4th day of Treatment

Today the ketamine infusion was increased to 200mg over the 4 hours. Emma is feeling good now after a deep 5 hour sleep this afternoon, but towards the end of the infusion she got quite upset - a bit disorientated and also with pain. The barometer pressure dropped last night/this morning and when this happens it causes an increase in pain (unfortunately happens in all RSD patients) and for Emma it causes an increase in her muscle spasms in her right foot and leg. It is part of the infusion protocol that they periodically test her pain levels at various points. Some nurses have simply asked "If I squeezed you foot that'd be a 10 out of 10 right?" while others actually do the squeezing which causes a lot of pain. She has been given some Zanaflex (tizanidine hydrochloride) 4mg morning and night to help with the spasms. Dr S. is trying to find another doctor here that will treat Emma, as an outpatient, and perform a spinal procedure for the muscle spams. Emma has had these spasms for years but nothing has been prescribled to her before. Dr S. has also recommended more nerve blocks for the spasms in NZ. While Emma has the infusion we are not allowed in the room as it is kept quiet and limited light as most patients sleep. During the infusion Dr S comes and sees the patients and discusses their condition with them. We have been told that we will get a chance to have a catch-up with Dr S. tomorrow. Its 8pm now and Emma is feeling good and eating well.