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 04-21-2009, 03:50 PM #1
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Quote:
Originally Posted by shogan7RSD View Post
All my docs say it is good we caught it early, but what good can that do if i am not responding well to the treatments?
Catching it early simply means that your chances are optimal. They might be able to stop it before you have (too much) function loss, or before it starts to spread. There are patients who get worse despite early diagnosis and early treatment because the treatment doesn't work well, but at least you had a better chance to begin with (and to those that were diagnosed late, that means an awful lot).

I would discuss other kinds of treatment with your doctor. The nerve blocks don't seem to do you much good, on the contrary!
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Work related (car) accident September 21, 1995, consequences:
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- RSD both legs (late diagnosis, almost 3 years into RSD) & spread to arms/hands as of 2008
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Old 04-21-2009, 10:40 PM #2
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I agree with Gymjunkie. There are lots of different treatment options. Try whatever you can, but give it time to see if it's having an effect (good or bad) before you throw in another therapy. For me, I had 8 nerve blocks and it's hard to tell if they were ultimately helpful or not (I don't know what would have become of me had I not had them). I think everything I've done in combination has helped incrementally. I was diagnosed within 6 weeks of surgery and treated. At first when the cast was removed and after the boot came off, I could barely move my ankle--it was in such pain (that is NOT where I had my surgery; surgery was in my foot). If I hadn't started PT right away then it would have probably gotten much worse, and my ankle would probably still be frozen now. I had almost all the classic signs of RSD (bone wasting, swelling, coldness, sweating, discoloration, etc.). I just didn't have the sensitivity to light touch; mine was more of a deep muscle and bone ache, and nerve sensitivity, and it spread up my leg pretty quickly. I consider myself in remission now; but this is after at least 18 months of trying LOTS of different therapies and doing a lot of hard work. I consider myself very lucky. I know for some it never gets better. For me it did.
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Old 04-21-2009, 11:11 PM #3
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Sorry, I been asleep for about 3-4 days.
DOWN!

I've got this bastard 26 years, with TOS, and an acquired TBI a decade ago.

The "Problem" that I see going on with "catching it early",
is this:

The doctors all stand around playing Pocketball, because they're too afraid to do anything about it!
They won't get aggressive with their treatments!

If you catch it early, you need Aggressive PT!
And, that means WORKING THROUGH THE PAIN!
90% of humans, I don't think are willing to do that.
(I'm sorry to say that).

But,
If you get an Aggressive doctor, one who will give you
the painkillers you need, and a PT who will MAKE YOU WORK,
THEN,
(Maybe only then),
You might have a chance to beat this bastard,
in the first so many months, depending on how hard you're willing
to work "Satan" out of your body!
Get the medicinal help you need, and TELL Your doc and PT,
you WANT to be Aggresive!
Cure it? I think it may be Kick it's *****, early!

Give it to them in writing!
Like I always suggest, don't go to a docs appointment with nothing but "Your brain",
Write on your computer, a log, a digest, of how things are going.
and, finish it up with how you'd like to be treated!
Then, you save / print it, and hand it over.

Done.

Carry On.

You can still fight it outside of PT, if, you've got the (what it takes ).
FIGHT FIGHT FIGHT!

And then, there's no promise or guarantee.
Only hope.

That you won't have this Gorilla on your back, when, as you grow older,
you KNOW that other things will go wrong.
How's that gonna work?

I'm not being a bearer of bad news.
Just keepin' it real.

And, Just in case, this doesn't work to a cure....
It's the way you've got to deal with it almost every day.

I had such a week, last, that I just hadto rest, because I was up 23 hours/day!
Because I hadto be. I hadto fight!

I wish everyone well.

Pete
ASB
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Old 04-22-2009, 08:45 AM #4
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Quote:
Originally Posted by AintSoBad View Post
Sorry, I been asleep for about 3-4 days.
DOWN!

I've got this bastard 26 years, with TOS, and an acquired TBI a decade ago.

The "Problem" that I see going on with "catching it early",
is this:

The doctors all stand around playing Pocketball, because they're too afraid to do anything about it!
They won't get aggressive with their treatments!

If you catch it early, you need Aggressive PT!
And, that means WORKING THROUGH THE PAIN!
90% of humans, I don't think are willing to do that.
(I'm sorry to say that).

But,
If you get an Aggressive doctor, one who will give you
the painkillers you need, and a PT who will MAKE YOU WORK,
THEN,
(Maybe only then),
You might have a chance to beat this bastard,
in the first so many months, depending on how hard you're willing
to work "Satan" out of your body!
Get the medicinal help you need, and TELL Your doc and PT,
you WANT to be Aggresive!
Cure it? I think it may be Kick it's *****, early!

Give it to them in writing!
Like I always suggest, don't go to a docs appointment with nothing but "Your brain",
Write on your computer, a log, a digest, of how things are going.
and, finish it up with how you'd like to be treated!
Then, you save / print it, and hand it over.

Done.

Carry On.

You can still fight it outside of PT, if, you've got the (what it takes ).
FIGHT FIGHT FIGHT!

And then, there's no promise or guarantee.
Only hope.

That you won't have this Gorilla on your back, when, as you grow older,
you KNOW that other things will go wrong.
How's that gonna work?

I'm not being a bearer of bad news.
Just keepin' it real.

And, Just in case, this doesn't work to a cure....
It's the way you've got to deal with it almost every day.

I had such a week, last, that I just hadto rest, because I was up 23 hours/day!
Because I hadto be. I hadto fight!

I wish everyone well.

Pete
ASB


Pete -

Why do you call yourself "Ain't so bad" when all this stuff s*cks?

Like many others, my excrutiating pain doesn't occur when I use my affected extremity. That comes on after. And a lot of the time it's like a day or so after. Unfortunately, though, I also sometimes get really bad pain when I can't remember doing something strenuous (but my memory is not that great).

I've been cleaning my yard the last few weeks because I can't stand the mess and my plants are really special to me. There are a ton of oak trees on my property and the leaves are are all stuck in the shrubs and covering up my perennials, and there are lots of sticks on the ground. My head hurt so bad last week my PT couldn't even touch it, and I had trouble brushing my hair. I figure its because I've been doing the extra yard work. I also gave my dog a much needed bath and trim.

I wish I could conclude that I've gained something from the extra physical activity. I know I really enjoyed being outside and I get a lot of satisfaction from seeing my gardens look good. The pain is truly awful and might not be worth it, though.

Take care. Sandy
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Old 04-24-2009, 08:48 AM #5
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Quote:
I just didn't have the sensitivity to light touch; mine was more of a deep muscle and bone ache, and nerve sensitivity, and it spread up my leg pretty quickly.
Hello everybody!
That is the type of pain i usually hav and sometimes burning pain.
The other day I was reading outside on my campus, it was a very nice day, and i went inside after about 10 mins and felt not only burning pain, but my right arm was really red and it had gotten really hot. This is the first time i noticed these symptoms.
My RSD spread up my right arm and to my left w/n 2 months of the docs suggesting i had RSD. The nerve blocks did give me complete pain relief for a few hrs but didn't last much longer. I got a second opinion and he started me on cervical ESIs that seemed to help more than the blocks (no complete relief but lasted much longer than the blocks).
I just turned 21 and just want to be rid of this. I will definitly tell my doc I want to be more aggressive tho. Hopefully w/ God's help, I can go into remission. My only problem w/ PT is how expensive it is. My mom is supporting me (yes, 21 and my mom has to take care of me. I think it's sad) and she is having so much trouble w/ all the doc bills piling up.
My boyfriend isn't very supportive, and I just don't know what to do w/ him. He wants me to work, even tho I am telling him "I can't!" He wants the best for me, he just doesn't seem to understand all that i am going thru and dealing w/. He is having such a tough time w/ this crap. Any thoughts on this?
I really appreciate every1's replies and hope to hear more! We are all together in this fight!
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Old 04-24-2009, 06:40 PM #6
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Doctors don't seem to have gotten the message yet that rsd is a very individual disorder, it is progressive, it does spread and not everyone will have the same symptoms! You do not have to have touch sensitivity in order to definitely have rsd. I didn't! My only sensitivity was to air and even that for a few months was touch and go. I developed sensitivity to air about 3 years into it. The burning was not present for me at first either. I felt my first burn around 3-4 months into it. The most "common" symptoms of rsd are swelling(which isn't always there. I did have it bad in the beginning and after learning to walk again it disappeared and never returned.), pain out of proportion to the original injury, skin color and skin temperature change. The skin and hair/nail changes may or may not develop over time, as well as bone changes. My bone scans done at 5 months and 1 yr 5 months show my bones to be absolutely normal. I knew a guy in 2003 who had had rsd for 10 yrs then and every bone scan he had done came back normal. Just goes to show everyone and how their body deals with rsd is different.

Hugs,

Karen
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Old 04-24-2009, 07:08 PM #7
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My pain management physician says "it's a good thing we caught this thing early" at every visit. I want to throw up when she says it because I don't feel like it's a good thing. However, after reading the horror stories here, I am fortunate. For me there haven't been years of tests, multiple doctors, and failed therapies. Now I realize that's what she meant. The disease is the same it's just now I know what I'm up against. In 3 months it's spread from my right hand up my arm and my left hand is starting to show signs of the "mirror" thing.

My rsd came from a CESI gone awry so I've sworn off needles - no blocks in my future. So far Lyrica works but I'm going to try PT in an effort to lower the dosage.

I'm so sorry your boyfriend doesn't understand. However, he may come around so don't loose faith. Try looking on the website American RSDHope - they have some useful information about helping loved ones learn to cope.

As far as your mom goes... I have 4 daughters (about your age), and i'm confident that she'll do whatever she can for you no matter what your age. I know from working in a hospital (I'm a patient advocate) that if you mom has hospital bills, they will work with her. If she goes to the financial counselor and tells them her situation, they will work with her. Try not to feel guilty about her taking care of you. Your independence is right around the corner.
Sally
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Old 04-24-2009, 09:15 PM #8
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There are some papers that show catching RSD early and treating it with calcium channel blockers may prevent long term issues or spreading:
Quote:
Clin Neurol Neurosurg. 1997 Feb;99(1):26-30.Click here to read Links
Complex regional pain syndrome (reflex sympathetic dystrophy and causalgia): management with the calcium channel blocker nifedipine and/or the alpha-sympathetic blocker phenoxybenzamine in 59 patients.
Muizelaar JP, Kleyer M, Hertogs IA, DeLange DC.

Department of Neurosurgery, University of California, Davis, Sacramento 95817, USA.

Complex Regional Pain Syndrome (CRPS) is the new name for entities formerly known mostly as Reflex Sympathetic Dystrophy and Causalgia. Treatment of CRPS with either the calcium channel blocker nifedipine or the alpha-sympathetic blocker phenoxybenzamine was assessed in 59 patients, 12 with early stages of CRPS, 47 with chronic stage CRPS. In the early stage CRPS patients, 3 of 5 were cured with nifedipine and 8 of 9 (2 of whom had earlier received nifedipine) with phenoxybenzamine, for a cure rate of 92% (11 out of 12). In the chronic stage CRPS patients, 10 of 30 were cured with nifedipine; phenoxybenzamine cured 7 of 17 patients when administered as a first choice and another 2 of 7 patients who received nifedipine earlier, for a total late stage success rate of 40% (19 out of 47). The most common side effects necessitating discontinuing the drug were headaches for nifedipine and orthostatic dizziness, nausea and diarrhoea for phenoxybenzamine. All male patients on phenoxybenzamine experienced impotence, but this did not lead to discontinuing this agent and immediately disappeared after stopping the drug. These results once again stress the importance of early recognition of CRPS, and treatment with either of these drugs could be considered as a first choice for early CRPS, especially because in this series this treatment was not combined with physical therapy making it very cost-effective. In the chronic stage of CRPS, treatment with these drugs was much less successful (40%), even though it was always combined with physical therapy, but it can still be considered, either as a first choice or when other types of treatment have failed.

PMID: 9107464 [PubMed - indexed for MEDLINE]
from http://www.ncbi.nlm.nih.gov/pubmed/9...ubmed_RVDocSum

Of course, the trick here is for accurate early diagnosis!
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