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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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Hi,
The reason those two physicians want to exclude RSD because your arm isn’t “discolored” is simple and complicated at the same time: It’s simple because physicians who have treated RSD patients know that cyanosis is the most common objective sign of this disease. It’s complicated because cyanosis isn’t mentioned in any list of signs and symptoms of this disease. The word literally vanished in the late 1940s, after researchers proved that it isn’t caused by abnormal SNS vasoconstriction.
I have written about the reasons for this in previous posts, and will have more to say in a series I plan to begin posting in a few weeks, but for now I’ll limit myself to saying that there is a very good reason why those two docs you saw want to see cyanosis, and there are good reasons why it sometimes isn’t evident in RSD.
Cyanosis means that blood in the capillaries closest to the skin surface don’t contain adequate oxygen. Arterial blood isn’t flowing through the capillaries the way it is supposed to, and the oxygen has been leeched out of it. Capillaries below the skin surface will also be blocked, but we won’t see cyanosis.
Most RSD results from trauma to the skin surface, and we can expect cyanosis to spread over the skin surface as the RSD spreads, In cases of fracture, some ligament injuries, needle injuries, etc, the injury occurs below the skin surface and may not spread to the skin. Even some skin injuries may not present with cyanosis.
So, while cyanosis is common, it isn’t essential to diagnose RSD. Hyperhydrosis is much less common than cyanosis, and its absence should never be used to exclude this disease.
I was diagnosed with RSD in 1995, and have spent more than ten years talking to RSD people on the Internet; most, but not all, talk about cyanosis. Physicians who have treated RSD patients expect to see cyanosis, even though “experts” who write about the disease never mention it. I believe that visible cyanosis without another explanation is proof of RSD, but absence of cyanosis doesn’t mean it isn’t RSD.
Nobody wants this diagnosis, but I think we all understand what you’re going through; you want to know what it is. If it is RSD, not being properly diagnosed just makes things worse. Perhaps you can talk to one of these docs and help him/her understand that visible cyanosis isn’t essential. I hope this helps you sort things out a little…Vic
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