Vrae -

Completely agree with your assessment that the cognitive loses can be the hardest to bear. I said as much to my pain doc maybe 8 months ago - I would happily live with the physical pain of I could just return to full strength on the cognitive ice - and even though the man is "triple-boarded" in psychiatry, anesthesiology and pain medicine, his jaw almost hit the floor. And I was just as surprised he hadn't heard that before.

And just looking at your avatar, which blows up quite nicely on your profile page - see my comment - it's clear to me that your talent deserves more than an early retirement. If it's any help, my boss put on a very nice lunch with a few of my personal clients of long standing a few months after I turned 50: it was bittersweet and nothing to recommend if there are feasible alternatives.

Accordingly, I beseech you to explore tDCS before calling it a day. You could easily get set up with everything you need by way of equipment for just under $400 and with a pain doc/psychiatrist prescribing a brief starting course of Seromycin, along with maybe a weekly booster thereafter (and perhaps one or two other psycho-pharmacologic meds for good measure) there's an excellent chance of controlling at least the cognitive side-effects of your CRPS.

But before I launch too far into the specifics of the medical literature in hopes of encouraging your further exploration of the subject, here's some information of a more general nature that I didn't share above.

First of all, you should be aware that the most important site in the country (world?) for tDCS research is that of the Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, in Boston, MA. And the names of two of its principals, who are among the most respected neuroscientists in the country/world, keep popping up a lot in the literature: Alvaro Pascual-Leone and Felipe Fregni. And there's an incredible amount of valuable information on that site. And then, for something completely different, you may want to check out a quick over-view on the impact on a reporter’s immediate sense of a shift in her conscious awareness - specifically dramatically improved concentration and the cessation of internal chatter - Better Living Through Electrochemistry, Sally Adee, Feb. 9, 2012, The Last Word On Nothing.

That out of the way, and to get on with it, . . . [Please see the t.D.C.S. Update Could remission be within my reach and your's too? thread, post 461.]

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Finally, here's one showing the value of using Seromycin with tDCS, for what it's worth:

Consolidation of human motor cortical neuroplasticity by D-cycloserine, Nitsche MA, Jaussi W, Liebetanz D, Lang N, Tergau F, Paulus W, Neuropsychopharmacology. 2004 Aug; 29(8):1573-8.

I suspect there's more stuff here than I could reasonably ask you to assimilate, but if nothing else, you can print this stuff out to share with a willing physician. And if all you can get in Denver is a pain doc/psychiatrist who's willing to play ball, but only under the lead of another physician, then do what I was finally talked into: make an appointment with James Fugedy, MD for a one-time 4 - 6 hour consultation on a Friday, fly to Atlanta the day before and come back that night. Or the next day if that sounds too daunting. (Alternatively, I'm told there are some very smart pain guys in SLC at Intermountain Healthcare who might be persuaded to play ball, dunno.)

So, simply put, you have everything to gain, while, sadly, you are all too aware of what there is to loose. And please forgive the proselytizing zeal, but there's enough riding on this that I'm perfectly happy to stay up most of the night writing this. (As noted, sometimes I get a little carried away . . .)

And, finally, I understand that sometimes, in the words of Ram Dass, we just "have to take the curriculum" and get on with the changes that have found their way upon us. That said, it can’t hurt all that much to take another shot, as many times as we may have been disappointed before.

Mike