Hey. For years it seemed like my pain went off like clockwork, starting around 10:30 am and at it's worst my mid-afternoon.

For years I assumed this was tied to the known peaks and valleys of cortisol in the bloodstream, on account of which people with asthma - who need some vaso-constriction on theier lungs do the best at mid-day and are often in trouble at night. I figured that was sort of a no-brainer, where the vaso-constriction of adrenal "fight or flight" responses of acute stress plays on the systemic vaso-constriction inherent in CRPS: except [and at different times from the onset of CRPS/RSD for different people] at the sites of our original injuries and the most "dependant" areas of our bodies, e.g. the feet. By example, no one has been able to get a 20 guage iv line in me in years. When it's absolutely required, such as a scan where a set amount of contrast dye is pumped in a fixed period of time, I just go strait to a "PICC line" planted in a central vein in my arm with an ultrasound assist.

That said, just over the last couple of years - I've been with this since 2001 - the pain is now often at it's worst by early evening, but late night through the morning I'm still okay. Witness the hour of this post.

But if someone can tell me that daily the cycle of cortisol production can in fact gradually shift within some range over time, then I'm completely sold on the cortisol explanation.

For what it's worth . . . .

Mike