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Vicc · 09-14-2007, 05:45 PM

Hi Joan,

You wrote: First, before I get in trouble, let me state that I enjoy everyone fo your postings and think you do lots and lots of homework. i agree with a lot of what you say and then there are times when i am confused my it. so that being said:

I have become increasingly impatient with two people who have followed me from thread to thread and repeatedly misquoted me, falsely summarized my views and asked questions that I have already answered more than once. In my view they are harrassing me. On the other hand, I consistently ask for questions and for arguments.

Replying to them has sapped my energy and made it appeat that I object to legitimate questions or debate. I don't.

You and Amber ask essentially the same question in different ways: You apparently suffered nerve damage during your surgery, while she suffered nerve damage that led to the surgery and possibly more nerve damage during the procedure; these injuries are in addition to what appears to be classic models of IRI.

I think that neither group of surgeons recognized that both of you suffered a classic ischemia reperfusion injury: Some sort of tourniquet ischemia done in order to prevent blood loss, followed by a widening area of inflammation and then by a new ischemic stage in which the arterial blood is blocked from reaching the capillaries and thus the cells.

The fact that they failed to correctly identify an IRI is easy to understand: The disorder was long believed to only occur after surgeries involving internal organs. In the 1980s, researchers learned that it can happen in skeletal muscle, but very little has been written about this, and the little I was able to find involves transplanted tissue or restoring amputations (cases that involved long periods of ischemia due to being completely disconnected to the circulatory system).

I believe that physicians who understand IRI believe they completely understand how it is caused and haven't shown any interest in looking for other examples of possible IRI. This makes sense.

I think it important to point out than in just 20 years they discovered a completely new disorder, learned how to prevent it and how to effectively treat it. Contrast this with RSD "experts", who can't agree on a cause for this disease; have no idea how to prevent it, and; have no clue as to how to effectively treat it.

It is time that the RSD "experts" to look beyond nerves and nervous systems, which have led nowhere after 140 years, but they won't. They continue focusing completely on some sort of nerve damage thay hope to find someday, and have closed their minds against any other possible cause.

I believe if they were aware of evidence of tissue hypoxia in RSD, specialists in IRI might suspect what I concluded, that RSD is IRI; They don't know about tissue hypoxia in RSD because they are mostly thoracic surgeons who never see an RSD patient, and if they did have occasion to operate on a patient with RSD and looked up this disorder, they wouldn't see a word about cyanosis, which could provide the clue they need. They don't find it because RSD "experts" deliberately refuse to mention this most important sign.

In a previous post, I went out on a limb and said that every instance of RSD following surgery is, by definition, an IRI. I don't regret saying that, and believe it is only a matter of time before this becomes a uniform belief among medical professionals.

I believe that if cyanosis had not been deliberately omitted from the signs and symptoms of this disease, it is possible that someone familiar with IRI would have already figured this out.

Amber, while my reply was directed to Joan in order to keep it focused, it is the same reply I would make to you. I suggest that both of you suffered both nerve damage AND an IRI...Vic