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Old 04-22-2013, 05:09 PM
cailinruaidh cailinruaidh is offline
Junior Member
 
Join Date: Mar 2012
Location: Ireland
Posts: 13
10 yr Member
cailinruaidh cailinruaidh is offline
Junior Member
 
Join Date: Mar 2012
Location: Ireland
Posts: 13
10 yr Member
Default PepperCross

Quote:
Originally Posted by PepperCross View Post
Hi,
My name is Pepper and I have CRPS in my left ankle and foot, and I have a suspicion it is moving to my right ankle and foot. I say I have a suspicion, since neither my podiatrist nor pain management doc agree with me, although my right is feeling a bit stiff from day to day. I knew absolutely nothing about CRPS a year and a half ago, when I developed it after I broke my left ankle and foot for a second time falling down some hotel stairs. The first time was just before a job interview when I fell down some cement stairs, which also caused me to sprain my right ankle. I have also torn ligaments in the left ankle back in high school, which was many years ago.
When an orthopedist saw me the second time I broke my ankle and foot, he declared me "cured" after wearing two different boot casts for 4 months. My ankle and foot were still swollen, but he said he saw nothing interesting or anything to worry about and told me to go back to the shorter boot (up to my knee), and try wearing that for another couple of months. Okay, I took nursing classes at university, and I knew there was something else going on, so I sought out another orthopedic doc. He put me in an unna boot for a week, and took x-rays he said showed nothing. After a week my swelling was still there, and my foot had red splotches on it. He said I had CRPS, and he didn't know what to do about it! What?
So I went to a podiatrist I found who put CRPS on his treatment list on his website. He took x-rays right away, and found there was a "body" (piece of broken bone) in my ankle. Neither of the other docs caught it, but it was obvious in his x-rays. He said normally he would remove it, but he also said I had CRPS and didn't want to make things worse, so he referred me to another doc in his office who only dealt with CRPS. She then gave me a nerve conduction test, which was negative, a bone scan that was negative, and an MRI that was negative. I met with both docs after all the tests, and even though they found nothing, they agreed it was CRPS, since my foot and ankle were still swollen, very painful (even to the touch), and had red splotches on it. They said, and I have learned, even though those tests came back negative, CRPS could be and was still present.
I was then sent to an anesthesiologist who has been giving me sympathetic lumbar blocks for over 14 months, and prescribed a cream, with ketamine, lidocaine, clonidine, gabapentin, and some other meds, which I was using about 6-8 times during the day. There was some relief, but we kept up the nerve blocks, since I would get some relief for about 4 weeks at a time. The last time I had a lumbar block, about three weeks ago, I didn't get hardly any relief at all, and I had an appointment with the podiatrist, so I mentioned it to her. She then gave me a most painful shot of cortisone in my ankle, slapped an unna boot on it, and told me to see her in 4 weeks, even though she didn't think she could do more than that for me. The shot caused a great deal more pain than I already had, so needless to say, I won't be going back to her.
I called my pain management doc and left a message for his nurse regarding the last lumbar shot and the cortisone shot, and included I was in some severe pain. I didn't get a call back for several days, so I called again, and when she called back, the same day this time, she said she had given the message to my doc and they would get back with me when he responded. When I finally got a call back, a few days later (this took a week and a half!), I was told he wanted me to come by his office for a consultation on what to do next, what my options would be. The kicker is the appointment was a month later! I have no oral pain meds (he doesn't believe they work), and I have been in pain, though the degrees of pain vary dependent upon my activities, or just when I'm not sitting with my ankle and foot propped up. Once I even got out of bed, just after a four hour sleep (I don't sleep a lot, which oddly doesn't bother me), and I couldn't walk on it.
I do have my cream, which I have been putting on about 6-8 times a day, but my pain just continues, although at different levels.
I have heard about ketamine infusions, outpatient and inpatient, and I don't believe my pain doc performs them, but I'm not sure till I see him about three (OMG) weeks from now. I did get in the internet to see if a doc in Nashville performed these infusions, since we have Vanderbilt Hospital, which is always on the cutting edge and performs lots of procedures most hospitals around the country don't.
After searching the Vanderbilt website, I found nothing about ketamine infusions. I have searched ketamine infusions in the state of Tennessee, but find nothing. I have read about others in Florida, Oregon, and California, and I think one in Pennsylvania, but have yet to find one here.
I am pretty desperate right now. I also have fibromyalgia, which has been flaring up (no surprise there), and so I have quite a bit of pain every day.
Does anyone here know of a hospital or doctor in Tennessee who performs the ketamine infusions? I have read they have a high success rate, and I have responded well, up until recently, to the lumbar shots, even if it was for only 4 weeks.
I have been reading the posts here for a while (sorry I didn't sign up till now), and on other sites these infusions really have helped quite a few people.
Any advice or information would be awesome!
Seems there are some really great people here, so that is why I've joined this board.

BTW, so sorry that was a long story! I also haven't been able to find a support group in the Nashville area, so I guess I had to spill it all out here. Also, my husband is tired of hearing about all this, and I don't have any real friends here; Long story cut short, I have lots of interests, but one isn't church or religion (which is huge meeting place in my area), although I wish it was, might help, and the other interests, my love of different types of music, movies, my love of writing, and so forth, don't appeal to women in my age group, or anyone I've met here period. I feel a bit lost.
Thanks for reading!
HI again, sorry I didn't get back to you yesterday. First of all, start taking Vit C , at least 500 mg/day. It is thought to improve outcome of injuries and it helps get swelling down. It's not definitive yet but there are several small studies on it.
Also eat berries: blueberries, raspberries, blackcurrant, as they are also anti-oxidants. You can also put them in smoothies.
Add anti-inflammatories olive oil or flax oil to your diet as a salad dressing or off the spoon. Heating these oils destroys the anti-inflammatory. Take Omega 3 fish oil capsules daily; the best ones are high in EPA and low or no DHA. Fish oil is a great is great anti-inflammatory.
Immunocal or bio-active whey protein, as explained by Mark Hyman in the
HuffPost, contain Glutathione, the major anti-oxidant which the body makes to get all the other anti-oxidants moving. Glutathione is low in those people who fail to recover from illness. Dr Oz does segments on glutathione on You Tube.
All this might seem like a lot of work but inflammation plays a huge role in early CRPS and and maybe even a continuing role. This was what your podiatrist was trying to alleviate with the cortisone. However putting a needle into a CRPS limb just added further injury and was way too late. It might have helped when the foot was swollen first but before the CRPS started.
You're already getting the message about CRPS: you have to be your own advocate. You have to learn enuff about it to do that. Read about it here on the forum, on the RSDSA website and there is some great information on the Florida RSD foundation site, particularly about the various uses of ketamine and things to be aware of when working with a physical therapist. Never let anyone use ice on it and never let a therapist stretch a limb out. You must do the stretching yourself, preferably in a pool. Because of the danger of re-injury, pool exercise is the gold standard.

I hear you when you say you're off painkillers. Are you at least still taking the clonidine, gabentin etc? They may help prevent the CRPS spreading. The clonidine and lidocaine can be delivered by patch, and the lidocaine won't take the pain away but it may take the edge off the pain. The ketamine cream is useful in that it can be applied directly to the pain, there's no worry about pulling an adhesive off the worst part. You may be able to wesr the lidocaine patch higher up the leg. I used the ketamine cream and would put it in a circle around my leg just above the injury as well as on the injury.
I don't know if it was imagination, but I thought that helped.

Do all the exercise you can while you wait for your ketamine treatment. If you can't walk, then swim, bicycle or leg cycle in the air.
Warm the limb in water, smooth cream onto the limb if you can, just above the injury if you can't. Always Massage towards the heart to help swelling and edema.
Try to get into the habit of touching the limb yourself several times per day, I know you don't trust anyone else to do it.
Look for You Tube videos on Graded Desensitization and Desensitization Exercises. You have to keep the circulation moving in the limb to prevent further damage and this also helps swelling.
See Pepper, my letter is as along as yours! There will always be someone on here to talk to. We all started where you are and we all remember the fear and the isolation. You can also send private messages here.
Hope you get the ketamine soon, but in the meantime there are things you can do to help yourself and regain your power. Lots of Hugs. Paula
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