hey everyone:

FYI:

in case you have not seen this -- this is a very well done video by some tDCS researchers who are trying to standardize the tDCS protocol.

http://www.jove.com/video/2744/elect...nt-stimulation


voner

So funny you would post this...I just came across the same video in the past hour and downloaded the PDF on their site to read through. Great minds I guess and all that.

The purpose of this video is not to standardize tDCS protocols. It is merely an example of one of the research protocols. Many folks with chronic pain have no response to this particular protocol.

I agree that the video itself doesn't seem like it is meant to standardize the protocols...but the researchers in it say that they would like to. Tha PDF download gives some more information about a couple of different protocols and the common benefits and limitations of each one.

I am so excited about trying this out. I ordered everything (hope I got all the different parts I need) yesterday. Honestly...my biggest concern is trying to figure out the best times of the day to do the treatments. Assuming I am allowed to return to work, my hours are pretty funky. Do you do the treatments at the same time every day or do you think it matters? I don't think my workplace would be a good place to do the treatment as it is extremely rare to ever get a break where you don't get pulled back out to the floor for something and I know you sort of need to sit still with the tDCS treatment.

But I'm getting ahead of myself I think. I haven't even started yet and already I am worrying about how to fit treatments in with my work schedule.

It would probably be ideal if you did not start tDCS the same time you are returning to work. Doing so may be akin to starting two new meds at one time. If you have to return to work next week it might be a good idea to adjust to work first to more or less get a baseline for you pain level during the workday and then begin tDCS so you can assess how the treatment is effecting you.

I agree that treatments at work may be precarious if you can't get a total of twenty minutes of quiet, uninterrupted time. Fitting the treatments in should not be a problem as long as you allow at least six hours in between treatments.

Another reason for adjusting to work first is to also establish how work is effecting your sleep. Beginning the job and tDCS may present a challenge if your sleep is disrupted and you are not sure what the culprit is. For me if I do tDCS after 5pm my sleep is disrupted, but others do not have this issue.

Just my random thoughts.

Best to you!!!

Thanks for the advice...I will definitely keep this in mind. I hadn't thought about that but it does make sense. Delaying the tDCS for a few weeks while I adjust work will not kill me. I have no doubt that my sleep habits will be wonky after I start back to work...though maybe I will be able to get more than 3-4 hours if it tires me out. It's just that it is not uncommon to work until 1am-2am in the morning when working the closing shift and then need to be back there at 6am to open up the next morning. But I am sure I will adjust. Thanks for the advice.

I still haven't heard back from work though...sigh...it seems they are going to continue to play games with me. Oh well...I will get that all sorted out soon enough one way or another.

I just had to respond to your post after reading it. What a rare doctor you have! I mentioned tDCS to my Pain Specialist and this is what he said "Oh you should be careful about any treatment out there that is experimental. They'll just suck up a bunch of money and be ineffective plus most of them have little to no evidence to support their claims. I would not do it unless there has been a double blind study with CRPS patients." And I'm thinking to myself what medication have we tried that has had a double blind study with CRPS patients? And that was the end of the conversation. He had never heard of it, he didn't care to look into it or discuss it.

Anyways, it is great to hear that your doctor is on board! Please keep us posted on how the treatment goes once you start. I really hope it works!

I know...she's been so great. I almost had a heart attack back in November when I called on a Monday to schedule an appointment with her and the receptionist told me, "Wednesday is her last day...we can get you in tomorrow." It was one of those moments where I felt someone must be looking out for me because I just called on a whim because I had a few minutes to spare...I had planned on calling Wednesday. So I spent all day Monday completely stressed out...worried she was moving out of state or something. Thankfully...no...she was just moving to a different practice because the one she was in (while great) had just been bought by a large medical group that was going to impose a bunch of restrictions on the amount of time they could spend with patients and a lot of other stuff like that and she felt moving to an independent group would be better for her and her patients. She's very frank about stuff like that.

I am so so so lucky to have found her. She's a general practitioner, is not an RSD specialist, but I have gotten better care with her than any other doctor since I got RSD. My lawyer kept giving me a hard time (my RSD is the result of a work injury) insisting that I needed to get to a board certified pain management doctor (which work comp wasn't approving anyway...long complicated story) but this was at a point where my health was finally improving and I was finally getting better instead of getting worse and I just told him that I needed to do what was best for my health which was to continue treating with my current doctor. I told him that if work comp wanted me to see a pain management doctor then I would (assuming I didn't have to pay for it) but that I would not stop treating with my current doctor and mess up a treatment plan that was working. He may think I am crazy but I decided to put my health first and I am so very thankful I did.

It is a shame that your doctor responded with ignorance. I suspect that since he is a pain management doctor he recommends and or implants spinal cord stimulators for CRPS patients. If so why don,t you ask him if the devices he recommends/implants have met his same criteria. As to "sucking up a bunch of money" tDCS is the cheapest form of pain management I know of. Does he know the actual cost?

Did you ask your doctor about tDCS because you are interested in trying it? If so has his response discouraged you? If you have been discouraged by his comments you might supply him with some research, suggest he avail himself of the training offered by Harvard, ask him to consult with physicians knowledgable about tDCS, find a new doctor you don't have to educate, or save yourself time and money and try the treatment yourself.

Just some food for thought.

Hoping better days are ahead for you!

It is great that you stuck to your guns about staying with a doctor who is working for you. I find it is sometimes hard b/c we get pushed around by doctors, lawyers, insurance companies and after all that it is sometimes hard to listen to our own intuition, wants and needs. I'm really glad that you were able to do that and that this doctor has been able to help you. I hope you have further success with the tDCS.