The Carpal Tunnel Release Surgery and RSD

High Dose Ketamine and CRPS/RSD Spread

Wednesday June 20^th, I finally had my carpal tunnel release surgery with the wonderful Dr. Brian Leung.  I had it arranged that I would get 100 mg of Ketamine during the surgery and would then drive down to Miami for high dose Ketamine with Dr Denmis Patin the following week.

The risk of spread of the RSD from carpal tunnel release surgery is 50%.  My dilemma was that I was losing function of my right hand due to the carpal tunnel syndrome.  I was having difficulties doing my activities of daily living.  So if I didn’t do the surgery, I could totally lose function of my dominant hand.  If I had the surgery and the RSD spread to my hand, I would not only lose function but have pain as well.  After talking to my RSD neurologist, we decided that the risk would be greatly reduced if I had Ketamine during and after the surgery.  Of course he could not make a promise that I still wouldn’t have RSD spread; there are no promises when it comes to this disease.  I weighted the risks and benefits and decided to have the surgery.

I had arrangements made for a friend to drive me to and from the surgery and another friend to accompany me to Miami for the Ketamine as it is required that someone spend the night with you after the infusion.  Two weeks prior to the surgery, the friend who was going to go to Miami with me had a person issue come up and all of a sudden, I had no one to spend the night with me.  Fortunately I was able to get another friend to stay with me. She lives in Miami so I would make the drive to and from Orlando on my own.

The surgery went well.  I was in a bit more pain than I expected, but nothing that I could’t handle.  It did cause a flare in my RSD however.  I expected that.  I had hoped that by getting the Ketamine during the surgery that I wouldn’t flare, but for me 100 mg isn’t enough to prevent me from flaring.

Sunday, I headed down to Miami driving through tropical storm Debby.  That was a harrowing drive.  I was never more relieved than when I pulled up in front of the Spring Hills Suites!!

Monday through Wednesday, I got 200 mg per hour of Ketamine along with IV Versed and IV Ativan.  The resident was wonderful as is the nursing staff at Sylvester Cancer Center’s Surgical Center.  I can not say enough about the staff there!!  The resident made sure that I was asleep the entire time so that I would not have any negative side effects from the Ketamine.

When I got home, I still had a suture in my wrist and was still having some burning pain.  I rubbed my Ketamine cream into my hand four times a day.  Within 48 hours, the burning was gone and although I was still having surgical pain it was soothed by NSAIDs.

Tuesday July 3^rd, I saw the surgeon and the suture was removed.  I had my first OT session.  I realized during the OT session how far I have to go to get full range of motion back.  During this week doing the home exercises, I have already seen improvement.

Thanks to a great surgeon, high dose Ketamine and now OT, I feel confident that I made the right decision to have the carpal tunnel release surgery with the high dose Ketamine.

 Immediately after surgery this is what my hand looked like

This is my hand July 6, 2012 sixteen days after surgery and a week after high dose Ketamine.