Hi, keepsmilin:

Quote: "So what does stage 4 RSD consist of??"

A document titled "Spread of Complex Regional Pain Syndrome (CRPS)", written by H. Hooshmand, M.D. and Eric M. Phillips, from the Neurological Associates Pain Management Center in Vero Beach (Florida), says the following about stage 4 of RSD:

STAGE IV:

1) Failure of the immune system, reduction of helper T-cell lymphocytes and elevation of killer T-cell lymphocytes.

2) Intractable hypertension changes to orthostatic hypotension.

3) Intractable generalized edema involving the abdomen, pelvis, lungs, and extremities.

4) Ulcerative skin lesions which may respond to treatment with I.V. Mannitol, I.V. Immunoglobulin, and ACTH treatments. Calcium channel blockers such as Nifedipine may be effective in treatment.

5) High risks of cancer and suicide are increased.

6) Multiple surgical procedures seem to be precipitating factors for development of stage IV.

Stage IV is almost the flip side of earlier stages, and points to exhaustion of autonomic and immune systems. Ganglion blocks in this stage are useless and treatment should be aimed at improving the edema and the failing immune system. Sympathetic ganglion blocks, alpha blockers, including Clonidine, are contraindicated in stage IV due to hypotension. Instead, medications such as Proamantin (midodrin) are helpful to correct the orthostatic hypotension.

[B]Stages[B] Stage IV: Irreversible disturbance of plasticity; autonomic failure
Signs/Symptoms Systemic autonomic failure; visceral edema; irreversible low BP; MRSA; elephantiasis; cancer

This is all I have as information about stage 4. I might have more information at home. I will check tonight. Of course, I do not understand all the technical terms used in this document.

Thanks for your kind words.

Karen67:
Thank you for the post. When I posted my first time, I wasn't sure why I did it, I just knew that I had to do it. This is especially true when I realized tonight after a shower that I'm losing not only my fingernails but my toesnails first. I guess this has been a pretty bad week regarding my symptoms. My hands are so darn cold all the time. To the outside world, I "look fine." My close friends know when I'm having a significantly painful day because they told me that they can "tell by looking into my eyes." The pain is very apparent. Cyber hugs would be very much appreciated. My 22 year old son and his fiance moved out this past weekend so I'm alone now. I know that I'll be on this site more and more, especially during the winter time when my symptoms in my hands and arms are at there worst!
Yes, you did give me some peace of mind. You'll never know how much that means to me right now.

Hi Irish4luck,

I see you are a visitor. Please join for some much needed support. I have just spoken to a friend who is also a school psychologist, also injured in a car accident. He is in his second remission. He would love to offer you support. If you pm me I can give you his e-mail address.

Better days are ahead for you!!!!!!

Hi Irish4luck, funny how things work out sometimes... I am in a horrific flair right now and was not going to visit the site tonight. Then when I did and I saw your reply, it made me feel so good. THANK YOU. Really. Its funny, but sometimes we don't understand the full impact that we have on each other until we read a post and it just makes everything seem like I can do this! I can and will have a happy and full life even with this satanic disease. I am so happy that my screwball toenails let you know that you ARE NOT alone, ever. Please join us on here and we can hold each other up when one of us is down. BIG gentle *hugs*. <3 Karen67

Hi. I just joined this. I have been diagnosed and treated for hypothyroidism for over 35 years. And have had RSD for almost 11 years which is now spreading. Living Hell is putting it mildly. You are NOT alone.

Hi. I just joined this. I have been diagnosed and treated for hypothyroidism for over 35 years. And have had RSD for almost 11 years which is now spreading. Living Hell is putting it mildly. You are NOT alone.

This is wonderful. Truly. Approaching something Shinzen Young http://www.shinzen.org/ refers to as "happiness independent of conditions."

Mike

I have both conditions my RSD coming second. Im very overweight and for the last 4 weeks have been dieting and walking for exercise and the weight is not coming off I have heard that RSD causes weight gain but have not researched if it can keep you from losing weight. I will be now!!! My RSD started in right wrist after surgical removal of a cyst and has spread up the arm, shoulders and now to the left arm and hand as well. Hope this info helps and its off to Google I go.....

It's a vicious cycle. I started a thread about Dr. Hooshmand's 4 Fs diet a few weeks ago, so I won't repeat myself, but we do experience hormonal changes related to RSD that can be exacerbated by our food choices. You might also want to check out the Weight Loss Forum here as well.

Wow.. thank you Michael. I think I am caught in a beautiful circle of joy. Karen