Quote:
Originally Posted by shogan7RSD
Hi every1!
I had carpal tunnel and cyst surgery on my right wrist in Dec '07. I got better for a little bit, but then 6 months down the road I started having pain again in my right wrist. I saw my surgeon and he immediately figured RSD, but sent me to a PM to get a diagnosis. The PM wouldn't give me a complete diagnosis but did 3 nerve blocks in my right arm and 1 in my left. In that time the pain spread up my right arm to my shoulder and started in my left arm till it got from my finger tips to my shoulder. No doctor will give me a comfired diagnosis bc i am missing some key symptoms (like burning pain, which has started recently in small amounts, excessive swelling, sweating and dryness). I know that people sometimes don't have all the symptoms, but my docs are treating me for RSD, and the blocks didn't help me for long, like maybe a day or two.
All my docs say it is good we caught it early, but what good can that do if i am not responding well to the treatments?
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Hi Shogan7RSD
There is a definitive set of diagnostic rules that have to be met in order for you to get a confirmed CRPS diagnosis requiring that you show a certain number/type of signs and symptoms. The diagnosis can only be reached oafter every other possibility has been ruled out based on testing, observation and and medical history.
There are other neuropathic pain conditions that can cause similar pain to that of CRPS which don't produce the same set of symptoms as CRPS - its a complex business indeed!
To be honest you are probably answering your own question - if early treatment interventions don't work and you don't respond then ultimately it is no real help to have caught it early. The only benefit is that the earlier it is identified and treatment interventions are started, it is generally thought that there is a greater chance that you might respond well.
Early and agressive treatment may mean that pain cycles and some of the reorganisation and sensitisation that is believed to happen in the nervous system, spinal column and brain can be managed before the pain levels become so chronic and severe that it is much harder to try and manage or control them. If you can get and keep a body part moving before it becomes immobile then there is a greater chance that it won't ever become immobile.
Nobody will ever know whether early intervention actually makes a difference for any given individual because you can't tell what would have happened if it had been different. Mine was regarded as a reasonably early diagnosis and I started early treatment at 6 months post the triggering surgery. However I have pain spread to all 4 limbs and can barely walk due to the movement problems I have from CRPS.
I was given a sympathetic block right away on diagnosis and it didn't work for me - like many people I got no therapeutic value from it at all - I was in agony before I even left the hospital. I have had aggressive drug intervention and the drugs were changed rapidly when the first ones weren't working - that has made a big difference to my pain levels. I have severe movement disorder symptoms as part of my CRPS (spasms, intermittent paralysis, tremor, weakness, jerking, uncontrollable movement, problems with voluntary movement) This affects my whole body virtually all of the time and absolutely nothing that has been tried has made any difference.
All you can do is push forward and try as many early interventions as you feel you can take. If you don't respond, at least you can then come to terms with your diagnosis and whatever symptoms you have to live with on the basis that you gave it your very best shot and that you had the best chance. I am well on in the "acceptance" process now, I am re-establishing a new life as a wheelchair user who has to deal with endless pain but at least I know that I have tried everything I could and given it my best.