Doctor Harbut is known as the “Father of Ketamine” in the United States since brought the ketamine infusion treatment here to the USA for pain patients back more than 13 years ago and he was treating CRPS patients with it in Australia with Doctor Correll for many years before that. In 2003 Dr. Harbut shared his methodology and ketamine infusion treatment protocol with Dr. Schwartzman and his treatment team in Philadelphia so that they could also help relieve patients of pain and from there it really took off. Dr. Harbut subsequently became the first physician in the United States to receive FDA approval for an official ketamine treatment protocol. 

If you would like to contact Dr. Harbut at his new clinic, The Hot Springs Pain Institute, to be seen as a pain patient or for low-dose ketamine treatment, you can contact the clinic at (501) 651-4488 or Fax (501) 651-4490. 


Low-Dose Ketamine and Me, One Patient’s Story – KEITH ORSINI – Updated 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.  


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 seemed 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 ( now known as the Father of Ketamine in the United States ) 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 with it in Arizona a few months prior.

After lengthy discussions between the three of us where we learned all about the low-dose ketamine infusion method that Doctors Harbut and Correll had developed, also called the “awake technique”, we got very excited about the potential that 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 takes if there is even a chance. Especially since this procedure did not involve any cutting of my body, it was simply an continuos 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. We stopped after five days. By the time we flew home it felt like I was a new person.

The relief from the first ketamine low-dose infusion from Dr Harbut lasted about 3 1/2 years. I never needed any boosters. Dr Harbut’s method does not involve the use of boosters.


Let’s skip ahead to 2007

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 first female 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 of Dr. Harbut and make no use of it at all.

By the beginning of 2007 my RSD pain and allodynia had returned to a large percentage 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, etc.

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. ( you do have to do some pre-testing, such as psych evaluations, send in your medical records, etc. to be sure you will be able to handle the ketamine during the treatments. Ketamine is a strong medication and even used under heavily monitored conditions only pre-screened patients should be using it)

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 clonidine 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, originated in my eyes. It wasn’t until 1985 when I broke my back that it spread everywhere else so the eyes have had a very long time and that pain cycle has 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 10-15% 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.


peace, Keith Orsini – (written in summer of 2007)

UPDATE – Fall of 2007In late summer of 2007 Keith Orsini was in Georgia conducting a CRPS/RSD Seminar at a Hospital for the Doctors and Nurses there. After the Seminar he went back to his hotel. As he walked into the lobby, it was late afternoon and the lobby was not well lit. He slipped on what turned to be a 32 oz. coke someone had spilled on the floor of the lobby and simply left there. 

Keith landed on his back/head/neck. He tried to break his fall with his arms and injured those as well. He was in severe pain immediately and knew within an hour that the partial remission he had gained only months before was slowly leaving/dissipating and he could feel the CRPS slowly re-gaining its foothold throughout his body. Keith had to stay at the hotel for nearly a week following the fall and within a few days his fears were confirmed, all of the remission was gone. (and yes, if you are wondering, the hotel actually charged him for his entire stay).

He wanted to share this part of the story for three reasons. Firstly, to remind everyone that even this amazing treatment can be fleeting, at least in its current form and this version has had the greatest and longest-lasting results; years instead of weeks or months like other versions. Secondly, to remind all patients that we need to always be vigilant against further injury because not only are we more susceptible to over-reaction from our bodies to a “typical” or everyday injury but it can have far-reaching consequences. Lastly he wanted to say, don’t let this disease stop you from doing what is right, what you want to do, from living your life, from being a real person. Life will happen anyway, things will happen anyway, most accidents occur in the home they say so get out and enjoy life! Don’t let your chronic pain define who you are now and don’t be bitter about life interfering with your plans. That is just the way it works. Move forward anyway, enjoy life. It can be a wonderful experience everyday if you let it be!

Peace, Keith Orsini

You can read more about Keith Orsini’s CRPS Story by visiting the CONTACT US page.