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Vicc · 04-23-2007, 11:24 PM

Oh, goody, Mike. I knew you wouldn't let me down.

There is a more succinct definition of cyanosis in the OMD, it reads: a bluish or purplish discoloration (as of skin) due to deficient oxygenation of the blood. I like to stick to the KISS (keep it simple, stupid) model, but I know that lawyers pay the bills by confusing and obfuscating things.

The thing is, those "experts" back in the 1940s didn't want people to talk about blue to purplish skin, so they used the word "dystrophy". As I pointed out in my first reply to Bronco's thread Upset, if they used the word "cyanosis" people might ask what causes it, and they were fresh out of neurological explanations, what with the evidence showing no sympathetic vasoconstriction in the disease.

It was more convenient (expedient) to pretend the word simply ceased to exist than try to claim sympathetic dysfunction at the very moment when sympathetic dysfunction had been demonstrated to be not a factor in RSD. I can understand that: lots of people prefer pretending to facing reality

You might like to put it another way, but I'm not going to: we are not talking about a loss of nutrition, we are talking about blue to purplish skin. Blue to purplish skin means the cells aren't getting enough oxygen, and oxygen is only delivered by the arteries, which science had just proved were not being affected by sympathetic vasoconstriction. The experts back then, and doc S and you today, didn't want to talk about blue to purple skin.

The ground that's being covered is not essentially the same. Doc S and the other experts want to define the ground in terms of dystrophy, for a very good reason (and one I may have mentioned before): They have no neurological explanation for cyanosis.

And I'll be damned! Doc S actually did come close to using the C word, but in typical doc S fashion he distorts reality. The clear implication in the phrase "cyanotic-like" is that it may look like cyanosis, but it isn/t. That's just doc S, up to his usual manipulative tricks again.

In fact, the entire article appears to be nothing more that his manipulative tricks. He's either talking out of both sides of his mouth or out of both faces. The next time you two chat, you might ask him is this is the result of a sympathetic dysfunction; which his double-talk here seems to indicate, or if he still stands by his previous statements that RSD pain is caused by a peripheral nerve injury which is later assumed by the spinal cord during spinal sensitization.

You'll have to watch his lips (both sets) carefully, to see whether they are saying the same thing.

I haven't seen Coderre's presentation of this as an ischemia reperfusion injury, but I'll bet its lotsa fun to read: He is after all, the same guy who authored that silly article about ketamine therapy. (Yup, I'm baiting you again. I wasn't real happy when you tossed that in your final post during our last contratemps. You weren't obligated to honor my request that you limit your reply to topics we had already discussed, but you knew I had already said I wasn't going to make another post: that really was a cheap shot, and I'm looking forward to round two).

As to your concluding statement: The point is neither simple nor fundamental when you, doc S and the rest of the RSD "experts" want to hide cyanosis inside a box labelled "dystrophic changes".

You are correct that much has been written about "dystrophic changes" through the years. That's because these liars (doc S included) use that phrase to avoid using the C word. A rose by any other name would smell the same, but "dystrophic changes" isn't a rose; it's a splivet: ten pounds of horse **** in a five pound bag.

In both of my posts on Dana's (Bronco's) thread Upset, I asked people in our forum family to imagine how different things would be if cyanosis were listed among the signs and symptoms of this disease. I now point out how different things are because it isn't:

Instead of an agreed upon sign that leaves no doubt that an objectively identifiable disease process is going on, proof beyond contradiction that RSD is real, we live in a world where lawyers for insurance companies can argue that there is no objective evidence for this disease.

Instead of an agreed upon sign that doctors could immediatly identify and thus confirm that the pain the patient reports is indeed real, we are treated like junkies when we have to go to an ER because even our own doctors won't believe us.

I could go on, but I believe I've made my point. Doc S is a liar. He lied agan when he used the phrase "cyanotic-like". I don't know why he lies. It could be the money he makes off of ketamine; it might be that he simply doesn't have the guts to admit he was wrong all these years; or he may just be a pathological liar. Whatever his motives, he is, as I've said before, not just a liar but a damned liar...Vic

Jose, Liz, Pat, everyone; I finished my reply to Jose's post, and its a biggie: 1900 words. I was too tired to go back and edit it, and too tired to reply to other posts here, but obviously not to tired to do another thousand or so words here.

Don't be mad at me. Yeah, I'm irresponsible, but playing with Mike is so much fun