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theoneRogue420 05-24-2007 03:26 AM

Not finding...
 
...what I need in all these links.

I am having a VERY hard time finding articles/sites that talk more about cold crps type II. I know it's not as common as crps I, the hot kind, but you'd think I could find something out there! I'd especially like to see any pics, to see what (if any) differences there are. The only difference I am sure of is that I do not have the same skin issues as most of you... which I am mighty grateful for. But it also makes me wonder, sometimes, if I have been misdiagnosed. I've seen too many "experts" and had too many tests for that to really be possible, but I still wonder sometimes. How was I lucky enough to escape the swelling and sores?

Do any of you suffer from this type of rsd? I'd really appreciate any info you might have. I may have had rsd for 14 years, but for many of those years I was offline (internet connections are almost impossible to find in Mexico, and we traveled in an r.v., had no permanent address), plus there is sooo much more known about rsd than there was when I was first hurt and seeing specialists. After those first two years, I went w/o treatment of ANY kind for 9 years. Until 3 years ago, all I could do was self-medicate with marijuana, which helped tremendously, but that was all I had access to. Other than that, I used a more holistic approach... mainly because it was cheap and didn't need an rx, lol.

Any help would be greatly appreciated, thanks in advance :D

JOAN_M 05-24-2007 08:56 AM

i'm not quite sure what you are refering to as 'cold' rsd. my foot and lower leg are freezing to the touch and yet the foot sweats badly at times. do you mean cold to the touch? joan

Jomar 05-24-2007 12:23 PM

I didn't look thru all of these but here is a google listing of images-
http://images.google.com/images?um=1...d+crps+type+II

websites listing for terms "cold CRPS type II"
http://www.google.com/search?q=cold+...ient=firefox-a

websites listing for terms "cold crps II"
http://www.google.com/search?hl=en&c...II&btnG=Search

InHisHands 05-24-2007 07:28 PM

Ok, this has been boggling my mind a lot lately- I have symptoms of cold and hot RSD! I have cold purple skin one day, and sometimes hot, red, swollen extremities/ face/ back, etc!! What is this?! A combo of both?! :confused: Do I have hot or cold RSD?

Rogue, when reading RSD literature I usually think of it as concerning both types.

My feet on a "cold" day:
http://i160.photobucket.com/albums/t...D/DSC_0302.jpg
My feet on a "hot" day:
http://i160.photobucket.com/albums/t...fectedfeet.jpg
Kind of "both" on a very calm day (not real bad coloration):
http://i160.photobucket.com/albums/t...D/DSC_0009.jpg
(as you can see, my left foot is worse)

buckwheat 05-24-2007 07:56 PM

http://www.neurology.org/cgi/content/abstract/67/4/673

NikonKid 05-24-2007 10:12 PM

One of the many doctors I've seen, an Orthopedic surgeon, recently labeled my RSD as Cold. I was diagnosed last Fall with RSD in both hands...after two stellate ganglion blocks my arms turned to two giant ice cubes so I was put on Norvasc for my circulation.
In Febuary it spread to both feet, burning pain constantly and an almost overnight thing. My feet burn but to the touch feel cold. Ortho did a scan of my feet and cold stress test....basically no circulation. The scan should show red and my feet and hands were all blue with just a couple of red dots. That's when the Cold label came in. I still can go from hot to cold in moments but the cold external temperatures are really hard for me to recover from.
Hope this helps a bit....
Jeanne

theoneRogue420 05-25-2007 07:00 AM

Thanks, everyone! I really appreciate the responses, they were very helpful.

I also got out all my old med records and went through them again. It's all the paperwork from court, including records.... not sure why I've kept them all these years, lol... but it was very insightful to reread them.

It turns out that I DID have the sores and discolorations, way back at end of year one. Not as bad as I see in your pics, however. But when I had the Guanethidine blocks for that gov't trial, they went away and never came back. I don't know how they handle those blocks now, but for the trial I had over 30 of them done! I didn't realize just how many had been done... I only knew it was a LOT, lol. They helped so much I wouldn't have cared if I had to have them twice a week for the rest of my life. Have any of you had them done? Where they remove all the blood from your leg and fill it instead with the meds? The tourniquet was painful, of course... but well worth it in the end. I was heartbroken when the study was over.... and back in a r.o.m. boot within 2 months. (I wore that danged thing for seven years!)

IHH... I only had the blueish cold foot (only in the right leg at first, spread took quite a few years... could that also be credited to the Guanethedine?), never the red angry swollen ones I see in all the pics. That's why I was asking all this in the first place. Michael was beginning to question my dx, after seeing all the pics. I got freaked out by that, I admit it. I found myself wandering around the net searching for other possibilities, none of which fit the bill. M has always been my biggest supporter, and to have HIM question what was going on was a mind-blower.

After doing all the research I could, I am left knowing my dx was right on target after all. There is just a difference between hot/cold rsd, rsd I and II, and between types and longevity of treatments. If the Dr.s don't fully understand rsd, why would I think I could?!? But it does look like being a "Guanethedine guinea pig" was a very good thing to be, lol. I can't imagine what would be going on if I hadn't been! :eek:

bassman 05-25-2007 08:06 AM

Cold and Hot
 
I know it very well. For many years, with the RSD in my left foot only, it was extremely hot. Not only did it feel like it was burning, but it was hot to the touch.

About a year and a half ago, the right foot all of a sudden it got cold. I mean, it feels like I have it in a freezer. I can't figure out how to get comfortable at night. (Heavy bankets or not?) I end up with one foot in bed and one out in the open.

I visited South Florida a short time ago and tried to keep my right foot directly in the hot sun as much as possible to warm it up, but it never felt anywhere close to a normal temperature.

I have to keep a heating pad under my desk at work and have it plugged in and on my right foot (the left one is still hot) to deal with the cold.

This is so wierd. :( I don't wish this on anyone, but it is comforting to know I an not alone. Thanks for starting this thread.

Mike

InHisHands 05-25-2007 08:12 AM

Well, here is what I think: I have cold RSD, my hands rarely go hot/ swell, they are usually purple and cold. My feet are cold/ purple at times, and you know what makes them go hot?! Getting the blood flowing~ whether it is wearing the compression stockings for a while, soaking them in warm water or walking/ using my feet.

Strange. My conclusion is that I have cold RSD. No doctor has told me what type I have got, but they always write on the records that my RSD skin is cold to the touch (and every time I have gone it has been... strange!), so I guess I'll assume "cold"... not sure if it makes much of a difference? Unless it has something to do with what stage of RSD I am in... :confused:

artist 05-25-2007 12:03 PM

Hi all
:Wave-Hello:
Technically, the term CRPS (Type1) has replaced RSD, and CRPS Type 11 has replaced Causalgia. So a search with "Causalgia" in it gets you further, as does searching for "CRPS Type 2" - dunno why the "2" makes the difference, but it does, almost nothing comes up with that 11!

Putting "Causalgia" into the google *image* search engine will get you some pics (horrid!).

And here's what I got with an ordinary google search:
http://www.google.com.hk/search?num=...a=lr%3Dlang_en

I would really, really recommend all of you with plain old RSD (CRPS Type 1) to read the most recent Dutch guidelines (the most exhaustive and recent research in the world). (I know, here I go again with the Dutch..:rolleyes: ) - I've posted the links in the sticky and also at the bottom of my post here.

In the Guidelines for Physicians, it makes it very clear that there are 3 temperature types - hot, hot and cold, and cold. Treatment can be different for the temperature types/phases, in that their research has shown differing responses with things like DMSO cream.

Relevant bits:

From the Patients PDF:
"A distinction is drawn between 'warm CRPS-I' and cold CRPS-I. Warm CRPS-I affects 95% of patients. In this form the skin is red and feels hot. Only 5% of patients experience 'cold CRPS-I' from the onset of the condition: the arm/leg feels cold, the skin is blue in colour and circulation is impaired."

From the Physicians PDF:
"Perez et al. conducted a double-blind randomised study on a large group of CRPS-I patients (n = 146) and found that DMSO cream had a beneficial effect on the symptoms of CRPS-I. This was the first study to also analyse the effect of N-acetylcysteine (NAC) at a dose of 600 mg three times a day. NAC was found to have a significantly better effect on primary cold CRPS-I than DMSO cream."
"In general, DMSO generates lower (direct and indirect) costs than N-acetylcysteine. However, sub-group analysis indicates that N-acetylcysteine generates lower costs and is more effective for patients with a cold form of CRPS-I. DMSO generates lower costs and is more effective for hot forms of CRPS-I."

BTW, N-acetyl cysteine (NAC) is a supplement, an anti-oxidant molecule that can absorb free radicals within the body.

Everything in these guidelines are backed up with research papers and cited (of course).

You can download the PDF for Patients and the PDF for Physicians.

Rogue420, if you can't find anything else, read these anyway, I don't think (?) the actual experience of the condition is very different between the two types of CRPS.

So: the direct link is:
http://pdver.atcomputing.nl/english.html

And just to explain why I think it's so important for us to read these, I'm going to quote a bit from my "links sticky" post below,
all the best :)

"I urge everybody to download both PDFs from the http://pdver.atcomputing.nl/english.html site, listed again at the bottom of this post, and take them along to your doctor.

The Dutch are streets ahead when it comes to dedicated research into RSD/CRPS and associated neuropathies, they have just published "The Evidence Based Guidelines Development (EBGD) Guidelines on Complex Regional Pain Syndrome type I (CRPS-I) dealing with the diagnosis and treatment of CRPS-I" published in 2006, which I cite below.

To read more about the developments in Holland, here's a good rundown provided by the Canadian PARC site. The research list starts with the oldest, and although you may be inclined to skip the older publications, reading it all from the top gives you a very good insight into how their thinking has emerged. Lots of cutting edge stuff on DMSO and oxygenation here." etc...etc...
http://neurotalk.psychcentral.com/sh...6&postcount=21

InHisHands 05-25-2007 01:06 PM

Quote:

Originally Posted by artist (Post 104806)
From the Patients PDF:
"A distinction is drawn between 'warm CRPS-I' and cold CRPS-I. Warm CRPS-I affects 95% of patients. In this form the skin is red and feels hot. Only 5% of patients experience 'cold CRPS-I' from the onset of the condition: the arm/leg feels cold, the skin is blue in colour and circulation is impaired."

Thanks, Artist! You're a big help. :)

According to this, I am still going along with the assumption I have
cold CRPS I... with the onset it started with cold, blue RSD hand/ arm...

I will go with that assumption, but will talk to my doctor about it!

Quote:

Originally Posted by artist (Post 104806)
Rogue420, if you can't find anything else, read these anyway, I don't think (?) the actual experience of the condition is very different between the two types of CRPS.

That is what I was thinking, but could be wrong... *hmm...*

Thanks so much, again, for all you've shared... I will be downloading all that info again. I did before, but a computer crash ruined that all, and I never got the chance to read everything. Will be doing that! :winky:

betsyherm 05-25-2007 02:40 PM

From what I know, I believe that article means that most people start with "warm RSD" and if not treated, transition to "cold RSD." Really though, the classic presentation of RSD is cold.

Most people also have periods of hot and periods of cold, sometimes changing suddenly many times a day. When I'm up and walking around, my foot/leg is usually warm, and it goes cold very quickly when I stop walking. In the evenings and and night, it's always pretty cold, but usually late at night it starts to get really uncomfortably hot. Most of the people with RSD I've talked to (hundreds, probably, over the past 12 years) describe some periods of hot and some of cold.

I do have a bit of a question though! Does anyone else kind of prefer the cold? When my leg is hot, I feel like the zappy pains are worse. When it's cold, I feel like I have a little bit of numbness or reduced sensation, which is better than actually having to feel EVERYTHING.

-Betsy

InHisHands 05-25-2007 03:48 PM

Quote:

Originally Posted by betsyherm (Post 104858)
I do have a bit of a question though! Does anyone else kind of prefer the cold? When my leg is hot, I feel like the zappy pains are worse. When it's cold, I feel like I have a little bit of numbness or reduced sensation, which is better than actually having to feel EVERYTHING.

I prefer the cold a little bit more than the hot. Sometimes with cold I get numb in a few areas (which is nice!), too. Overall cold is really bad, but hot is a teeny bit worse- still severe pain for me no matter how you toss it! :( :Sob: :Sob:

theoneRogue420 05-25-2007 06:49 PM

My crps is always cold. (I prefer that term, I have used it since I first heard it.... add an "A" after the r, and you get how I feel, lol) I get burning hot "spots" on my legs mainly, about the size of a silver dollar... but the rest of my affected limbs are always cold.

I deal with it by dressing in sweats and wool socks, lol. I always have slippers on, too. Even if the weather outside is 95 degrees, I still have on my socks, which looks awful silly with shorts, I tell you what. :eek: I don't even take them off during "private moments" with Michael anymore, I am ashamed to admit, lol. But any more than 1/2 an hour w/o those thick socks and slippers, and my legs go bluish-purple and hurt five times as bad.

I also go through two heating pads every three years... they just don't hold up to continual use. And let's not forget the hot soaky baths... in winter, on the worst days, I might take two even three baths a day.

InHisHands 05-25-2007 06:57 PM

Quote:

Originally Posted by theoneRogue420 (Post 104961)
My crps is always cold. (I prefer that term, I have used it since I first heard it.... add an "A" after the r, and you get how I feel, lol) I get burning hot "spots" on my legs mainly, about the size of a silver dollar... but the rest of my affected limbs are always cold.

This is freaky... I get those "hot spots" sometimes too! The one night my neighbor was here, and was like "look at those red spots on your purple legs"!

I know *exactly* what you are talking about! :eek:

jennyk38 05-25-2007 07:08 PM

cold or hot
 
hello, i'm anewbie here as well as to rsd just diagnosed 4 wks. ago. i have read everything i could find but never really knew there was hot or cold. it's kind of funny (not ha! ha! funny) because as i sit here typing on the computer i am wearing a pink glove that belongs to my daughter. my right hand will feel like it's burning sometimes but other times it's cold as ice. i thought that's how everybody was! thanks for the info. you guys have really neat and inspirational sayings and pictures and links. i'm lucky just to figure out how to use this board so forgive me if it's a little bland i'm not very good with the computer. thanks again, jennifer

Desi 05-25-2007 07:23 PM

Hi Jennifer! nice to meet ya in cyber space.. LOL:D I get such cold hands.my daughter says, mommy.. please, your hand is cold. I forget!! I also get a sweaty hand and shiney too.I have a hand now that is getting kinda deformed.. all due to RSD the swelling, pain, discomfort is awful... but thank God for this board, eh?? Love, Desi

Jomar 05-25-2007 07:41 PM

jenny - I'll copy your post and make a new thread with it for "hellos" and such.

here's the link to it-
http://neurotalk.psychcentral.com/sh...ad.php?t=20474

artist 05-25-2007 08:10 PM

Quote:

Originally Posted by betsyherm (Post 104858)
From what I know, I believe that article means that most people start with "warm RSD" and if not treated, transition to "cold RSD." Really though, the classic presentation of RSD is cold.....-Betsy

Hi Betsy, no, as IHH spotted, it does not mean that at all.

The piece says exactly what it means, it's talking about how RSD presents itself "at the onset", meaning right off the bat, from the very start. You'll see more in the article itself if you care to look - as I said, I included just examples, extracts.

Many things have changed in just a few years regarding RSD literature, we're trying to keep up to date.

I posted it precisely to make that point, not everyone begins with a hot stage. Since we're discussing "cold RSD" here, some hard reference seemed helpful - (but only if you read it!;)).

Anyway, here's a link (from the 3rd edition Clinical Guidelines) about the old concept of stages that I think you were talking about:
http://www.guidelines.gov/summary/su...2&string=treat
Reflex sympathetic dystrophy/complex regional pain syndrome clinical practice guidelines - third edition.
Stages of RSD/CRPS:

"The staging of RSD/CRPS is a concept that is dying. The course of the disease seems to be so unpredictable between various patients that staging is not helpful in the treatment of RSD/CRPS. Not all of the clinical features listed below for the various stages of RSD/CRPS may be present. The speed of progression varies greatly in different individuals. Stage I and II symptoms begin to appear within a year. Some patients do not progress to Stage III. Furthermore, some of the early symptoms (Stage I and II) may fade as the disease progresses to Stage III. The following stages are presented in these guidelines merely for historical significance."

If anyone needs further info on the old staging descriptions, they're here:
http://www.ninds.nih.gov/disorders/r..._dystrophy.htm

BTW, While that "staging" concept may not be used any more, my RSD *has* progressed, from hot and swollen at first, then cooling. Not cold yet, though and more greyish, dry and withered. I think RSD does progress, but they superceded the "staging" because everyone is so different and we don't fall into nice, neat categories.

all the best :)

betsyherm 05-25-2007 10:25 PM

Artist,

I'm sure you're right about what the article means, but I also tend to disagree with it, if I didn't read it completely wrong (which is possible, since I read through it quickly). I know that there are people who have primarily what they're calling "hot" RSD. But most people have times with both hot and cold symptoms. I don't think it's nearly as clear-cut as saying someone has "hot" RSD or "cold" RSD. Plus, most of the people I've talked to (and those I've met in person) talk more about the cold than the hot, so I'm really confused about that 95% having hot RSD thing.

I've never believed in that "staging" stuff. I don't think really anybody's RSD has ever followed a strictly outlined course. I'm not sure ANY disease ever follows an outlined course! I've had RSD for more than 12 years, and I don't fit into any stage. I have aspects of all of them! I also don't believe that there are real distinctions between hot and cold RSD, at least right now. I'm fairly sure that when and if the researchers get off their you-know-whats and find an underlying cause for this stupid disease, we'll find out that there are different causes in different cases, possibly corrolating with different symptoms and/or responses to treatment. Of course, then they'll have to come up with even MORE names for RSD/CRPS/whatever-they're-calling-it-this-week...

-Betsy

Linmarie 05-25-2007 11:21 PM

My hands and feet have alway felt cold to me (some coolness but not much to other people's touch, not like Reynaulds) even before the RSD. My hand did start to turn a bluish/purple but now has a red area on it. My legs are always mottled & my knees get purple. But, sometimes my feet will get "hot flashes". Weird. I too, almost always have on socks & slippers. Wish I could wear those cute shoes I see others wearing.
Linmarie

artist 05-25-2007 11:23 PM

Hi Betsy,

Then I don't think there's anything to agree or disagree with :) That small paragraph I quoted was just talking about the starting temperature of the RSD process, but the Guidelines (not an article) agree with you (and me) throughout, that there is "cold RSD" "hot RSD" and "both RSD".

Yes, I'm sure in 10 years times it'll be a whole other story; many of us here believe there are probably many different kinds of RSD, possibly including things like erythromelalgia and Reynaud's....time will tell!

all the best.

PS Here's the PARC link:
http://www.rsdcanada.org/parc/englis...anderlaan.html
"A huge committee of doctors, researchers and experts in Holland worked tirelessly for 5 years to write the standard treatment protocols guidelines for treating CRPS in Holland..."

Linmarie 05-25-2007 11:38 PM

That's what my PM doc recently told me, only he said in 50 years there will be alot of different RSD classifications. I don't like to think the research is going that slowly.
Linmarie

betsyherm 05-26-2007 12:03 AM

I didn't read the whole article...it shows, huh? I probably should have, I'm bored out of my mind (I don't start work until August)...but oh well!

-Betsy


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