Wednesday, July 16, 2008


On Monday I said I definitely hit the WALL, that place during Hyperbaric Oxygen Therapy where the pain actually gets worse before it gets better. It is also, unfortunately, the place where far too many patients call it quits feeling that getting worse wasn't in the bargain. 

So, how did today go? The third day banging my head against the wall? Well, my head, feet, legs, arms, hands, etc.? 

I walked in today and Phil, Doctor Spiegel's HBO technician, asked my what my pain level was my reply was "8% less than Monday". 

"8% less?" he said. "But what is that on a 1 to 10 pain scale?"

Now any of you who know me know the conversation that followed :)

I hate the 1 to 10 pain scale that traditional pain medicine uses. I don't think it is useful when applied to CRPS patients especially. I understand, and Phil explained it well, the reasons that the medical community needs to use it; the universality and understanding of it across all types of medical issues.

My problem with it, and many CRPS patients problem with it though is that it is only useful as a yardstick, when looked at in totality of the patients numbers, rather than as a single days number. My 8 is nothing like a typical patients 8. CRPS is ranked as the most painful form of chronic pain that exists today. 

Doctor Ronald Harbut, who is known in the pain community as the "Father of Ketamine" for his groundbreaking work in the field of treating chronic pain patients with low-dose ketamine, created a Pain-Chart sheet that I discussed with Phil and he asked me to bring it in to him and said he thought they might be able to use it. I have shared it with many Drs over the years who have adopted it.

Basically it is a standard 1 to 10 chart across the top, then below that you break down your pain even further by symptom; burning, tingling, crushing, etc. Many different symptoms are listed and you mark each one on the 1 to 10 scale. There is also a figure of a body where you mark where your pain is currently. Last, there is a space for additional remarks. Patients are asked to mark a new page for each day of the week, three times per day; morning afternoon, and evening.

By using three each day for a week, the Dr gets a very accurate idea of when your pain is the worst/best, how your pain ebbs and flows, and also eliminates the possibility that on the day you have a Drs visit you might have a day when your pain isn't too bad and you aren't showing many symptoms the Dr doesn't understand what your symptoms are; (which does happen, like bringing your car to the shop and it suddenly stops making that rattling noise, until you get it home again).

Long story short, well, ok, long story long, I said my pain was pretty much the same as Monday but a little bit less, still about a "9".

whew, I sure took the long way 'round the block there.

What I was trying to point out was that I think I am coming down off of the WALL, it is just a little so far, the pain is still pretty high, but it does feel like I am a little improved from Monday. I am really looking forward to tomorrow and Friday! I figure the rest of my treatments are all forward, that the hard part is behind me. I am not out of the woods yet I know. But I know I can see the other side of the wall :)

And that's a good thing!

Tomorrow I will have some additional HBOT information to share with you. Also, if you have any questions for me, please email them to 

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Have a good day guys!

Peace, Keith

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