Dear Amy -

I am so sorry for what you are going through. And while it may come across as a truism, we have all been there.

The first thing that you should know is "this too shall pass." The pain from RSD/CRPS is at its worst, for most people, during the first couple of years: not that it's of great comfort in the here and now, but it may help keep things in perspective. Then too, you should let your pain management doctor know that not only didn't the block work, but your pain is excruciating. S/he may be able to put you on something stronger right away, I know that mine did and I had the good fortune of never having to go "up" from there.

There are also meditative exercises specifically for intense pain that can really help, which can be performed from whatever position you are in. The most basic one begins by carefully "scanning" your body in your mind, going from the top of your head to the tips of you fingers and toes, but excluding (for now) any areas that area in pain. (This is important for a number of reasons, not the least of which is that neuroscientists have shown that RSD/CRPS alters the image of your own body location, as represented/projected in your cerebral cortex.)

Then, although you may not be aware of it, there are always places of refuge and relaxation you can find in your own body. The first and most obvious is in the breath. If you pause for a moment between breaths, be aware of a sense of pleasure on the inhalation as oxygen comes into the body, and more importantly, be aware of the complete relaxation - from your lungs to the tip your nose - as all of the muscles relax as you exhale.

Next, bring your attention to the space behind your closed eyes. It may be primarily dark or light, or a mottled mixture of the two. Pick whatever you find to be the most comfortable, and just hang out with it.

And and then, in dealing with the pain, begin by trying to keep your attention on the restful place behind your eyes (call it blank) and simultaneously be aware of the rest in your breath. And after focusing on the breath and the blank - as best you can - for a couple of minutes, try "picturing" the rest in the breath directly on top of the area in your body that's experiencing pain, and holding the two together. You may be pleasantly surprised at what happens.

Mike