Dear Stressed -

I join the others in expressing their concerns for you.

One of the things that peple don't realize about folks with RSD is that after a while, the disease begins to effect our emotional regulation through a thinnning of the cortical cells of the "anterior insula" in the brain. The Brain in Chronic CRPS Pain: Abnormal Gray-White Matter Interactions in Emotional and Autonomic Regions, Geha PY, Baliki MN, Harden RN, Bauer WR, Parrish TB, Apkarian AV, Neuron 2008;60:570-581, FREE FULL TEXT @ http://www.rsds.org/2/library/articl...aliki_etal.pdf As a reult, it much easier for us now to become emotionally overwhelmed.

Now, add to that, we add the fact that roughly 2/3rds of us will lose some organizational abilities or "executive funtioning," a matter of particular consequence in dealing with mass disruption in our life. Neuropsychological deficits associated with Complex Regional Pain Syndrome, Libon DJ, Schwartzman RJ, Eppig J, Wambach D, Brahin E, Lee Peterlin B, Alexander G, Kalanuria A, J Int Neuropsychol Soc. 2010 May;16(3):566-73, Epub 2010 Mar 19, FREE FULL TEXT @ http://www.rsds.org/2/library/articl...ychol_2010.pdf

Department of Neurology, Drexel University, College of Medicine, Philadelphia, PA 19102, USA. dlibon@Drexelmed.edu

Abstract
We sought to elucidate the existence of neuropsychological subtypes in Complex Regional Pain Syndrome (CRPS). One hundred thirty seven patients with CRPS were administered tests that assess executive control, naming/lexical retrieval, and declarative memory. A 2-step cluster analysis that does not require any a priori specification regarding the number of clusters, classified patients into three groups. Group 1 obtained scores that were in the average range on all tests (n = 48; normal CRSP group). Group 2 (n = 58; dysexecutive CRSP group) presented with mild impairment or statistically low average test performance on working memory/verbal fluency tests. Group 3 (n = 31; global CRSP group) produced scores in the statistically low average/borderline range on all tests with particularly reduced scores on naming/declarative memory tests. Between-group analyses found that the CRPS group 1 obtained higher scores than CRPS groups 2 and 3 on all tests. However, groups 2 and 3 were equally impaired on executive tests. CRPS group 3 was impaired on tests of naming/memory tests compared to the other groups. Significant neuropsychological deficits are present in 65% of patients, with many patients presenting with elements of a dysexecutive syndrome and some patients presenting with global cognitive impairment.

PMID: 20298641 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/20298641

In other words, what would be a terribly upsetting experience for anyone is likely to be that much more challenging for someone with RSD, and that's before we get to issues how stress triggers pain!

So, may I suggest that it is time time to take a breath and give yourself occasional unconditional "self love" - truly caring for yourself - because I truly believe it's only once that us underway that that we are in a position to fully give ourselves to those we love in their hour of need as well.

Thinking of you and yours,
Mike