okay..... my RSD brain is shot!!!!
 

I can't stand it as my memory has not hit the dumper...Seems like I can not remember anything.. I know our little friend is a brain affected condition but I tell ya... this is cruel.... anyone??? Lately, I am not beating myself up over it but it is crazy... one second to the next.. I am not remembering...

Hugz friends...:winky:KS

I hear ya..Your not alone with this at all. Can't blame everything on the meds. Although,,Lyrica has the effect. Sometimes i find myself writing things down and the list is not long. Have to look at the positive side though. I forget a lot of the negative things the doctors tell me I CAN"T do. So be it.
Have a safe evening and a pain free tomorrow

BTW... I am not on ANY meds either so I can't blame any of my mindless losses on that!!!!!!

Ditto .. mellowguy...

KS

Hi KS,
I think all of us can relate to different degrees what you are talking about.
RSD affects the Limbic Part of our Brain that impacts short term memory. We can be speaking about something this boom we forget what we are saying, or forget a word or grasp for a word to express our thoughts. This is PART of RSD. I also write things down to help remember.
I'm planning on HBOT treatments-it helps circulation and hope it helps in a lot of different areas. I do take meds, but have been able to reduce some meds and eliminate others. I was on a trial study and now take a med that helps me sleep 10 hrs. a night that overall has made a huge difference.
Hope you have a low pain day. Yoour friend, loretta with soft hugs:grouphug:

Keep Smiling,
I am the same way. But after reading side effects of all the medications I am on, I tend to blamed them not my brain. crps has taken so much from me that i don't want to think it has also taken part of my cognition away.. lol

Hoping for a pain free day to all.

I appreciate hearing from you all... I am sorry that you can relate to this...it is like giving just one more piece of ourselves to our RSD illness!!!! I do know one thing for sure is... I feel very lucky and blessed to have you all here with me!!!

Much love, KS:grouphug::grouphug::grouphug:

welcome to the club... lately I have been asking people the same question like 5 to 6 times without even remembering that I asked the question. :) you arent alone. :)

The Brain in Chronic CRPS Pain
 

Hi. This topic, sometimes referred to as "brain rot," comes up with some regularity. (So my apologies to those who've heard some of this before.) And we've all been told by our doctors that it's all the meds we're on, as though going to cognative-behavioral boot camp is going to make this all better. But the comments of KS would appear to put that to the lie, as does the stufy from the "Pain and Pleasure Labratory" of A. Vania Apkarian, Ph.D. at Northwestern - perhaps the leading academic lab for the study of the neuroscience of pain in the United States - which is at the end of the post.

But to begin with the meds, Baclofen for one can be hard on short term memory. I knew that from prior experience while I was still trying to practive law and have it up after a day and a half. Over the last few years, I've been back in it, having blown through Zanaflex and been advised that it's the most effective drug out their for CNS induced spasms, in constrast to - say - Flexeril, which is designed for cramping secondary to local muscle tears and the like. Opioids can, of course, have their effects as well.

I'm on a lot of meds though, and niether Zanaflex nor Oxycontin should be contributing to the profound loss of organization ("executory function") I've experienced over the last year: where my consumption of meds has been stabile for years: but I'm told that "rare reactions" are possible. And while I got an overblown diagnosis of small vessel brain ischemia from a radiologist in August, and had an apparent TIA in September, a complete neurovascular workup at UCLA by a stroke specialist just came back clean, including any constriction of the arterioles, the small diameter blood vessels in microcirculation that extend and branch out from arteries and lead to capillaries:

Arterioles have thin muscular walls (usually only one to two layers of smooth muscle) and are the primary site of vascular resistance. Arterioles receive autonomic nervous system innervation and respond to various circulating hormones in order to regulate their diameter.

http://en.wikipedia.org/wiki/Arteriole

Schwartzman et al found that in a study of 656 patients had CRPS duration of greater than 1 year, found, among other things that:

More than half of the patients in this study reported cognitive and memory difficulties. Deficits in information processing48 and short-term memory49 have been reported in patients afflicted with chronic pain. Chronic pain has also been shown to impair working memory50 and decision-making.51 The disruption of cognitive performance in chronic pain patients could result from a number of factors such as pain medications,50 stress,52 the engagement of the prefrontal cortex by chronic pain,51 and the fact that pain may act as a distractor resulting in impairedworking memory.50

Notes
48. Grigsby J, Rosenberg NL, Busenbark D. Chronic pain is associated with deficits in information processing. Percept Mot Skills. 1995;81:403–410.
49. Ling J, Campbell C, Heffernan TM, et al. Short-term prospective memory deficits in chronic back pain patients. Psychosom Med. 2007;69:144–148.
50. D_i_c_k BD, Rashiq S. Disruption of attention and working memory traces in individuals with chronic pain. Anesth Analg. 2007;104:1223–1229.
51. Apkarian AV, Sosa Y, Krauss BR, et al. Chronic pain patients are impaired on an emotional decision-making task. Pain. 2004;108:129–136.
52. Patil PG, Apfelbaum JL, Zacny JP. Effects of a cold-water stressor on psychomotor and cognitive functioning in humans. Physiol Behav. 1995;58:1281–1286.

Schwartzman RJ, Erwin KL, Alexander GM, The Natural History of Complex Regional Pain Syndrome, Clin J Pain. 2009;25:273-280, 278, FREE FULL TEXT AT http://www.rsds.org/2/library/articl...lexanderGM.pdf

My hunch had been that it was a side effect of the sympathetic neurogenicvasoconstriction (and vasodilation in areas of edema, wahere water leeched out of the untoned blood vessels). See, e.g., J. Schattschneider, K. Hartung, M. Stengel, et al, Endothelial dysfunction in cold type complex regional pain syndrome, Neurology 2006;67;673-675, 674-65:

Microcirculation is regulated by neural and endothelial factors. Disturbances in thermoregulatory control of skin blood flow followed by a decrease in skin temperature due to enhanced vasoconstriction have been demonstrated in chronic stages of CRPS.7 It is assumed that in cold type CRPS patients, peripheral vasoconstriction results in tissue hypoxia and tissue acidosis. 2,3 The production of free radicals within the ischemic limb may be responsible for the endothelial dysfunction observed in the present study and the histopathologic changes observed by others.8 This process may induce a vicious cycle of impaired perfusion, hypoxia, and acidosis followed by the production of even more free radicals. [Italics in original.]*

Notes
2. Birklein F, Weber M, Ernst M, Riedl B, Neundorfer B, Handwerker HO.
Experimental tissue acidosis leads to increased pain in complex regional
pain syndrome (CRPS). Pain 2000;87:227–234.
3. Koban M, Leis S, Schultze-Mosgau S, Birklein F. Tissue hypoxia in
complex regional pain syndrome. Pain 2003;104:149–157.
7. Wasner G, Schattschneider J, Heckmann K, Maier C, Baron R. Vascular
abnormalities in reflex sympathetic dystrophy (CRPS I): mechanisms
and diagnostic value. Brain 2001;124:587–599.
8. van der Laan L, ter Laak HJ, Gabreels-Festen A, Gabreels F, Goris RJ.
Complex regional pain syndrome type I (RSD): pathology of skeletal
muscle and peripheral nerve. Neurology 1998;51:20–25.

However, when I was tested at UCLA with transcranial Doppler under a CO2 challenge, my "Pulsiltility Index" was within nomal limits, e.g., there was no evidence that the arterioles in the brain failed to dilate properly when presented with a loss of O2. And while my neuologist has advised me that the transcranial Doppler is not as reliable as the "Gold Standard" test of CT angiogram, I have to discuss the "risk/reward" scenario with my internist, where I've had my share of nuclear medicine studies over the last few years.

Finally, there remains the area of gray matter loss secondary to chronic pain in general, and CRPS in particular. See, e.g., Geha PY, Baliki MN, Harden RN, Bauer WR, Parrish TB, Apkarian AV, The Brain in Chronic CRPS Pain:
Abnormal Gray-White Matter Interactions in Emotional and Autonomic Regions, Neuron 2008;60:570-581, 577-578, FREE FULL TEXT AT http://www.rsds.org/2/library/articl...aliki_etal.pdf

Conclusions
We provide several lines of evidence indicating that the patient with CRPS has multiple pathological changes of the brain. We observe global disorganization of the relationship between gray and white matter in these subjects. Regional gray matter atrophy seems limited to brain regions that can be related to these patients’ deficits in emotional decision-making and abnormal sympathetic outflow. Regional white matter anisotropy was observed in a bundle in the hemisphere contralateral to the gray matter atrophy, where long distance connections and branching patterns were reduced. The interrelationship between gray matter atrophy and white matter connectivity provided evidence for both decreased long distance connectivity and regional increases and decreases in connectivity and branching patterns. These results suggest that the abnormal anatomy of the CRPS brain may underlie many of the autonomic, cognitive, and pain abnormalities seen in this pernicious syndrome.

While the article is technical and taxing in spots, most of the terms that are used are dedined in it, and those that aren't can be accessed using the Medline Medical Dictionary at the top of the NT page. If you are not aleady familiar with area of this work, I suggest that you look it over now. It may well be the answer to the question this thread has posed. And as such, it makes potential cures like ketamine (which I can't have due to pre-existing glaucoma) and maybe even RUL ECT (illegal for the treatment of chronic pain in California since a 1976 voter initiative campaign) look a heck of a lot less radical, all things considered.

Mike

* If anyone wants a copy of this one (for personal, non-commercial use) just drop me a PM with your email address.

Okay.... I am confused.. (what's new right?)... SO because I am medicine free.. that rules out the drug affects on my memory... our/my brain absences is due to the RSD effects on the cognitive part of the brain or is the pure chronic pain that wears us out and not able to rmember??? I am so with Hannah in that..I ask questions .. receive an answer and I don't even remembering asking the question.....

I so appreciate you all here!! I would be lost without you!! KS:grouphug:

I think for me a lot is I am distracted by either pain or thinking about this condition. It is hard to focus when one hurts so much.

KS -

Good question! In "The Brain in Chronic CRPS Pain: Abnormal Gray-White Matter Interactions in Emotional and Autonomic Regions," Neuron 2008;60:570-581, reference is made to a couple of studies that have shown differences between the (abnoral) brains of people with CRPS than those with fibro or chronic low back pain. So the short answer is this: chronic pain causes physical changes in the brain - some of which is apparently reversable with sucessful treatment - but different conditions effect the brain differently.

And in fact, some of those changes, specifically with respct to "Regional Cerebral Blood Flow (rCBS)" are believed to assist in maintaining the condition, especially in chronic (or "cold") CRPS. See, E.G., Fukui S, Shigemori S, Yoshimura A, Nosaka S, Chronic Pain With Beneficial Response to Electroconvulsive Therapy and Regional Cerebral Blood Flow Changes Assessed by Single Photon Emission Computed Tomography, Reg Anesth Pain Med. 2002;27(2):211-213, FREE FULL TEXT AT http://www.rsds.org/2/library/articl..._Yoshimura.pdf


I've got at least one other study locked up in the c-drive of my currently defunct old computer, which I hope to get to soon.

Mike

Hi KS!
 

When I would visit my doctor, I would say, "I'm not trying to brag, but I used to be a really smart person. Since this RSD came along, I am not anymore..... and I miss it."

I worked 13 years at the same hair salon and was considered "the brains" there. I was the top Colorist Consultant, for both my colleagues and the clients because I was a genius when it came to both math and science. I could look at a person and pop a guaranteed to work formula in a matter of seconds, and multi-task like crazy. Lots of times, I never even had to keep a record of a clients haircoloring formula because I had an AWESOME memory. All that changed after I had my car accident that changed the RSD. Both co-workers and clients became frustrated with me (let alone, me being frustrated myself) because I couldn't "pop" formulas out of my head like I used to. And my ability to multi-task went out the door! I went to working on 5-7 clients at once to snapping at people saying "I can only do one thing at a time" because if I didn't concentrate on what I was doing, I would FORGET what I was doing!!!

Also, you brought up a great point about this problem being from meds or RSD itself. I believe it is from a combination of both, or even from RSD or meds alone; my reasoning behind this thought is because I have gone on long periods of being on meds and long periods of being on NO meds.

Great post........ the problem with the short term memory is truly a hard, frustrating problem in my life and I really wish I could just accept it :(

:hug:Vanna

Thanks Vanna and Thanks Mike....

Losing our short term memory is fustrating..I try to giggle it away but inside I know its a problem and real!! Largely my wondering thought is how far will this go?? Will we remember to brush our teeth one day or did we already do that???? Mike, I can see how the Chroinc pain could definately be the problem as we are tired... but also changes in the brain itself knowing the area affected by RSD... we just have to give up one more part of our self to this monster... sad!!!(can you tell I was scientist by trade?)...Vanna, I hear you, sweetie.. In that you were a pro at what you did and many held that professionalism to you...daily...My job the same..we or should I say I did techniques in my work for 25 yrs... everyday!!! Then one day..not long ago I would start a process..walk away..and forget that I started it until one of my co-workers would say, Kathy..did you do such and such.. Oh yea..I did.... feeling foulish... and once again laughing at myself but this really scares me inside...and like I said..I am med free..as my tummy kicks everything so far back out...

painfree gentle squeezes all....KS:grouphug:

Welcome to the club... thats the worrst... I ask a question someone answers it.. and I sit with a confused look on my face- I cant remember what I just asked!!! Aiii!!! lol... I like that Vanna... I used to be a smart person. Let me tell you, honestly I really used to be a really smart person. And then Rsd came!! Who knows what happened, for whatever reason behind it, I cant remember. Mike-- wow. my brain hurts from reading that...:D:p very interesting, except in 5 minutes I probably wont remember what i read... lol. I just have alot of laughter about it now!
:grouphug: Hannah

Hi ks,
 

I can surely relate. I wanted to take a Methadone earlier for my pelvic pain and headed to the bedroom, ended up in the bathroom wondering where I was headed and what for. Finally remembered.

I go see my Dr. and sometimes I feel so stupid trying to find the right words when I am talking to him. Luckily, like other friends of mine, they can figure out what I'm talking about. I feel like a fool sometimes trying to talk to people and not getting the right words out.

Like Vanna said also, I think a lot of us were pretty smart in our day before RSD and it's just made us look not so smart at times. I was always proud of my Math, Spelling, and being able to learn most anything. Boy has that went out the window.

Ada

Ada...

I can so relate..just the other day.. I sat in front of 13 ladies from my work..so sweet they came by for lunch since I have left... anywho... I was telling them a story when all of a sudden, you can imagine this..my mind went totally blank..I mean totally.. and I sat there to where is was an uncomfortable amount of time....trying to re-gain my thought it took so dang long...it actually became embarrasing... it seemed like minutes.. but man was I feeling lost..my mind left me...so I understand your bathroom trip..

Nice to talk with you...KS:hug:

I needed to take a LOA because I caught myself making mistakes on the job. I am a CPA and started to mess stuff up, just couldn't keep it all together. Plus I was getting sicker and was just so tired all the time. I really, really needed a rest when I finally took my leave. But it was so hard at first getting used to NOT having anything to do all day!

XOXO Sandy

my brain isn't shot yet!
 

I don't think I have anymore trouble remembering things, but maybe I just haven't noticed.... is this what I have to look forward too!! YAY!! HA!

Same here but my memory loss is supposedly from my meds. Its hard to get good grades on tests and stuff when you cant remember things.

one thing that helps me is if i walk around a room relating objects in the room to whatever im trying to remember then when i sit in class i can walk through the room in my mind and i see a object that reminds me of something in say like chemistry. it takes some getting used to but it might help:winky:

Unfortunately, courtw84... it may be but lets hope not...And Sandy..well said as being so tired from our usual routine was beating the blue mud outta me/us...I was not any good to my work any more nor myself...but my heart said stay but my body said...I surrender!!!!Even now my days here at home are no way near as productive as I thought or wished..I am snail pace now... I surely don't want a crystal ball for our future... no way jose'....!!!!

Hugz, Kathy:grouphug:

I was laid off from my job in December. At first I was really angry - I had always been such a good worker. Great performance reviews, raises etc.

But now that I have had time to reflect, I know I was not doing the job like I used to. It was taking me 3-4 times as long to get things done because I would recheck my work and find some small thing I over looked and then redo my work, only to find something else I over looked. I caught all my mistakes, but before my RSD got so much worse, I would have flown through my work and not even bothered to check myself.

For me, it is not so much short term memory - at least I don't think so. My 86 year old Mom lives with me, and her memory is failing. She can't remember what we had for lunch an hour after we ate, sometimes doesn't even remember that we ate at all. My "brain" issue does not seem to be in the same way she has.

My problem seems to be understanding and comprehension. Since being off work, I have tried to take a couple online computer courses - simple ones. I can't seem to "get" it at all.... I used to be able to take a course online and hardly take any notes. Now I can't figure out what they are trying to say to be able to take a note.

I can read a novel, and have to go back and re-read parts again because I missed the drift of the story.

I love the show 24, which has lots of plot twists and turns. When it started a couple weeks back, I recorded it on DVR... and have played the first few episodes over and over because I can't seem to figure it out this year.

I have taken 30 mg a day of Namenda for the last few months --- it helped me a lot a couple years back when I was on it. Now, it doesn't seem to be helping much at all. I am on a couple high blood pressure meds, but that is all. Nothing else has really helped enough to warrent taking it.
Jules

Dear Jules...

I am sorry about your job loss but understand your lapses as I got em too.. our lack of focusing and missing the throughness of our earlier days... Plus I respect your honesty... I just find this topic so amazing as we all can relate to our lapse in mindfulness in some way..My Mom is 80 yrs. old with moderate demensha... I can understand the "oh my..I lost that one" feeling that she and many others experience... I also relate to your lack of attention to detail that was once yours... I would think of taking a short cut on my work and that was NEVER ever my style!!!! Always first time thru with the best quality.... At first I blew by this pretty easily but now it is real and I ain't laughing quite so much at myself as I once was..Once again.. and thanks RSD..yur a real sweetie!!:grouphug:

All concerns may be real enough, but that's one reason why I'm so encouraged by - and keep citing - Schwartzman RJ, Alexander GM, Grothusen JR et al, Outpatient intravenous ketamine for the treatment of complex regional pain syndrome: A double-blind placebo controlled study, Pain 2009 Dec 15;147(1-3):107-15. Epub 2009 Sep 23, FREE FULL TEXT AT http://www.rsds.org/2/library/articl...n_Pain2009.pdf (suggesting that with the right protocol, outpatient infusions of ketamine may be useful in chronic cases afterall).

Please look at this particular article closely, if you haven't done so already. If larger trials bear these particular results out, we might be on the verge of a cure, in which case it would no longer be an "experimental treatment" requiring, among other things, the complete absence of any psychiatric "co-morbidities," including but not limited to mood disorders due to underlying medical conditions (DSM IV 293.83).

There is hope yet.

Mike

memory. . .hello? are you still there?
 

I have this same problem since I started Lyrica, but I am newly diagnosed so, don't know if it is the effect on the limbic system or the Lyrica.

And then. . . I have this same problem since I started Lyrica, but I am newly diagnosed so, don't know if it is the effect on the limbic system or the Lyrica.

And also:hug:. . . have this same problem since I started Lyrica, but I am newly diagnosed so, don't know if it is the effect on the limbic system or the Lyrica.

Oh. . .did I tell you that ever since I started on Lyrica, my memory has gone to hell in a handbasket!

I am newly diagnosed so, don't know if it is the effect on the limbic system or the Lyrica.

LOL sorry to be a smart-***! we all need laughter to get through. But seriously, I am considering switching from Lyrica to neurontin. Does anyone know if they have the same side effects?

Gentle hugs to all,

Kelly

I felt horrible on both Lyrica and Neurontin, but I generally I thought Lyrica was worse. I am now taking Topamax (I suffer from head pain more than anything else), and depression is a major problem for me. I don't know if it's the meds or the pain or the RSD or a combo of all three that's causing the depression. Hard to tell. In general I think the meds are taking a toll and I'd like to toss them all and get back to my normal self....

Good luck, Sandy

Hello Sandy..
I agree the meds are big butt kickers and caring with them large side affects... The least you can take and still live with RSD and not havingto cross your eyes in pain the better off you will feel as far as meds interaction..As you probably read, I am not taking any meds as I have such a sensitive tummy.. part of me is relieved that I don't have to think about the harshness of the meds on my system.. but then again RSD naked is a killer ... so where we going here..happy medium I guess.. some meds to take the edge off but not to take too much...then again over time the effectiveness of the meds does wear off.... Oh dear!!!

Enjoy your day, Sandy..

KS:hug:

This is a real good topic! I too suffer the mental anguish of losing my mind.

Back in the days of working I was a dynamo, never needing to write anything down. I could remember every detail of everything I heard or seen. I even had 3 assistants, one was my personal marketing assistant, the other was the Food and beverage assistant, and lastly was my IT personal assistant.

They had nothing to do because of my uncanny ability to remember dates, numbers, names, everything. So I was always trying to find little jobs for these people to justify keeping them LOL. Plus if I deleted their job it would make it hard for the next directors to rehire an assistant.

The meds DO cause problems with the memory because I was on all the meds that have been mentioned in this thread for a few years. When I lost my insurance and was not able to get anymore the withdrawals were terrible, but as my mind cleared...well it was a whole new world!

I noticed that I could think clearly, and remember some things. My wife, family, friends all welcomed me back to their world as they realized I was mentally back with them. I had no idea I was gone, but they assured me that I was LOL!

Because of this I take the least amount of meds possible, because once I was a bit more clear minded I realized the meds werent really doing the job anyways. I was only hurting a bit more taking only a norco instead of all the long acting morphine, neurotten, and the likes. I learned I have to pace myself, and try not to let the pain get out of hand.

Easier said than done most of the time, but if I watch it I can keep the pain to a 5 or 6 which is bearable to me after almost 10 years of this RSD stuff.

I do dream of having the mental capabilities I used to, but at least am glad that I can enjoy talking with my wife, playing with the grandkids, and building/fixing computers. Things that were almost impossible, or completely out of the question on meds.

Lately I have been thinking about retaking the Ca real estate exam. I took it about 3 years ago and passed even on all the drugs! In fact I finished a 3 and a half hour test in just under 20 minutes LOL!!! The proctor was freaking out when I told her I was done, she told me I should look it over to make sure. I told her I checked it over twice and wouldnt change anything. So it should be a breeze now that im almost on zero pain meds!

I guess the best advice I can give...that is if I was going to give any LOL! Would be to not beat yourself up, just live everyday to the fullest. Dont worry about tomorrow until it arrives, and if you need to take meds to have any kind of a life, then take them and dont let others mentalities about pain meds faze you. :winky:

Hi I am the exact same way now days i just can't remember much but a few weeks ago i started taking zinc and thats seemed to help a bit. :)

Funny thing happened on my way thru the daily RSD posts.. I saw a post I started a mere 3 years ago... memory loss.. Loss of direction. Now I can honestly remark how this delima stands today, 3 years later and with my ever changing, worsening RSD, I can say my memory loss has worsened. But, with the daily struggles of my RSD, my memorie loss is not my biggest concern. I guess, I incorporate my mindless forgetfulness as part of my life now.. Like into the Rollin RSD ball.. My RSD has taken weaves and turns that I never thought I could be strong enough to hang too, but I have. Just to say that as I look back RSD has taken me on a very bumpy, scary ride but Im honestly a stronger, made of Steele kind of person because of my RSD illness. I have learned to appreciate the moment and not to place expectations on tomorrow. I also know I can survive anything that comes my way.. Because I have survived my RSD for almost 6 years now.. And I am still smilin.... Hugs to you all my old friends and those who have recently joined us.. Please, never give up... Hugs..Kathy