Further to Mikes comments I actually do have my life back, I was out shoveling snow and had no major problems. I'm not cured, but I am substantially better than I was before I had the surgery. It is believed that the screw that was placed between my 1st & 2nd metatarsal was the main cause of my RSD (why an orthopedic surgeon would place a screw in a foot like that is beyond most medical reasoning but that's another story). My body is still healing, recent x rays show osteoporosis is still evident in the area of trauma but my bones are strengthening and my RSD symptoms are very mild now.

Mike is right, sadly this treatment is not being offered to patients in the acute phases of RSD. My doctors in Germany were very surprised I had never been offered it here in Canada. When I explained this procedure to my PM Dr after I returned home, he replied defensively that he only has 4 bed for the whole of the province of BC. Honestly I think it is because he isn't familiar with the procedure. I am truly happy to see it being used for the injured soldiers, lets hope the knowledge gets transferred to other medical professionals so it can be used more widely. The anesthesiologist who gave me the continuous "peridural" block serves part time with the German Navy helping with the injured from Iraq. I was very happy to be in his expert hands.

MsL

I happily stand corrected! (And am thrilled to here of your continuing recovery. Clearly your RSD was being aggrevated by the screw. One wonders how many of us have such "reversable" conditions.)

Mike

MSL,
May i ask you what is peridual anesthesia?
Would you please clarify?
Numb

Hi,
I forgot who post this but i want you to tell me more about the ketamine drip and morphin button. How is the ketmine drip being administer, is it through the IV? and what about the morphin button?
Please inform and thanks,
Numb

Sorry for my late reply, I just saw your question now. I'll try my best to explain the "peridural" anesthesia.

The day following my surgery in Germany this past August, I was given a 7 day continuous "peridural" anesthesia with Bupivacaine and an opiate.

Doctors don't seem to know what a peridural is here in North America. In Germany it is considered a "gold standard" treatment for newly diagnosed RSD patients with great success.

It is similar to an epidural except that the catheter is slightly bent and so instead of it paralysing me completely from the waist down, this bent catheter gives direct access to the sympathetic nerves of just my left leg. It should not paralyze that leg completely and the drs slowly increase the medication until maximum pain relief is reached. There is the risk of losing control of bladder and bowel functions so they carefully increased the dosage until I was pain free but still able to stand. I was not allowed to get out of bed on my own (even though I could walk).

The first attempt to insert the catheter actually got my right leg (opps), completely paralyzed it with the lowest dosage so they had to reposition the catheter. It was interesting to see that the same amount of medication that paralyzed my normal right side barely even affected my left rsd side. They had to increase the medication by more than double of that given at first to my right side to reach the maximum benefits of pain relief.

I am doing very well now, was it the peridural, the ongoing Lidocaine infusions I get or the fact that the offending screws were finally removed from my foot? I will never really know that answer completely.

What I do know is that while I am 10 times better than before the surgery I do still have RSD, albeit mildly. Sadly it was told to me that because I have had the RSD for so long it was very unlikely that I could be cured with the paridural treatment. The reason we did it was to mitigate the risk of rsd spread from a surgery on the rsd affected limb and I think that was definitely accomplished.

Fortunately it is a treatment that can help those newly diagnosed and or those of us who have to go under the knife again.

MsL

Hi MsL
I do not understand why these procedures and precautions are not taken here in the USA for everyone - if it truly works for all of us dealing with this unfortunate condition why can't the world come together for the sake of good. I do know that were I am being treated that they are well aware of preventions and precautions but, am not sure to what extent as I haven't gotten that far yet - I am still deciding about going through w/the surgery and haven't discussed all the factors yet.
I am being asked to wait a bit longer for more pain-relief from my meds and other things considered such as waiting until the summer and the warmer weather. And, I am sure that they want you to be totally sure about going through w/it as the consequences are always there. Everyone THANKS for all your input and experiences - greatly appreciated!!

That is a good question Island Girl.

Another good question is why did I have to go all the way to Germany to be properly taken care of? I lived through 6 years of burning hell with every step I took and not one doctor here would help me fix the problem. They all said she has RSD, we don't want to touch her. It's too dangerous! It will make her RSD 10 X worse. Well they were wrong!

When I told my pm doctor here what the German doctors did for me, that they consider it the gold standard of treatments, he just shrugged his shoulders and complained that he only has 4 beds for the pain program that treats the whole province. Even worse there is a 2 to 3 year wait list to get into this Pain Clinic so if your newly diagnosed with RSD here forget it. A very sad state of affairs.

Personally I think there is quite a divide in the medical profession when there is a language barrier, perhaps this is why some information is not known or shared or taught. I was very happy to see that this procedure is now being used preemptively for injured soldiers in the Iraq war. It could save them from developing rsd.

Of interest to note, the Ketamine treatments, coma and awake, started in Germany and were introduced to us here in North America through Dr. Schwartzman's association with those doctors in an academic research program. Perhaps the international barriers to medicine are lifting, but it is hard for those of us who are lay persons to really know why.

I know this is a big decision for you to make and I'm happy to know you are being well cared for. Summer is definitely a better time if one does have to go through surgery.

I wish you much peace and good health what ever you decide to do.

MsL

Hi MsL,
Thought you might be interested in Dr. Schwaratzman, Dr. Harbut, Dr. Correll, a German Dr. a Austrailian Dr. Did that research program regarding Ketamine here in Scottsdale, Arizona at the Mayo Clinic. My girlfriend work with them in typing up notes etc. After the study was over, some set up a practice in Page, Arizona and then after that went on to Philly. I did call Dr. S in Philly a few years ago, but the wait list was too long. Thank you for all your good, encouraging information. I'm so happy for you and your outcome in Germany. Your friend, loretta