I forgot to add: Just as there are ignorant, mis-informed MEDICAL doctors, when it comes to RSD, the SAME can be said for "PSYCHIATRISTS" and "PSYCHOLOGISTS".

I think by now we ALL AGREE that it is IMPERATIVE to find a COMPETENT MEDICAL doctor for evaluating and treating the RSD. It is EQUALLY important, should one find the need to seek psycholgical or psychiatric counseling, to seek a COMPETENT COUNSELOR as it pertains to their RSD/Pain/Coping difficulties.

Can you IMAGINE the ADDITIONAL HARM, should an incompetent counsellor ERRONEOUSLY "Label" the RSD patient with a diagnosis such as "Borderline Personality Disorder", "CONVERSION REACTION", Paranoid Schyzophrenic??

Those are just my concerns. Again, it is my belief that the issue of counselling is best discussed between patient and doctor.

Also, based on the available research, RSD has pretty much to be proven to be a Neurological disease. NOT caused by a Psychiatric condition.

Dreambeliever: You hang in there! May time, friends and prayer ease the sadness over your loss.

Most Sincerly,

Rumbler

I am not sure how it is there, but here in Australia it is VERY rarely automatically presumed that someone with CRPS has a pre-existing psychological disease.
Our doctors are generally well informed and know it not to be the case.
If being sent to a psychiatrist or a psychologist as a crps patient is presumed by the patient to be an indication that they have a "mental illness" (I hate that crude terminology) then it can lead to a feeling of paranoia when in fact the "psychological disorder" has come about as a RESULT of CRPS and not the reverse.

Decided to update

Decided to Update

WELL SAID!

I could not agree more - that the pain needs to be managed FIRST. You would never take someone who was screaming in pain because of a broken bone, severed limb, etc and attempt to reason with them and discuss/talk/etc with them about pain management. Would you send them to a "shrink" while they were in the midst of their worst pain? NO you wouldnt - you would get that pain under control and then talk with them about pain management, coping and what further you could do for them.

As far as psychologically healthy beings before their RSD my husband was one of them. He was/is still as positive as he can possibly be. We focus on laughing instead of crying. We focus on doing instead of letting things just happen to us, we are motivated individuals dispite the downside of this.

I can say he has recently had to go on anti-depressants (has never had to before even after the 1st round of RSD). The only reasons he had to this time was because 1. his other meds have lowered his endorphins - 2nd because dealing with a w/c issue has been extremely stressful - He is on the lowest dose possible but the psychological aspect set in AFTER he had been on the meds for a while and AFTER the insurance company started jacking with him and our finances.

So my point here is, is that I am COMPLETELY convinced that 999 out of 1000 (or awfully close to it) cases of RSD the psychological comes AFTER the RSD, not before - I believe as Brokenwings that you can not classify everyone who has RSD as someone having psych issues before the RSD - from what I've seen and read those problems generally come after - and it's no wonder why - most here have had to fight w/c, insurance companies, for meds, for SSI or SSD, have had Drs call them liars and fakers, fought to keep a roof over their heads, have received inadequate treatment and the list could go onnnnnnnnnn and onnnnnnnnnn. GEE - It doesn't take a rocket scientist to figure out where the psych issues come from.......

Hubby--you said it FAR BETTER than my attempts could!!!!!!! THANK YOU!


Hope you and your Hubby have a very nice, PAIN-FREE evening!

Brokenwings

i also had a neurologist dare to tell me it was all in my mind etc and so forth. but i had some ammunition that i'm sure made him look stupid among his peers.

in 2001 i had a hysterectomy. everything was fine until the 3rd week after the op. that was when the abdominal pain started. i was in and out of hospital every 2nd or 3rd day with the gynae giving me morphine shots every 4 hours. after doing all sorts of scans and x-rays and tests the doctor said to me he couldn't find anything wrong and that he believes it's all in my head. now this was after having 3 c-sections and not having a moments problem after any one of them. in fact i got up and walked after 8 hours, the same after the hysterectomy. eventually after being admitted the umpteenth time i told him he was to investigate. he agreed to this and was probably thinking it was all still in my head.

6 weeks, to the day, i was wheeled into theater for him to do a lapscope. only when he took the first look he got a shock of his life. everything was messed up inside that he had to urgently call for a surgeon to come fix me up. this took 5 hours on the operating table. he apologised to me afterwards. i was in ICU for 3 days after the op.

when i mentioned this to that twit of a neurologist i said, that time the doctor was able to do an exploratory op and find out what was wrong. this time where the hell are you going to operate on me to figure out that this is not in my head.

i never went back to that neurologist. and did i spread my hysterectomy story around the medical doctors. i bet he's still red in the face.

I want to clarify first that I don't think people with chronic illness automatically develop psychological complications. There are plenty who don't and plenty who come into them with disorders. My point is that in order to evaluate the function of the pain meds the patient has to be assesed psycholocically. I also don't mean that a patient should be denied pain management pending an evaluation. I do know that the hospital I flew back and forth to (UNC )will not do a procedure or give narcotics to anyone who isn't cleared by the therapist first. That being said if a person comes in in agony she drops everything to evaluate them right then. They have a extraordinary pain clinic because they take the whole person aproach. The mind and body work as one machine. You can alter one with out altering the other. The stigma of haaving psychological reactions is so great that many Doctors over focus on it and many patients won't even look at it. I would like to see a better balance because that is the wya to find good accesible care.

I think it is so odd that people with the saame condition don't have the same options for treatment. I use Buprenex injections for pain. It is a narcotic but with a drug to counteract the side effects of regular morrphine or fentanyl. Very few doctors will even consider giving this dug even though it is a far better alternative to OXY or Fent. It all has to do with the Doc's opinion on narcotics, the psychological state of pain patients..... what they had for breakfast.................... Some docs will only use neurontin an those types and won't consider narcotics. My surgeon and I made this home epidural system that I know many of you could benefit from but I am the only one who has it. That is awful! How many of you would like to have a full 7 days a month pain free to to your physical therapy with out going inpatient for an epidural? Would your doc even consider it? That is wrong. I would like to see a more cohesive community between docs and patients. The division is over the " how much is in your head debate" and we suffer as a result. If there is a better system to evaluate and treat the emotional aspect it frees up the doctors to focus on the pain which is what we want. I encourage you all t let them explore the mind side with you because I know for me when they saw my willingness to go there and figure it out they were willing to pull out all the stops as far as treating my pain. When we resist the psych angle it plays into the notion that we have something to hide or are malingering ( which we are not). I hope I am making sense. I get the feeling people feel attacked which I get considering what pain patients are put through but I hope through continuing the conversation that you come to see that I aam on your side. I think you all should have acess to ALL pain treatment options with out predjudice. Have a peaceful day................we are hvaing a snowstorm.... not so peaceful!!!

To quote Dr Robert J. Schwartzman, MD, chair of Neurology at Drexel University College of Medicine in Philadelphia, "it's never, ever psychiatric. When you have severe pain that totally wrecks your life, you're depressed."