last minute suggestions?; Seeing doctor tomarrow
 

Greetings,

I see my doctor tomorrow 10/15 and i’m curious if anyone has some last minute suggestions on things i should think about or things i should ask my doctor i would appreciate it. He is a CRPS specialists and anesthesiologist, i refer to him as DR. A in the condensed history below. My main concern at this point is getting a clear diagnosis, as it’s still disputable if i have CRPS or not. Seconday is what treatments i should consider; this seems hard to do without a diagnosis so i have put less time into researcing it. Here is a consolidated history of events as best as i can remember them

5/5/2014:
Dropped 5lb on foot. Pain was probably a 6.5/10 pain for a moment then subsided into a 4/10. Iced it in cold water for 5 mins.

5/5/2014 - 8/1/2014:
pain
Driving uncomfortable 2/10
Walking uncomfortable 2-3/10
wearing shoes 4/10
standing 1/10
elevated feet 0/10
Its worth mentioning that i mis-managed by not properly immobilizing it. I wore sandals and altered my gait to not put pressure on the toes.

6/24/2014:
Saw Dr. K (ortho). Diagnosed with fracture in 2nd digit. Later i would learn their was a slight fracture in the 4th digit as well.
Ignore advice to get post fracture shoe until 8/7/2014

8/1/2014 - 9/3/2014
No work,very little driving, was able to elevate foot much of the day
This is when i can first recalled the redness, warmth and tingling 1/10 in toes.
Walking would result in throbbing
elevation would alleviate symptoms.

9/3/2014
Saw Dr. K, he suggested it might be CRPS ordered bone scan and referred me to dr. E

9/10/2014
Bone Scan results: no evidence to suggest rsd.

9/3/2014 - 9/13/2014
Tingling decreasing, warmth and redness seem to steadily decrease in severity and frequency. I would get about an episode a day.

9/13/2014
Dr. E (ortho) diagnosed with CRPS.
I have a Nerve block done
steroid kenalog -10. hcl percent.
I recall a feeling of warmth in toes immediately after nerve block

9/13 - 9/17
toe no longer tingles
very infrequent light shooting pain 1/10
walking would result redness and warmth in toes

9/17/2014
see Dr. A (anesthesiology, CRPs specialists) he remarks that he isn’t sure about a diagnosis of CRPs and wants to see me in two weeks. orders lidocaine patches.

9/18/2014
Dr. C ( another anesthesiology and CRPS specialists) diagnosis me with CRPS and suggests lumbar nerve block and Gabapentin

9/18 - 10/6
Symptoms: typically show up later in the day.
Redness and warmth 1/10. About once aday, no longer connected to walking.
very infrequent shooting pain in leg 1/10
Odd night time pains that decreased over time i believe due to therapy (walking, stretching)
one episode of toe vibrations after some steped on foot.
some insomnia due to anxiety
right toes might be sw
Activity (no of which caused pain or symptoms increase)
moderate weight lifting: dead lifts squats and benching (attempted twice)
light jogging attempted once
walking daily
toe temp: using an infrared temp gun i kept records that show that my right foot is on average 1.8 celsius warmer then the left, though it can get upto 6 celsius.

10/6/2014
Dr. A does a superficial peroneal nerve block

10/6 - current
Symptoms: show up more often later in the day
redness and warmth 1/10
3-4 days of slight muscle twitches no pain, just uncomfortable
3 days of a dull ache alongside the foot. Possible connected to some trauma ( I stepped on something) or due to self therapy.
1 episode of shooting pain, 1/10
very very infrequent tingling which went away.
red rash on elbow (developed 10/11- current) 0, inflamed (red, warm and swollen) itchy, dry skin 1/10 (nurse said it looked like eczema). I’m currently using neosporin to mixed results.

picture of redness in foot
 

This is from today 10/14. No pain associated with it. infred scanner says its 4c warmer then the left foot.

I really do not have any suggestions for you. I am still new at this CRPS/RSD stuff. I am just here to wish you the very best at your appt. If I did make a suggestion it would be to ask a lot of questions. The questions to be asked only you know. You know what you feel and how you react to different stimuli.

Just a suggestion.

Exercise increases circulation, and with an injury may be more noticeable. People with peripheral neuropathy may have redness with no swelling. There is also a disorder, called erythromelalgia which is a circulatory phenomenon of redness and warmth. In extreme cases, it tends to cause burning pain.

You can Google this. You might find using magnesium lotion on your leg may improve your circulation some to enhance your healing. The reactive redness may stop if you improve circulation on a daily basis. This redness is similar to what happens when you get exposed to cold, and then warm up. The pinkness or redness of nose and ears when exposed to cold is similar. Inflammatory cytokines (Cox-2), will cause poor circulation if present in abundance. So daily changes in circulation imply inflammation is still present.

Morton Epsom lotion rubbed into your lower leg and ankle on that side once a day, may help, stabilize your circulation.

Available at WalMart, and online at Amazon for very little cost.
http://www.amazon.com/Morton-Epsom-L...n+epsom+lotion
Use only a quarter's diameter amount once a day. Apply to only intact skin. Many of us at PN forum here and other forums too, use it with great success.

Sounds like you got things well documented to me.
Good luck at your docs...

It sounds like your goal of trying to get a clearer diagnosis and course of treatment is a good one...and I would keep the focus on that and on what your goals for treatment are.

It doesn't really sound like CRPS to me...but since there is no such thing as a textbook case of CRPS that doesn't mean it isn't. To me the biggest thing missing is the excruciating pain...pain can present itself in different ways with different triggers...but it's one of the key symptoms of the condition. I know when I read about RSD/CRPS...I had no doubt in my mind that's what I had...all these random puzzle pieces suddenly made sense when no other explanation did.

So I would keep your focus on getting a diagnosis and then proceeding with treatment. I will note that it is good for them to proceed with caution so they don't cause more damage if it IS CRPS...so don't be too quick to jump on something else if the treatments are something that should be avoided with CRPS unless your dr is very sure it's the other thing.

Good luck at your appointment and take care!

I don't have anything to add since I'm still new to all of this. However, I wanted to wish you luck!