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 05-12-2009, 08:43 PM #31
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Originally Posted by fmichael View Post
Hi. This is first an aside to michelles's last post. I too walked around for over 2 years in "ankle foot orthotics" that corrected for the bilateral injury to tendons in my feet on some gym equipment that resulted in CRPS in both legs, before a podiatrist of all people told me to get rid of them, that the immobilization of the ankles was doing me more harm than good. And he was right. Pain that had been regularly at a 9 by early afternoon was down to more managable levels.

So I worry about you wearing a fixed boot all day, especially where you report that your foot is already frozen. That said I realize that, in Idaho, you don't have the same luxury that I have in So Cal., to spend most of my days in sandles.

Now, to SunshineGirl and everyone else, a couple of general points that should be made about CRPS in the feet. First of all it's impossible to overstate how important P.T. can be: I didn't realize how much my feet had constricted into something approaching a fist until I was being worked over (gently) by a physical therapist. Something I can't recommend enough, just avoid anything that comes under the heading of "strength training" like the plague.

Secondly, there are a couple of somewhat novel treatments that SunshineGirl and others should be aware of. I've gotten great benefit in term of the worst of the deep "bone crushing" pain from period infusions of a drug called Zometa, which is a new and imrpoved version of Pamironate, in a family of drugs called bisphosphonates, originally used to prevent the uptake in the blood stream of bone tissue in patients with multiple myeloma. If anyone wants an article to show their doctor, take a look at "Efficacy of Pamidronate in Complex Regional Pain Syndrome Type I," Robinson JN, Sandorn J, Chapman PT, Pain Med. 2004; 5: 276-280, and available for free download off the RSDSA website at http://www.rsds.org/2/library/articl...e_Robinson.pdf. But a note of caution, it is associated with the death of jaw tissue in people who need serious dental work, like root canal, so I know that my pain doc. at least required a sign-off from my dentist, to the effect that I was in good dental health, before we could procede.

The second treatment -- one that I could never have because my RSD is bilateral -- is something called "Mirror Therapy and Graded Motor Imagery." For a quick summary, check out this piece written for lay people in the Spring 2008 issue of the RSDSA Review: http://www.rsds.org/1/publications/r...pring2008.html Basically, it involves putting a mirror between you and the "bad" foot, so all the brain sees are two matching "good" feet. You go through a series of exercises moving only the good foot, and people have reported remarkable improvements in only a matter of weeks. I know it sounds way too good to be true, but there's apparently a lot of deep neuroscience behind this.

Good luck!

Mike
i wish i had all of you with me in my home.. i need the strength to have someone put on a shoe for me.. my husband knows i hurt and he will see me cry and he trys to push me but then i yell at him and he will walk away, i have tried to put a shoe on every week i try but the pain is so bad that i cant, i sound like a big baby,, but it is really hard for me . and then my head takes over what if someone steps on my foot? what if i trip and hurt my bad foot? all of these things start going through my head so what do i do .. just put the boot back on and know that no one will hurt it. so got a question for anyone of you? who wants to come to idaho falls and go shoe shopping
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Old 05-12-2009, 10:38 PM #32
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Originally Posted by michelles View Post
i wish i had all of you with me in my home.. i need the strength to have someone put on a shoe for me.. my husband knows i hurt and he will see me cry and he trys to push me but then i yell at him and he will walk away, i have tried to put a shoe on every week i try but the pain is so bad that i cant, i sound like a big baby,, but it is really hard for me . and then my head takes over what if someone steps on my foot? what if i trip and hurt my bad foot? all of these things start going through my head so what do i do .. just put the boot back on and know that no one will hurt it. so got a question for anyone of you? who wants to come to idaho falls and go shoe shopping
So, so sorry to hear this. The thought of knowing that you have to go through that agony at a set time every workday must often be overwhelming.

There is one more thing though, and that's the use of topical anesthetics. If you've tried everything available over the counter, I can share something else with you. It's expensive, but some insurance plans will pick it up, Medco for one. It's a "compounded" prescription gel, which is to say that your pharmacist mixes it up for you, pursuant to your doctor's instructions. (Don't even think about going to the chains for this one, it's only done out of mom & pop operations.) Anyhow, the gel I use has as its active components the following: ketamine (10%), gabapentine a.k.a. Neurontin (5%) and lidocaine (5%). I don't have pain to speak of in the morning, but by the time I go to bed my feet are really starting to cook, and this takes it away immediately. According to the pharmacist, it should last for only 15 minutes or so, but it seemed to work for me longer when I was still wearing those awful AFOs. And no, I'm not aware of the ketamine in my system, at this dosage it's effect is purely topical.

This might be worth checking out. PM me if you need any further info.



Mike
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