Dear Catra -

I agree that the two issues are probably unrelated, but surgery with CRPS is an altogether different question. There is a significant amount in the literature (or was before every paper co-authored by Scott Reuben, MD was withdrawn due to his acknowledged fabrication of data in the interest of drug manufactures: the alleged benefits of COX-2 anti-inflammatories prior to surgery in the general population) which have shown that surgeries on an extremity (arm/leg) in a patient with CRPS will greatly increase the chance of "spread" to the affected limb. And there, the usual treatment of choice is continuous regional anesthesia, during and after the surgery.

That said, I know that when I was considering surgery on a hernia, my PM doc wanted me to at least have an epidural - if the surgery could be performed in 2 hours or less - or the appropriate block.

The problem in many hospitals is that patient's don't have the opportunity to a pre-op consultation with the anesthesiologist, who is often assigned just the day before. I am informed that in Los Angeles, the only two hospitals offering pre-op anesthesiology consults - and hence the opportunity to do something a little different - are at UCLA and USC. As a result, all parties agreed that should surgery be necessary for my hernia - and so far it hasn't - it would be performed at USC, where my PM doc practices.

So, the need for surgery may be your ticket into Rush, at least for that first consult, and possibly jumping towards the head of the line while you are at it!

Mike