[stillsmiling]

Hey everyone, I'm really excited to have gotten a call this morning that I would be able to (in 2 days!!) see a new Highly Certified Pain Specialist who is also a Neurologist! (Yay because I have seizures he could hopefully treat too!) He was trained under "world renowned Dr. Shwartz???????? For treating and understanding RSD." This guy has BIG time Credentials...... Definitely more than any other Dr. I have been too. Here's the deal though. I have been having alarming memory issues and serious brain fog. I like to go into my Doctors appts totally understanding my options. I have never had a doctor willing to do much except prescribe meds. The information below was on his sight and because I am having trouble with very bad brain fog today, I would so appreciate ANY thoughts on his way of doing things, experiences with any of the drugs he mentions, or procedures he does. I want to go in there equipped. Any information would be great!! Thanks in advance! So this is what it says on his sight............

"Patients diagnosed with CRPS for over 2 months should receive a psychological evaluation, which includes psychometric testing, to identify and treat psychological disorders, such as anxiety, depression, or personality disorders. Counseling, behavioral modification, biofeedback, relaxation therapy, group therapy, and self-hypnosis should be considered. The goal of psychotherapy is to improve patient motivation and coping skills.*

Tricyclic antidepressants, antiepileptics, and narcotics such as methadone are commonly used empirically for CRPS, even though clinical controlled studies have not proven their efficacy. Corticosteroids have proven to be effective analgesics in several trials with early CRPS patients. However, this is not widely used, possibly due to the side effects of corticosteroids. Subcutaneous calcitonin and intravenous phentolamine studies have had conflicting results. NMDA receptor modulation is a major interest of current research. A recent study indicated that sub-anesthetic infusions of ketamine might offer a promising therapeutic option in the treatment of appropriately selected patients with intractable CRPS. However, more studies are needed to further establish the safety and efficacy of this novel approach.*

Minimally invasive techniques have been used extensively for the treatment of CRPS. These techniques include sympathetic block, intravenous regional block (IVRB), somatic nerve block, epidural drug administration, intrathecal drug delivery, and neurostimulation. Stellate ganglion blocks in the early stage CRPS may significantly decrease pain and hasten clinical recovery. It may also prevent the recurrence of CRPS after re-operation of the affected extremity. In a double blind study, IVRB with bretylium provided significantly longer analgesia than lidocaine. Epidural delivery of clonidine and ketamine, intrathecal baclofen and morphine have reported to provide good pain relief. A randomized trial, with a two-year follow-up of 36 patients, suggested that spinal cord stimulation results in a long-term pain reduction and improvement in health-related qualities of life."








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[Littlepaw]

Hi! So happy to hear about the consult. I hope it is everything you could wish for. I find it encouraging that this doc has posted so much info about different treatments and that those statements jive with what I, at least personally, have seen in the literature. It sounds like they are familiar with the options. What a concept!

Maybe write down what treaments you have tried and what has or has not worked for you. This includes meds and any negative reactions. Don't write a book, just a shorthand list.

Take notes while you are there if needed. Ask where the doc thinks you should start and lay out any ground rules you have. I told my PM right off the bat what I did not want so we were both clear and he was totally respectful of that.

Good luck! Let us know what happens!

[stillsmiling]

Originally Posted by Littlepaw

Hi! So happy to hear about the consult. I hope it is everything you could wish for. I find it encouraging that this doc has posted so much info about different treatments and that those statements jive with what I, at least personally, have seen in the literature. It sounds like they are familiar with the options. What a concept!

Maybe write down what treaments you have tried and what has or has not worked for you. This includes meds and any negative reactions. Don't write a book, just a shorthand list.

Take notes while you are there if needed. Ask where the doc thinks you should start and lay out any ground rules you have. I told my PM right off the bat what I did not want so we were both clear and he was totally respectful of that.

Good luck! Let us know what happens!

Thank you Littlepaw for your feedback. Fortunately I'm thinking clearer today, so I will be compiling a list of ground rules tonight along with all the meds that haven't worked or have done more harm than good. Thanks for the prompts I am pretty sure EVERYONE on here has been let down by "specialists" who don't think out of their small boxes, but I am trying to stay positive regardless of the past experiences I've had. I am so grateful for the support from this forum. I will update for sure.