I am like Cindi. Since I've had RSD my symptoms have flared out of control -in particular, my head pain - every time I have gotten sick...

Dear Sandy/Cindi -

Please make sure you are not taking Sudafed or any other product containing pseudoephedrine, which works by constricting the small blood vessels in nasal passages:

Pseudoephedrine is a sympathomimetic amine. Its principal mechanism of action relies on its indirect action on the adrenergic receptor system. The vasoconstriction that pseudoephedrine produces is believed to be principally an α-adrenergic receptor response.

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These adrenergic receptors are located on the muscles lining the walls of blood vessels. When activated by pseudoephedrine, the muscles contract, causing the blood vessels to constrict (vasoconstriction). The constricted blood vessels now allow less fluid to leave the blood vessels and enter the nose, throat and sinus linings, which results in decreased inflammation of nasal membranes as well as decreased mucus production. Thus, by constriction of blood vessels, mainly those located in the nasal passages, pseudoephedrine causes a decrease in the symptoms of nasal congestion.

http://en.wikipedia.org/wiki/Pseudoephedrine (For a list of the many over-the-counter products containing pseudoephedrine, see http://www.nlm.nih.gov/medlineplus/d...s/a682619.html.)

And as I believe Sandy is well aware, anyone with RSD/CRPS has way too much experience already with vasoconstriction. See, e.g., An Update on the Pathophysiology of Complex Regional Pain Syndrome, Bruehl S, Anesthesiol. 2010;113(3):713-725 at 717 ONLINE TEXT @ http://www.rsds.org/2/library/articl...ology_2010.pdf, citing, Alpha-adrenergic supersensitivity of the sudomotor nerve in complex regional pain syndrome, Chémali KR, Gorodeski R, Chelimsky TC, Ann Neurol. 2001 Apr;49(4):453-9:

Abstract
alpha-Adrenoreceptor supersensitivity in many tissues has been described in patients with complex regional pain syndrome type I (CRPS I). Because excessive sweating of the affected limb is an important feature of CRPS I, we investigated whether this supersensitivity also occurs in the sudomotor system. We compared the sweat response to iontophoresis of an alpha-adrenergic agent (phenylephrine) in 4 patients with acute CRPS I and 3 patients with resolved CRPS I with that in 9 control subjects using the methodology of the quantitative sudomotor axon reflex test (QSART). A significantly higher sweat response was observed in the affected limb of patients with acute CRPS I compared to their unaffected limb (p = 0.03), to control subjects (p > 0.018), and to the affected or unaffected limbs of patients with resolved CRPS I (p = 0.02), whose sweat response was not significantly different from that of control subjects. We conclude that the abnormal response in patients with acute CRPS I is most likely mediated by an axon reflex and that alpha-adrenoreceptor supersensitivity occurs in the presynaptic portion of the postganglionic sudomotor axon. This supersensitivity is reversed when CRPS I resolves.

PMID: 11310622 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/11310622

So while Sudafed, etc., is constricting the small vessels in your nasal passages, it's doing the same number on the rest of your body: something I figured out the hard way. Hence the contraindications for those with cardiovascular disease, hypertension, etc., as set out in the Wiki article. Better we should take something like Zicam® Cough Max Cough Spray (100% Dextromethorphan HBr - just search the forum for Dextromethorphan) and let the nose do what it will!

Mike

Thanks Mike - you are amazing.....

Well, I just came off a wonderful(?) trip down withdrawal lane. I knew I was going to be out of xanax by the weekend and on Monday I called the dr's office and she asked me to have the pharmacy fax the request. Went to pick it up on Wed, not there. Pharm faxed again, not there on Thurs. This was late, so Fri morn I called. Oh yes, our fax printer was on the fritz and we didn't know it. And Oh doc's in LA, can you call your reg doc and get the refill, he is the one who originally wrote the script. I did, but on Fri's they seldom get Fri calls filled and PM Doc had increased dose so I really couldn't get another script of the original because it wasn't time. So I went from Thurs until Tues(doc delayed his return) without Xanax.

All this to say, my headache was out of this world and all the other withdrawal symptoms, but my RSD stuff was like non-existent. My feet were just as white as a normal person's, no swelling, some tingling but not high on the scale. Most likely because I wasn't walking AT ALL, I wasn't really moving except from recliner in one room to recliner in another, I wore no shoe and few socks, and didn't go out at all. All the things that cause my RSD to 'reveal' itself. So total bedrest would be my guess for any lessening of symptoms, but don't expect me to go through withdrawal to test anybody else's theories. Withdrawal stinks. My head felt like it weighed 100 pounds.

I'm taking 'offering my body for science' off of my resume!

pat
PS - Ha, I had to go to the Doc on Wed after I got the Xanax back on Tues. Took my slippers(I told you I don't wear shoes) and socks(size 10-13 mens[I used to have very small feet]) and lo and behold there were my familiar old black feet. The asst who was helping me get ready for my block was beside herself. I guess she's never seen it up close and personal.