RSD - Nothing Left To Chance

Whether you call it Reflex Sympathetic Dystrophy Syndrome or Chronic Regional Pain Syndrome - it's still a hideous soul-sucking disease.

28.5.05

Article - Ketamine Infusion for CRPS

Here is the URL for the article, Multi-Day Low Dose Ketamine Infusion for the Treatment of CRPS that has just been published in Pain PhysicianYou need to have Adobe Acrobat, cut & paste it in your browser:

Multi-Day Low Dose Ketamine Infusion for the Treatment of Complex Regional Pain Syndrome

RSD Hope - Quilt Project Info!

http://www.rsdhope.org/


QUILT - FACES OF RSD NATIONAL PROJECT

WHAT IS THE FACES OF RSD NATIONAL QUILT PROJECT?
WHAT INSPIRED THIS PROJECT?
DETAILS ON TAKING PART IN THE PROJECT
WHERE DO WE SEND IN OUR PICTURES AND QUILT PIECES?
QUILT PROJECT PERFECT FOR GROUP MEETINGS!
WHEN IS THE PROJECTED DATE THE QUILT BE DONE?
ONCE FINISHED, WHO CAN USE THE QUILT?

20.5.05

Oregon folks - we need your help!

IF YOU LIVE IN OREGON OR HAVE FRIENDS OR FAMILY RESIDING IN THAT STATE, WE NEED YOUR HELP! Please read below. Thank you.

The chairman of the Oregon House Committee on Health and Human Services, Rep. Billy Dalto,
will hold a hearing on the RSD Awareness bill, HB 2414

What does this mean?

At least we have an opportunity to have legislators hear our concerns about how health care providers often do not know about RSD, about how to treat it, etc. It means that there is a chance that we can still pass this bill on to become a law.

Right now we need People Power!

Contact Rep. Dalto to express your support of HB 2414. (contact info below)

You can email, FAX, write, or call him. Ask your friends, family and neighbors to help out as well. Below are some things you can include. Don't make it too long or it won't get read.

Or, you can simply say: "I support HB 2414 on RSD Awareness."

You can also contact the committee members to express your support, but only if you live in their district- see the list below.

Reasons to Support HB 2414 to Promote Awareness and Education about RSD About RSD (Reflex Sympathetic Dystrophy)

RSD is a severe neurological disease that can result in intractable pain and permanent disability. The pain of RSD is rated on the McGill Pain Index as 42. (Cancer pain is rated at 28.) If RSD is treated properly in the early stages, the prognosis can be good proper treatment, the results are usually devastating and irreversible.

Why Oregon needs HB 2414

1-Educate Healthcare Practitioners:
Most healthcare practitioners in Oregon do not know about this disease.
Most patients have to explain their disease to practitioners.
Most patients do not receive the proper treatment.

2-Help DHS obtain grant money:
We understand that the Oregon budget does not have the funding for these efforts, so this bill will likely help the DHS in obtaining grants to educate Oregon practitioners and the public, facilitating early diagnosis and proper treatment.

3-Save Oregon money:
A-RSD is relatively common amongst worker compensation patients.
B-When RSD is not treated properly, many patients can't work anymore, and must seek public assistance.
C-When RSD is not treated properly, many patient must obtain disability assistance.

4-Save lives:
Suicide is relatively common amongst RSD patients due to the pain and the accompanying symptoms and circumstances these people, having a knowledgeable and supportive healthcare team can make the difference between life and death.

Helpful Websites:
http://www.rsds.org/

http://www.rsdsa-ca.org/

Rep. Billy Dalto of Salem
Email: rep.billydalto@state.or.us
Phone: 503-986-1421
Fax: 503-986-1347
Address: 900 Court St. NE
H-291
Salem OR
97301

You can also contact the committee members to express your support, but only if you live in their district. So, if you live in any of these districts, we strongly encourage you contact them:

Representatives Tom Butler of Ontario,
Carolyn Tomei of SE Portland/ Milwaukie,
Gordon Anderson of Grants Pass,
Deborah Boone of Tillamook,
Kevin Cameron of Salem, and
Mitch Greenlick of NW Portland.

How to contact your state legislators
For all of the legislators in your district, go to:
www.leg.state.or.us/writelegsltr/

Write to members of the Oregon House and Senate at: http://www.leg.state.or.us/writelegsltr/writeset.htm

View bills in process at: http://www.leg.state.or.us/searchmeas.html

See Current schedule of public meetings and events at: http://www.oregon.gov/index.cfm?CurrPID=665

Streaming A/V of floor sessions & many committee hearings at: http://www.leg.state.or.us/listn/listenset.htm

View current laws at: http://www.leg.state.or.us/bills_laws/home.htm and type in the subject.

13.5.05

A great media article on RSD/CRPS!

Chronic sufferers push for awareness

'Idol' judge draws attention to cause

BY WILLIAM MOYER
Press & Sun-Bulletin

The burning pain can attack with a red-hot intensity that feels like the skin is ablaze.
"It's like you take lighter fluid and set yourself on fire," said Cheryl English, a 45-year-old Vestal resident who suffers from Complex Regional Pain Syndrome/Reflex Sympathetic Dystrophy Syndrome. "It's a burning pain that doesn't go away."

American Idol judge Paula Abdul recently put the disorder on center stage when she attributed her erratic behavior on the televised show to the disease, not drugs as some had said. Abdul, 42, said she has suffered from chronic pain for 25 years, after a cheerleading accident and several automobile accidents. Abdul was diagnosed in November, she said, and medication has helped managed the pain.

The disorder is life-changing.

"You're forever living around it because you can't go anyplace," said English, a wife and mother of two grown children. "You live with it; you don't control it. The disease controls you."

Since she was diagnosed about 13 years ago, English has gone from an active life that included sports, dinner and dancing to sedentary nights of watching the family's wide-screen television. Sometimes, she stays in bed all day because the pain rules her world.

CRPS/RSDS is a neurological disorder characterized by burning pain, pathological changes in bone and skin, excessive sweating, tissue swelling and extreme sensitivity to touch, according to the Reflex Sympathetic Dystrophy Syndrome Association in Milford, Conn.

The disease can arise after a major or minor trauma. That could be an ankle or wrist fracture, heart ailment, infection, surgery or spinal injury. Without warning, the first attack often paralyzes its victim with pain described as burning, throbbing, aching, stabbing, tingling or crushing.

Essentially, nerves go amok.

"It's normal for your sympathetic nerves to react to pain," said Dr. Kevin L. Hastings of Osteopathic Pain Management Services in Vestal. "What's not normal is for (the nervous system) to take on a life of its own that continues long after the injury."

As the disorder progresses, the potentially debilitating pain can spread throughout the body, regardless of the trauma's original location. The slightest touch, even a mild breeze from an open window or air conditioner, and loud noise can trigger excruciating pain.

About one million people in the United States suffer from the disease, according to the RSDS association. So far, the disorder can be only managed, not cured, the association said. For unknown reasons, the syndrome affects twice as many women as men, according to the Center for Rehabilitation of Pain Syndromes at UCLA.

Hastings said a diagnosis can be difficult because physicians don't have a single, simple test to confirm the disorder, although a bone scan can give some indication of whether CRPS/RSDS is causing a patient's extreme pain.

Taking a toll

The flu and a nightmarish scream unexpectedly introduced a Unadilla family to CRPS/RSDS in February 2002.

Laurie Rowe's daughter, Brittany, went to bed about 9 p.m., a few nights after recovering from a bout with the flu. About 90 minutes later, Laurie heard frantic screams from her daughter's bedroom.

There, Laurie saw Brittany rolling in pain. Her right knee was red-hot and swollen about five times its normal size, Laurie recalled. On a scale of 1 to 10, Brittany pegged the pain as "off the charts." Within hours, the pain and swelling had subsided, but the family's search for a cause had only begun.

For months, the Rowes scrambled from doctor to doctor, including specialists at well-known East Coast medical centers and teaching hospitals, for a definitive diagnosis. Some mentioned CRPS/RSDS, but no one confirmed the diagnosis, Laurie said.

Brittany's attacks continued, spreading from her right to left knee and elsewhere. The pain became a daily grind, although Brittany, now 15, endured and went to school daily with the occasional aid of crutches or a wheelchair.

Finally, the family got an "official" culprit when an Oneonta-based physician used the words Reflex Sympathetic Dystrophy Syndrome to describe Brittany's condition at a November 2003 examination.

"I was stunned to silence," Laurie said. "I couldn't say anything. We had waited (almost) two years for a diagnosis."

Brittany takes an antiseizure medication and over-the-counter painkillers. Despite the pain, the freshman gets honor-roll grades at Unatego High School, sings in the chorus and played a minor role in a play.

Cheryl English's introduction to RSDS began in 1991 after she hurt her left hand while working in a company cafeteria.

After the injury, her left shoulder unexpectedly locked. From there, English trudged from doctor to doctor, seeking a medical explanation.

Along the way, she endured countless tests and treatments, including nerve blocks and a spinal cord stimulator. Nothing relieved the pain.

At one time, English took 27 pills a day, which led to various allergic reactions. Today, she manages the disorder with an anti-anxiety medication and holds to a low-stress lifestyle.
By most standards, though, life with CRPS/RSDS is anything but normal for English and her husband, Bill.

"The simple is magnified a thousand times," said Bill English, 47, a New York State Gas & Electric Corp. employee. "We don't have a life like everyone else. We know that this thing could attack at any moment."

Cheryl and Bill, who've been married for five years, don't plan vacations. In a perfect world, they'd like to attend B-Mets' or B-Senators' games, but do so knowing they might need to leave if Cheryl gets an attack. That's happened several times.

Bill handles most of the household chores, grocery shopping and yardwork.

"It runs everything; you can't plan anything," said Bill, whose health insurance has covered Cheryl's medical care. "You want to do something about it, but all I can do is just stand back."
Ditto for Laurie Rowe and her family.

"It's very hard," she said. "It's taken its toll on everybody. Vacations and day trips require special planning."

Search for understanding

Neither family wants pity, but they do want understanding.

They hope Abdul's revelation will make others aware of the disease. CRPS/RSDS is obscure only by ignorance, they said. The disorder was first noted in medical annals during the Civil War, the RSDS association said.

"A lot of people don't understand, including family, so you feel alone," said Laurie Rowe. "People want to hear she's OK, but she's not."

Cheryl English hopes the attention will bring funding for research to find a cure and effective treatments.

"It's a lonely life. My friends don't understand," she said. "I want people to know it's a real disease."

Gannett News Service contributed to this report.
http://www.pressconnects.com/today/news/stories/ne051305s166209.shtml


12.5.05

I declare...!

Glendale, California Proclaims May as Reflex Sympathetic Dystrophy Awareness Month

May is Reflex Sympathetic Dystrophy Awareness Month in California.

Please note that May is Reflex Sympathetic Dystrophy Awareness Month in California. Dana Wilson, RSD survivor for five years and Co-Facilitator of the only Los Angeles County RSD support group, will be accepting a proclamation at the Glendale City Council meeting on May 24, 2005.

Other cities we have recently had proclaimed in California are Del Mar, Burbank, Sunland-Tujunga, and Los Angeles. We're going to keep going until we have all the cities in California and grow the circle of awareness.

Abdul puts syndrome in spotlight

Paula Abdul says she endured complex regional pain syndrome for years before she got the right medication.

By Elizabeth Weise, USA TODAY

American Idol judge Paula Abdul has come forward to say she has been battling an obscure, difficult-to-diagnose pain syndrome for the past 25 years. That publicity has raised hopes that the condition, called complex regional pain syndrome, may finally get the medical recognition it deserves.

Abdul, the focus of controversy this season because of allegations of an inappropriate relationship with former contestant Corey Clark, made the announcement last month. She said her occasionally hyper-animated behavior on the show was caused by her joy at finally being pain-free.

But no matter the questions surrounding Abdul, the condition is very real.

First described by a doctor treating soldiers with cannonball injuries in the Civil War, the syndrome has gone by many names over the past 150 years: Causalgia in soldiers, reflex sympathetic dystrophy syndrome in civilians, and today, complex regional pain syndrome (CRPS) types I and II.

CRPS happens when an injury to a nerve, often on the hands, feet or legs, causes the nervous system to begin behaving erratically. It frequently spreads from a single injured digit to the entire arm, leg or throughout the body.

The sympathetic nervous system — the fight-or-flight nerves — is "trying to heal itself and it gets confused," says Pamela Palmer, who directs the pain management center at the University of California-San Francisco. "It starts sending out chemicals that hyperactivate the regular nervous system."

Symptoms typically show up about a month after the initial injury. Instead of getting better and being in less pain, the patient feels more pain.

For many patients, it takes months, if not years, to get an accurate diagnosis. During that time, they're frequently told that "it's all in your head," says Tom Looker of Winchester, Va. A former immigration agent, he fell down an embankment 20 years ago and has been in pain ever since.

The syndrome's hallmark is agonizing, burning pain. In the worst cases it can attack the bone, skin and muscle, leaving patients with useless, withered and extremely painful limbs.

For reasons that are unclear, the syndrome affects women twice as often as it does men, says Joshua Prager of the Center for Rehabilitation of Pain Syndromes at UCLA.

Doctors don't yet know why it happens, and they don't know why it happens to some people and not others. What they do know is that early and aggressive treatment — within the first three months — is the key to stopping it.

Treatments include anesthesia injections to block the sympathetic nervous system and, in extreme cases, insertion of a catheter so continuous doses of anesthesia can be administered. For some patients, electrical stimulators are implanted in their spines to block the pain.

But the end goal is not pain relief but to get patients comfortable so they can start moving again.

"The core of treating these patients is 'Use it or lose it,' " says James Rathmell, a professor of anesthesiology at the University of Vermont. "You need to use the limb — no matter how painful — because otherwise you'll lose function."

http://www.usatoday.com/news/health/2005-05-11-abdul-pain_x.htm

11.5.05

Who decides policy for pain patients?

OxyContin maker says Lynch bill a real pain
By Ann E. DonlanSaturday, May 7, 2005

The makers of the chronic pain medication OxyContin vowed to fight a Bay State congressman's bill that would outlaw the drug in the U.S. because of the rate of addiction and overdose deaths.

``We absolutely share a concern that the illegal use of this drug is a serious problem in the Boston area,'' said Robin Hogen, vice president of public affairs for Purdue Pharma, the maker of OxyContin. ``It is not however a national problem. If you take it off the market because it is being abused . . . you're really allowing criminals to dictate health care policy.''

U.S. Rep. Stephen F. Lynch (D-South Boston) has filed a bill seeking to pull the controversial drug from the market, a move that prompted many medical professionals and patients taking the drug for chronic pain, to express alarm.

``It has revolutionized comfort for many of my patients,'' said Marybeth Singer, a nurse practioner at New England Medical Center who works with cancer patients.

Singer said the drug, which several patients praised yesterday because they say it is the only way they can live with chronic pain and still work and enjoy their families, is ``a very useful drug when used appropriately.''

But when it's not used as directed, the time-release drug, if crushed and then injected or snorted, can deliver an almost immediate heroin-like high that is highly addictive.

Hogen predicted that Lynch's mailbox and phone lines would be jammed from health care specialists and patients who oppose his proposed ban.

Here is his offical website:
http://www.house.gov/lynch/

9.5.05

Pain Articles in USA Today

The ABC News/USA Today series on chronic pain has begun:

Living with pain

Chronic pain: The enemy within
http://www.usatoday.com/news/health/2005-05-08-chronic-pain-cover_x.htm

Kids' distress is no small thing
http://www.usatoday.com/news/health/2005-05-08-kids-pain_x.htm

Here is the URL for the second day of the series on pain in USA Today

http://usatoday.com/news/health/pain-series.htm

If it won't load in your browser, just go to:
www.usatoday.com
and a link is on the front page.

Pain beyond endurance...

Dealing with pain beyond endurance
By Kimm Groshong Staff Writer

PASADENA -- It's been four years since Dana Gambill accidentally struck her right ankle on the metal seat track of her car.

What at first seemed like a smarting sprain, a fluke incident, led to years of excruciating pain, a months-long search for a diagnosis, loss of Gambill's lifestyle and, most recently, a new sense of purpose.

Today, Gambill is coordinator of the National Awareness Campaign for the disease that took over her life, a chronic pain disease called reflex sympathetic dystrophy, or RSD. She also heads up the only RSD support group in Los Angeles, which meets once a month in Pasadena.

Gambill says her work with RSD advocacy "helps me get out of my pain... for any of us, being of service helps us get out of ourselves."

Pop star Paula Abdul has recently begun discussing her 25-year experience with RSD. Now, other patients and pain management doctors hope the celebrity's activities will shed some light on the still largely unheard of disease.

Despite the relative obscurity of the debilitating nervous system disease, the Reflex Sympathetic Dystrophy Syndrome Association estimates between 1.5 and 6 million Americans currently live with RSD's pain.

Edward Carden, director of Southern California Academic Pain Management in Santa Monica, said he sees three or four new RSD patients a week. The reason more physicians don't know about the disease is "medical schools never taught the disease," he said. "The simplest thing for them to do is for the physician to say the patient is crazy and send them to a psychiatrist."

RSD, also known as complex regional pain syndrome (CRPS), type 1, normally sets in following an injury or surgery. It often goes undiagnosed or misdiagnosed for months or years. Symptoms vary from patient to patient, but it is characterized by pain out of proportion with the injury that triggered it.

The bodies of RSD sufferers are basically continuously responding to pain signals, which become imprinted in the nervous system over time. "You learn how to feel a pain the more you feel it," said Joshua Prager, director of the California Pain Medicine Centers at UCLA and an RSD specialist. "The more chronic it is, the more autonomous and spontaneous it becomes. It almost takes on a life of its own."

RSD patients describe the continual pain of the disease as a deep ache and cold or hot burning in the injured area. The skin there often becomes extremely sensitive to touch, discolored and puffy.
Within weeks of Gambill's injury, she had many classic symptoms of the disease but lacked the doctors to properly diagnose RSD. Some of the physicians she saw diagnosed fracture, others tendinitis, prescribing Advil and Aleve, which did little for the pain.

"I was in so much pain, it was just unbelievable," Gambill said. "I, in my gut, knew it was something else. Something else was going on and this doctor wasn't listening to me."

For five months, she lived with the deep achiness, weakness, extreme temperature changes and bluish color in her foot before a foot and ankle specialist diagnosed her with RSD and began treating her for the debilitating disease.

Time is of the essence for RSD sufferers. There is a three- to six-month window of opportunity following onset of the disease during which treatments are much more successful than they are likely to be later, experts say.

"With early diagnosis and aggressive, multidisciplinary treatment, it can go into remission," Prager said. He said many of his patients get rehabilitated and can even return to work. "It's something that we can treat, but we cannot treat it if it is not properly diagnosed and sent to the appropriate specialists."

The treatment plan for RSD patients involves pain management, psychological treatment and rehabilitation, largely through physical therapy. Prager, whose RSD patients go through a four-week "RSD Camp," said physical therapy is the mainstay of the treatment, but "the patient has to be reasonably pain free at the time of physical therapy," and that's where medication and treatments like nerve blocks come in.

Since her diagnosis, Gambill has had about 45 nerve blocks, which were once very helpful in her fight against pain and have become less effective with time. The disease has spread to her right arm and hand and she has a spinal cord stimulator implant that helps ease that pain.

Prager said in many RSD cases, patients' brains change with the disease. Functional MRI studies have shown that an area of the brain associated with emotion, including depression and anxiety, often becomes activated in longer-term RSD patients.

Cynthia Toussaint, a former ballerina who developed RSD when she was 21 years old, now runs an organization called For Grace. She was misdiagnosed for 13 years and today uses a wheelchair and has a morphine pump implant. She and her partner, John Garrett, created For Grace named for the daughter Toussant will never have now, recognizing the need for quality information about RSD and advocacy.

Toussaint said RSD is known as "the suicide disease" because of the depression it's associated with and the fact that it has caused so many patients to take their own lives, having lost hope that the pain will ever subside.

Often adding to that depression is the fact that many RSD patients are abandoned or disowned by friends and family members who cannot cope with a loved one living with the sometimes mysterious pain RSD inflicts. Also, many patients like Toussaint are told by their doctors that the pain is all in their heads.

Gambill's National Awareness Campaign is an outgrowth of For Grace and is a messaging support and encouragement board for RSD sufferers and their family and friends. It's also a place to share ideas for awareness projects. Gambill encourages those who want to start RSD support groups like hers.

In February, 17-year-old Lucia Jimenez and her parents attended their first meeting of Gambill's support group. Lucia had been dealing with RSD pain since August when she was hit by a bicyclist and developed the burning pain, coldness, discoloration and sensitivity of RSD in her right leg.

She relied on crutches for a while but when the disease spread to her left leg, she had to begin using a wheelchair. Eventually, Lucia had to begin homeschool. Her father, Byron, had to take off work most days of the week as Lucia's pain worsened.

Her mother, Esther, said after months of doctors bouncing Lucia around, without a proper diagnosis or effective treatment, she would cry to herself in the shower, not wanting to worry her daughter and other children. Finally, one night, researching on the Internet, she found what she called a "Godsend" -- information about RSD symptoms and a notice for Gambill's support group.

The support group immediately recognized Lucia's RSD symptoms and suggested some pain specialists.

Just two months later, Lucia walked into the April support group meeting. Wearing jeans and a T-shirt, with iPod in hand, she looked as healthy as an average high school junior. A specialist had diagnosed her and given her two nerve blocks.

"As you guys can see, I'm walking," she told the group as they went around the circle sharing positive notes from the week. For the Jimenezes and the group, that was reason enough to smile.
Dana Gambill's RSD support group meets on the fourth Saturday of every month from 4 to 5:30 p.m. at the Lake Avenue Church, 393 N. Lake Ave., Room 202. For more information, call (626) 755-0105 or e-mail designforliving@earthlink.net.

For more information about RSD, For Grace or the National Awareness Campaign, see http://www.forgrace.org.

-- Kimm Groshong can be reached at (626) 578-6300, Ext. 4451, or by e-mail at kimm.groshong@sgvn.com
http://www.pasadenastarnews.com/Stories/0,1413,206%257E22097%257E2859600,00

5.5.05

A great resource page!

http://www.ux1.eiu.edu/~cfthb/RSD/

**********************************
The ACPA
The American Chronic Pain Association (ACPA), founded in 1980, is a non-profit, self-help organization that offers educational materials and peer support groups to help individuals liver fuller lives despite their pain. The ACPA is dedicated to raising awareness about issues of living with chronic pain among the healthcare community, policy makers and the public-at-large. The organization now has hundreds of chapters/support groups in the U.S. and internationally. Chapters must be run by individuals with chronic pain. Meetings are free and open to anyone with chronic pain. Individuals do not have to join the organization to come to meetings but, if you do join you receive an excellent quarterly newsletter and a pain management workbook.

http://www.theacpa.org/

No cure for me...

Paula Abdul disease could help battle neurological disorder

GENESEE COUNTY - THE FLINT JOURNAL FIRST EDITION
Sunday, May 01, 2005


By Rose Mary Reiz
rreiz@flintjournal.com • 810.766.6353

American Idol judge Paula Abdul's recent announcement that she suffers from a little-known neurological disorder could be a mixed blessing for those battling the same disease.

"I'm already calling it 'the Paula Abdul disease,' " said Cynthia Toussaint of California, a former ballerina who suffers from Reflex Sympathetic Dystrophy (RSD), a chronic disorder that causes severe, debilitating pain.

"I've been on the phone with Paula Abdul's publicist, because there's so much Paula could do to help other people with this," said Toussaint, the founder of For Grace, a nonprofit organization devoted to raising awareness about RSD. '

"She could make RSD a household name."

Abdul, 42, has said she was diagnosed with RSD in November after a series of accidents triggered severe pain. The disorder is characterized by unrelenting pain following an injury.

Added to the physical pain of RSD is the emotional pain of not being believed. Most doctors are unfamiliar with the disorder and Toussaint, like many RSD patients, was dismissed for years by physicians who told her the problem was "all in your head."

Improperly diagnosed and treated, the condition can cause permanent, irreversible damage. In Toussaint's case, she lost her career and her mobility to the disease.

"I spent nearly a decade of my life bedridden, writhing in pain, thinking about suicide," said Toussaint, who is confined to a wheelchair. "I still have days when I don't know how I'm going to get through the next minute."

Toussaint's experience with RSD is more typical than that of Abdul, who says she finally is pain-free after treatment.

"Four out of five people with RSD don't ever return to their former activities," said Jim Broatch, executive director of the Reflex Sympathetic Dystrophy Syndrome Association.

Broatch is hopeful that Abdul's announcement will bring attention to what he calls "our little-known, under-diagnosed syndrome." But both he and Toussaint are concerned that the public will see how well Abdul is doing and discount the severity of the disorder.

"I hope her case doesn't make other people with RSD feel like failures because they're not cured," Toussaint said. Perhaps Abdul's case shows what can result when a patient is believed by doctors and gets excellent, early care, she added.

"Unfortunately, I'm the example of the dancer who was not believed and didn't get care in time."

2.5.05

Links

About RSD Information of Reflex Sympathy Dystrophy, a debilitating disease of the nervous system that causes chronic pain, is progressive and cannot be cured.
http://www.aboutrsd.com
American RSDHope A non-profit organization providing information for medical professionals, patients and families. Features newsletters, submitted poetry, and details of support programs. http://www.rsdhope.org/
Australian RSD Support Group Contains references for RSD patients, including treatment, diagnosis and support information, as well as pictures and an icq contact list.
http://www.ozemail.com.au/~ozrsd/
Canadian RSD Network Non-profit, education and support group offering archival material, news, stories of hope and links.
http://www.canadianrsd.com/
Complex Regional Pain Syndrome Patient information from the American Academy of Family Physicians.
http://familydoctor.org/238.xml
CRPS Chatville Forum offers answers and support to patients with this condition and related disorders.
http://crpschatville.proboards19.com/
Difficult to Manage Pain Of Reflex Sympathetic Dystrophy Article explaining possible treatments.
http://healthlink.mcw.edu/article/1020192036.html
Donald A. Rhodes Information on diagnosis, treatment, and research on RSDS.
http://members.aol.com/drrhodes2/RSDS.htm
For Grace - Changing the World of RSD A nonprofit organization passionately devoted to raising awareness of Reflex Sympathetic Dystrophy in the medical community and general public. Events, information, and resources.
http://www.forgrace.org
HELPRSD Dedicated to helping victims of Reflex Sympathetic Dystrophy and insuring that doctors and elected officials are made aware of RSD and it's symptoms such as chronic pain.
http://www.freewebs.com/helprsd/
International Reflex Sympathetic Dystrophy Foundation Delivers information resources, puzzles, studies, articles, surveys and FAQS.
http://www.rsdinfo.com/
International Research Foundation for RSD/CRPS Clinical guidelines for treatment of Reflex Sympathetic Dystrophy, physician and patient resources, scientific advisory to governments and doctors worldwide. Multilingual site.
http://rsdfoundation.usf.edu/
Jim O'Donnell's RSD/CRPS Site This site contains information and comfort for those experiencing Reflex Sympathetic Dystrophy.
http://rsdcrps.com
My Child and RSD Mothers view of watching her child cope with RSD/CRPS. Diary, links of information and personal poems.
http://www.angelfire.com/tx/brattybrat/RSD.html
Neurological Associates Pain Management Center Information about this Florida based practice and practioners. Contains education material for RSD/CRPS patients and members of the medical community. Includes RSD puzzles and articles.
http://www.rsdrx.com/
Neurovascular Dystrophy in Feet due to Frostbite Case History: major post traumatic Neurovascular Dystrophy in feet and lower legs resulting from severe frostbite, cold injury and toe amputation.
http://rpm.spinn.net/FootPain.htm
Pain Management Center Comprehensive program that includes treatment options for patients with RSD, trigeminal neuralgia and chronic pain. A look at the center itself as well as the specific treatments offered.
http://www.clevelandclinic.org/painmanagement
Pain Pal's RSD Support Offers information, support by providing a daily digest, message boards, chat rooms, media campaign and RSD database.
http://www.angelfire.com/me2/rsdpainpals/
Promoting Awareness of RSD/CRPS in Canada PARC supports, provides information and referrals to those with this disorder. Features free radical scavenger treatments, latest research and photon therapy.
http://people.becon.org/~rsdinfo
Reflex Sympathetic Dystrophy Personal page by a sufferer of this condition, including links and stories of others with RSD.
http://hometown.aol.com/dale2tammy/
Reflex Sympathetic Dystrophy RSDS and CRPS site offers information, links to related RSD sites and UK listings for general practitioners, consultants and hospitals. Link to join a Yahoo group for email and chat.
http://uk.geocities.com/tonymasoncoleman/
Reflex Sympathetic Dystrophy Hub A brief definition, followed by links to research articles, overviews, case studies, support groups and associations.
http://www.projectlinks.org/rsd
Reflex Sympathetic Dystrophy Syndrome Information page compiled by NINDS, the National Institute of Neurological Disorders and Stroke.
http://www.ninds.nih.gov/health_and_medical/disorders/reflex_sympathetic_dystrophy.htm Reflex Sympathetic Dystrophy Syndrome Association of California Details about this nonprofit organization that provides medical information and resources on RSD and CRPS.
http://www.RSDSA-CA.org
Reflex Sympathetic Dystrophy Syndrome Database
A completely searchable database of all known RSD/CRPS sites from many countries.
https://www.quickbase.com/db/68b9q3hq
Reflex Sympathetic Dystrophy UK Online Support Group Aimed at patients, carers, friends, relatives and professionals. Includes information, links, stories, hints, tips and an email group at Yahoo.
http://www.rsd-crps.co.uk
RSD Alert Information about Reflex Sympathetic Dystrophy Syndrome, including personal experience, data and links to support groups. For sufferers and all active people who are at risk.
http://www.rsdalert.co.uk
RSD Canada Offers information on the latest treatments, research, survival tips, RSD coping advice and photon therapy.
http://www.rsdcanada.org
RSD Helpline Support Group Designed to support those who are dealing with all issues related to Reflex Sympathetic Dystrophy.
http://groups.msn.com/RSDHelplineSupportGroup
RSD Hope Teen Corner A support group for children and teenagers with Reflex Sympathetic Dystrophy. Includes a message board, chat room and a writers corner.
http://www.angelfire.com/wi/rsdhopeteens/
RSD Site UK Personal page from a sufferer of Reflex Sympathetic Dystrophy/Complex Regional Pain Syndrome.
http://www.rsdsite.com
RSD Won't Bring Me Down A place for RSD suffers, as well as loved one's of the afflicted, to receive love, understanding, and support. Features message boards and a chat room.
http://groups.msn.com/RSDWontBringMeDown/
RSD/CRPS for Southern New Jersey and Other Areas Support site for those suffering from Reflex Sympathetic Dystrophy. Includes links, a personal story, great doctors and a message board.
http://www.angelfire.com/nj2/RSD1
RSD/CRPS World News Group Daily updates on new sites, medicines, proceedures and papers on the subject. People can submit features, columns and writings.
http://groups.yahoo.com/group/RSD-WorldNews
RSDHope College Quad A site built by and for college students suffering from Reflex Sympathetic Ddystrophy. Read stories from sufferers and get advice from those who are dealing with this disease.
http://www.angelfire.com/biz5/rsdgimps
RSDS HOPE Non-profit organization that concentrates on increasing awareness of the RSDS community, holds a local monthly support group meeting to share thoughts, discuss alternatives and ideas. Contact information, staff, links to related sites.
http://www.rsdshope.com
RSDS/CRPS for the Southwest of the UK Includes an introduction, facts and fiction, new research and links.
http://www.angelfire.com/weird/health12/
Support For RSD/CRPS sufferers Support and information for sufferers of Reflex Sympathetic Dystrophy and Complex Regional Pain Syndrome. A free to join non-profit making organization.
http://www.rsd-arena.co.uk/
Tony's Reflex Sympathetic Dystrophy How RSD affects the author and links to other sites. Includes stories from other sufferers and support through chat room.
http://www.geocities.com/rsdsiteuk/

Research Article - CRPS

Lessons from the Front
Questions for Lt. Col Chester C. Buckenmaier, III

In the February, 2005 issue of Wired, Lt. Col Chester C. Buckenmaier, III talks about casualties in Iraq. He believes “the future of wartime pain control is a new form of anesthesia called a continuous peripheral nerve block, which takes a more targeted approach by switching off only the pain signals coming from the injured limb, leaving patients' vital signs and cortical functions unimpaired.” Further in the article, it says, “Pioneered in experimental programs at Duke University and St. Luke's-Roosevelt Hospital in New York City, continuous peripheral nerve blocks could transform civilian medicine in the next few years by reducing the incidence of chronic pain…" Further, this technique "will enable patients to take control of their own pain relief at home, with less dependence on addictive pharmaceuticals.” [1]

We were intrigued by this, and asked Lt. Col Buckenmaier, an acute pain specialist at Walter Reed Army Medical Center (WRAMC), about this technique and its potential use for people with CRPS.

Q: Could physicians use regional anesthesia, continuous peripheral nerve blocks, for peoples who have complex regional pain syndrome?
Yes. It is a technique we use at WRAMC to provide patients with a 'pain free interval.' We believe this temporary adjustment in the afferent pain input from the affected CRPS area allows the brain to 'reset,' often resulting in improvement in symptoms when the block is resolved. Currently, this treatment is purely investigational and has not been formally studies to my knowledge. Again, it is a treatment option we employ at WRAMC.

Q: What about using it for other neuropathic pain syndromes?
Regional anesthesia blocks for a variety of chronic pain syndromes are common in chronic pain practice. Though I practice chronic pain medicine, my specialty is acute pain and perioperative medicine. Chronic pain is a clinical, outpatient activity while acute pain is an inpatient hospital activity. We have a close working relationship with chronic pain but our focus is different.

Q: Could this be used as a preventative measure, to keep acute pain from becoming chronic pain?
We know that uncontrolled pain has a number of ill effects on the body- depressed immune function, increased stress response to surgery, up-regulation of inflammatory mediators, to name just a few. We believe that true preemptive pain control (pain management before, after, and long after the surgical insult) has a positive impact on patient recovery and possibly limits the development of chronic pain. You have essentially hit on the fundamental question for regional anesthesia and advanced pain control. Do we impact on morbidity and chronic pain states? We are hoping our Regional Anesthesia Combat Casualty database will help us begin to answer this question. We have the largest cohort of wounded soldiers, many with amputation, who have been exposed to regional anesthesia during their care. We plan to compare these soldiers to other databases with soldiers who did not receive this intervention. This is a fundamental question that the Army Regional Anesthesia & Pain Management Initiative is trying to answer.

Q: Is it appropriate for chronic pain patients? With any modifications?
It is appropriate for a variety of chronic pain patients as one of a variety of therapies. Because it is an invasive technique, it is usually reserved for the most difficult cases.

Q: Have any studies have been conducted on this procedure for long-term pain relief?
Studies are available that have tried to define an impact of regional anesthesia on phantom limb pain following amputation. Results have been mildly encouraging. The biggest problem with these studies in the 'n' number (sample size) of participants is usually very small. Considerable work remains to be done in this field of study. I am hopeful our database will help clarify some of these issues.

Q: Are you seeing many soldiers returning from the war with symptoms of CRPS?
No, CRPS is a rare condition that strikes patients with a variety of injuries. Some people with CRPS have the condition begin with something as simple as an ankle strain. The use of regional anesthesia for the management of CRPS is an interesting footnote; it is not the focus of our organization. We are specifically interested in how pain adversely affects recovery from major surgery (an improvised explosive device that blows off a soldier's leg for example) and how we can improve on pain management in general after surgery. While regional anesthesia is a focus of our organization because it is so effective, it is just a slice of the whole pain management pie. We are the Army Regional Anesthesia & Pain Management Initiative, we are also interested in innovative uses of narcotics, ketamine (and other NMDA receptor antagonists), new nanotechnology pain medications on the horizon, NSAIDS, drug combinations, and true multimodal pain therapy. We are working very hard to improve the experience of our soldiers in the current war to ease the strain of the very successful but difficult evacuation realities facing them after wounding.

[1] Silberman S, The Painful Truth, Wired Magazine, February 2005.13;02:accessed http://www.wired.com/wired/archive/13.02/pain.html?pg=6

http://rsds.org/5/news/2005/buckenmaier.htm

RSD Quilt Info!

This message is from Janice N.

"I AM PRESENTLY MAKING A QUILT THE SIZE OF A FOOTBALL FIELD AND I AM HOPING THAT PEOPLE AFFLICTED WITH RSD WILL SEND ME A PICTURE OF THEM WHEN THEY WERE DIAGNOSED, A BRIEF STATEMENT OF WHAT THEY GO THROUGH ON A DAILY BASIS.

ALSO, I WILL NEED A PIECE OF MATERIAL ONE FOOT BY ONE FOOT, THEIR FAVORITE COLOR AND SEND IT TO ME.

IF ANYONE WOULD LIKE TO HELP ME WITH THIS, PLEASE SEND THE ABOVE ITEMS AS SOON AS POSSIBLE.

THANKS."

(Please send me a message and I will forward Janice's address to you when your quilt piece is cut & your photo is ready. Let's find some nice fabric!)