Reflex Sympathetic Dystrophy (RSD and CRPS) Reflex Sympathetic Dystrophy (Complex Regional Pain Syndromes Type I) and Causalgia (Complex Regional Pain Syndromes Type II)(RSD and CRPS)

 
 
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Old 02-01-2012, 01:37 PM #10
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fmichael fmichael is offline
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fmichael fmichael is offline
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Join Date: Sep 2006
Location: California
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Hi. Thanks for the support! In the interest of time, I've responded to some of your specific comments in blue.

Mike

Quote:
Originally Posted by ballerina View Post
Welcome to the party! I am thrilled beyond words! I know only too well the frustration of trying to bring doctors around. I am not surprised that your pain doc is not on the same page as you. Regarding his fear that tDCS is not FDA approved I am curious to know if you doc implants SCS in patients with CRPS since FDA approval was based on conditions like FBS, not CRPS. Nope/not on your life. He is, however, open to referring patients for rTMS, but that's cost prohibitive, especially where re-treatments are required every 14 months or so. Boston Scientific management admitted to me that PM docs use SCS for CRPS "off label." tDCS as an off label use for FDA approved iontphoresis is no different, (except of course that it has virtually no side effects and can't put a pm doc's kids through harvard) Confused, a quick online check for definitions of "iontphoresis" at answers.com gets this:
A medical treatment used to drive positive or negative ions into a tissue, in which two electrodes are placed in contact with tissue, one of the electrodes being a pad of absorbent material soaked with a solution of the material to be administered, and a voltage is applied between the electrodes.

Read more: http://www.answers.com/topic/iontoph...#ixzz1l9iSKYvo
So for what specific conditions is tDCS iontphoresis already FDA approved? And there are no doubt some - and my pain doc had to be in err - where the equipment can be legally ordered with a doctor's Rx.


Regarding you shrinks comparison of tDCS to SCS he may be comparing apples and oranges. The stimulation in SCS only masks the pain. tDCS targets the root cause of CRPS, cortical reorganization. No comparison was being made with SCS, we were simply in agreement as to how ludicrous it would be to require only a fixed series of treatments from tDCS while almost everything else, including MCS - which in all likelihood operates along the some pathways as tDCS - is applied continuously.

I have a suggestion. To prevent yourself from paying for your shrink's training with your time and co-pays please consider giving Jim Fugedy a call (Transcranial Brain Stimulation Clinic Atlanta, Ga.) to see if you can arrange for a video consultation between the three of you. It could save you both time and frustration through experimentation and trial and error. Jim Fugedy has a particular interest in tDCS and attentional deficits. Good idea!

Additionally, if I may tread for a moment where I have not been invited, a thorough review of all meds, perhaps with a good internist, may be in order to see which meds, if any may be contributing to some of your executive function issues in addition to your neuropathic pain. Sometimes PM docs and shrinks, for a variety of reasons, don't regularly perform this kind of evaluation. Sadly, the drugs I'm on are not significantly different from those I was using 8 years ago, when none of this was an issue. And while Baclofen and opioids - and there, without developing any tolerance - I've been on a constant dose - and I guess the benzos too have been implicated in memory loss, to the best of my knowledge, none of them show up as under the headings of executive dysfunction or aphasia, both of which are typically associated with left prefrontal dysfunction. See, Lubin et al (2010).

Sending you hugs my friend!!!!!!!!!!

Please keep everyone posted!!!!!

I am doing the happy dance for you!!!!!!!
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