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Thread: Dr Jay Joshi Pain Management Anesthesiologist Ketamine, Stem Cells, Stimulators

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  1. #1
    Join Date
    May 2008
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    reno,nevada
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    Dr Jay Joshi Pain Management Anesthesiologist Ketamine, Stem Cells, Stimulators

    Valuable Pain Doctor talks about pain....

    http://www.nationalpain.com/dr-jay-joshi

    Ketamine infusion
    https://www.youtube.com/watch?v=QshZ_unVDQQ

    IV Ketamine and Cutting edge treatments
    https://www.youtube.com/watch?v=2bvzG4GknRU

    Marijuana for Chronic Pain, Pharmacology, Neuropathic Pain
    https://www.youtube.com/watch?v=pPacWyzClz4

    Ed
    49 yr old male, now 60, the new 55...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  2. #2
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    Notes on 1st video:

    What is a pain expert? (Does anyone know?)

    The reality of pain management 20:07

    1) 90% Have no formal training. 90% Have no formal training. 90% Have no formal training.90% Have no formal training. 90% Have no formal training.
    2) Board certification can be bought
    3) Variable quality of training....trained by the un-trained
    4) Unaccredited programs...."work for me for free and get your fellowship"
    5) Outdated training programs...

    (Smug face)

    Central Sensitization (Hyper-reactive brain, highly excitable) 24:00

    Hyperactive feedback loop (neurons continually fire) sending pain signal after injury (tissue damage) is over.
    Every injury results in brain re-organization resulting in memories....major changes in both the spinal cord and the brain.

    Types of Central Sensitization
    1) Anxiety
    2) Chronic pain
    3) CRPS/RSD (Central regional pain syndrome)
    4) Depression
    5) Fibromylagia
    6) Headaches
    7) Opioid Induced Hyperalgesia (Causes increased Central Sensitization, Horrible feedback loop)
    8) Phantom limb pain
    9) PTSD

    Disinhibition...Basically what happens, is a complete short circuit...(29:50) Cord and Brain
    ================================================== ========================================
    Ketamine Infusion 34:20

    FDA Approval 1970
    World Health Core Medication
    Brand name Ketamine vs non brand name (Cheap stuff) makes a big difference
    Resets the NMDA receptors (Spinal cord and the brain) (Magnesium used for CRPS)
    Ketamine reduces sensitivity to new opiate receptors 39:33
    Use of Ketamine to reduce opioid use (resets receptors) 39:50

    Effects of Ketamine 41:40
    Does not inhibit breathing
    Increases blood pressure and heart rate and cerebral blood flow (headaches)
    Reduces chronic pain and need for opiate medications Lots of evidence 42:35 Prevents hyper sensitization
    Why isn't it used more often? Lazyiness and ignorance 43:00
    Ketamine reduces and reverses PTSD 43:28
    Dr Joshi does Ketamine infusion in a surgery center, (North of Chicago) not a closet. 44:45
    Central sensitization sometimes reduced to zero...

    ================================================== =======================================

    Once again, some members here have had Ketamine, including myself. I think it explains why I terminated Percoset as quickly as I did. I had it in ICU post surgery, and didn't feel a thing. I did not have infusions after my surgeries. I would not do this unless I had a cutting edge anesthesiologist in a hospital setting. Your reprogramming your Central Nervous System.

    Its pain month around here, that why I am posting this valuable material.

    Ed
    49 yr old male, now 60, the new 55...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  3. #3
    Join Date
    May 2009
    Location
    Topeka, KS
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    Well, seeing as the past 16+ hours I have spent in bed these past couple days I did a lot of thinking about this pain issue and scoliosis. It seems if u have surgery and a good surgeon, have no problems postoperative, you will do just fine. No surgeon wants to get in on fixing someone elseís screw up. Thatís bad for me, too, unfortunately.
    Rita Thompson
    Age 46
    Milwaukee Brace wearer for 3 years in childhood
    Surgery Mar 1st - 95 degree thoracic curve
    Surgery by Dr. Lenke, St. Louis, MO
    Post-surgery curve 25-30 degree

  4. #4
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    reno,nevada
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    Rita, it is scary for the surgeon....They will try, but its always a major undertaking especially if its a full procedure. Sometimes the answers are not always surgery.

    I don't know if you watched the video, it can be a lot to absorb, (That's why I did the notes) but when neuropathic pain gets out of control, and no-one is seeing anything standing out saying "operate here", the next step is seeing a pain specialist just like what Jackie did. A Central Nervous System expert, one with high caliber credentials. For neuropathic pain, heavy nerve pain, this is all we have.

    Initial scoliosis surgeries like what we had years ago are easier decisions when we have huge curves and there are 50 things wrong that anyone can see. Revision surgeries on scoliosis patients for pain are much more difficult since the surgeons have to find that pain source. I don't know if its in this video or another video, but there are many many injection points for blocks, and these injections have to be located within a very tight area 1/2mm or .02. (2 matchbook covers) The proposed location can be correct, but the injection can fail to prove out the cause due to location inaccuracies. If there are multiple pain sources, this really makes things difficult in the diagnosis process.

    You can have major pain and have the best spine surgeons in the world say they don't see anything wrong. This was Jackie's story....and Pam's story. I don't know if this is due to a radiological miscall, (running wrong diagnostics parameters) or lack of diagnostic technology, or if its not an orthopedic bone or hardware related problem. It "could" be a CNS problem. That's why I posted this video.

    If I had a pain problem, I would want to know the cause. If there is a good clue, I would prefer to keep the revision on a small scale, possibly minimally invasive if at all possible. If there are no clues, this makes surgical intervention an extremely difficult decision.

    If one has the inability to pay for any "desperately" needed medical procedures, there is always crowdfunding.

    Ed
    49 yr old male, now 60, the new 55...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  5. #5
    Join Date
    Jan 2008
    Location
    NC
    Posts
    9,174
    Hi Rita,

    I am sorry you are going through this. I don't have scoliosis but have had herniated discs starting when I was about 30. I am on this forum because both my daughters were fused for scoliosis.

    Anyway a few years ago I read or heard on Doctor Radio about a spine surgeon who stopped doing one and two level fusions for pain because they weren't working. He did thousands of them and just had to stop. He changed specialties and now does pain research to try to help his patients. He is working at the level of the brain and trying to disrupt the circuitry that gives the sensation of pain. Like Ed said, it seems like surgery is not going to be the answer for some pain associated with spine.

    I can see why a surgeon would not want to operate if they didn't see anything on imaging that could be causing the pain. That might even be malpractice if they did.

    I will try to find that guy's name.

    Good luck.
    Last edited by Pooka1; 08-10-2019 at 02:10 PM.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  6. #6
    Join Date
    Dec 2008
    Location
    illinois
    Posts
    816
    Ed is spot on. Sometimes the orthopaedic doctors are looking at the structure situation not the big picture. Sure everything looks good on X-Ray but you know something is not good.
    I was fortunate to trust a neurosurgeon and a second opinion. While the scan showed some questions of another surgery the neurosurgeon was it is too dangerous so he sent me to a pain specialist.
    It is through a teaching hospital in Chicago. And there the correct doctor for me worked hard and listened to every thing I said. Never was my littlest concern dismissed. It was addressed and then helped in some way. Ed has posted a link to a presentation by my doctor. A young man who truely cares for his patients.
    On my last surgery ketamine was used. It is a wonder. It brought instant peace. I guess it is used in other ways but for that surgery and those few days it was great. The feeling continued for awhile afterwards just like the research said. I do understand it is an expensive drug. It is worth looking into.
    Last edited by jackieg412; 08-10-2019 at 02:28 PM.
    T10-pelvis fusion 12/08
    Fractured t-9 six days out of surgery
    C5,6,7 fusion 9/10
    PJK at t-9
    T2--T10 fusion 2/11
    Removal of left side t6-t10. 8/14
    C 4-5 fusion 11/14
    Right scapulectomy 6/15
    Right pectoralis major muscle transfer to scapula
    To replace the action of Serratus Anterior muscle 3/16

  7. #7
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,951
    Quote Originally Posted by Pooka1 View Post
    Hi Rita,

    I am sorry you are going through this. I don't have scoliosis but have had herniated discs starting when I was about 30. I am on this forum because both my daughters were fused for scoliosis.

    Anyway a few years ago I read or heard on Doctor Radio about a spine surgeon who stopped doing one and two level fusions for pain because they weren't working. He didn't thousands of them and just had to stop. He changed specialties and now does pain research to try to help his patients. He is working at the level of the brain and trying to disrupt the circuitry that gives the sensation of pain. Like Ed said, it seems like surgery is not going to be the answer for some pain associated with spine.

    I can see why a surgeon would not want to operate if they didn't see anything on imaging that could be causing the pain. That might even be malpractice if they did.

    I will try to find that guy's name.

    Good luck.
    There are actually two such doctors:
    David Hanscom (https://backincontrol.com/)
    John Sarno (http://johnesarnomd.com/
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

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