Dear Ms. L -

I had missed that redefinition. Thank you.

But as a general point, the "less informed doctors" are not whom one might think. In 2006 I was totally blown off by the neuro-immunoly group in the Mayo Clinic's Department of Neurology, in my hometown of Rochester MN. None of them would see me when I was going through the Clinic on largely other issues, because they didn't reccognize CRPS as a neuro-immune condition, by which they basically meant MS. A similar result at Johns Hopkins, but with a twist: they didn't rule it out at the laboratory level, but were without means to put it into clinical practice, which I guess was fair.

On the issue of Mirror and Graded Motor Imagery Therapy - as in, where is it (?) - I got an answer from my long time neurologist today, who also does a lot of work with stroke victims. The issues are cost control and economies of scale. Basically, in almost all the studies done to date, much of the work was done by the high priced help. In order for this to work in practice, there would have to be enough work in one place to justify the training of therapists. And where the same routines could work with both stroke and CRPS patients, a tertiary medical center or "the largest hospital" in a major metropolitan area in the U.S. might be able to pull it off, as soon as the insurance companies realize that this is going to save them money in the long run. That in turn may take larger studies with more funding that's been available so far, and it's not as though this is going to be carried by the mirror and glass industry.

Who knows? Maybe we'll get lucky and get in once it's approved for the much larger group of stroke patients, on whose behalf government grants are much more likely.

Mike