A KETAMINE TREATMENT

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"My hair is starting to fall out and the skin is beginning to peel on my feet," said Medeiros, who lives in East Fallowfield with her boyfriend, Brad Sylvester, 41, and their daughter, Kyra Sylvester, 18, a 2004 graduate of Coatesville Area Senior High School. "I don't sleep hardly ever. The burning keeps me awake. I have to sleep with ice packs on my legs."

"Overall, it's pretty hard to watch, her going through all this," said Sylvester. "There's been nights where she's in pain and I can't do anything."

According to Dr. Philip Getson of Marlton, N.J. who diagnosed Kristin Medeiros and has been treating her, 10 million people in the U.S. have been diagnosed with the disorder and another 10 million go undiagnosed. "There's probably five times that number where fibromyalgia has been diagnosed," he said.

He explained the disorder "comes from a malfunctioning of nervous system that allows people to sense hot, cold...or their sympathetic systems." Or in other words, he said, it's "when the sensory system goes haywire.
"It always follows some kind of accident or surgery (usually after an accident)," he added.

In Kristin Medeiros' case, it was a crash near West Chester in which she was involved. In March of 2001, she was working as a delivery truck driver (she asked that the company not be named since she is in litigation against the company over workman's compensation issues) when another delivery truck driver rear-ended the truck she was driving.

"I was sitting still in truck. I had stopped to make a left turn when another driver slammed into the back of the truck," she said.
In the process, she hurt her lower and middle back and neck. She did return to work, but only for a few months.
Since September 2001, she has been out of work. From there began a long-drawn out process of being passed off from one doctor to the next that would continue for the next six months. In all, Kristin Medeiros saw about 30 doctors, she said.

Only three or four indicated that it might be RSD, she said. "A lot of doctors see workman's compensation and they think you're lying," she said. She said she would look forward to each appointment thinking that finally "this would be the one." But time after time, it wasn't.

Finally on May 16, 2002, a doctor that her father, Raymond Medeiros of Franklinville, N.J. recommended, a Dr. David Zalut, chief of medical surgery at Voorhees Hospital, referred her to Dr. Getson.

On Dec. 11, 2002, after having her tested on a thermogram machine, Getson diagnosed her with RSD. The disorder is incurable. However, treatments are available.
Conventional treatments, according to Getson, include, but are not limited to the following: physical and occupational therapy, oral medication, hospital-based therapy, epidurals, spinal card infiltrations, implantable pumps and most often ketamine therapy.

Once used as an operating anesthetic, ketamine has since been discovered by researchers to treat patients with RSD, he explained. One of the drawbacks, though, in order for the drug to be effective, it has to be used in high quantities, and when given in large doses, it makes people psychotic.

"So then they (doctors) said, 'Let's find a way to do this without that happening,'" said Getson. As a result, in a German hospital, doctors discovered they could put patients into a drug-induced coma to give the higher dosage of ketamine.

This, in turn, led to a problem with the Federal Drug Administration in this country, he explained. "They said they wouldn't allow people to be put into a drug-induced coma," said Getson.

But a concession was made: Hahnemann Hospital in Philadelphia and Cooper Hospital in N.J. were allowed to use hospital-based infusions of ketamine in smaller doses to treat patients over a five-day period. So far, they have treated 60 patients in the last 18 months. "Eighty-nine to 90 percent of the people have gotten better," said Getson.

Kristin Medeiros, however, wasn't allowed to have the treatment. According to Getson, there were two reasons she couldn't have the treatment:

"1. Because insurance company flat out refused to pay

and

2. Because her insurance company flat out refused to pay."

"They tried to get me in as an in-patient and they denied that too," said Kristin Medeiros. She said she even went to state Rep. Art Hershey, to see if he could help, and has since contacted a law firm in Philadelphia to represent her.

"Obviously in a perfect world they would pay for you," said Getson. That said, he said the difference between the hospital-based infusions here in the U.S. and the treatments in Germany is "apples and oranges."
"You get it in huge doses, you're getting better," he said. For that reason, Kristin Medeiros is now looking to get the treatment done in Germany.

This past Monday, she was scheduled to have seen Dr. Robert J. Schwartzman, professor and Chairman of Neurology at the MCP Hahnemann School of Medicine in Philadelphia, and the person who recommends patients for treatment in Germany. Last week she said the earliest she probably would be able to go would be sometime this summer.

The only catch is that the treatment costs $25,000: money that neither she nor her boyfriend, who is a mason for a local company, have. While she hasn't asked for help, her stepmother, Myra Medeiros, has: last month she sent a letter to the Coatesville Ledger asking the community to help. To that end, an account has been set up at Citadel Federal Credit Union in Thorndale to help with the expenses.

In a telephone interview last week, Myra Medeiros said her stepdaughter was a very proud person and it wasn't easy for her to ask for help from other people. She said her hope in writing the letter was to make people more aware of RSD and also hopefully be able to support her stepdaughter.

"We are standing by her a 100 percent," said Myra Medeiros of her and her husband, Raymond Medeiros. "She's been a real trooper with this and has tried her utmost to take care of her family responsibilities," said Myra Medeiros. "We're just hoping to see the light at the end of the tunnel with this procedure and would appreciate any kind of support."

As for the treatment itself, Getson said the key is that patients have to follow up with outpatient infusion of ketamine after the treatment in Germany. "Everybody who went to Germany and didn't get follow up went back into the same situation," he said. He noted it was sort of like the movie "Awakenings," in which Robin Williams was a doctor who was treating patients with sort of like in Awakenings.

Asked if the treatment was dangerous, he said out of 20 people that have gone to Germany that have been recommended by Schwartzmann, none had a problem with the treatment itself. "One returned pain free and 17 to 19 with varying degrees of problems," he said.

He said yes, it could be considered dangerous in that a person is having their body put into a coma for several days. However, he said most people with RSD already lose so much of their lives anyway that to them, it is no loss.

Kristin Medeiros admitted she was worried about the treatment. "But I understand if it doesn't get done, I could be way worse," she said.

"We're willing to give anything a try," said Kyra Sylvester.

(END OF ARTICLE)


A Word from Lisa Regarding Dr. Getson

Dr. Philip Getson has been my treating doctor for 4 years now.

He is an angel send from heaven!!!
If anyone needs an RSD Specialist, I would recommend him in a second! It is not uncommon for RSD patients to travel a distance to see a specialist for this disease. So if you live in the surrounding area of Marlton, NJ, please don't hesitate to contact Dr. Philip Getson.
If you want to make an appointment though, you better make it now because you will be waiting for an appointment...So apparently I am not his only fan!

I have listed a few sites below that specifically have Ketamine links on them. You can also do a Yahoo or Google search for KETAMINE INFUSION THERAPY or Reflex Sympathetic Dystrophy / Complex Regional Pain Syndrome; Although these sites should give you a vast amount of information.

RSD HOPE

RSDSA

RSD FOUNDATION