Dear Ada -

We have to be careful to look at the donut and not the hole, as my mother says. While they may not be conveniently located, the fact of the matter is that many medical schools affiliated with major universities have perfectly good RSD docs on staff. (Sadly, there are exceptions, UCLA here in L.A. being one of them.) The trick is in tracking them down, but with a little effort, it's not that difficult. And the joke is that medical school doctors tend to take all insurance and are somewhat cheaper than many physicians in private practice: they're not in it for the money. That's where my doctor is and I'm beginning to get the sense that - overall - it's a good fit for relatively archane and often frustrating conditions like CRPS.

Moreover, I commend for your consideration an editorial written in lay language that appeared in 2007, in a leading medical journal, Pain, "Editorial: How common is complex regional pain syndrome-Type I?" (Stephen Bruehl and Ok Yung Chung) Pain 129 (2007) 1–2. Because the editorial is so short, I am able to attach it here. The bottom line is that the authors reject a much more conservative estimate by Paola Sandroni of the Mayo Clinic - who saw me in 2002 and applied her conservative criteria and ruled that I didn't have RSD/CRPS - and conclude instead that the actual rate of new cases is somewhere between 16.8 to 26.2 per 100,000 per year, which should be more than enough to encourage young doctors to enter post-doc fellowships centered around the treatment of CRPS.

So I guess I can't agree that the situation is as dismal as some have painted it, at least if you're lucky enough to live near a major university medical center that, in turn, is with the program.

Mike

Attached Files

How common is complex regional pain syndrome-Type I - Bruehl - Pain 2007.pdf (45.4 KB, 2008 views)