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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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#1 | ||
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Junior Member
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My story is somewhat long so I will try and make it as short as possible. Almost 1 and 1/2 years ago while I work I fell about 2 and 1/2 feet, landing on my left ankle. I was brought to the ER and recieved an X-Ray it came back as nothing broken. They said it was just a bad sprain and to stay off it, if the pain and swelling didnt let up see an ortho the following week. I was lucky enough to already be seeing a good ortho due to knee problems. Upon seeing him I was diagnosed with a 3rd degree sprain. Basically I have torn all the ligaments in my ankle.
He said PT would eventually be needed to correct this, stating ligaments don't repair themselves due to lack of a blood supply and PT would help the formation of scar tissue in the ankle to support everything. PT was a horrible experience and very painful. Forgot to mention this is a workemen's comp case, so I had them checking up on me. My 1st round of PT lasted about 3 months. Upon going to my ortho again my case manager said my ankle didn't look right and she suggested I have RSD after looking more at the ankle the Dr. also came to this conclusion. After they both told me what exactly RSD was I was pretty scared of what it could turn into. I was assured with the proper PT everything would take care of itself. Another 3 months went by and I did have some relief, but at this time PT said I had reached a point where they couldn't help me, but I was still using a cane whenever I would leave the house. After talking to my case worker I saw a neurologist RSD was present, but he was unable to provide me with a proper treatement. So We went to the next steep and looked up a very good neurologist in Boston, MA. Lucky for me it's not a far drive This Dr. was very experienced with RSD and provided me with a good PT treatement. However as time went along it was clear I still had ligament and tendon issues. After spending quite some time in PT for the 2nd time my progress began to slow and halt. I was still using a cane, I had greater range of motion, but the RSD wouldn't go away. Another round of PT was order, finally I had some luck and the RSD started to go away. Now thid became a ligament issue, which PT wasn't helping. I got in touch with a very good surgon in Boston. Upon going over my records he told me my only option was ankle ligament reconstruction surgery, but he was very worried about the presence of RSD. He told me I would be better off living the way it was instead of going forward with an operation since there was a very good chance it would cause full blow RSD and be potently crippling. Having no other options and wanting to lead a normal life again I went with the surgery. I was told due to having RSD I would have to stay overnight so they would moniter and manage my pain. I had surgery on Oct 27 2008. What was supposed to be 1 day, turnt into 2 and 1/s days due to the levels of pain I experienced. I was on a pain pump, which hardly took the edge off. After the 1st 24 hours I was taken off it and give meds orally. This didn't do anything and I was literally laying in bed in tears till a nurse came and gave me a shot of morphine. This went on for an another 24 hours. On my 3rd day they started to refuse me morphine saying I can't keep recieving it. By this time the oral medication was having some effect, but I was still in a considerable amount of pain. It was decided for me to spend a 3rd night to get it under control, but the attending Dr. or what ever he was said I was stable enough to go home. And I was pretty much discharged against my will. I spent about a month in bed, only getting up to use the bathroom and wash up. I was on some pretty heavy medication which by this time was working on controlling the pain. When I went for my follow up my surgon said the site had become infected and I was put on antiboitics. This cleared up in a few weeks. Now a little over 2 months I am NWB when I go out of the house, but I got cleared to WB around the house while using both crutches and in an aircast. I have another appoitement coming up, but I'm unsure how I feel about it. I am still in pain and fear PT may upset the RSD, the Dr. also fears this. Going into this whole thing he was against it saying my odds of getting full blown RSD are quite high since it was such an envasive operation. I have been trying to find out what I should avoid doing to reduce the chance of my RSD becomming worse, but I haven't out too much on how to exactly stop RSD. Everything I read points to leaving an infected limb with RSD alone, but this is the exact opossite of what PT is. I have to underdo PT to get the ankle moving and healing, but I am weary on how much I should push myself with the treatement. I realize this is a long post, I tried to shorten it was much as I could while keeping the severity of the issue in context. I hope to get some answers and welcoming into this community. |
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#2 | ||
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Junior Member
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Good luck , Sherrie |
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#3 | ||
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I am too tired to locate all of the sites that I have read regarding surgery on an RSD patient, but I have them bookmarked and will post them tomorrow for you. Quick and dirty, if surgery is deemed necessary, it is imperative that you receive sympathetic nerve blocks before, during, and after your surgery to lessen the odds of a flare. Your pain specialist (if you don't have one, you need to find a really good one) should be an active participant in that process. Also, PROPER PT is necessary......but NOT to the point of pain. You need to try to seek out a PT that is familiar with RSD patients and has successfully treated several already. PT for us is different than PT for others. Again, I will post those links tomorrow (if another member doesn't post them first!). Lack of movement will exacerbate the painful symptoms of RSD. Your time on bed rest or time in the cast probably caused the RSD to flare. I know that I was immobile for only a week after my ankle surgery and the pain and swelling was unbearable. Finding the balance to keep the affected limb(s) moving is a delicate process....moving often and carefully, but with rest in between. Certain massages that my PT instructed proved very helpful......they are specific massages with the purpose of moving the edema into the lymph system away from the affected area and needs to be done several times a day. It is a very gentle and specific massage....it will not be comfortable, particularly if you have allodynia.....but getting the swelling down will help in the overall healing and mobility. I am still struggling with this issue myself as well as poor wound healing. I am seeing a wound care specialist this Friday to hopefully assist in this process. PT for us should NOT be tiring, taxing, or aggressive. If it hurts, it should be scaled back a bit to the point where it can be comfortable (relatively speaking.....as NO movement is "comfortable" for us). It takes longer for us to heal anyway due to circulation problems, so it will be a long and arduous process. Do NOT use ice and do NOT allow them to use contrast baths on you. Ice destroys the myelin sheath that surrounds the nerve cells and fibers only increasing the damage. Additionally, it is extremely painful for us. I hope this helps a bit. Again, I will post the links I have found in the morning. There is also a DVD that I am considering purchasing that deals with PT in an RSD patient. Again, it is critical that your "team" is all familiar with treating RSD and is willing to learn more about it. Each person with RSD is different, so the treatments must be individualized. Since there is no cure, there is really no way of "stopping" it. We all have to know our bodies and listen to our fluctuating cues. Do not do ANYTHING to the point of exhaustion. You will only set yourself back. Best wishes to you. I am so glad that you're here and I look forward to following your continued progress!! |
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#4 | ||
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Member
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Welcome.
It seems triggers vary a lot from one sufferer to another and MominpainRSD has given a pretty good overview. For me very few things hurt much when they happen but the next day or two days later my hand gets very bad. I seem to experience a lot of the immediate effects in my stomach. I've found ghinko biloba extremely helpful but you might want to clear this with your doc first. I take 120 mg in the morning and 60 mg at bedtime after building up to this for some time. Avoid stress and any painful stimuli like lights and noise (odors). Warm water seems to help a lot though it helps me only if I keep it down to about an hour per day. Epsom salts baths might help. Triggers can be anything and seem to change regularly so keeping ahead of them is a job. For me sodium nitrite even in relatively small quantities would set me off. This is a preservative in all processed meats so was very difficult to avoid. This sensitivity almost went away for a couple years and now seems to be returning a little. Salt intake might be an issue for some. It's difficult for me to keep my salt levels in a narrow range which the condition seems to demand. For me high blood pressure seems to be a result of the pain rather than a cause but this is something to consider. Most people consume far more salt than they need and this can cause high B/P too. You should still have a good chance of beating this thing since you've had it less than two years and you almost had it beaten once. Don't give up. There's still life after RSD. |
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#5 | ||
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Senior Member
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Hi LoneHunter21,
Welcome to kind and caring group of fellow rsders. I'm so sorry you have RSD and has gotten worse after surgery. Mine started the day following surgery, but was diagnosed for 4-5 years. There is one treatment that has been found effective for RSD and it is HBOT. Within a chamber your are given 100% oxygen, pressurized at over twice the pressure we take in 21% oxygen. Mostly they are found in hospitals and a few clinics around the country. They advance healing because the 100% oxygen spreads inside the body,especially in hard to get to areas. I'm going to go for this form of treatment in a couple of months when my Dr. gets them installed in his 2 new clinics. There are good results for many, putting them into remission. RSD is an autonomic disorder, meaning it affects involuntary organs. Thus, we have increased sweating. We have high blood pressure -sympathetic nervous system, and low blood pressure-para sympathetic nervous system. Skin temperature is effective, fluctuating from hot to cold to hot rapidly.. I have both burning hands and feet and ice cold to the bone hands and feet. Actually I have full body, generalized. I had a lot of massage therapy and pt for over a year for frozen shoulder, then moved to other shoulder more massage therapy and pt Got full range of motion on both arms and shoulders, thru both forms of therapy. I just thought it was something that followed breast surgery for some women. NO RSD So be aware of your others limbs and of many symptoms in other limbs. I'm so sorry you have this. Please READ READ READ as much as you can, There is a vast amount of experience here, but remember everyone reacts different to various treatments and meds. So be careful in making decisions, and make sure your dr. has experience is the area he is working on. Do you have a support group on your town or nearby. You can find the RSDS organization and type in your area code and they will tell you the closest location with a phone number of the group leader. They have wonderful presentations by Drs. Pharmacists,, etc. Also can ask arouond for Drs. ETC Epson Salt Baths can be relaxing, but not too hot. Swimming in 86 degree water or warmer, but me mobile and helped from my feet being crippled. I have one hand partially crippled, but can cut my own food, so it works pretty good. Even warm bath water and working toes hands etc are very helpful. Please let us know how to continue to do? I'm so sorry you are dealing with this, but and any time you can write us, and we'll be there for you. Take care, Loretta Jewell |
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#6 | ||
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Junior Member
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I wanted to thank everyone for their posts and support. Like I said its been almost 1 and 1/2 years that I've been dealing with this and it is very frustrating to do through this at such a young age (22). During this time there has been a noticable drop in my GPA and overall drive to do anything. If it wasn't for my girlfriend I don't know where I would be right now. Now that I have had my surgery I am more scared then before, the risk of full blow RSD is quite high I am told. So not only do I have to worry about getting the ankle itself taken care of now I have RSD looming over head. The pain I have been on this whole time has been bad at times, but mostly managable. I can't imagine dealing with full blow RSD.
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#7 | ||
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Member
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"It may be on the menu, but it is not on my plate today". I only deal with what I have to deal with right now. Let tomorrow worry about itself. Best wishes to you!! I hope you'll stick around and keep us posted on your progress!!! |
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