Pain Management - DREZ
Pain Management - DREZ
Hi,
I’m new to UBPN.
The following are my questions regarding pain management associated with my brachial plexus injury:
1. Based on the background information appearing below, are there any pain management options that I have missed and should consider before a DREZ lesion?
2. What are the success – failure statistics associated with a BPI DREZ?
3. What are the risks associated with a BPI DREZ?
4. What are the side effects associated with a BPI DREZ and how long should I expect these side effects to last?
5. How long will the pain reduction last from a BPI DREZ?
6. Do you have a recommendation regarding a doctor to perform a BPI DREZ?
Background
I am a 69 year old female having suffered a brachial plexus avulsion (C5 – T1) in my left arm as a result of a motor vehicle accident in January 2007, I have had a number of procedures performed initially to regain some use of my arm/hand and more recently to reduce neuropathic pain associated with this injury. So far none of the procedures have been successful and some have increased the pain. Each doctor that I have seen has tried his specialty and when the pain was not reduced, the doctors have recommended another doctor with another special procedure. I am told that I am at the bottom of the barrel as far as pain management options are concerned. At this point various doctors from around the country have are recommending a DREZ, a motor cortex stimulator or a deep brain stimulator. Since a DREZ is a destructive procedure and cannot be “undone” and both MCS and DBS procedures are very invasive and potential success (pain reduction) is estimated at less than 20%, I am reluctant to try any of these procedures. However, when you are desperate, you’ll try anything,,,,,,,,,,,,so I am considering a DREZ, since a number of doctors have recommended it based on my background information appearing below.
Procedures that have been performed so far:
3/6 – 12/07 – Free Gracillis muscle transfer – Not successful
1/30/07 – Physical therapy to prevent contractions
1/3/07 – 6/3/06 – Dilaudid, Oxicontin – Not successful
8/07 – Onset of central pain
9/07 – 3/08 - Mirror Box a la Ramachandran – Not successful
6/08 – Spinal Cord Stimulator – Not successful
8/08 – Lydocaine infusion – Not successful
11/4/08 – Ketamine (100 mg) infusion – Not successful
12/10/08 – SCS removed
12/15/08 – Ketamine (125 mg) infusion – Not successful
2/09 – TENS unit – Made pain permanently worse
2/09 – Physical therapy – Made pain permanently worse
Oral medications – Methadone, Neurontin, Lyrica, Gabapentin, Cymbalta, Lamictin – not successful
I look forward to your responses.
Thanks for your help,
I’m new to UBPN.
The following are my questions regarding pain management associated with my brachial plexus injury:
1. Based on the background information appearing below, are there any pain management options that I have missed and should consider before a DREZ lesion?
2. What are the success – failure statistics associated with a BPI DREZ?
3. What are the risks associated with a BPI DREZ?
4. What are the side effects associated with a BPI DREZ and how long should I expect these side effects to last?
5. How long will the pain reduction last from a BPI DREZ?
6. Do you have a recommendation regarding a doctor to perform a BPI DREZ?
Background
I am a 69 year old female having suffered a brachial plexus avulsion (C5 – T1) in my left arm as a result of a motor vehicle accident in January 2007, I have had a number of procedures performed initially to regain some use of my arm/hand and more recently to reduce neuropathic pain associated with this injury. So far none of the procedures have been successful and some have increased the pain. Each doctor that I have seen has tried his specialty and when the pain was not reduced, the doctors have recommended another doctor with another special procedure. I am told that I am at the bottom of the barrel as far as pain management options are concerned. At this point various doctors from around the country have are recommending a DREZ, a motor cortex stimulator or a deep brain stimulator. Since a DREZ is a destructive procedure and cannot be “undone” and both MCS and DBS procedures are very invasive and potential success (pain reduction) is estimated at less than 20%, I am reluctant to try any of these procedures. However, when you are desperate, you’ll try anything,,,,,,,,,,,,so I am considering a DREZ, since a number of doctors have recommended it based on my background information appearing below.
Procedures that have been performed so far:
3/6 – 12/07 – Free Gracillis muscle transfer – Not successful
1/30/07 – Physical therapy to prevent contractions
1/3/07 – 6/3/06 – Dilaudid, Oxicontin – Not successful
8/07 – Onset of central pain
9/07 – 3/08 - Mirror Box a la Ramachandran – Not successful
6/08 – Spinal Cord Stimulator – Not successful
8/08 – Lydocaine infusion – Not successful
11/4/08 – Ketamine (100 mg) infusion – Not successful
12/10/08 – SCS removed
12/15/08 – Ketamine (125 mg) infusion – Not successful
2/09 – TENS unit – Made pain permanently worse
2/09 – Physical therapy – Made pain permanently worse
Oral medications – Methadone, Neurontin, Lyrica, Gabapentin, Cymbalta, Lamictin – not successful
I look forward to your responses.
Thanks for your help,
