By Dr. Michael J. Cooney, Program Director, Calmare Therapy NJ
I’ve frequently been asked by patients if they can undergo Calmare Therapy after or in conjunction with Ketamine Infusion Therapy. Before I respond, let me offer a little background on Ketamine. For RSD, CRPS and fibromyalgia sufferers, Ketamine therapy 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. Published successful outcome statistics for RSD patients is less than 50%, as an average. Boosters are necessary every two – three months and the cost averages about $2,000/ treatment. Each treatment takes about four to five hours. Some patients experience significant side effects from this drug, including hallucinations, nausea, extreme fatigue and ‘claw hand’ syndrome.
If you have undergone Ketamine treatment without a successful outcome, you can still be treated with Calmare (assuming your condition is determined to be appropriate for treatment). However, there must be a full three-month span between the last Ketamine treatment and the start of Calmare Therapy. In fact, the less neurolytic drugs (Lyrica, Neurontin, Morphine) 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.
I fully realize that for patients who have been reliant on neurolytic drugs for months or even years, reducing the dosage can be daunting. My argument is that the potential rewards from undergoing Calmare Therapy can eliminate the need for these expensive and debilitating drugs. I fully believe this is a gamble worth pursuing.
Every patient’s case is unique because we all react to injury, acute or chronic, in different ways. If you or a loved one are interested in learning more about my expertise using Calmare Therapy, please feel free to contact me at (201) 933-444-zero.
July 23, 2013 at 9:45 pm
Reblogged this on A CRPS angels world and commented:
Hey everyone!
Those of you who read my blog, know that I’ve been trying to raise money to receive HBOT treatments. Well, I can’t raise that much money alone.
So I started to do more research on other types on treatments,that doesn’t include surgery.
I found something called Calmare Therapy by Dr. Cooney in New Jersey.
Many of you know that I have had 2 ketamine infusions, so this is something that I am 95% sure about doing.
I will be doing an update about everything going on tomorrow. Thank you!
Check out this post!
Heather Lynn
September 4, 2012 at 3:42 pm
Dr. Cooney and Calmare NJ:
Can you speak to the instance of using Calmare with a spinal chord stimulator in use, please?
September 4, 2012 at 3:39 pm
Very useful info here for people who have or are using ketamine for CRPS. I have undergone a ketamine regime but it was not successful (but offered very negative side effects such as constant sweating and weakness in ankles and wrists to where I felt unsteady on my feet). Thank you for the insight.
September 4, 2012 at 2:27 pm
After reviewing the following article, I feel it is worthwhile to try Calmare.
Some insurance companies are now paying for this treatment.
Dennis A. Miko
Treating NPS with Ketamine and LDN 1
Running Head: WHY OPIATES ARE CONTRAINDICATED FOR THE TREATMENT OF
CRPS and Other Neuropathic Pain Syndromes
Treating Neuropathic Pain with Ketamine and LDN: Why Opiates are
Contraindicated for the Treatment of CRPS and Other Neuropathic Pain Syndromes
Renee Glick, B.A.
Psychology Trainee
Nova Southeastern University
U.S. Pain Foundation
Director of Research Studies
http://www.uspainfoundation.org
Pradeep Chopra, M.D.
Brown University
The gold standard treatment for the burning, stabbing, and bone crushing pain
associated with Neuropathic Pain Syndromes (NPS) such as Diabetic Neuropathy,
Complex Regional Pain Syndrome and Trigeminal Neuralgia has been opiate
analgesics such as morphine, oxycodone, and hydrocodone. Although opiates have
helped people with NPS initially manage pain and increase functional abilities, longterm
usage has been paradoxically found to cause increased pain sensitivity,
decreased pain tolerance, and cause neuroinflammation via activation of glial cells
in the brain and spinal cord. Research demonstrates that opiates activate glial cells
and maintains neuroinflammation by releasing neuroinflammatory agents. Thus,
counter intuitively, treating NPS with opiates fundamentally exacerbates pain and
instigates disease progression.
Most people with NPS cannot fathom getting through a day without the pain
relieving effects of narcotic painkillers. Day to day functioning often depends on
watching the clock to remain ahead of pain, for if it reaches a certain intensity, the
pain is difficult to allay with even large doses of narcotic medications. Considering
the level of pain people with NPS endure with the aid of the strongest medications,
navigating daily activities without the relief of opiates can be a terrifying thought.
However, the short‐term relief achieved with opiates has long‐term consequences
that include further disability and increased pain and CRPS related symptomatology.
What is the solution to this unfortunate catch twenty‐two, where relieving pain
creates pain? Are people with NPS supposed to endure pain that is at times
inhumane to endure in order to prevent disease progression and increased
discomfort? Many people with NPS are exhausted and extremely eager for pain
relief that living is a moment‐by‐moment achievement. In this place of desperation,
planning for the future can feel overwhelming. Nevertheless, it is imperative that
people with NPS explore new pain management techniques that are not found to
exacerbate pain and further disability. Many people with NPS have experimented
with an array of painkilling agents and have found opiate related pain relief
superior. Luckily, new agents such as ketamine and Low Dose Naltrexone (LDN)
have been found to provide pain relief, increase functionality, and reduce
neuroinflammation.
The ketamine coma was introduced and evoked both hope and fear into the CRPS
community. Tails of complete remission of refractory CRPS had hundreds clamoring
to “eboot”their central nervous system at the risk of death, memory loss, seizures,
and horrifying hallucinations. Physicians later found that the pain relieving and
disease remitting effects of ketamine could be achieved at lower levels and thus,
ketamine infusions were introduced to the CRPS community and are becoming a
supported treatment by several insurance companies. Despite the tails of
miraculous remission, the pain relieving effects of ketamine infusions can be shortlived
and ketamine comes with risks like all drugs and can be expensive.
Nevertheless, infusions
can help people with CRPS and possibly NPS make the
adjustment of functioning without opiate analgesics.
Naltrexone is a drug that has been used to prevent heroin overdose by blocking
opiod receptors in the brain. Dr. x treated people who acquired HIV via needle drug
use with naltrexone and subsequently compared HIV symptomatology of those who
acquired HIV through other means (i.e., sexual transmission and blood infusion). He
found HIV patients treated with naltrexone developed cancer less frequently and
were in less pain and he concluded that naltrexone appears to modulate immune
responses. Thereafter, LDN was utilized in the treatment of autoimmune disorders
such as multiple sclerosis (MS), Chron’s Disease and lupus with exciting results that
included significant pain relief. Research supports that CRPS related
neuroinflammation is partially maintained by autoimmune reactions. These
aforementioned results inspired the usage of LDN for NPS such as fibromyalgia,
Diabetic Neuropathy, Trigeminal Neuralgia and CRPS. Although more research is
needed, LDN has demonstrated good prospective pain relief and has been shown to
increase levels of daily functioning in a myriad of case studies. LDN is also found to
decrease neuroinflammation by deactivating glial cells in the brain and spinal cord.
With the known long‐term negative effects of opiates, physicians should consider
utilizing LDN and Ketamine in the treatment of CRPS and NPS.
In preparation for ketamine infusions, physicians often recommend that patients
tapper slowly off opiate medications. Tapered withdrawal can be a painful and
scary process, which requires the support of family members, friends, and a
treatment team. Nevertheless, the benefits of enduring these hardships can be life
altering and is akin to a person with cancer tolerating the sickening effects of
chemotherapy for the prospect of a hopeful future. After the infusions, initiating
LDN may help boost the anti‐inflammatory and pain relieving effects of ketamine;
although pain relief may take weeks to months to achieve. Although this several
month investment can be difficult to endure, the resulting payoff according to case
studies conducted thus far is hopeful, as the many people who have made the switch
off opiates, have enjoyed increased quality of life and reduced pain.
September 2, 2012 at 10:59 am
When other treatments don’t work, ketamine may bring relief to patients with CRPS. However, patients are carefully screened before receiving the treatment. There are two common reasons a patient may not be considered for the treatment: psychiatric history and cardiopulmonary disease.