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My son has CRPS/RSD - need help

post #1 of 18
Thread Starter 
I used to be a regular contributor to basenotes but have been missing for a while. About a year ago, my son developed CRPS also known as RSD. It is a nervous disorder that is rare and has few treatment options. Last year, he injured his big toe while horsing around with friends. His doctor taped it and said it would be OK in a week or so. It got progressively worse. An x-ray showed nothing so it was assumed to be a fractured growth plate. His foot was casted for a month - all the while his pain got worse. An mri revealed no injury and he was diagnosed as having CRPS (complex regional pain syndrome). His autonomic nervous system is telling his brain that his foot is injured and the brain is sending down pain and circulatory responses. His pain is excruciating. Not only can he not use the foot, he cannot touch it with the lightest object. Moving air is too painful for him to tolerate. He cannot go outside. He must remain in a room with the a/c off and windows closed. The slightest air movement sends him into a screaming fit that lasts an hour. He remains on the sofa with his leg elevated over the back of the couch so that nothing can touch his foot from the ankle down. He is severely depressed and has tried to hurt himself several times. He is only 12 and has suffered more than most do in a lifetime. He sleeps for only short periods of time before being awakened by pain.

We tried physical therapy during the early stages of the disorder. He spent a month in a specialized program where they forced him to use his foot despite the pain. Not only did this not help, but he is now extremely anxious about pain which makes further treatment difficult. Since then we have tried spinal blocks, pain killers, reiki, hypnotherapy and biofeedback therapy. Nothing has worked. We can not travel for more than 10-15 minutes because the car windows must be closed, the a/c off and all vents closed. We are at wits end. This has put an extreme strain on our family as well as on our son.

I have spent hours searching the web and found a lot of good information. The best ideas, however, have come from networking. If you have experience with CRPS or RSD please let me know what has worked for you. You may have a "friend of a friend" who has it and this person may have found a treatment.

I appreciate any ideas you might have. I appreciate your kind thoughts and prayers.
post #2 of 18
Setamp, I wasn't familiar with this illness at all until I read your story. It sounds like one of the worst things that can happen to a person - it appears to be such a "small" thing but it clearly has extreme consequences. Do more children suffer from it and have any of them healed successfully? Sorry I can't provide you with help, but let me tell you that I wish him, you and the rest of your family all the best. Keep us posted and take care!
post #3 of 18
Ah, man! That really sucks.

Have no experience with - had never even heard of this condition - but please know that positive vibes are going out to you and your boy. Any parent can empathize, and there are many members here with a medical background - perhaps more help will surface.

It is said that a burden shared is a burden halved - hope this is true for you both and that you will keep us informed.
post #4 of 18
Thread Starter 
The prognosis is very uncertain. Some kids can get total pain relief. Others can achieve tolerable relief. Physical therapy works for some. It did not work for my son and he is now well beyond the point where it can be prescribed. His sensitivity is far to great and his leg has atrophied from disuse for close to a year. Other kids have responded to spinal blocks others to medications. We just haven't found our particular answer yet. There is an experimental treatment in Germany in which people are put into a drug induced coma for a week and given extreme doses of ketomine (special k on the street). When they come out of the coma they can be free of pain. There is an 18 month waiting list to try this. It has a lot of risks, however, and there is a high probability of recurrence.
post #5 of 18
I am so sorry to hear about this. You probably have already done this, but my wife who is a Nurse Practioner asked me if you had gone to see a Rheumatolgist for this.

My thoughts and prayers are with you, my friend.
post #6 of 18
Poor boy indeed!
I'm so sad for you and your family Setamp!!!
Never heard before your post of this terrible desease though. Anyway if I happen to step into some useful info I will let you know absolutely!
Best wishes!
post #7 of 18
I can only offer prayers and good thoughts to you, your son, and the entire family. I hope that some relief can be found ...
post #8 of 18
Sorry to hear about this. I can't imagine what it would be like to go through something like what your son is dealing with. My thoughts are with you guys. Keep us updated.
post #9 of 18
Setamp: I haven't heard of this disease either, I am glad you let us know, though. Perhaps someone will answer who does have experience. I can't think of anything worse than seeing someone you love in pain, I wish there was something more I could do besides sitting in za-zen or praying the rosary . . .

As ' Brother' Theodore used to say: " Dear God, if you exist, please help me! And if you don't exist…help me anyway!"

May your son, your family, and you get all the help you can, as soon as possible,

Mario.
post #10 of 18
My first thought on this is you need a good Pain Management team, especially considering the age of your child.

I know that does not solve the underlying cause of this condition, I have not heard of this one, but I do strongly believe in addressing pain and comfort issues ESPECIALLY in pediatric patients...sometimes it is overlooked depending on your primary care doc.

I encourage you to specifically have this addressed with you primary doctor - if your son can reach some degree of comfort, he will be more able to do what the other practitioners are asking of him.

My son is in hospital with pneumonia and it took several days of him struggling before his chest pain and muscular pain from straining to breathe and the constant coughing was addressed. Not to necessarily fault anyone, there is so much going on sometimes that it takes a while to filter down the various concerns. Once it was addressed, however, with some IV toradol to reduce the inflammation, he did much better with his breathing treatments. Just an example. hope this helps a little.

Keeping you in my thoughts and prayers.
post #11 of 18
Has any medication been prescribed? The depression should surely be addressed because the more episodes and the deeper they get well... I speak from experience.

I have a broken back, post stroke pain, peripheral neuropathy and fibromyalgia with chronic fatigue. Oh yea diabetes too.

PM me and we can discuss some things that work for me for neuropathic pain.

He's so young and I am so sorry to hear about this.

Gary

btw: I found this discussion board. Are you familiar with it?
http://messageboards.ivillage.com/iv-bhrsd

and this Yahoo message board
http://health.groups.yahoo.com/group/RSD-WorldNews/
post #12 of 18
GOOD GOD!!! I'm so sorry! And sorry I've been in absentia from the boards a couple of months!


GET THEE TO A TERTIARY CARE CENTER WITH AN INTERVENTIONAL PAIN CLINIC!!!!



The autonomic chain for lower extremities runs parallel to the spinal cord in the vertebral gutters--a good two inches from the motor/sensory nerve roots and below the end of the actual spinal cord. Your son may benefit from a selective lumbar sympathectomy. I did one as a resident after the fellow dumped a Friday night consult on me. I dx'd RSD (*go me!*) and my supervising attending looked at the fellows, foaming at their mouths, and said, "You eat what you kill." I gave one side to a resident doing six months of pain clinic and the fellows --who'd taken a year off private practice to get the training, stomped and blew to no avail. Your son would only need one side done.

The procedure is done in radiologoy, the patient may be sedated. The needle is placed under flouroscopy and an injection of plain Lidocaine if given to prove proper placement. If the Lidocaine kills the pain and all other functions are left intact, an injectaion of neurolytic phenol is given (or alcohol--but the alcohol is painful but more complete) that disrupts the chain and gives pain relief.

I only did a three month elective of acute pain management (which is why the Friday night chronic pain consult was such a dump.) I don't know how long the pain relief lasts but a year at least if not longer. I don't know what it's like when the nerve recovers or even if they always do recover (I think they do.....) I don't know if a permanent surgical sympathetomy is an option later or if in the last 15 years better agents exist for the injections.

MY PRAYERS ARE WITH YOU.

I'd recommend Cleveland Clinic without hesitation on the east side of the Mississippi because it has a sterling cutting edge rep and because I've been there. There are many other good places I'm sure. Out west, Seattle is considered a mecca for pain training. You are looking for a great, strong Department of Anesthesiology with a multidisciplinary pain managemnt clinic. The recommendations may be different now, but by God I know there will be one besides letting a 12 year old lie on a couch and get suicidal!

Expect an antidepressant--Cymbalta or Effexor perhaps, and Neurontin, and probably Trazadone for sleep. Cymbalta is heavily marketed, but high dose Effexor is occasionally better. The pain really drains the brains neurotransmitters, like a car battery with the lights left on--slow but profound and complete. A person in pain gets pain relief from antidepressants and it doesn't have to be a lifetime on them--if the pain is resolved a year may be all he needs, or two perhaps.
post #13 of 18
I sincerely hope what Shycat suggested works for your son. Our prayers are with you and your family. I know you and your wife must be going through a lot too. Times like this make me wish I had a magic wand.

Please keep us posted.
post #14 of 18

C.,

I am so overwhelmed with what your son has been through, not to mention your whole family, that I find it hard to say much at the moment. I did, however, want to say as a friend that my most positive thoughts and best wishes will be unremitting for your son and your family.

scentemental


post #15 of 18
Setamp,

I just can't imagine what your family's going through right now. God bless you all.
post #16 of 18
Your story made me feel so incredibly bad for your son. No 12 year old should have to go through something like that. Is it generally a lifelong condition, or do you expect it to pass with time? Either way, I hope and pray that he feels better fast, for his sake and yours.

Now for my suggestion (and I almost feel silly saying this after Shycat's knowledgeable words)...I have a friend who underwent about 6 knee surgeries. Her knee was basically fixed, but she still suffered from regular bouts of pain for no apparent reason...and of course with physical activity it was exponentially worse. After a long series of other attempts, acupuncture was what finally helped the most. I have no idea if it's even remotely applicable to your son's condition...but there you have it.
post #17 of 18
As a person with Aspergers (a high-functioning form of autism) who also had to undergo massive back surgery two years ago (a fusion, fixation, AND an insturmentation), I feel your pain.

Stay calm and keep searching for more treatment options. Maybe you could join an Internet support group, too. Anyhoo, I will keep your son in my thoughts.
post #18 of 18
Quote:
Originally Posted by Setamp View Post

I appreciate your kind thoughts and prayers.

That's all I can offer at the moment. I will keep my eyes and ears open. Maybe acupuncture can be a way, at least to ease the pain.
I wish you and your son all the best.
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