I just want to follow up now that I've completed the inpatient 5-day infusion. Going in I was averaging between 7-9 on a 10 point pain scale, now three weeks out I'm averaging 4-5. There have even been days where I'm at a 3, although rare because just about anything I do shoots my pain up. I would continue to push your doctors to give you another try, and this time go with the inpatient setting, the infusion is continuous (titrated), and I believe more effective because there is no break in the treatment.

Thanks for coming back to give the group your updated experience with ketamine infusions for SFN, @jdrhoads. Do I understand correctly that the infusion was continuous for 5 days? How long did it take before you started to notice a reduction in pain? How long is the treatment expected to last?

The ketamine was slowly increased (titrated), and I noticed some initial effects and slight relief by mid-day Tuesday. At that point the pain was going down as the meds were being titrated up until late Thursday, at which time I felt no pain (I walked in on Sunday evening at a high 7 nearly 8 pain level). As the meds were decreased over the course of Friday the pain slowly returned to around a 5, which is not uncommon and occurs every time that I get infusions. It took a day or two, but by Monday I was at a 4 and was 3 by that evening. This Friday will mark a month post-infusion, and I am at a steady 5. One thing that my pain management and I believe is that my booster infusions have not been frequent or long enough to maintain the lower pain levels. I just continued going in for a 2-hour infusion every other week, which was what I was doing before the 5 day treatment. Doctors will tell you that there is no set protocol for infusions, it is entirely based off response by each patient. I've had relatively good luck keeping the pain at a tolerable level through the use of ketamine, although its use has not (so far) led to a reduction in my other meds (Lyrica, Savella and Tramadol as required). Hope this information helps to some degree, its just so tough finding the right regimen, and when you seem to have done so the pain is creeping up even more!