Kimberly J. Gambarin, MD

At age 33, I thought I had it all – a wonderful husband, a beautiful 3 year old daughter, and a blossoming career as an Infectious Disease doctor. I enjoyed competitive martial arts, playing the piano, gardening, crocheting, cross-stitch, tennis, and cooking to name just a few. I had even worked as a paramedic/firefighter before finishing medical school.

Then in 2003, a shoulder injury changed my life. I had surgery to repair a left labral tear and the pain began. It started first in the left shoulder, an intense, burning ache. No amount of pain medication seemed to control it. I was referred to Dr Matthew McCarty, a pain specialist, who performed a stellate ganglion block and diagnosed me with RSD / CPRS. Despite upwards of 20-30 stellate ganglion blocks, 8-10 pulsed radiofrequency ablations, a bupivacaine catheter in the shoulder, multiple trigger point injections with botox and steroids, a magnesium infusion, a spinal cord stimulator trial, and years of behavioral therapy working on relaxation techniques, I could find no lasting relief.

The pain spread over the next four years, first down the left arm, then up the right. I developed high blood pressure and panhypopituitarism. I have lost much of the hair on my body and frequently sweat profusely even in air conditioning.

The pain spread down my legs and I began to have trouble

walking and frequent falls. I developed marked swelling in my extremities, especially on the left. Even with diuretics I need shoes two sizes larger than my normal size. I gained 50 lbs from the steroids and water retention.

Now age 38, I have difficulty writing, cutting meat, doing my hair or makeup, or opening up a can of soda. Most recently I have developed problems chewing and I often choke. The most devastating of all, however, has been the inability to pick up or hug my daughter for almost 5 years.

I am blessed with a very understanding child and a very supportive husband and family, but this does not begin to relieve the depression this disease has caused. A once highly active individual, I am crippled in the prime of my life.

I was first exposed to ketamine in February 2008 when I received a 10 day trial of 50 mg/hr x 4 hrs/day. I sustained significant relief and was able to cut my medications in half. The effects lasted for about 6 weeks with some lasting relief even out to 3 months. I was then referred to Dr Robert Schwartzman for evaluation for the ketamine coma. I subsequently was referred to Dr Anthony Kirkpatrick for enrollment in the ketamine coma study and possibly a chance to get my life back.

Kimberly J. Gambarin, MD

Austin, Texas USA

August 17, 2008

Kimberly Gambarin, MD, an expert in infection control has allowed the Foundation to share her comments about the San Jose Hospital in Monterrey, Mexico.

Her email below was sent to Timothy Lubenow, MD, Professor and Director of the Pain Center at Rush University Medical Center in Chicago.

From: Kimberly Gambarin
Sent: Monday, November 09, 2009 10:00 AM
To: Tim Lubenow MD
Cc: akirkpat@tampabay.rr.com; fercan7@yahoo.com
Subject: ketamine coma experience in Monterrey

Dr Lubenow- My name is Kimberly Gambarin. I am an infectious disease physician in Austin,TX. My husband is a general surgeon here as well. I developed full body RSD and underwent the ketamine coma procedure Sept 2008. My experience with Dr Cantu and the staff at San Jose Hospital was wonderful (and believe me, with two doctors watching every move along with a concerned father there were a lot of eyes watching!). I was very impressed with the care I received. I was especially concerned in my case because I have an indwelling port a cath which I was afraid might get infected with all the IV medications, but there were no problems there, I also have hypertension, panhypopituitarism, severe vitamin D deficiency and severe hyperprolactinemia which complicate my case, keeping me on about 60 pills per day. While I was there in Monterrey  I developed severe constipation followed by intractable vomiting when I came out of the coma which were rapidly and appropriately addressed. I developed a minor UTI after the foley was removed, but this too was rapidly addressed. I felt that the quality of care that I received while I was in Monterrey, even with the language barrier, was extremely good and I would not hesitate to return there if the need arises. I can (unfortunately) say that I have been hospitalized several times in the US since I developed RSD 6 years ago and the care I received in Mexico was just as good as the care here. If there are specific concerns that you have, feel free to contact me.

Sincerely,

 

Kimberly Gambarin, MD

GOOD NEWS

Hi Dr Kirkpatrick- I wanted to give you the good news. I have finally taken the leap and opened my own practice. I start monday. It is called Hill Country Infectious Disease Consultants. To start I am just going to do inpatient consultation. If all goes well maybe I will open an outpt practice in a year or so. I found someone who is willing to cover for me when I need ketamine or other procedures. Wish me luck! Thanks for everything!

Kim Gambarin, MD
November 11, 2010