Reflex Sympathetic Dystrophy (RSD and CRPS) Reflex Sympathetic Dystrophy (Complex Regional Pain Syndromes Type I) and Causalgia (Complex Regional Pain Syndromes Type II)(RSD and CRPS)


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Old 04-29-2015, 12:53 PM #1
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Default "Waste basket diagnosis"

Has anyone heard crps refered to as a waste basket diagnosis?

I was seeing an Ortho who did surgery on my shoulder then started treating my hand. He injected it the most he could and asked that I go see a hand specialist. I saw said specialist and got my crps diagnosis.
So yesterday I was in with my dr at the old Ortho (I've always liked him) and I let him know I had a bone scan and told him what the hand specialist said. He replied "that's a waste basket diagnosis"

Is this the common thought with drs about this diagnosis? What's your experience with drs recognizing this syndrome?

I was unsure what my gp would have to say about the diagnosis and after Ortho docs comment I feel reluctant to tell her. I did however get a referral to a pain management center and I am going to talk to them about this. Surely a pain specialist will not scoff at the diagnosis.

Pardon my typos. My typing hand is my affected hand.
Jenni

Last edited by Jennijojo; 04-29-2015 at 02:13 PM.
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Old 04-29-2015, 03:51 PM #2
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It might not mean your ortho doesn't believe in it. It might just mean that to him CRPS is a "wastebasket" where doctors throw symptoms that they can't figure out. In my experience working with doctors the term has been used in frustration (sometimes with other doctors) that they could not come up with a clear cut reason for what is happening.

I wouldn't take offense just yet or be fearful of bringing it up to other doctors. You can always broach it as "so and so thought this might be CRPS. What is your experience with that? What do you think it is?" This gives enough ambiguity for difference or affirmation of medical opinion. I can also say for sure doctors don't often like to stab each other in the back clinically.

The other way a diagnosis can be a wastebasket is as a repository for evey complaint the patient has. And I think this is dangerous. It is too easy, especially with chronic pain issues for everything to get thrown in with the diagnosis someone has, potentially ignoring or not adequately working up "spread" or new problems that just maybe, are being caused by something else.

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Old 04-29-2015, 04:17 PM #3
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That makes sense littlepaw, because he looked disappointed and had a frustrated tone to his voice. He also shut his mouth quickly and changed the subject. I didn't tell him very much about why this was diagnosed and that it was from one visit and one scan and that he kinda suspected it off the bat.
He's been very good to me and many others in my family. And he's definately protective of his patients. I could definately see his wheels turning but he did not dispute it. It is my nature to assume when I see frustration and the like to assume it is with me.

Thank you for the info. It turned that overhead head lightbulb on and I am a little less apprehensive in getting some more info.
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Old 04-30-2015, 06:19 AM #4
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Default It's just an UNEDUCATED doctor

Unfortunately there are many medical providers even specialists out there who do not believe in CRPS. It's just because they really don't understand how it works and what it does. You do need to try to find a doctor who will work with you and knows about CRPS and knows how to treat it. Unfortunately you will run into a lot of medical professionals who have no idea what CRPS is and if they do they don't believe in it and think it's just some sort of mental psych out. I really hope you can find somebody who can help you with your treatments.

You do have a long tough road ahead of you but it can be pushed into remission. You're gonna have to reach for reserves of strength that you didn't know were there but it is possible. You have to try to stay as positive as possible throughout this entire thing and do as much as you physically can without causing yourself more pain. If you don't try to keep using your affected limbs as much as possible again without causing pain then your condition will only worsen. The longer you go without using your muscles the worst muscle wasting atrophy can become an intern your symptoms will get worse. . .

Please know that here at Nero talk we are here for you whenever you need us . Don't hesitate to contact us if you have any questions or concerns or just need to vent with a bad day that you had. Stay strong and know YOU ARE NOT ALONE! All of us here have experienced medical professionals to don't believe us and all sorts of other things there's at least one person here who can empathize with your situation a matter what it is . I'm sending you all the love and support and prayers your way that you can handle.

Love and hugs!
Emma




Quote:
Originally Posted by Jennijojo View Post
Has anyone heard crps refered to as a waste basket diagnosis?

I was seeing an Ortho who did surgery on my shoulder then started treating my hand. He injected it the most he could and asked that I go see a hand specialist. I saw said specialist and got my crps diagnosis.
So yesterday I was in with my dr at the old Ortho (I've always liked him) and I let him know I had a bone scan and told him what the hand specialist said. He replied "that's a waste basket diagnosis"

Is this the common thought with drs about this diagnosis? What's your experience with drs recognizing this syndrome?

I was unsure what my gp would have to say about the diagnosis and after Ortho docs comment I feel reluctant to tell her. I did however get a referral to a pain management center and I am going to talk to them about this. Surely a pain specialist will not scoff at the diagnosis.

Pardon my typos. My typing hand is my affected hand.
Jenni
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Old 04-30-2015, 11:28 AM #5
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Thank you emma!
I have a pain management referral I'm hoping these drs are ones who know about crps!
I must admit I had no clue what it was when I was diagnosed. But this hand specialist went right for that. It's often hard for me to believe and accept cause I can't wrap my head around it not being a broken bone or torn tendon or something go that can just be fixed by a surgeon. Even harder for me that I have no clue what actually started this.

Thank you all for your words, I'm really looking forward to talking to a dr about this and hopefully get it under control!
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Old 04-30-2015, 11:39 AM #6
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Default Recognizing CRPS

Oh boy. Mine is always recognized. Like I am an elusive white unicorn they have come upon in the woods. Some Doctors are very happy to pick my brain about it because they have researched it but never seen it. Even still! Others have asked me to talk to their newly diagnosed patients to help them through it.

Mine always "looks" like something though. I have inflammation and discoloration in my skin. I imagine if it were invisible that they would dismiss me more often. The atrophy, color differences, edema, temperature fluctuations and capillary refill are always an issue. My reflexes are missing in that limb. They can physically find reasons to believe in it. I don't think they would be so nice if they didn't see all of that physical stuff.

I start appointments with new Doctors by showing them a picture of what it looks like on me. It helps qualify the diagnosis quite a bit. If they don't think it's a big deal, I tell them how well I am doing by comparison and how it used to look/feel and how debilitating it was vs. now when I just hurt a lot.

You could see it on my bone scan too. My Qualitiative Sensory Testing was a bust, no function at all. My skin punch biopsies revealed severe small nerve fiber neuropathy. They measured how much my leg had atrophied and the temperature difference between my legs was almost 10 degrees. The Bone Scan is one piece of the puzzle. Let him put the rest of the pieces together for the whole picture - this one seems to be a skeptic. I'm sorry that you're going through it. If you have a Doctor who does not recognize this, he is not helping you.

I recently saw a counselor for unrelated issues. I was her white unicorn. The only RSD she had seen outside of clinic. She told me her talks usually involve stories of RSD/CRPS patients because it is the worst pain you can have and people dismiss it because they can't see it. I think she pointed me in the direction of the pain index that CRPS is at the top of the chart for. In any case, she uses our diagnosis as her example of how people with pain should not be labeled as mental health cases. It just means they don't understand our pain yet. People with CRPS tend to have a really high pain tolerance too so by the time you know we are in pain, it's probably worse than "normal" people can tolerate. Hang in there, and find a new Doctor who wants to help you. Pain Medicine should be a good place because at least they have seen this before.
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Old 04-30-2015, 11:47 AM #7
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As you read more about CRPS/RSD you'll know what fits in your case. Maybe the ortho was concerned that the surgery was what set off the CRPS for you.

If you feel CRPS is the correct diagnosis, maybe he was a bit upset that he missed the signs...

Since you mention shoulder/hand issues, I'd like to suggest - if CRPS is not a clear fit - that you read about thoracic outlet syndrome also (TOS) for short.
It is possible to have both TOS & RSD/CRPS too...
I haven't had time to read about your symptoms..
post #1 in our useful sticky thread is a comprehensive collection of info about TOS -
http://neurotalk.psychcentral.com/thread84.html
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Old 04-30-2015, 11:56 AM #8
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Hi Theodora,
The skeptic isn't a dr I see anymore he was just the one who noticed the problem and referred me out for someone to figure it out when he couldn't.

What I don't understand is my bine scan showed in my wrist, which just gets red but not really swollen, and it hurts bad of course. However, the vusable stuff is in the first knuckle of my thumb. It gets so swollen I sometimes thing it's going to pop and red and hard to move. It even is starting to look like its twisting. I lose circulation and often light touch makes the nerves in my hand go crazy. I had all the ra blood tests done xrays etc. one thing I haven't had was have my soft tissue checked. This hand specialist seemed to suspect crps the minute he saw my thumb. But said the bone scan didn't explain my thumb.
This doesn't make much sense to me because the thumb is what is the worst part.

So the doc who didnt seem satisfied with the diagnosis isn't the dr I will be seeing for treatment. I just saw him in passing and mentioned it to him and that was his response.

Out of curiosity, once the diagnosis is made, is everything from here out going to be pinned to this? there's been no suggestion of further testing and I can't help but wonder about what they haven't checked. Maybe I do have a soft tissue injury that possibly caused this or is why my thumb is so bad. Even though they are probably right, I feel like it was a bit hasty. Maybe this is why Ortho doc said what he did.
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Old 04-30-2015, 12:00 PM #9
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Quote:
Originally Posted by Jo*mar View Post
As you read more about CRPS/RSD you'll know what fits in your case. Maybe the ortho was concerned that the surgery was what set off the CRPS for you.

If you feel CRPS is the correct diagnosis, maybe he was a bit upset that he missed the signs...

Since you mention shoulder/hand issues, I'd like to suggest - if CRPS is not a clear fit - that you read about thoracic outlet syndrome also (TOS) for short.
It is possible to have both TOS & RSD/CRPS too...
I haven't had time to read about your symptoms..
post #1 in our useful sticky thread is a comprehensive collection of info about TOS -
http://neurotalk.psychcentral.com/thread84.html
Thank you! I do have thoracic outlet syndrome. I've had it for years. I did a lot of pt for it probably 15 years ago, they thought being short and having a job that required the constant overhead arm repetition was the root.

I felt better for a while but can easly aggravate it. I do my at home stretches and exercises and it will ease it off
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