Q: I have no life – can’t do stairs, walk or stand. I spend 90% of each day in bed in order to have a normal life with some of my pain under control. I have one grandchild with another on the way anytime now and I have no idea how I’m going to be any help with the four-level home. My daughter’s 2 ½ year old is very active and he wants me to play with him.
We have tried everything to control my pain – chiropractic, acupuncture, hyperbaric treatments, many many different shots, and I’m on my third spinal stimulator. My pain meds are Fentanyl, Percocet and Neurontin. Please help. I want to try the ketamine coma. I’m 52 and have had this since a horse fell on me in 1997.
A: It is somewhat difficult for me to offer help because other than the extreme pain you are obviously experiencing, I don’t know the extent of your injuries. Did you suffer any bone fractures, loss of consciousness, severe injury to any internal organs, or a brain injury during your accident and where is the location of your pain?
I surmise you live with your daughter and want to participate in the care of her children. As uncaring as this may appear, you must consider yourself first and will have to explain to your grandson that you are unable to play with him as much as you would like. As active as he is, perhaps you can involve him in listening to the stories you read him or movies you may watch together, help him draw on a sketch pad, and choose some games that are not so physically demanding.
The Fentanyl you have been prescribed is an opioid used to control pain and is 80 to 100 times more potent than morphine and substantially more potent than heroin. Percocet is a combination of acetaminophen and oxycodone which is another opioid taken for break- through pain. It should not be used by individuals who have recently used sedatives, tranquilizers, or other narcotics. Neurontin is an anti-convulsant prescribed for seizure activity and for some types of pain such as from herpes zoster (shingles). I cannot determine if you take the neurontin because of seizures or if this is another form of pain control but either way, you are really on some strong pain relievers that should be carefully monitored because of the potential for addiction.
It’s important to understand that a ketamine coma is an experimental treatment that has been used mostly outside the United States to treat chronic, severe pain. The studies have been quite contradictory with varying results and without any doubt more research is needed before we can conclude whether or not this is a treatment modality that could help.
Some facilities in the US are now providing ketamine infusions which are costly and may have to be repeated because of some purported low doses being administered. It appears the more consecutive days of infusions received (at about $1,000 a day), the better the results will be.
To be considered is that some reports indicate some patients have found relief from their chronic pain and have been able to completely wean themselves from using opiate narcotics altogether. However, a factor that remains unknown for each individual is the duration of any relief obtained and those results are not available. Having said that, you must consider that ketamine infusion therapy (or any other for that matter) comes with no guarantee of success, regardless of which provider is used and individual responses may vary. It is possible to undergo therapy and come away without any beneficial results. Thus, substantial thought should be made prior to undergoing such a procedure. Have a frank talk with your physician regarding the next logical step in your plan of care. There are other options that may be more appropriate so personally speaking, I cannot endorse this management treatment at this time. Ask for a second opinion at a pain clinic before making this potentially critical decision.
