Tag Archives: new crps treatment

My position on Ketamine for the treatment of CRPS and RSD

By Dr. Michael Cooney, Clinical Director, Calmare Therapy NJ

KetamineOver the past few years, a significant percentage of the RSD / CRPS /fibromyalgia patients I treated had previously undergone Ketamine Infusion Therapy.  I’d like to offer a little background on Ketamine and share some feedback from my patients who used it in various forms—through IV, creams and even as a form of coma-inducing sedation.

For RSD, CRPS and fibromyalgia sufferers, Ketamine is sometimes recommended for temporary chronic pain relief. It is an NMDA blocker that shuts down pain signals coming from the brain and then reboots the brain without the pain signal.

Successful outcome statistics for RSD patients treated with Ketamine are less than 50%. Boosters are necessary every two – three months and the cost averages about $2,000/ treatment. Each IV infusion takes about four to five hours.

Patients sometimes experience significant and unpleasant side effects from this drug, including hallucinations, nausea, extreme fatigue, mental confusion, substantial weight-gain and ‘claw hand’ syndrome.

Criteria to undergo Calmare scrambler therapy after Ketamine treatment

If you have undergone Ketamine treatment without a successful outcome, you can undergo Calmare (assuming your medical condition is determined appropriate for treatment). However, there must be a full three-month span between the last Ketamine treatment and the start of Calmare.

In fact, the less neurolytic drugs (Lyrica, Neurontin, Cymbalta) patients are using during Calmare Therapy, the better. Why? Because these drugs have an effect on brain activity and conflict with the functionality of Calmare to optimally do its job.

In other words, you need to feel your body’s untreated pain in order to identify when the scrambler therapy is lessening the neuropathy, for how long and to what degree.

I realize that for patients who have been reliant on neurolytic drugs for months or years, reducing the dosage of medication before our treatment starts can be daunting. My argument is that the potential rewards for patients who undergo Calmare Therapy may eliminate the need for these expensive and debilitating drugs.  Permanently.

Therefore, I believe this is a gamble worth pursuing.

Every patient’s case is unique because we all react to injury and pain, acute or chronic, in different ways. If you or a loved one is interested in learning more about Calmare Therapy, please feel free to contact me directly at (201) 933-444-zero.

Joy from West Virginia wins the RSD war with Calmare Therapy

Last week, I received this update from Joy:

“I have come off of 5 meds so far since my last Calmare treatment. I can’t believe the difference in my clarity. I never really read the side effects of them until yesterday… Thanks again for your magic machine.  The first Saturday I was home, my husband and I took a little hike! He has been so happy with the outcome of the treatments! Okie dokie, keep working your magic!!”

Joy_WV_4.2013Joy is one of those vivacious people who are bigger than life–she has a winning personality and charisma that is off the charts  (her name suits her perfectly). The fact that she’s been living for years with RSD pain in her foot after a fall is unbelievable.

Yet again, her neurologist told her that to minimize the RSD pain she would need a neurostimulator implanted into her spine and a tabletop full of drugs. And, like many,  she simply said, “no.”

Joy came to see me last year to try one Calmare treatment.  I offer this to anyone who I feel may benefit from the treatment. (The first visit is free if there is no reduction in pain. If they feel the relief, then that visit is the first of ten). While patients don’t always experience immediate pain relief, so do. This was Joy’s case. In fact,  she went home after a single treatment (the standard protocol is a 10-treatment series, one per day). But a year later the pain returned and she decided to undergo the full treatment series to achieve longer-lasting pain relief. However, her response early on was so successful that we agreed that eight treatments was enough and off she went back to West Virginia.

She filmed a video here depicting her experience. As you can see, this is not a woman who is going to give up easily. And, thankfully, she left us, wearing her favorite boots again.

Insurance coverage for scrambler therapy is on the upswing

When it comes to convincing government and private medical insurance to cover newer medical treatments, it can feel like climbing a mountain. At night. With no shoes. In the pouring rain.

But, we’re happy to begin to see some light at the end of the tunnel. At last, health insurers are recognizing the cost benefit and effectiveness of Calmare’s scrambler therapy in comparison to endless medications, expensive and invasive chronic pain treatments such as Ketamine therapy and spinal chord stimulators (SCS).

 Here is what we know or have been advised to date:

 Worker’s Comp:

The following states are covering scrambler therapy:

New York

Connecticut

Rhode Island

Wyoming

Private Insurance:

*There have been sporadic reimbursements for indications including CIPN, RSD, Herpes and CRPS from the following private health insurers who have approved and paid for at least one patient of treatment for Scrambler Therapy: 

United  

Aetna  

Chartis 

Beacon Mutual  

BCBS UT

Cigna   

Zurich

Liberty Mutual

GHI

BCBS-NV

Anthea

CorVel

Empire BCBS

The Empire Plan 

 *Patients have reported the highest percentage of success when they appeal an initial denial of coverage. 

Additionally, patients living in New York and Wyoming with private insurance have reported the highest percentage of coverage in the U.S., to date.

Without appeals or submittal of claims for coverage, the insurance company’s Medical Directors see no demand from providers for the new technology and therefore have little motivation to establish coverage.

 CPT Code for Scrambler Therapy

The AMA released the new CPT code (0278T) on January 1, 2012.   This code is now used by all Scrambler therapy sites for billing/reimbursement claims.

If you live in a state where Worker’s Comp offers coverage and would like to pursue Calmare Therapy:

1) Schedule a consultation with a certified Calmare provider to determine if your medical condition is appropriate for Calmare Therapy. Bring along your medical records and a history of other chronic pain treatments you have undergone.

2) IF your doctor confirms Calmare is appropriate for your medical condition, contact your Worker’s Comp representative to obtain “pre-certification” before beginning treatment.

There is activity, we are getting there

Slowly but surely, insurers are beginning to see that scrambler therapy is a cost-effective treatment to help people minimize or eliminate chronic pain which is preventing them from working and enjoying the high quality of life they deserve. It’s proven and remarkably inexpensive in comparison to prescription drugs, Ketamine therapy, spinal cord stimulators (SCS) and other invasive and painful treatments.

But patients and their loved ones must put up a fight. What does this mean? According to patients we have spoken with who received reimbursement for Calmare, they did not accept the bevy of “Denial of Coverage” form letters. They wrote their own letters, appealed, appealed and appealed until someone listened.

As a Calmare provider, we will do anything we can to help you win the coverage you deserve. We have staff that interacts with insurance companies and Worker’s Comp personnel 40 hours a week. We are fighting the same battle, right beside you.