance was standard at all the ketamine docs I went to a few years
ago in Boston, NYC, and NJ. I know Dr. S requires it, too. a doctor from NYC told me that one of his patients that was injured in the collapse of the World
Trade Ctr just could not tolerate ketamine at all - as soon as they began his first infusion he started hallucinating about 9/11 and they had to stop.
Interesting topic...

Oh yes...this is interesting..My situation, I was approved for the 5 day infusion with Dr. S...but my insurance will not budge for any booster coverage... In order the 5 day infusion to be affective, I need the boosters.... AND I live 6 hours away from Philadelphia... Which there lies My next dilemma... As trips and company to stay there with me during the treatment is almost not realistic... I'd have to almost move there...plus we have two kids heading for college. I can't justify using all of our savings for a temporary pain relief... this is no way a cop out but a bump in my road for sure... Since my appeal process began for insurance to cover for any costs, my condition has worsened...My RSD is now internal...chest wall and tummy involvement...Eating is a problem...and this twist in my condition has caused me to stayed focused and feel so much more poorly that the red tape of the rest of this has become a big job... If only we could all receive the medical help and recognition it takes to live with this puppy without the constant fight... And money worries!!!!

Again..Iam so appreciative of all of you!!!!!
Hugz to all...

Kathy

daniella 05-23-2011 02:08 AM

To me the psych clearance is less of an issue as the physical issues. Those psych tests to me are not very reliable and more done for insurance then ones true mental status unless something is seriously off.
Like Daylily I am also concerned with the long term issues that may happen. Also not to be negative but for the most part I am not hearing about long term benefits of this. I have been reading blogs of people who have done both op and even the coma and for some reason they stop the blog often times or are often struggling still. The people who have had the coma often are waiting to go for another. I know some stated here that they have had benefits so I am not sure.
As for the doctors many know that we are desperate for relief and why they charge such high fees and don't take insurance. If you go on Dr K website he has a list of the prices and procedures. You pay up front with him and then you can submit it to the insurance. Now I feel he could help so many more people if he worked with the insurance. I am not sure what kind of pre testing he does but I was told that I could go for the consult and stay in the area to do the procedure right away.
Lastly part of what scares me is that I wish the doctor would look at each person with rsd as an individual. I feel with some they would suggest this treatment to anyone with rsd but it may not be right for that person. We all respond different.

hannah1234 05-23-2011 04:13 AM

I am 21 and get a high dose of ketamine... and frankly I can care less if it does harm on my body and shaves 20 years off my life... because without it I would have NO life right now and be WAY more miserable, have no social life, not be able to walk, eat... nothing....

Its a personal choice.... if you dont want to get the high dose of ketamine I dont believe that you need to go that route... but I know I speak for MANY of my RSD young friends... and its our only chance to lead a semi functional life-- so it would make no sense to think about the negative parts of it. I would rather have 20 good years than 40 horrible ones.... just my opinion...

I just think your decision is the best for yourself... nobody can make that for you. If you are afraid of the meds, then maybe an alternate route is for you... But being 21 and not 40 it sucks because we havent even started our lives so we will grasp at what helps us (not belittling rsd later in life) I just think its a different mind perspective.

Blessings on all who take the adventure down the ketamine route or those that chose otherwise! make the decision that is best for YOU!!! :)

ali12 05-23-2011 05:33 AM

They don't do Ketamine infusions over here in the UK as they aren't covered by our National Health Service (NHS). My mum has looked into the infusions for me but it would mean travelling to the US and my Doctor feels I may not be able to get them done anyway because I live outside of the United States.

I am on oral Ketamine but my doctor has said I must only take it when i'm in a really bad pain flare. I can take it up to 3 times daily if things are really bad but he doesn't suggest that, partly because of my age (he thinks the Ketamine could mess around with my hormones) and also he feels it could cause other lasting health effects.

When I have the Ketamine, I have what others have described as the 'drunk feeling'. I don't know where I am, my heads a cloud etc. It's horrible! Other times I feel really sick. You can't tell how i'm going to react to it so I don't take it on school days as it messes around with my concentration wayyy too much! I do tend to find that if I have a meal before taking the Ketamine, it can minimise the side effects but even then I don't risk taking it for school unless absolutely needed.

I agree with what the others have said, do lots of research before trying the infusions ... try other treatments etc. I know for me, we have explored all other medications so the ketamine infusions may be the way to go one day but I don't want to go down that road at the moment from what i've heard ... especially if the pain is only going to return!

Take care everyone,
Alison

DeesRSD 05-23-2011 03:28 PM

hi
 
Quote:

Originally Posted by gabbycakes (Post 772762)
Hi Dee,

We are the lucky ones who are getting pre-testing and good medical care. But as SandyRI states the FB site states that there are young people getting ketamine infusions without any testing. I don't want to talk negatively and give names because I have no proof that this is true or not. But better safe then sorry. The FB Site is an "open" so if you have an account you can view all the post. It's really eye opening.

Have a great day.

Gabbycakes

Hi Gabbycakes,
Its sad to hear that there is even a chance of doctor(s) not requiring testing before doing these infusions, very sad. I will def. check out the FB site. I only wanted to make sure that everyone knew my doc, Dr. L, does require testing because I would never recommend him to anyone if he didn't nor would I be his patient.

Thank you for the info, and I will go check out the FB site.

Take care,
Dee :grouphug:

DeesRSD 05-23-2011 03:47 PM

hi
 
Quote:

Originally Posted by SandyRI (Post 772772)
Does Leverone require psych clearance?

Doesn't he use REALLY high doses of ketamine in a single outpatient treatment, then prescribe oral k for a week or two after? ( I get nauseous just thinking about it..ugh.)

Everyone is different, but I know that I've never had hallucinations at the low doses that I receive. They are also infused over a 4 hour time period with a lot of Versed. (But my doses also don't last anywhere near as long as Leverone's.). I did have really bad vivid dreams for the first several months after I started getting my treatments, I used to dream about my shoulder getting sliced up in pieces or yanked apart, probably because I had some pretty awful PT sessions after my surgeries that I was traumatized about.

psych clearance was standard at all the ketamine docs I went to a few years ago in Boston, NYC, and NJ. I know Dr. S requires it, too. a doctor from NYC told me that one of his patients that was injured in the collapse of the World Trade Ctr just could not tolerate ketamine at all - as soon as they began his first infusion he started hallucinating about 9/11 and they had to stop.

Interesting topic...

Hi Sandy,
On the pre-questionare, if you have anxiety, depression, ect., then if memory serves me right, then yes, you need clearance. I get panic attacks since getting RSD and I also get depressed when in flare, but, I also have been cleared by psych when I had my SCS trial, pain pump implant and even before I received my first infusions. I think some want psych clearance to make sure you don't suffer from mental problems not related to RSD, I think ( brain isn't working today)

Yes on the 2 weeks of oral ketamine after infusion. It didn't cause me to have hallucinations or to freak out or anything, in fact, I never sleep so good, and basically thats what I do, sleep, and its welcomed and much appreciated.

He does do a higher dose, based on the patient and how they are doing, adn he and the ICU RN's are watching you very carefully during the whole time you are there as well.

I'm still a bit mortified that there could be doctors out there not requiring pre-testing, my mind just cannot wrap itself around that. Whats going to happen when one of these patients die because of unknown liver problems, bad heart, glaucoma, etc.? I'm still shaking my head in disbelief, wow.

Okay, didn't mean to ramble, I will def. check out that FB site, and please, if you are reading this and new to RSD and ketamine, research your doctor and their facilities very very carefully, and the other options out there.

Take care,
Dee :grouphug:


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