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In Remembrance
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Join Date: Nov 2006
Location: SE Kansas.
Posts: 374
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In Remembrance
Join Date: Nov 2006
Location: SE Kansas.
Posts: 374
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I'll post replies to some of the replies on this thread, but won't begin trying for at least a few hours, but I've been waiting for an opportunity to talk about this:
Hey Liz,
I don't know if I talked about this here at NT, but I think I mentioned it twice at BT:
I have been a history buff since jr hi school, and over the years began to focus on U.S. Military history and the Civil War. The soldiers back then had it really rough; bad food, harsh discipline and about half the military deaths during that war came from disease.
Civil War medics were mainly cooks and bandsmen with no medical training at all; they would scour the battlefield for the wounded and carry them back to aid stations where they would wait hours (often without shade) until a doc could treat them. Because battles sometimes went on for two or three days, many of the wounded died alone in bloody fields.
They couldn't do anything about most of that, but they eased their fears a little by carrying tourniquets into the battle and this might help preventing them from bleeding to death. The tourniquet was the most common form of battlefield first aid in that war.
Realizing this makes it a little easier to understand how Weir Mitchell was able to treat enough causalgia patients to write a book about it. He had lots more RSD patients than most docs have seen.
It is obviously much easier to develop RSD following a tourniquet ischemia (TI), which is why I took a bold leap and posted on another thread that anyone who develops RSD following surgery has an diagnosable ischemia-reperfusion injury (IRI). Nobody seemed to pick up on that.
Explaining how RSD develops without TI is much more difficult, since IRI experts believe it is an essential factor, but they know that once blood flow is restored, the patient continues to suffer from waves of compression ischemias (CI) as inflammation swells the tissue, which compresses the tiny arteries that feed the microvascular systems.
They know that the bulk of ischemic damage is done following CIs, as the disease continues to spread throughout all or part of an organ. I know that no one really understands what I'm saying when I talk about IRI, but I hadn't intended to begin a major discussion on it; all of this is the result of my reply to a question about whether a person might have RSD.
I haven't managed much work on the second post to my thread titled Facts you may not know about RSD. That post will describe how ischemia is the most practical and logical explanation for cold RSD, I don't mind being diverted, because I think debates like this allow me to offer information in bite-size packets rather than my long and relatively dry "educational" posts.
Still, I didn't expect this sort of sustained response to a few simple words: All I can say is that you would be a real exception to the rule if your warm, red skin is RSD; 16 months is just too long.
Anyway, I can't complain: I wanted the opportunity to talk about why I believe RSD is an IRI, and I have had plenty of opportunities to do that here...Vic
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When in doubt, ask: What would Jimmy Buffett do?
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