Just skip this post.

Why do I insist on wanting to know more? Is it out of the hope that someone somewhere will say something better? That someone will give me some hope on this?

I feel pathetic right now. This is just ... overwhelming. Really. And it's a train wreck because I can't make myself walk away and stop reading it. I'm posting it for me, and I'm not even sure why I'm doing it.

No one else needs to wallow in my pool, but please feel free to push this whale back into the water.

A footnote: "b RSD causes TMJ disease and vice versa. The two usually coexist. Injections or operation for TMJ disease due to RSD aggravates the condition."

Aha!

"The dysfunction changes to dystrophy manifested by edema, hyperhidrosis, neurovascular instability with fluctuation of livedo reticularis and cyanosis - causing change of temperature and color of the skin in matter of minutes. The dystrophic changes also include bouts of hair loss, ridging, dystrophic, brittle and discolored nails, skin rash, subcutaneous bleeding, neurodermatitis, and ulcerative lesions.

It is accompanied by sympathetic dysfunction in all four extremities as well as attacks of headache, vertigo, poor memory, and poor concentration. The spread through paravertebral and midline sympathetic nerves may be vertical, horizontal, or both. "

Shit. I'm apparently closer to the evil 2 than I thought. Well ... the bruising, ridged nails and breast ulcers are accounted for, aren't they?

Oh. Well. That settles it, doesn't it? Apparently the number of stages depends on the one writing the article, and it goes from 3-4 depending on the author. I'm *well* into Stage 2 by most of them and partially into 3. It looks like they split stage three into two levels, one having the most extreme and "final" misery of this damn thing.

"RSD is a definitive chronic pain syndrome called by several different names such as reflex sympathetic dysfunction, (stage I), reflex sympathetic dystrophy (stage II), "

Man, I have to stop reading up on this. This is depressing enough without knowing more.

"RSD is accompanied by a certain degree of inflammation in practically all cases. This inflammation may be in the form of swelling (edema), skin rash (neurodermatitis), inflammatory changes of the skin color (mottled or purplish, bluish or reddish or pale discolorations), tendency for bleeding in the skin, skin becoming easily bruised, inflammation and swelling around the joints as well as in the joints (such as wrists, shoulders, knee, etc.) which can be identified on MRI in later stages, and secondary freezing of the joints.

The fourth component and pre-requisite of diagnosis of RSD is insomnia and emotional disturbance. The fact that the sympathetic sensory nerve fibers carrying the sympathetic pain and impulse up to the brain terminate in the part of the brain called "limbic system". This limbic (marginal) system which is positioned between the old brain (brainstem) and the new brain (cerebral hemispheres) is mainly located over the temporal and frontal lobes of the brain. The disturbance of function of these parts of the brain results in insomnia, agitation, depression, irritability, and disturbance of judgment. Insomnia is an integral part of an untreated RSD. So are problems of depression, irritability and agitation. "

And ...

"This can be in the form of flexion deformity of the extremity, difficulty with walking, flexor withdrawal of the muscles of the extremity, and lumbar and cervical paraspinal spasm. As a result, the patient develops muscle tension headaches, as well as spread of the muscle spasm to the facial muscles with resultant stress on the temporomandibular joint (TMJ) and severe pain and spasm around the TMJ.

With passage of time, the same phenomenon results in chronic trauma to the TMJ as well as clinching of the teeth and trauma to the teeth. The patient develops severe pain in the distribution of trigeminal nerve (sensory nerve for the face) and develops moderate migrainous vascular headaches (trigeminal vascular headaches). In later stages of RSD the immune system becomes disturbed, and the patient develops poor oral hygiene and dental deterioration.

Long-standing unilateral (one sided) spasm of cervical paraspinal muscles causes increased input of pain into the upper portion of the cervical spinal cord. As a result, a referred pain develops with resultant facial pain and secondary muscle spasm around the TMJ and the jaw. The same referred pain causes migraine headaches, TMJ pain and chronic stress on the teeth with dental deterioration"

Can someone please explain to me how every single doctor until now MISSED all of this?

Look at all the fun of the final stage!

1. Failure of the immune system, reduction of helper T-cell lymphocytes and elevation of killer T-cell lymphocytes.

2. Intractable hypertension changes to orthostatic hypotension.

3. Intractable generalized edema involving the abdomen, pelvis, lungs, and extremities.

4. Ulcerative skin lesions which may respond to treatment with I.V. Mannitol, I.V. Immunoglobulin, and ACTH treatments.Calcium channel blockers such as Nifedipine may be effective in treatment.

5. High risks of cancer and suicide are increased.

6. Multiple surgical procedures seem to be precipitating factors for development of stage IV.

RSD will leave significant residuals and will stay with the patient for the rest of their life under the following conditions:

1. Misdiagnosis.

2. Delayed diagnosis after two years and longer.

3. Additional trauma due to surgical procedures at the area involved with RSD (e.g., "tarsal tunnel", "carpal tunnel" surgery "rotator cuff tear" surgery).

4. Prolonged improper treatments such as ice application, inactivity, abuse of narcotics and benzodiazepans, etc.

5. Sympathectomy, amputation, or insertion of a needle in the area of scar of RSD for injections, blocks, or other purposes.

6. Prolonged litigation with resultant emotional aggravation and delay in treatment.

All right. This is me just walking away. No more.

The hard part of the cold front has just hit, so I'm gonna crawl into bed and pretend I'm not freezing and that my hands aren't starting to burn and swell despite the meds.