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In Remembrance
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Join Date: Nov 2006
Location: SE Kansas.
Posts: 374
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In Remembrance
Join Date: Nov 2006
Location: SE Kansas.
Posts: 374
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Hi.
I subscribe to Dish Satellite Network because it has three university or research channels: University of Calif; University of Washington and The Research Channel, all of which have pain, nerve injury and related programming.
I noted three recent programs in which RSD was mentioned. Pain in Women: Biology of Pain (UCTV); The Bane of Pain is Mainly in the Brain (UCTV) and, Symposium on Low Back Pain: Concepts of Pain (UWTV): In two of them the words RSD or CRPS appeared on a graphic but were not discussed. The third: The Bane of Pain... described the BP experiment I wrote about in my reply to Cumene's thread Need Advice:
The presenter in that program was the Chair of the Dept of Anatomy at the University of Calif at San Francisco, and what he said was mind boggling to me. He described RSD as resulting from a nerve injury, showing B&W photo of a person with an extremely hairy right arm and spoke of a minor ulnar nerve injury.
Then later he talked about causing ischemia (blockage of arterial blood flow) by using a blood pressure (BP) cuff and leaving the pressure above systolic for 30 minutes. (He explained he could only describe it because "They won't let me hurt people anymore"). Ischemia produces hypoxia (oxygen deprivation) and dystrophy (nutrient deprivation), which, in the BP experiment mediates cyanosis and allodynia.
I thought about this program for a long time, wondering if he had ever seen an RSD patient, and if he had, why he hadn't noted both cyanosis AND allodynia. I finally concluded that he had not. All he had was that B&W photo in which the patient had an extremely hairy arm in contrast with the other arm; a clear sign that the patient was still in the first (inflammatory) stage of the disease, it would most likely have been hairless in the later, chronic (cyanotic) stage.
Too bad. Here was a guy who knew that ischemia causes allodynia and talked very knowledgeably about exactly how it does; if he had the opportunity to see a real live patient in the chronic stage, he might have concluded that the ischemia explained every sign and symptom of this disease. What a powerful voice for ischemia reperfusion injury he might have been.
Even as I write this reply I know what I'm going to do: Dr Allan Neusbaum at the UCSF campus is going to get a letter from me. I didn't plan to write this; in fact it never entered my mind until one minute ago.
Anyway, med schools do talk about RSD today. The problem, of course, is that they teach that it is the result of a nerve injury. Hey, hasn't anyone pointed out to them that CRPS-I is the diagnosis when no nerve injury exists?
The contradictions in explanations of RSD are endless. How can it be a nerve injury and not a nerve injury at the same time? I hadn't planned on saying this either, but its a question that deserves an answer. Calling Dr Schwartzmann...Vic
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