[WolfLarsen]

Hello again!

First of all, thanks to everyone who responded to my first post! I can tell this is a very supportive place for RSD sufferers.

I did get an appointment with a specialist in town- a physiast/ pain management doctor (my foot doc, who is 1000 miles away now and I haven't seen in 2 months, suddenly called and picked the guy for me. Nice doc...). He said he did have a fair amount of RSD experience, and he *seemed* to be knowledgeable. He said nerve blocks might or might not work given how long I've had this, and would set me back $7500 for a set of 3, so he advised me to try medication first. I'm supposed to try prednisone ( a steroid) for 6 days, starting at 60 mg and tapering off, and then the antidepressant amitripityline at 25mg a day after that. The prednisone helping a lot, except....

I did something dumb on monday...I know they say avoid cold, but I thought I was an exception...the foot had gotten stuck in a warm hot swollen burning-prone state, with reduced mobility due to bulged-out veins. I could get it to go away for a little bit but it would come back. So I tried what had worked like a charm in the past- dipping in 60 F water a few times over a few hour period, then relieving the resultant stiffness at the end by splashing
with warm water. Unfortunately my RSD is so much worse now that it didn't really thaw out- I could just get it to barely move. The prednisone, which I started today, seems to have helped pretty noticeably- the tissues are pretty well unstiffened and also much less prone to hot/cold reaction. Mainly the tendons or maybe joints seems to have tightened up- I can't bend the toes down all the way, they prevent full motion of the ankle, and when a draft of cold air hits I can feel the tendons tighten up.

Running the joints under a hot faucet for awhile periodically seems to be helping a very little bit...I'm thinking of soaking in warm water (although this caused hot-burny-bulged-veins in the past) or contrast baths (although I fear the cold water might just balance out the hot to no net effect). Any suggestions?

What about the meds? They are ridiculously cheap and I'm hoping he didn't go too far in saving me money because I'm uninsured. Mainly I need to relieve stiffness and weird hot/cold reactions- actual pain is not a big deal in my case.

Contrast baths? When I did them before, when the RSD was less severe, the foot would immediately become immobile afterwards, and while I could loosen it up again, it was prone towards stiffening up again for a good while afterwards. My pt didn't know why it did this so I stopped. What is other people's experience with this?

Anyone tried mirror theapy? Sounded interesting,,,

Some asked how long I've had this. The precipitating injury was 13 months ago. It was a little weird from the beginning- it had excessive swelling that didn't dissappear and was really easily re-hurt- but the first really weird stuff was 2 months into it, when a soak in very hot water and epsom salts made it swell up really bad. I had to avoid warm showers for many weeks afterwards, but it wasn't that bad for awhile (aside from not healing and some swelling part of the time). My doc gave me an aircast which I wore until april and in retrospect was a bad idea because it caused atrophy which still hasn't been remedied. In February I started getting worse swelling, chills and numbness. By May this had gotten so bad that I tried heating pads, hot water bottles, soaking in warm water- which caused it to get red and swollen alternating with cold and stiff. It was finally diagnosed as RSD in June by the 4th doctor I went to. It improved gradually thanks mainly to physical therapy, but then over the past 4-6 weeks has really deteriorated, probably mainly due to getting hurt by dumb pt and by resultant lack of exercise. Also, my seasonal job ended, and
with it my own apartment- I've been stuck on my parents hide-a-bed and can't keep the air temp ultra-warm like I used to (yes, warm water and etc is bad for it but it likes warm air...hrm).

So I've had it for 13 months quite possibly, but it was a pretty mild case I guess until May/june. Right now all I have is the exaggerated hot/cold sensations + stiffness, which sort of hurt a little bit if they get really bad. How likely is it that I'll end up (if it worsens) with the horrible pain that seems to be so strongly associated with this disease?

Anyway, thanks!