Tuesday, November 8, 2011

Ketamine in the U.S.

I have been fortunate enough to be able to go to Germany to receive Ketamine treatments that are not available to the general public here in the US.  I have learned of a veteran who received coma Ketamine here in the US last September.  He is the only person that I know who has received this treatent here in the States.  I describe my coma Ketamine experience in my first post.

I have also had awake Ketamine treatment at Hahnemann Hospital on several occassions; the most recent was in 2009.  Today, I will describe this 7 day hospitalization.  At Hahnemann, Ketamine is given in the ICU, on a cardiac monitor.  For me, it was given via my mediport.  Additionally, a PICC (peripherally inserted central catheter) so that they could do lab work without additional sticks.  The Ketamine was adminstered via my port and the lab work was drawn from the PICC.  The reason that they didn't use the port for both is that they didn't want to have to stop the Ketamine drip in order to get an accurate blood Ketamine level as this would interrupt my Ketamine therapy.

Prior to my Ketamine, I under went some testing; neurological, psychological testing and lab work.  The treatment was scheduled in advance as there is a waiting list for the treatment.  Once admitted and having the PICC like placed, the Ketamine was started.  The dosage was increased hourly until it reached a maximum of 40 mg/hr.  In the ICU, visitation was limited, no phone access and I was encouraged to just relax and sleep through as much of the treatment as possible.

For many, 40 mg/hour of Ketamine makes them feel "tipsy" and sleepy.  Along with the Ketmaine, I was given Clonopin and Versed to minimize the chances of hallucinations.  They also help you to relax and let the treatment work.

The theory behind Ketamine is that it is a MDA Inhibitor and acts to "reboot" the nervous system much like hitting ATL, CNT, DLT reboots your computer.  It took a full day for the admission process and to get to the full 40 mg/hr dosage.  I spent my time listening to music and watching TV.  I brought bottled water, juice drinks and snacks with me as hospital food isn't my favorite thing.  Ketamine also decreases your appetite and  wanted to be sure that my nutrition was good to protect myself from any germs that the staff may be carrying.  RSD suppresses your immune system and I wanted to boost it as best that I could with vitamin C rich foods/juices, being sure that I was well hydrated and eating small healthy snacks.  You are able to write in requests on the menu which makes a wider variety of foods availble to you.

For me, the week in the ICU with the Ketamine was a chance to have down time, to allow the treatment to work without the stress of traveling to and from the clinic like you do with the outpatient treatment. 

So how did it FEEL while on the Ketamine...I did not experience any hallucinations or negative effects.  I felt relaxed by the versed and spent 6 days of Ketamine at 40 mgs/hr.  Being in an ICU is some what noisy and sleeping can be difficult especially with frequent vital signs and lights on on the unit; however I was able to cat nap during the day as well as at night with the assistance of sedating medications.  I know that many people sleep the entire week while on the Ketamine.  Most likely because I had had much higher dosages during my two stays in Germany as well as many booster treatments; I did not feel drunk, tipsy or even sleepy.  I would say that I felt relaxed and that I did get relief from the treatment.

Ketamine seems to be a controversial treatment as far as some are concerned but so are so many other treatments for chronic pain.  Treament for RSD is as different for everyone as their individual sypmtoms and as different as we all are as individuals.  For me (having had almost every treatment available over the past 15 years) Ketamine has proven to be the best treatment for ME.  It has lessened the "burning" pain that I have felt all over my body.  Now I only experience full body burning during flare ups as opposed to prior to Ketamine when I had that burning full body pain full time.

At this point I am having a flare that is a pretty bad one.  There is still a waiting period for the treatment.  At this point I have to put myself on this list for a future treatment as I know that for ME this is my best treatment option.  I also know that I need regular "tune ups" of Ketamine to keep this at bay (the burning pain).

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