Saturday, July 24, 2010

A Moment... and a Pause.

I have friends up this weekend.  I haven't seen them in over 5 years.  My best friend and his girlfriend. 
And the ironic part is- my best friend appears to be suffering from RSD. 
The doctors diagnosed him with neuropathy this past winter.
Neuropathy: A condition which is characterized by a functional disturbance or pathological change in the peripheral nervous system.
But after we discussed both our pains and experiences over the past years, it became apparent to me that it sounded more than just neuropathy to me. Could he possibly be suffer from RSD?

I checked my favorite link for an article that compared the pain of diabetic Neuropathy and RSD-
The neuropathic pain of Diabetic Neuropathy is the sole manifestation of this painful Neuropathy. The painful Neuropathy is accompanied by not only burning pain, but also stabbing and electric shock type of pain because in both diseases (Diabetic Neuropathy and RSD) neuropathic pain causes damage and electric short in the nerve fibers. This is the reason anticonvulsants (especially Tegretol) are so effective in both diseases. Obviously, Tegretol has to be non-generic. Carbamazepine, which is the generic name of Tegretol, does not do any good for either condition. Neurontin is also not as effective as the true, brand-name Tegretol. The neuropathic pain also causes temperature changes in the extremities in both diseases.

2. However, the RSD requires three other conditions to meet the minimum requirement of diagnosis of RSD. In other words, simple neuropathic pain is not enough for the diagnosis of RSD.

3. The other three conditions, other than the neuropathic pain, are:

A. Reflex constriction of the muscles in the extremities in the form of flexor spasm, dystonia, tremor, or weakness of the extremities due to muscle spasm (Orbeli phenomenon).

B. Inflammation in the form of edema, swelling of the extremities, skin rash in the referred pain area away from the nerve damage, and neurodermatitis in the referred pain areas away from the nerve damage.

In addition, in RSD the inflammation can cause trophic changes of the skin and hair, as well as inflammation of pain in the synovia and bursa of the joints. Such changes are usually not seen in simple Diabetic Neuropathy. So, if there are the above mentioned manifestations of inflammation, then were are not dealing with simple Diabetic Neuropathy, but the complication of RSD.

C. The disturbance of the limbic system in RSD is more persistent and more resistant to treatment with anti-depressants.

The symptoms in yellow were ones we shared, and knew we both shared, and could be either diagnoses.  The ones highighted in red, though, were things he discussed with me that made me consider otherwise.  He has only seen a foot specialist, lost his job, and is waiting for SSI to kick in.

Hopefully he can get to see a pain management doctor.  He is only taking anti-seizure medication for the pain, and wearing 'New Balance' shoes, as recommended by his doctors.  His insurance will not approve Lyrica.

For now, I am letting him use my TENs unit... and we are both getting some relief from our pain.  It's nice to catch up with old friends, no matter how you feel.  I feel like a teenager again... and then I fell old... and that's okay too.  I have a smile on my face.

1 comment:

  1. Excellent post although to hear of another person being diagnosed with RSD is awful.