Dear Catra -

I'm not necessarily concerned with what you think I am. If an EEG or EMG/NCS were ABNORMAL I would have no problem with you going to the Mayo Clinic. But for an undifferentiated pain condition? That's another story. And this is something I have experienced up close and personally, and came as real shock, having grown up in the bosom of that institution.

But that said, we both agree that it's important that you begin receiving treatment for the underlying physical malady you do have, which I assure you, as an out of town pain patient, you would not obtain from the Mayo Clinic. Ask around, their exhaulted Dept. of Neurology is NOT considered to be in the forefront when it comes to pain medicine, despite the fact that it has one premiere name in particular on the marquee.

So, do the follow up with Rush, and see a real CRPS specialist there. In fact, I was surprised to be advised on Wednesday afternoon (by someone whose judgment in the field I regard as unquestionable) that you could even get an even shake if you came to the R.I.C as a paying customer, rather than a workers compensation case, although I still wouldn't bet the farm on it. My contact did, however, speak quite well of Rush.

This, as opposed to the highly regarded specialist in peripheral neurology at the Mayo Clinic who dismissed my with a Dx of pain of unknown origin and suggested that perhaps I return in a year or two because - less than a year unto this disease - at that point I did not have enough classic CRPS symptoms, while at the same time she was putting the finishing touches on a major study on the rate of occurrence of CRPS in the population, one that was was later shredded by other researchers for it's use of an overly restrictive approach in ratifying a diagnosis of CRPS. An opinion validated by an accompanying Commentary in Pain, the leading journal in the field.

Then too, consider that the pain program of the Mayo Clinic writ large is closely allied with the workers compensation industry, and their professionals testify as expert witness regularly as expert witnesses in civil cases on behalf of defendants, where plaintiff's allege that the have received CRPS as a result of an injury of some kind, and you may have a better idea of where their bread is buttered, so to speak. And I've heard a couple of real horror stories as well, one going directly to a pain specialist I saw on a subsequent trip through the Mayo Clinic on a predominantly unrelated issue: and I would still trust my life with them in so many areas. But again, don't rely simply on my vague assertions when it comes to pain consultations at the Mayo Clinic, if you want, put up a polling thread on people's experience, here and/or in the Chronic Pain forum, and check it out.

And frankly, my big concern with you going to Rochester is that there would be so much equivocal diagnostic opinion in your file that it could not only delay treatment, but cause others to have doubts about taking you on in the first place. To say nothing of subsequently qualifying for disability. As it is, all you've got against you is one specialist at Northwestern who ruled out CRPS without even looking at your toenails!

Mike