JOURNAL OF PAIN MEDICINE ARTICLE ON LOW DOSE KETAMINE INFUSION THERAPY
Low Doses Of A Common Intravenous AnestheticMay Relieve Debilitating Pain Syndrome
"Limited, low-dose infusions of a widely used anesthetic drug may relieve the often intolerable and debilitating pain of Complex Regional Pain Syndrome (CRPS), a Penn State Milton S. Hershey Medical Center researcher found. "
This is an article on the Low-Dose Ketamine Infusion treatment for RSD patients covering NINE YEARS of it's use in treating and helping CRPS patients, dating back to around 1995! Doctor's Harbut and Correll were getting 75% success rate way back then with these patients.
This article was written by the two author's who did the previous article (see below); Dr. Correll and Dr Harbut as well as other authors as stated in the article.
We have been very fortunate to have had the company that handles re-print requests for this Pain Journal, allow visitors to the American RSDHope website access to read this article.
Please let us not abuse this privilege.
You may link from your site to the to this RSDHope page describing it.
Also, copying and printing of the article is not allowed as this is copyrighted information. Re-print information is available on the website and also at the end of this page.
These folks have been great, thank you BLACKWELL PUBLISHING!
Here is just a taste.
"Complex Regional Pain Syndrome (CRPS) is a disorder that can be accompanied by severe pain that is often both chronic and resistant to conventional therapy. Harbut and Correll previously reported the successful treatment of a 9-year case of intractable Type I CRPS with an intravenous inpatient infusion of ketamine in an adult female patient "
" Objective. The purpose of this study was to ascertain if indeed the use of subanesthetic inpatient infusions of ketamine provide meaningful improvements in pain scores, and thus, quality of life, in patients suffering from CRPS. To achieve this objective we focused our analysis on the relief of pain obtained by patients undergoing this novel treatment option developed at Mackay Base Hospital, Queensland, Australia. "
"Results. A total of 33 patients with diagnoses of CRPS who had undergone ketamine treatment at least once were identified. Due to relapse, 12 of 33 patients received a second course of therapy, and two of 33 patients received a third. The degree of relief obtained following the initial course of therapy was impressive (N=33); there was complete pain relief in 25 (76%), partial relief in six (18%), and no relief in two (6%) patients. The degree of relief obtained following repeat therapy (N=12) appeared even better, as all 12 patients who received second courses of treatment experienced complete relief of their CRPS pain.
The duration of relief was also impressive, as was the difference between the duration of relief obtained after the first and after the second courses of therapy. In this respect, following the first course of therapy, 54% of 33 individuals remained pain free for 3 months and 31% remained pain free for 6 months. After the second infusion, 58% of 12 patients experienced relief for 1 year, while almost 33% remained pain free for >3 years. The most frequent side effect observed in patients receiving this treatment was a feeling of inebriation. Hallucinations occurred in six patients. Less frequent side effects also included complaints of lightheadedness, dizziness, and nausea. In four patients, an alteration in hepatic enzyme profile was noted; the infusion was terminated and the abnormality resolved thereafter."
.....
"Conclusion. This retrospective review suggests that limited subanesthetic inpatient infusions of ketamine may offer a promising therapeutic option in the treatment of appropriately selected patients with intractable CRPS. More study is needed to further establish the safety and efficacy of this novel approach."
The full article published in Pain Medicine, the official journal of the American Academy of Pain Medicine. is very extensive and includes all the numbers and charts you could want. This will be an invaluable tool to share with your Drs.
Since this study was completed, much more has been learned and the success rates and relief obtained have improved significantly.
For more information on getting re-prints or jounal copies, contact;
Dave Surdel
Medical Sales Representative
Blackwell Publishing
350 Main Street
Malden, MA 02148
Tel: 781-388-8200
"Limited, low-dose infusions of a widely used anesthetic drug may relieve the often intolerable and debilitating pain of Complex Regional Pain Syndrome (CRPS), a Penn State Milton S. Hershey Medical Center researcher found. "
This is an article on the Low-Dose Ketamine Infusion treatment for RSD patients covering NINE YEARS of it's use in treating and helping CRPS patients, dating back to around 1995! Doctor's Harbut and Correll were getting 75% success rate way back then with these patients.
This article was written by the two author's who did the previous article (see below); Dr. Correll and Dr Harbut as well as other authors as stated in the article.
We have been very fortunate to have had the company that handles re-print requests for this Pain Journal, allow visitors to the American RSDHope website access to read this article.
Please let us not abuse this privilege.
You may link from your site to the to this RSDHope page describing it.
Also, copying and printing of the article is not allowed as this is copyrighted information. Re-print information is available on the website and also at the end of this page.
These folks have been great, thank you BLACKWELL PUBLISHING!
Here is just a taste.
"Complex Regional Pain Syndrome (CRPS) is a disorder that can be accompanied by severe pain that is often both chronic and resistant to conventional therapy. Harbut and Correll previously reported the successful treatment of a 9-year case of intractable Type I CRPS with an intravenous inpatient infusion of ketamine in an adult female patient "
" Objective. The purpose of this study was to ascertain if indeed the use of subanesthetic inpatient infusions of ketamine provide meaningful improvements in pain scores, and thus, quality of life, in patients suffering from CRPS. To achieve this objective we focused our analysis on the relief of pain obtained by patients undergoing this novel treatment option developed at Mackay Base Hospital, Queensland, Australia. "
"Results. A total of 33 patients with diagnoses of CRPS who had undergone ketamine treatment at least once were identified. Due to relapse, 12 of 33 patients received a second course of therapy, and two of 33 patients received a third. The degree of relief obtained following the initial course of therapy was impressive (N=33); there was complete pain relief in 25 (76%), partial relief in six (18%), and no relief in two (6%) patients. The degree of relief obtained following repeat therapy (N=12) appeared even better, as all 12 patients who received second courses of treatment experienced complete relief of their CRPS pain.
The duration of relief was also impressive, as was the difference between the duration of relief obtained after the first and after the second courses of therapy. In this respect, following the first course of therapy, 54% of 33 individuals remained pain free for 3 months and 31% remained pain free for 6 months. After the second infusion, 58% of 12 patients experienced relief for 1 year, while almost 33% remained pain free for >3 years. The most frequent side effect observed in patients receiving this treatment was a feeling of inebriation. Hallucinations occurred in six patients. Less frequent side effects also included complaints of lightheadedness, dizziness, and nausea. In four patients, an alteration in hepatic enzyme profile was noted; the infusion was terminated and the abnormality resolved thereafter."
.....
"Conclusion. This retrospective review suggests that limited subanesthetic inpatient infusions of ketamine may offer a promising therapeutic option in the treatment of appropriately selected patients with intractable CRPS. More study is needed to further establish the safety and efficacy of this novel approach."
The full article published in Pain Medicine, the official journal of the American Academy of Pain Medicine. is very extensive and includes all the numbers and charts you could want. This will be an invaluable tool to share with your Drs.
Since this study was completed, much more has been learned and the success rates and relief obtained have improved significantly.
For more information on getting re-prints or jounal copies, contact;
Dave Surdel
Medical Sales Representative
Blackwell Publishing
350 Main Street
Malden, MA 02148
Tel: 781-388-8200
Low-Dose Ketamine and Me, One Patient's Story - Keith Orsini - 2011
This is a compilation of the two articles I wrote on my two low-dose ketamine treatments by Doctor Ronald Harbut. My first one was done in 2003 in Arizona. My second one was performed in 2007 in Hot Springs, Arkansas. Two very different places let me tell you. Fortunately for me the wonderful results were the same; about 85-90% CRPS pain relief! Since the information contained in the articles was very similar, and to save space, I combined the two articles into one on the new website.
-----------
5 DAY KETAMINE IN-HOSPITAL TREATMENT - DETAILS 2007
In 1974, when I was 14 years old, I was playing baseball. I was the pitcher. I was hit in the face by a hard hit ball and it shattered my cheekbones and broke my nose. That was the beginning of my journey with RSD. I was in an auto accident in 1985 which broke my back, among other things, and that seemd to be the catalyst for my RSD (now CRPS) going full-body or "systemic". Prior to that it had stayed mostly in my eyes, ears, and facial/head region.
Over the ensuing years I tried many therapies, treatments, and medications but nothing really did very much to relieve the pain. I was fortunate in that my parents and I were never convinced by a Doctor to do any type of surgery or implant which would have aggravated my CRPS and possibly negate the possiblity of certain treatments down the road. Of course, so little was known about the disease back then in the stone age.
Let us skip to 2002!
In 2002 my father and I met a Doctor named Ronald Harbut who had been writing about a treatment called Low-dose ketamine. He had been working on this technique for years over in Australia, where he helped develop it with a Doctor named Correll, before he brought it back to the United States. He had just started treating RSD patients in Arizona with it a few months prior.
After lengthy discussions between the three of us where we learned all about the low-dose ketamine infusion method, also called the "awake technique", that Doctors Harbut and Correll had developed, we got very excited about the potential this treatment held for the CRPS community. What started as an interesting article for the website, ended up in a treatment option for me. Long story short, I traveled there in early 2003 to try it myself.
I didn't hold out much hope for any great relief though. I had had the disease for almost 30 years at that point, it was full body, and I had tried nearly everything out there. But, as most of you know we are so desperate for relief, we are so willing to do whatever it took if there was a chance. Especially since this procedure did not involve any cutting of my body, it was simply an infusion of medication over a period of five days.
I spent five days in this hospital in Page, Arizona where I received the low-dose treatment. My RSD pain and allodynia went down 85%! I was amazed. It wasn't an easy thing, ketamine is a strong medication, but by the third day I was up and walking around dragging the infusion pump beside me. By the time we flew home it felt like I was a new person.
Let's skip ahead to 2006
In April of 2007 I traveled to Arkansas. I wasn't going to visit the birthplace of one of our past presidents or possible future president. I didn't go to visit the fabled Hot Springs, although that city was my ultimate destination. I went in search of pain relief.
I realize that some Doctors who are using a form of Doctor Harbut's low-dose infusion method are also requiring patients to undergo post-treatment "boosters". Dr Harbut does not do this so I did not have them either in 2003 nor in my subsequent treatment in 2007, nor have any of his patients that I am aware of. I cannot speak to the need or value of this particular course of action, I just know some Doctors require it, some suggest it, and others follow the original protocol and make no use of it at all.
By mid-2006 my RSD pain and allodynia had returned to a large ercentage of what it was before my 2003 ketamine treatment. It is hard to be exact with full body RSD of course especially when the pain is bunched in with so many other diseases.
I think it is important to note a few things.
Firstly, ketamine is not a cure for RSD/CRPS, it is merely a treatment. Even if the patient is fortunate enough to go to zero pain, it is not considered a permanent situation, but rather that the RSD/CRPS has been put into remission.
Secondly, a successful ketamine treatment typically has the most impact on the pain and allodynia. It will also have significant impact on other aspects of the patients "pain picture: such as tingling, spasms, tightness, etc., and to a much lesser extent concentration difficulties, memory problems, etc.. Some of these may be impacted even more by the accompanying reduction in medications that occur when the overall pain picture is changed. Many patients significantly reduce their medications upon leaving the hospitalI don't want to address too many medical issues though as I am not a medical Doctor, just pass along some things that I have observed myself and from discussions I have had with fellow ketamine patients over the years.
In late 2006 I got word my name was coming up on the list for my second treatment for ketamine with Doctor Harbut for the Spring of 2007. I made sure to get myself in as healthy a condition as possible before going in this time. During my last treatment I was much heavier than I wanted to be and I think that made the recovery harder. I also wanted to try and reduce some of my pain medications leading up to the treatment so as to reduce any possible withdrawal problems if I was able to be taken off my heavier pain medications after the treatment. I am glad I did both of these things, though neither was easy.
Here is a more detailed explanation of what happened in 2007 during my five days down at St Joseph's Hospital in Hot Springs, Arkansas where I had my 5 day low-dose ketamine infusion, also known as the "Awake Technique". My Doctor was Ronald Harbut, the same Doctor who helped develop the low-dose ketamine infusion technique that is in use by Doctors around the country today; places like Philadelphia, PA; New Jersey, New York; and soon, San Diego from what I understand.
The 5 day in-hospital infusion itself is fairly simple. On Monday morning I checked in to the hospital. I already had my paperwork completed from Friday so it was a breeze.
We were taken to our special room on 2 West. I say we because this special suite is built to accomodate not only the patient for the week but also their loved one. It comes complete with an over-sized chair that folds out to a twin bed. The room is decorated to be as comfortable as a bedroom in your home. Everything is done to make the experience as comforting as possible. It also includes an over-sized bathroom, a rocking chair, etc.
In addition, you have a nurse who is dedicated to your care only 24 hours a day. She is stationed right outside your door and some shifts she even sits in the room with you in the rocking chair! The nursing staff at this hospital is the most exceptional I have ever encountered. They went out of their way to make sure we were comfortable and they certainly knew their stuff. Having talked to many other patients who have also been through this procedure, they list countless instances where the nurses went above and beyond to make them feel special.
The ketamine itself is adminstered through an infusion pump, which looks like a fancy IV, and starts first thing Monday morning. It runs continuously until sometime on Friday, depending on how much pain you have left by then, if any. Doctor Harbut mixes in clonodine with the ketamine to increase its effectiveness. This is key as shown in his research.
We changed the level a few times during the week of course depending on how my body was reacting. By Friday we realized we had achieved all we were going to, about 90%, and so we stopped the infusion. I was fairly well exhausted. By late afternoon/early evening when Dr Harbut was satisfied that the ketamine had metabolized and I was totally coherent and able to ambulate safely, I was released.
That night I slept very well, no ill effects at all. On Saturday we spent a fairly quiet day but we did get out and do a few things. On Sunday we went to the Garvin Gardens, amazing woodland gardens located in Hot Springs. We walked among the waterfalls, gardens, bridges, and ponds for hours. It was very healing and refreshing after being in the hospital for a week. I guess we walked for about 2 miles altogether, stopping every so often but it felt great! WOW!
On Monday I was back at the hospital for a follow-up appointment and some blood-work. Some of my liver functions came back elevated but he said that was to be expected considering the amount of ketamine I was given. On Tuesday, more bloodwork and a final appointment. Liver numbers much better, doing follow-up blood-work here in Maine following week. Did a final check of where the CRPS burning pain was still and where there was allodynia still, looking for any slippage from the final result on Friday. Noted some difference but not much.
Bottom line; when I left Hot Springs on Tuesday afternoon my CRPS pain was about 90% gone. That is, 90% of the burning pain and allodynia I came in with before the ketamine infusion was now gone. What we were unable to touch was the burning pain in the eyes and ears. No real surprise there though as that was the original site. Back in 1974 my CRPS started there. It wasn't until 1985 when I broke my back that it spread everywhere else so the eyes have had a very long time for that pain cycle to become entrenched. There was also a little allodynia on the bottom of my feet left.
What it didn't help was my fibromyalgia nor did we expect it to. But to have my RSD pain drop down to 15% of what it was is great. We are extremely hopeful it will hold at this level for another 3 or more years. It also has enabled me to do more physically, especially walking every day, which helps the overall health picture.
I feel very fortunate and blessed to have been able to get this treatment and these results. I want to thank everyone who prayed for me and thought about me during my treatment and travel. I also want to thank those of you who called and/or sent emails. It was most appreciated by not only me but also my family.
Now it is summertime of 2007 and my relief is maintaining at about 80 - 85% relief. I am very glad that I went down for my second treatment in April, (the first being early 2003). Although initially my relief was about 85-90% it did drop a little in the weeks post-treatment, which isn't unusual.
I would recommend patients doing the treatment plan on getting lots of rest before and after the treatment. Rest is essential to getting the most out of the ketamine procedure. You are fairly exhausted but at the same time, because so much of your pain is gone you want to do so many things you haven't been able to do! STOP! REST! Take a few weeks and let your body catch up to how your mind is re-setting. Otherwise you will wind up back at square one. This is very important.
AM I HAPPY I WENT DOWN FOR THE LOW-DOSE TREATMENT? ABSOLUTELY!
peace, Keith Orsini - 2011 and 2007
This is a compilation of the two articles I wrote on my two low-dose ketamine treatments by Doctor Ronald Harbut. My first one was done in 2003 in Arizona. My second one was performed in 2007 in Hot Springs, Arkansas. Two very different places let me tell you. Fortunately for me the wonderful results were the same; about 85-90% CRPS pain relief! Since the information contained in the articles was very similar, and to save space, I combined the two articles into one on the new website.
-----------
5 DAY KETAMINE IN-HOSPITAL TREATMENT - DETAILS 2007
In 1974, when I was 14 years old, I was playing baseball. I was the pitcher. I was hit in the face by a hard hit ball and it shattered my cheekbones and broke my nose. That was the beginning of my journey with RSD. I was in an auto accident in 1985 which broke my back, among other things, and that seemd to be the catalyst for my RSD (now CRPS) going full-body or "systemic". Prior to that it had stayed mostly in my eyes, ears, and facial/head region.
Over the ensuing years I tried many therapies, treatments, and medications but nothing really did very much to relieve the pain. I was fortunate in that my parents and I were never convinced by a Doctor to do any type of surgery or implant which would have aggravated my CRPS and possibly negate the possiblity of certain treatments down the road. Of course, so little was known about the disease back then in the stone age.
Let us skip to 2002!
In 2002 my father and I met a Doctor named Ronald Harbut who had been writing about a treatment called Low-dose ketamine. He had been working on this technique for years over in Australia, where he helped develop it with a Doctor named Correll, before he brought it back to the United States. He had just started treating RSD patients in Arizona with it a few months prior.
After lengthy discussions between the three of us where we learned all about the low-dose ketamine infusion method, also called the "awake technique", that Doctors Harbut and Correll had developed, we got very excited about the potential this treatment held for the CRPS community. What started as an interesting article for the website, ended up in a treatment option for me. Long story short, I traveled there in early 2003 to try it myself.
I didn't hold out much hope for any great relief though. I had had the disease for almost 30 years at that point, it was full body, and I had tried nearly everything out there. But, as most of you know we are so desperate for relief, we are so willing to do whatever it took if there was a chance. Especially since this procedure did not involve any cutting of my body, it was simply an infusion of medication over a period of five days.
I spent five days in this hospital in Page, Arizona where I received the low-dose treatment. My RSD pain and allodynia went down 85%! I was amazed. It wasn't an easy thing, ketamine is a strong medication, but by the third day I was up and walking around dragging the infusion pump beside me. By the time we flew home it felt like I was a new person.
Let's skip ahead to 2006
In April of 2007 I traveled to Arkansas. I wasn't going to visit the birthplace of one of our past presidents or possible future president. I didn't go to visit the fabled Hot Springs, although that city was my ultimate destination. I went in search of pain relief.
I realize that some Doctors who are using a form of Doctor Harbut's low-dose infusion method are also requiring patients to undergo post-treatment "boosters". Dr Harbut does not do this so I did not have them either in 2003 nor in my subsequent treatment in 2007, nor have any of his patients that I am aware of. I cannot speak to the need or value of this particular course of action, I just know some Doctors require it, some suggest it, and others follow the original protocol and make no use of it at all.
By mid-2006 my RSD pain and allodynia had returned to a large ercentage of what it was before my 2003 ketamine treatment. It is hard to be exact with full body RSD of course especially when the pain is bunched in with so many other diseases.
I think it is important to note a few things.
Firstly, ketamine is not a cure for RSD/CRPS, it is merely a treatment. Even if the patient is fortunate enough to go to zero pain, it is not considered a permanent situation, but rather that the RSD/CRPS has been put into remission.
Secondly, a successful ketamine treatment typically has the most impact on the pain and allodynia. It will also have significant impact on other aspects of the patients "pain picture: such as tingling, spasms, tightness, etc., and to a much lesser extent concentration difficulties, memory problems, etc.. Some of these may be impacted even more by the accompanying reduction in medications that occur when the overall pain picture is changed. Many patients significantly reduce their medications upon leaving the hospitalI don't want to address too many medical issues though as I am not a medical Doctor, just pass along some things that I have observed myself and from discussions I have had with fellow ketamine patients over the years.
In late 2006 I got word my name was coming up on the list for my second treatment for ketamine with Doctor Harbut for the Spring of 2007. I made sure to get myself in as healthy a condition as possible before going in this time. During my last treatment I was much heavier than I wanted to be and I think that made the recovery harder. I also wanted to try and reduce some of my pain medications leading up to the treatment so as to reduce any possible withdrawal problems if I was able to be taken off my heavier pain medications after the treatment. I am glad I did both of these things, though neither was easy.
Here is a more detailed explanation of what happened in 2007 during my five days down at St Joseph's Hospital in Hot Springs, Arkansas where I had my 5 day low-dose ketamine infusion, also known as the "Awake Technique". My Doctor was Ronald Harbut, the same Doctor who helped develop the low-dose ketamine infusion technique that is in use by Doctors around the country today; places like Philadelphia, PA; New Jersey, New York; and soon, San Diego from what I understand.
The 5 day in-hospital infusion itself is fairly simple. On Monday morning I checked in to the hospital. I already had my paperwork completed from Friday so it was a breeze.
We were taken to our special room on 2 West. I say we because this special suite is built to accomodate not only the patient for the week but also their loved one. It comes complete with an over-sized chair that folds out to a twin bed. The room is decorated to be as comfortable as a bedroom in your home. Everything is done to make the experience as comforting as possible. It also includes an over-sized bathroom, a rocking chair, etc.
In addition, you have a nurse who is dedicated to your care only 24 hours a day. She is stationed right outside your door and some shifts she even sits in the room with you in the rocking chair! The nursing staff at this hospital is the most exceptional I have ever encountered. They went out of their way to make sure we were comfortable and they certainly knew their stuff. Having talked to many other patients who have also been through this procedure, they list countless instances where the nurses went above and beyond to make them feel special.
The ketamine itself is adminstered through an infusion pump, which looks like a fancy IV, and starts first thing Monday morning. It runs continuously until sometime on Friday, depending on how much pain you have left by then, if any. Doctor Harbut mixes in clonodine with the ketamine to increase its effectiveness. This is key as shown in his research.
We changed the level a few times during the week of course depending on how my body was reacting. By Friday we realized we had achieved all we were going to, about 90%, and so we stopped the infusion. I was fairly well exhausted. By late afternoon/early evening when Dr Harbut was satisfied that the ketamine had metabolized and I was totally coherent and able to ambulate safely, I was released.
That night I slept very well, no ill effects at all. On Saturday we spent a fairly quiet day but we did get out and do a few things. On Sunday we went to the Garvin Gardens, amazing woodland gardens located in Hot Springs. We walked among the waterfalls, gardens, bridges, and ponds for hours. It was very healing and refreshing after being in the hospital for a week. I guess we walked for about 2 miles altogether, stopping every so often but it felt great! WOW!
On Monday I was back at the hospital for a follow-up appointment and some blood-work. Some of my liver functions came back elevated but he said that was to be expected considering the amount of ketamine I was given. On Tuesday, more bloodwork and a final appointment. Liver numbers much better, doing follow-up blood-work here in Maine following week. Did a final check of where the CRPS burning pain was still and where there was allodynia still, looking for any slippage from the final result on Friday. Noted some difference but not much.
Bottom line; when I left Hot Springs on Tuesday afternoon my CRPS pain was about 90% gone. That is, 90% of the burning pain and allodynia I came in with before the ketamine infusion was now gone. What we were unable to touch was the burning pain in the eyes and ears. No real surprise there though as that was the original site. Back in 1974 my CRPS started there. It wasn't until 1985 when I broke my back that it spread everywhere else so the eyes have had a very long time for that pain cycle to become entrenched. There was also a little allodynia on the bottom of my feet left.
What it didn't help was my fibromyalgia nor did we expect it to. But to have my RSD pain drop down to 15% of what it was is great. We are extremely hopeful it will hold at this level for another 3 or more years. It also has enabled me to do more physically, especially walking every day, which helps the overall health picture.
I feel very fortunate and blessed to have been able to get this treatment and these results. I want to thank everyone who prayed for me and thought about me during my treatment and travel. I also want to thank those of you who called and/or sent emails. It was most appreciated by not only me but also my family.
Now it is summertime of 2007 and my relief is maintaining at about 80 - 85% relief. I am very glad that I went down for my second treatment in April, (the first being early 2003). Although initially my relief was about 85-90% it did drop a little in the weeks post-treatment, which isn't unusual.
I would recommend patients doing the treatment plan on getting lots of rest before and after the treatment. Rest is essential to getting the most out of the ketamine procedure. You are fairly exhausted but at the same time, because so much of your pain is gone you want to do so many things you haven't been able to do! STOP! REST! Take a few weeks and let your body catch up to how your mind is re-setting. Otherwise you will wind up back at square one. This is very important.
AM I HAPPY I WENT DOWN FOR THE LOW-DOSE TREATMENT? ABSOLUTELY!
peace, Keith Orsini - 2011 and 2007
LOW-DOSE KETAMINE TREATMENT
A PATIENT GOES TO ZERO PAIN IN HOT SPRINGS!
READ HER STORY
JANUARY 24, 2007
After 12 years of pain, woman comes to Arkansas for relief
By JOAN JACOBSON
HOT SPRINGS VILLAGE VOICE
Anyone who has struggled with intense pain or is sympathetic to someone should read this heart-wrenching story about Kristin Meredick-Travis.
Travis came from Scranton, Pa., in search of a specialized pain treatment offered at St. Joseph's Medical Health Center in Hot Springs.
For the last 12 years this young woman has suffered tremendously from an often very resistant pain disorder called Complex Regional Pain Syndrome (CRPS), also known as Reflex Sympathetic Dystrophy (RSD).
Travis' story is a journey from untold pain and disability to virtual pain relief through a neuropathic pain treatment program under the medical direction of Dr. Ronald E. Harbut.
Her story begins in 1994 when Travis first experienced headstabbing pain accompanied by sensitivity to light and sound.
An X-ray identified a golf-ball size tumor in front of the sinus cavity in her forehead, so at the age of 18 she underwent a craniotomy to remove the "osteoblastoma" and the pain went away.
But six months later, Travis began experiencing a deep, stabbing pain on the right side of her face in the area of the trigeminal nerve.
For the next two years she suffered debilitating pain. She and her mother, Nancy Meredick, searched the state of Pennsylvania for help.
On a trial basis, medical intervention to relieve the pain was attempted by placing teflon pads around the fifth-cranial nerve to reduce conduction of the nerve pathway.
The procedure, known as "micro vascular decompression," along with pain medication, brought back some quality of life. Temporarily.
Within six months the pain was back, with a vengeance. Now it traveled to the back of the head.
Seeking help from a neurologist, Travis underwent more surgery - this time to implant a spinal cord stimulator in her chest and back with wires running to the area in the spinal-cord causing the pain.
"The stimulator, the size of a transistor radio, is programmed to create a substitute sensation to trick the brain, which was sending out pain messages," said Travis.
"Due to several complications, the device had to be replaced several times and I developed a staff infection."
The family sought help from several family practitioners. Travis was sent for a psychological evaluation. "They thought the problems were all in my head," she said.
One doctor advised her to go to the Pennsylvania State University Milton S. Hershey Medical Center.
There she met Harbut, who changed her medications and started her on a treatment program.
After two-and-a-half years of Harbut's care, the young woman enjoyed 50 percent improvement.
But she was still suffering from a debilitating disorder.
Last July, Harbut became medical director of the Mission Pain Medicine Consults Clinic in Hot Springs. The clinic became a reality through St. Joseph's commitment to pain control and is next to St. Joseph's in the medical office building.
Harbut, who is board certified in both anesthesiology and pain medicine, came to St. Joseph's from the Hershey Center where he was assistant professor of anesthesiology and pain medicine.
He was also the director of the Neuropathic Pain Treatment program.
Harbut secured his fellowship training in pain medicine at the Mayo Clinic in Scottsdale, Ariz
After earning a bachelor of science degree in pharmacy from the University of Health Sciences - Chicago Medical School, he obtained a doctorate degree in pharmacology from the University of Utah.
After moving to Arkansas, Harbut contacted Travis and suggested she seek treatment at the pain clinic in Hot Springs. She and her mother arrived at the first of the month.
Travis began a relatively, new "ketamine" technique Harbut introduced to the United States. The treatment lasts one week and the patient stays in the hospital during that time.
The technique is used with CRPS or RSD and employs a lowdose, sub-anesthetic continuous infusion of "ketamine." The patient remains conscious and is able to interact with the clinic staff.
Travis' hospital treatment was carefully charted using a pain diary and diagrams indicating the presence or lack of presence of pain. It also reflected the intensity of the pain.
Each day there was less pain. On the seventh day, after waking from a nap, Travis said, "I just started to cry and called for my mother who was out of the room. I had no pain and I thanked Jesus, who suffered much more than I did.
"I now have peace in my life," she added.
Travis and her mother thanked all the nurses and doctors at St. Joseph's. "They were wonderful," she said. Special thanks went to Father Alan Rosenau, Deacon Bill Freidman, Sister Dorothy Calhoun, R.S.M. and especially Harbut and the clinic staff.
"These wonderful people were with me all the way," said Travis.
"God gave me a lot of gifts," she said. "I feel like a whole new person. Now that the pain is gone, it is replaced with enthusiasm."
Travis has returned to her home in Pennsylvania and will be monitored by phone for a year. The clinic has had contact with her since she has arrived home and is delighted she is still pain free.
CRPS is a disease which affects the nerves and can cause intolerable pain and suffering. The most predisposing factor for this disorder is some sort of trauma to bone, soft tissue or nerve.
It can be caused by minor surgery, accidental injury or a more traumatic event such a spinalcord injury, mastectomy or stroke.
For more information about the clinic and its services call 622- 4878. Pain related questions may also be emailed to sphillips@ htsp.mercy.net
Original article
A PATIENT GOES TO ZERO PAIN IN HOT SPRINGS!
READ HER STORY
JANUARY 24, 2007
After 12 years of pain, woman comes to Arkansas for relief
By JOAN JACOBSON
HOT SPRINGS VILLAGE VOICE
Anyone who has struggled with intense pain or is sympathetic to someone should read this heart-wrenching story about Kristin Meredick-Travis.
Travis came from Scranton, Pa., in search of a specialized pain treatment offered at St. Joseph's Medical Health Center in Hot Springs.
For the last 12 years this young woman has suffered tremendously from an often very resistant pain disorder called Complex Regional Pain Syndrome (CRPS), also known as Reflex Sympathetic Dystrophy (RSD).
Travis' story is a journey from untold pain and disability to virtual pain relief through a neuropathic pain treatment program under the medical direction of Dr. Ronald E. Harbut.
Her story begins in 1994 when Travis first experienced headstabbing pain accompanied by sensitivity to light and sound.
An X-ray identified a golf-ball size tumor in front of the sinus cavity in her forehead, so at the age of 18 she underwent a craniotomy to remove the "osteoblastoma" and the pain went away.
But six months later, Travis began experiencing a deep, stabbing pain on the right side of her face in the area of the trigeminal nerve.
For the next two years she suffered debilitating pain. She and her mother, Nancy Meredick, searched the state of Pennsylvania for help.
On a trial basis, medical intervention to relieve the pain was attempted by placing teflon pads around the fifth-cranial nerve to reduce conduction of the nerve pathway.
The procedure, known as "micro vascular decompression," along with pain medication, brought back some quality of life. Temporarily.
Within six months the pain was back, with a vengeance. Now it traveled to the back of the head.
Seeking help from a neurologist, Travis underwent more surgery - this time to implant a spinal cord stimulator in her chest and back with wires running to the area in the spinal-cord causing the pain.
"The stimulator, the size of a transistor radio, is programmed to create a substitute sensation to trick the brain, which was sending out pain messages," said Travis.
"Due to several complications, the device had to be replaced several times and I developed a staff infection."
The family sought help from several family practitioners. Travis was sent for a psychological evaluation. "They thought the problems were all in my head," she said.
One doctor advised her to go to the Pennsylvania State University Milton S. Hershey Medical Center.
There she met Harbut, who changed her medications and started her on a treatment program.
After two-and-a-half years of Harbut's care, the young woman enjoyed 50 percent improvement.
But she was still suffering from a debilitating disorder.
Last July, Harbut became medical director of the Mission Pain Medicine Consults Clinic in Hot Springs. The clinic became a reality through St. Joseph's commitment to pain control and is next to St. Joseph's in the medical office building.
Harbut, who is board certified in both anesthesiology and pain medicine, came to St. Joseph's from the Hershey Center where he was assistant professor of anesthesiology and pain medicine.
He was also the director of the Neuropathic Pain Treatment program.
Harbut secured his fellowship training in pain medicine at the Mayo Clinic in Scottsdale, Ariz
After earning a bachelor of science degree in pharmacy from the University of Health Sciences - Chicago Medical School, he obtained a doctorate degree in pharmacology from the University of Utah.
After moving to Arkansas, Harbut contacted Travis and suggested she seek treatment at the pain clinic in Hot Springs. She and her mother arrived at the first of the month.
Travis began a relatively, new "ketamine" technique Harbut introduced to the United States. The treatment lasts one week and the patient stays in the hospital during that time.
The technique is used with CRPS or RSD and employs a lowdose, sub-anesthetic continuous infusion of "ketamine." The patient remains conscious and is able to interact with the clinic staff.
Travis' hospital treatment was carefully charted using a pain diary and diagrams indicating the presence or lack of presence of pain. It also reflected the intensity of the pain.
Each day there was less pain. On the seventh day, after waking from a nap, Travis said, "I just started to cry and called for my mother who was out of the room. I had no pain and I thanked Jesus, who suffered much more than I did.
"I now have peace in my life," she added.
Travis and her mother thanked all the nurses and doctors at St. Joseph's. "They were wonderful," she said. Special thanks went to Father Alan Rosenau, Deacon Bill Freidman, Sister Dorothy Calhoun, R.S.M. and especially Harbut and the clinic staff.
"These wonderful people were with me all the way," said Travis.
"God gave me a lot of gifts," she said. "I feel like a whole new person. Now that the pain is gone, it is replaced with enthusiasm."
Travis has returned to her home in Pennsylvania and will be monitored by phone for a year. The clinic has had contact with her since she has arrived home and is delighted she is still pain free.
CRPS is a disease which affects the nerves and can cause intolerable pain and suffering. The most predisposing factor for this disorder is some sort of trauma to bone, soft tissue or nerve.
It can be caused by minor surgery, accidental injury or a more traumatic event such a spinalcord injury, mastectomy or stroke.
For more information about the clinic and its services call 622- 4878. Pain related questions may also be emailed to sphillips@ htsp.mercy.net
Original article
KETAMINE INFUSIONS USED TO TREAT DEPRESSION?
Is Club Drug 'Special K' a Quick Fix for Depression?
Natalie Wolchover, Life's Little Mysteries Staff Writer
LiveScience.com – Tue Jan 31, 3:10 pm About 30 million Americans suffer from depression, and when a sudden wave of severe symptoms hits them, there's no instant fix. The most commonly prescribed drugs — Prozac, Celexa and Zoloft — take a few weeks to kick in, and in the meantime, depressed people are at an escalated risk of suicide. More than half the time, the prescribed drug doesn't end up working at all, and patients must start over with a different treatment.
But there's a new drug in town: ketamine. It's not new, exactly — it has been used as an anesthetic for decades, and it's a popular drug among night clubbers (called, in that context, "Special K"). But after noticing the euphoric effect the drug seems to have on anesthetized patients, psychiatrists have begun conducting clinical trials of ketamine as an anti-depression medication. The initial results are extremely promising.
"Once the patient takes ketamine, it causes euphoria and a rapid antidepressant effect within two hours," said Asim Shah, associate chief of psychiatry at Ben Taub General Hospital in Houston and a professor at Baylor College of Medicine, where the new study is taking place. Furthermore, ketamine helps a greater proportion of the affected population than traditional antidepressants. Prozac and other treatments each improve conditions for only about 30 to 40 percent of the patient population, barely outperforming placebos; meanwhile, a single infusion of ketamine washes away the symptoms of 80 to 90 percent of patients who try it, Shah said.
Scientists understand how ketamine chemically affects the brain, but they don’t quite know why it alleviates depressive symptoms. According to Ken Robbins, a clinical professor of psychiatry at the University of Wisconsin-Madison, ketamine binds to portals in the brain called NMDA receptors; this prevents a chemical called glutamate from occupying the same spots. Because glutamate revs up the system and can cause cell damage, ketamine has a sedative effect by blocking it. Somehow, this causes euphoria.
"The hypotheses for why ketamine might be helping depression are in their infancy," Robbins said. Whatever the explanation, "it's a very different mechanism from that of other anti-depressants we now use. I think what we're seeing is there may be a whole other neurotransmitter system that plays a role in depression that we weren't aware of."
In the new study — a joint effort of Baylor College of Medicine's Neuropsychiatric Center and researchers at Mount Sinai Hospital — depressed patients are given one dose of ketamine, and doctors monitor how long this keeps their depression at bay.
"We're seeing the benefits lasting a few days to a few weeks," Shah said. The researchers are already planning a follow-up study in which six infusions of ketamine will be administered. If the positive results continue, Shah believes the Food and Drug Administration will eventually approve the drug for use as an antidepressant; he hopes it will become available in two years, though the drug will be more expensive than the $4 per month cost of generic versions of Prozac.
The researchers suspect that ketamine — which is addictive, and must be administered intravenously — will most likely end up being used in tandem with other drugs, rather than replacing them. It would make a good temporary fix, significantly reducing patients' suicide risk, while they wait for longer-term treatments to kick in.
Some doctors are administering ketamine as a quick fix for depression already. "The fact of the matter is people have picked up on the promising research results, and doctors are prescribing it off-label without FDA approval. Even if it is not approved, when you tell a patient, 'I have an anesthetic agent that is an instant fix for your depression,' they want it," Shah said.
This puts doctors at risk of getting sued if the unapproved treatment turns out to be ineffective, and the scientists say it would be best for doctors and patients to wait until the research process has run its course.
"I don't want people to think that taking ketamine illegally or from the streets will treat depression," Shah said. "Taking the wrong dose or taking too much of it might make you even more psychotic."
Follow Natalie Wolchover on Twitter @nattyover. Follow Life's Little Mysteries on Twitter @llmysteries, then join us on Facebook.
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