I am going in for some treatment in January to hopefully sort some of the pain. One of the planned treatments is a Ketamine Infusion, has anyone had one? Would any one like to share their experiences with it?
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I'm just new here, but I saw your post & thought that I could help you out a bit by telling you about my experience with Ketamine.
I've had Ketamine Infusion Therapy (for my Fibromyalgia) several times now with Dr Andrew Dean (over here in Perth). It's bloody brilliant - or at least it has been for me. The methodology that Dr Dean pioneered is even better because it doesn't use anti-psychotic drugs, just Ketamine.
About twice a year I go into hospital for the 2 weeks of having (low dose) Ketamine slowly pumped subcutaneously into the skin of my stomach. Starting low the doses are gradually increased until I hit my optimum therapeutic level of the drug in about 2 days. After a week or so the doses are gradually reduced back to zero, I get disconnected & go home.
Your first time can be a little unpleasant (), as your brain & body can be seriously out-of-whack (important medical term) from your many months/years of chronic pain & the Ketamine will be massaging your brain, making things adjust & rebalance. You can feel dizzy & nauseous (I even threw up once) with odd sensations (like parts of your body growing, moving & shrinking). These perceptual distortions will go away pretty soon at the low doses the Therapy uses. I had pretty bad leg cramps at this stage, but this wasn't necessarily the Ketamine. You can get to a stage of mild euphoria, feel distant & the pain will be reduced, with a slight floaty feeling. If you start to see or hear things that aren't there (hallucinate), then your dose is way, way too high - it's very unlikely at the correct amounts.
You'll be watched pretty intensely for the first few days, with observations being taken at 1 hour intervals (pain score, O2 sats, heart rate & blood pressure, etc) - Ketamine increases both blood pressure & heart rate. It's important to keep them informed as to what's happening, as the nurses will also be checking your mental clarity to make sure that you're not getting too much Ketamine at once.
After you wake up from your first good night's sleep (& dreams: ), you'll feel mostly clear-headed & a lot like you do now except for one tiny thing - your pain will be massively reduced or just plain gone! When this happened to me I'd been experiencing chronic neuropathic pain for the better part of twenty years - having it completely gone was one hell of a shock!
I'll point out that you still feel sensations - including normal, natural pain stimuli - it's the dysfunctional pain that's getting affected. Actually I find my other senses: vision, hearing, touch, smell, taste are incredibly clear without the pain taking up so much of my concentration (mental bandwidth).
Here are a couple of important things that I learned the hard way:
1 - Putting all that fluid into you will cause swelling at each of the sites (not infection, just inflammation). Keep the region of your belly clean & if you have any hairs on your stomach at all (even peach fuzz), you might want to consider shaving or using a depilatory before you start. Very small amounts of Anti-inflammatories like both Voltaren &/or Cortic-D Ointment will stop you ending up with bruising afterwards. Also cleaning with Betadine or Chlorhexadine will help to prevent you catching something nasty in hospital (like MRSA)
2 - Ketamine can increase the amount of free Sodium in your bloodstream, which will put strain on your kidneys (like drinking seawater). Avoid foods high in salt & drink more water (I usually go through 'bout 5 Litres a day on Ketamine, but I'm a big guy ) Check if your hospital uses water filtration systems as they add salt to the water - you may have to use bottled water.
3 - At these doses Ketamine is a metabolic accelerant, meaning you will be sweating, urinating, defecating, etc. more frequently than usual. Having a shower every 6 hours or so will help you feel much better & keep the site clean.
4 - Your mind will be feeling so much clearer without the pain clouding everything & when you add the Ketamine you'll be feeling quite stimulated (like on expresso), and you won't be allowed to do any real exercise as it can push your blood pressure too high. Take along plenty of books, smartphone, tablet, writing/drawing materials - whatever you've got (even if you've got a TV it can be really, really boring).
5 - Bring your own pillows - the hospital ones suck.
6 - Always discuss these things with with your doctors & nurses, and never use any drug, ointment or supplements without having them logged in & charted.
Anyway that's basically it: Ketamine, when used appropriately can be extremely useful, though it's an incredibly dangerous drug when abused [removed by moderator]
Any questions, just ask. Enjoy yourself.
Last edit: 3 years 10 months ago by Peter.
The following user(s) said Thank You: Wendles, Poplan, Bon65
I wish I could hit the thank you button several times, you have really helped soooo much. I have ready a few scientific papers on the procedure but they miss the patient perspective. All those little bits that make having the procedure just that bit easier, especially when I will be there alone. I wont have anyone to bring me things or help in any way as i must go away for it so I really need to know some of these things before hand so i am prepared. Thank you again for sharing your experiences with me.
There is always a SMILE
in your day,
you just need to find it!
Yeah, I know what you mean 'bout the patient perspective. There are so many little bits that the medical staff don't quite see any more. It can be damn isolating.
Other stuff that's occurred to me:
7 - It's always noisy in hospitals. Machines beeping, people talking, TV sounds & worst of all the sounds of patients in pain. Getting a single room isn't a choice for me 'cause of my chemical sensitivities (I'm reactive to cigarette smoke residue & some perfumes), but sharing a room is weird as well. Take some closed headphones if you've got them. Nurses will automatically leave the doors open (& some just wander in & out), but if you politely ask them to close it often enough, they'll adapt.
8 - Nurses are not servants, they're there to help you with your medical problems - not to pick up after you. Seriously, the number of people I saw acting like extraordinary assholes! (I get it that being in hospital is scary & acting like this is some people's way of dealing, but there's a limit.) I saw one guy escorted out after he grabbed a nurse by the arm during a busy period - he wasn't even a patient, just irritated about something & wanted someone to take his complaints. Take care of your own needs as much as possible (eg put your wet towels in the laundry basket), avoid pressing the button (note: you prob'ly won't get a response during meds rounds, anyway) & say thankyou, often. My mum's a nurse, so I've got a slightly different perspective of how everything works than most people, but there's still lots of things that you have to be a patient at least once to understand.
I did a lot of research on Ketamine & this procedure, myself. It's an incredibly dangerous drug with a very narrow, & highly subjective, functional window (Goldilocks zone). That said, it also has some unique properties that make it damn near perfect for people with chronic pain. The combination of mid brain stimulant & NMDA Antagonist rapidly puts the brakes on the production of Substance P throughout the body, then plasticises the Nociceptic regions in the brain & spinal cord enough to 'reset' them back to zero.
If it were possible I'd be on it permanently.
The following user(s) said Thank You: Wendles, Bon65
Hi there, I've just searched and came across this discussion, I'm a t-9 paraplegic with ridiculous amount of neuropathic pain from waist down, I'm on or have tried every med that I know of with no success, I have been on ketamine in hospital twice, first time after spiral fracturing my leg in half and non of the opiate drugs helped then again after my spinal cord injury. That seems to be the only mer that helps with my pain but just wondering how and if it is possible to use this ongoing? By reading this you say you are in hospital for 2 weeks then sent home, how long does it last in your system? Do many hospitals offer this?
Unfortunately, it's not possible to remain on Ketamine for more than a short term (which is different for everyone) due to it's side effects. The primary two that they focus on in hospital are the increases in heart rate & blood pressure - which are checked initially hourly for the first 48 hours, then every 3 hours or so. My sedentary Blood Pressure in abnormally low (100/60) due to my Fibro, etc. & it gets kicked up to regular levels (120/80) by the Ketamine, so it pushes an individual with a regular B/P to unhealthy, even Hypertensive levels. My heart rate jumps up from 80 to 95-110bmp depending on my activity levels, though this has stabilized down more with each Therapy session. People have stroked out & had heart attacks from the drug, and even short term use exhausts & strains the coronary system. The better your initial health is, then the better you deal & recover from this, so you can see how having a good cardio regime is pretty essential.
Less understood is the way in which Ketamine stimulates an increased level of Ionic Calcium & Sodium (Ca+ & Na+) in both the CS fluid & the bloodstream. Too much Ca+ in the Prefrontal Lobes & the.Limbic System (especially the Amygdala) Is related to perceptional distortions, hallucinations, delusions & paranoid aggression (Ketamine's cousin drug Phencyclidine is famous for producting these effects in moderate doses). The Ketamine therapy that I have used has very low doses to avoid this problem, but as it builds up in the system then eventually the only alternative is to stop taking altogether. The increased Sodium Ions (Na+) build up in the liver, kidneys & bladder & cause excruciatingly painful damage if not flushed from the system fast enough (as I learned when taking Ketamine for the 1st time). I frequently drink as much as 5-6 Liters of water daily while on the Therapeutic level of Ketamine. And then have to very carefully supplement my other electrolytes, especially Potassium (K+), which if it gets too low slows & can stop the heart functioning.
The whole 2 weeks of the Ketamine Therapy are exhausting, but I find that while on it I have Zero neuropathic pain (slight arthritis in my left knee & both hands - video game generation. : / ), after coming off the drug I'm tired but my pain remains very low, though it will gradually build up in tiny increments over 2-3 months.
I'm currently investigating other NMDA Antagonists / Modulators that I'd be able to take daily with similar effects to Ketamine with limited success (due to the high costs & government regulations in prescribing)
Ketamine is used worldwide as both an anaesthetic & analgesic, but under very different methods - too many to explain.
For your purposes you need to investigate hospitals with staff trained in Ketamine Competencies & specific Pain Clinics that supply Ketamine:
1 - In very low doses - either intravenously for a few hours or subcutaneously with an infusion pump over 2 weeks. Each has benefits. You can only repeat the Therapy every few months to allow the body to recover from the strain.
2 - Absolutely without using anti-psychotic drugs to deal with the side effects (they cause brain damage & counter some of the benefits of Ketamine).
3 - You need to research the various methods/dosages of using Ketamine & need to have a trustworthy & competent pain specialist that can advise you on the best one for your situation. Using it's like walking a razors edge - the 'Goldilocks' dosage window is incredibly narrow & very individualistic.
4 - Never forget how Fucking Dangerous Ketamine is - use at your own risk! Street drug dealers frequently supply veterinary grade shit or just shit - I was in so much pain all the time, that I was seriously tempted 'till I realised how much even one dose could fuck me up.
Finally, I don't know about how your paraplegia could be a factor in using ketamine. There may be better alternatives available to you: Surgery; Tens Machine; Electrode Implants; or other meds. Ketamine could be the right thing to reduce your pain but should be a last resort. Talk with your GP / MD, but do as much research yourself as possible: most doctors simply don't have the time to research every single thing, about every single injury/disease - there's just too much info to process.
You can talk to me if you've got any more questions.
btw - I'm not entirely sure that putting you on Ketamine while with a broken leg (femur?) was a good idea, as it could have put you at an increased risk of getting a fatty embolism - something else to investigate...