Dennis -

What you went through sounds hideous. And of course the guy was right about chronic CRPS being in your head, just not in the way that he meant.

See, e.g., "Contralateral thalamic perfusion in patients with reflex sympathetic dystrophy syndrome," Fukumoto M, et al, Lancet 1999 Nov 20; 354 (9192):1790-1 (PET scans showed substantial variation in thalamic perfusion of the side contralateral to the painful limb, with variations are related to time from the onset of symptoms, suggesting that the thalamus undergoes adaptive changes in the course of this neurological disorder) copy attached; "Chronic Pain with Beneficial Response to Electroconvulsive Therapy and Regional Cerebral Blood Flow Changes Assesed by Single Photon Emission Computed Tomography," Fukui S, et al, Regional Anesthesia and Pain Medicine, Vol 27, No 2 (March–April), 2002: 211–213 (following Fukumoto, thalamus of 50 y.o. woman with chronic CRPS was measured before and after ECT treatments, which resulted in pain pain being reduced to the point that VAS levels of post-ECT pain severity were rated 1-2 and rCBF in the thalamus was increased significantly increased after ECT, suggesting that rCBF change may be related to the analgesic efficacy of ECT) full text at http://www.rsds.org/2/library/articl..._Yoshimura.pdf ; "The Brain in Chronic CRPS Pain: Abnormal Gray-White Matter Interactions in Emotional and Autonomic Regions," Geha PY, et al [Apkarian AV], Neuron 2008; 60: 570-581 (finding, among other things, a significant reduction in the corticol thickness of the anterior insula, one of the key receptors of signals in the cortext from the thalamus, and linked with emotional regulation) full text at http://www.rsds.org/2/library/articl...aliki_etal.pdf

But I suppose it's too much to expect that the guy would have been caught up on his reading to the point that he would be familiar with a decade old article in The Lancet.

That said, a referral from a great pain psychologist to an MBSR instructor (Mindfulness Based Stress Reduction), a program with a substantial element of meditation that has been training teachers across the country out of the Univ. of Mass. for the last 30 years, http://www.umassmed.edu/Content.aspx?id=41252 has been the single best thing that's happened to me since I got this thing. It was there I first learned that while pain is all too often pain unavoidable, struggling against it just compounds - and in fact is - the suffering we experience. Plus I've made some really great friends in that community.

And of course not all neurologists are terrible, look at Robert J. Schwartzman or Anne Louise Oaklander or even my own neurologist, who left the faculty at UCLA where he was a full professor when, I was advised by someone else, UCLA wasn't interested in funding a rehabilitative program.

And for what it's worth, UCLA's reputation around town for treating chronic pain is dismal. While they may be the go to guys for stroke or brain cancers, they persist in being in the dark ages when it comes to pain. It must not generate enough research grants.

So to close with an apt and infamous bit of Dog Latin, illegitimi non carborundum.

Mike

Attached Files

Contralateral thalamic perfusion in patients with reflex sympathetic dystrophy syndrome - Mitsut.pdf (67.8 KB, 128 views)