Hello All,

Recently I posted a case report about the use of and Epidural Cath-A-Port that had given a young woman 10+ years of excellent pan control for CRPS II / Causalgia. I am excited to share with you all that after sharing this article with my doctor and a few others on the same, that we started the first steps to see if this will work for me also.

The first test was an Intralaminar Epidural Injection - this was a long acting right sided lumbar injection with Lidocaine, small amount of morphine & versed. The idea was that this would show whether or not the medication did indeed relieve the pain from where the nerves are damaged and caused CRPS II. I am happy to say that it did that 100% .. actually it worked to well (as expected) in that I was so numb from the right rib down that I could not walk. Much like getting an epidural for surgery to the lower limbs.

The next step is to place a temporary continuous flow epidural as in inpatient so that the meds can be adjusted to allow me to walk and most importantly still relieve pain. They will also monitor closely for any signs of infection as they would anytime you have an epidural. The insurance companies generally require this part of the process but, the bonus it that there are many studies that indicate the effectiveness of an epidural infusion so perhaps I will benefit just with that alone - there is always that hope. I am being admitted for 3-7 days starting at 11AM today .. oh am I looking forward to the relief, some directed PT and mostly for some much needed rest as pain has been increasing daily for months.

The final step as long as this is successful is placing what they call a 'tunneled epidural catheter w/port'. This is slightly different that the pain pumps that are used in that only the catheter and epidural are buried under the skin - the infusion part is attached when needed by a pouch that connects to the internal port. A home visiting nurse would come weekly to change meds and flush system.. another great bonus for me, since I live 3 hrs from my doctors office so that will be much less driving YIPPEE. This system will be filled with non-narcotic medications like lidocaine etc., more of an anesthetic effect rather than narcotic pain control which is what works best for neuropathic pain generally. That is also very important to me due to the cognitive effects of pain meds.

Oh.. I am dreaming of wearing something other than stretch pants, showering without the fear of water drops hitting my worst leg, actually wash my legs with soap!, going into a building and not immediately looking for all the air-vents so that I can plan my route accordingly with hopefully less pain and so many other things.. oh I hope this works!!

I know this isn't a common procedure but the theory behind the inpatient epidural is similar to that of a ketamine infusion only less potent and in my opinion dangerous meds. I plan to keep you all updated every step of the way since I really think this can help many of us who have exhausted all other options for pain control without any significant relief.

I do have an SCS and although that still works and runs 24/7 it isn't enough. For those curious about the epidural along with the SCS - the epidural catheter will be placed right along side or one vertabra lower than where the SCS leads are. Wasn't a problem when I had the initial injection so I am not worried about any problems there.

Wishing you all the best day possible - I'll check in as soon as I am able.

Tessa



Everybody needs beauty as well as bread, places to play in and pray in, where nature may heal and give strength to body and soul alike.
- The Yosemite