WEBCAM PHOTOS

 Cecelia Yinger likes this. (please)

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  Lisa Rogers Flaherty feel better Jen ♥
  

  Sunday at 10:46pm ·
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  Aunt Bee Crps Jen, . Sending prayers.
  

  Yesterday at 7:38am
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  Sami Smith JJ - i was just notified that the new patient coordinator with our doc wants to speak with you - i gave her your website - her name is stephanie - 941-488-5224; just call asap; the rest we will figure out...SAMI
  

  20 hours ago  1
• Cecelia Yinger I am praying for you Jen...I love you. <3

  

  June 14, 2012

  http://www.change.org/petitions/the-president-of-the-united-states-cover-ketamine-infusions-for-people-with-crps-rsd?utm_campaign=friend_inviter_action_box&utm_medium=facebook&utm_source=share_petition
  
  To those seeing this, I am posting my videos. I am not hiding my RSD. Today, I am going to begin posting what I have been through here. I am now having to use a wheelchair. I need home health and not one of my physicians has looked at it in 2 months. It costs me-But only pride. They are what I have been through in a 14 months struggle with RSD. I am now 100 "Indepently mediated pain. I have fought off the urge to end my life because of the destruction this has caused, and am soon to be wheelchair-bound.. Is it pretty at 40 that my house is filled with medical equpipment? That I use a bench to shower: really I need help with it, but no physician will agree on who writes THAT. Being so exhausted that my free fall in weight has reached about 80 pounds-I can't pay for Enure-not covered, it i a supplement? Not when eating i difficult. I live this way because NONE of the ketamine NASAL spray or cream is covered-or the marijuana I must smoke in order to ATTEMPT to not lose my head when EVERY noise, sound, or stumulus makes 10 not the level of my sharp, firey, BODY-WIDE RSD/CRPS. I will require 24 hour care likely before I am 45 because every day, my pain is taking it's toll on my body. I also have a website should anyone be interested.. But my situation can go back to my worst problem being a pinched nerve (sciatica) in my back, I don't notice it from the Body-wide RSD/CRPS, I don't live-I EXIST. I went into this 14 months ago and the nightmare has not showed any signs of stopping. Ketamine IV would offer me a CHANCE at a "normal life." But nope, instead my MedAdvantage insurance has been told NO in ketamine. Meanwhile I have to pray for a good day while the world acts a if I have chosen it or I want to live like this!
  
  Picture you working as a nurse, or even just volunteering to dropping over 50% of your body weight-I have already "surpassed the $50K mark" on anticonvulsants, plus no form of ketamine that helps is covered, so I PAY FOR IT. On normally $906, but Social Security "informed me the $400 they shorted me wa because I OWED them" for not getting Medicaid paperwork in on time.
  
  Sorry, I was busy being sick.  
  
  ----
  
   

Trouble in paradise

Oh, good : honesty!!!!

But LOOK at the FACTS, folks!!!  If you surveyed every doctor who operates on the "Hollywood 'elite' will likely be responsible for that person for the rest of their fucking career.   The "stars" are a VERY high maintenance group.

Even SO and that being said, syndromes and attorneys who specialize in RSD are the reason people like Paula Abdul have had  

FOURTEEN 

NECK

(cervical SPINE   SURGERIES)

FUCKING

SURGERIES

And not EXPECT something like this-let alone drug addiction, but don't you think they're some kind of problem when the patient is ending up with  a mind boggling surgeries at fourteen.  After my last knee surgery at ten, my doc said, "You are going to have to put up with some pain, we will help quiet the nerves~~~

Anticonvulsants:

Tegretol

Gabapentin

Zonasamide

Keppra

and other medications for the migraines: Fiorinol (withOUT codeine as it can make you worse)

For pain?  Between me and my physician...

 NEVER BREATHE A WORD 

 Whether a star or a "normie!"

Don't say you went green, nothing about ANYTHING that goes in your body! 

 

Signs of Neglect

Signs of Neglect

As our population ages, the number of elder Americans in nursing homes and assisted living facilities continues to soar.  Research indicates that one-half of women and one-third of men will eventually need nursing home or assisted living care.  By the year 2020, the demand for nursing home and assisted living beds will increase by almost 250%.  Nursing homes and assisted living facilities eagerly accept the financial benefits of the "graying of America."  They must also accept responsibility when our loved ones do not receive the care, dignity, and respect they deserve.
Nursing home and assisted living neglect and abuse take a variety of forms.  Pressure ulcers, falls, malnutrition, dehydration, and medication errors are painful, but frequent, reminders that more must be done.  Fortunately, increased media scrutiny of nursing homes and assisted living facilities and their business practices has resulted in a heightened awareness of the problem. State and federal governments have also come to the aid of families by enacting laws and regulations designed to ensure that patients receive appropriate care.

Unfortunately, media attention and regulatory oversight are poor substitutes for good care. Patients and their families need to recognize the "red flags" of nursing home and assisted living neglect and abuse.  If your loved one is a patient in a nursing home or assisted living facility, look carefully for any of the following signs of neglect and abuse:

• wandering and elopement 
• Resident to Resident Assault 
• Pressure Ulcers  
• Medication Errors  Malnutrition and Weight Loss 
• Falls 
• Dehydration 
• burns, fires, other hazard
•  Bedrail  entrapment and asphyxiation

Malnutrition and Weight Loss

A nursing home or assisted living facility must ensure its patients receive proper nutrition and maintain proper body weight and protein levels. Unplanned weight loss, peripheral edema, cachexia, and laboratory tests indicating low serum albumin levels are signs that a patient may not be receiving proper nutrition. The amount of weight lost during one-month, three-month, and six-month intervals reveals the severity of the weight loss:

                One Month, Significant = 5%, Severe = Greater than 5%
                Three Months, Significant = 7.5%, Severe = Greater than 7.5%
                Six Months, Significant = 10%, Severe =  Greater than 10%

For example, a weight loss of five percent of a patient’s body weight in one month is “significant,” but a loss of more than five percent in one month is “severe.” The percentage of weight loss is calculated using the following formula: (usual weight - actual weight)/(usual weight) x 100.

Malnutrition can be diagnosed clinically and with laboratory tests.
My H & H was positive for anemia.  Hemoglobin a patient (older than 60-but in my depleted state and record low of Vitamin D/Calcitonin was a red FLAG I was headed for a malnourishment.  Hemoglobin should remain between 180-300 g/dl. Hemoglobin in males should remain between 14-17 g/dl and in females should remain between 12-15 g/dl. 

Hematocrit in males should remain between 41-53 and in females between 36-46.

My albumin was 2.3g/dL
My hemoglobin was 67g/dL
My hematocrit was 12g/dL.





At the hospital, multiple other electrolyte and my ABG's were fouled up BAD!!!

My total vitamin D that day was 17

 Clinical signs of malnutrition include pale skin, dull eyes, swollen lips, swollen gums, swollen or dry tongue with scarlet or magenta hue, poor skin turgor, cachexia, swelling in the extremities, and muscle wasting. Laboratory tests can also detect malnutrition. For example, in a patient over 60 years of age, albumin (which reveals protein depletion) should remain between 3.4-4.8 g/dl. Plasma transferrin in a patient older than 60 years of age should remain between 180-300 g/dl. Hemoglobin in males should remain between 14-17 g/dl and in females should remain between 12-15 g/dl. Hematocrit in males should remain between 41-53 and in females between 36-46. Likewise, potassium levels should remain between 3.5-5.0 mEg/L and magnesium should remain between 1.3-2.0 mEg/L. Departures from these laboratory values may, with or without clinical symptoms, establish malnutrition.
Risk factors for malnutrition and weight loss include drug therapy that may contribute to nutritional problems (i.e. cardiac, glycosides, diuretics, anti-inflammatory drugs, overuse of antacids, overuse of laxatives, overuse of psychotropic drugs, anticonvulsants, antineoplastic drugs, phenophiazines, oral hypoglycemics), poor oral hygiene, poor eyesight, poor motor coordination, taste alterations, depression, dementia, cancer, a therapeutic or mechanically altered diet, a lack of access to culturally acceptable foods, a slow eating pace which makes food unpalatable, and poor feeding practices by staff like removing food trays before the patient has finished eating.

In order for a nursing home or assisted living facility to ensure a patient receives proper nutrition, the nursing home or assisted living facility must first assess the patient’s risk factors for becoming malnourished, plan and provide care to minimize the effects of these risk factors, and implement and document compliance with the care plan. For example, a nursing home or assisted living facility must monitor the amount of food consumed at each meal and at snack times and ensure all snacks and nutritional supplements are provided and consumed as appropriate. The amounts of all meals, snacks, and nutritional supplements, as well as any refusals by the patient to eat, should be carefully documented in the records of the nursing home or assisted living facility. Even if the patient becomes malnourished, sustains significant or severe weight loss, or does not eat, the nursing home or assisted living facility must consider changes to its plan of care (e.g. by providing the patient with alternative forms of nutrition like total parenteral nutrition (TPN), partial parenteral nutrition (PPN), or a feeding tube) to guard against worsening malnutrition.

 January 2012

February 2012

March 2012

APRIL 2012

 

In  the hospitaHELL

 

PROTEIN REQUIREMENTS

 Tube Feedings: Enteral Nutrition

1. Indications for Enteral Nutrition: the preferred route - "If the gut works, use it"

• Mechanical GI tract dysfunction/disorders - may have normal digestive & absorptive function with an oral/mechanical/physiological obstruction
• Facial/jaw injuries, head & neck CA, swallowing disorders, obstruction of the upper GI tract, GI tract fistulas, short bowel syndrome (feed beyond the obstruction/fistula)
• Metabolic GI tract dysfunction - may have impaired ability to digest & absorb nutrients
• Pancreatitis, infalmmatory bowel disease, radiation enteritis, chemotherapy
• Hypermetabolic conditions - may have increased energy & protein requirements that cannot be met with regular oral intake
• Major burns, trauma, sepsis, post-operative recovery following surgery

2. Contraindication for Enteral Therapy: GI tract not working

• Intractable vomiting
• Intestinal obstruction
• Upper GI tract hemorrhaging
• Severe, intractable diarrhea
• Severe, acute pancreatitis
• Expected need less than 5-10 days

3. Routes:

Short-term: Nasogastric, Nasoduodenal, Nasojejunal Long-term: Gastrostomy & Jejunostomy (surgically placed) and PEG - percutaneous-esophago-gastrostomy & PEJ - percutaneous-esophago-jejunostomy (endoscopically placed)

4. Tubes

Tube size: Consider viscosity of formula; select the smallest appropriate size for patient comfort. 8 French can generally be used for commercial formulas while the patient will need a 10-14 French for blenderized formulas.
Tube length: Depends on tube placement, with a 30" length for nasogastric feeding and 43" for nasoduodenal & nasojejunal feedings.

5. Selecting the formula: based on patient need

Consider each of the following factors:

• How well the GI tract is functioning and its capacity
• Underlying disease conditions
• Patient tolerance

Enteral Formula Categories

Category	Subcategory	Characteristics	Indications
Polymeric	Standard	Similar to average diet	Normal digestion
	High nitrogen	Protein>15% of total kcal	Catabolism Wound healing
	Caloric dense	2 kcal/ml	Fluid restriction Volume intolerance Electrolyte imbalance
	Fiber containing	Fiber 5-15 g/L	Regulation of bowel function
Monomeric	Partially hydrolyzed	One or more nutrients are hydrolyzed. Composition varies.	Impaired digestive and absorptive capacity
	Elemental
	Peptide based
Disease- Specific	Renal	Less protein, low electrolyte content	Renal failure
	Hepatic	High branched chain amino acids (valine, isoleucine and leucine, which are known as the stress amino acids), low aromatic amino acids (phenylalanine; tyrosine; tryptophan), low electrolyte content	Hepatic encephalopathy
	Pulmonary	Higher % of calories from fat instead of carbohydrates	ARDS
	Diabetic	Low carbohydrates	Diabetes mellitus
	Immune-enhancing	Arginine, glutamine, omega-3 fatty acid, antioxidants	Metabolic stress Immune dysfunction

from http://www.rxkinetics.com/tpntutorial/2_1.html (Note: N170 students responsible for Nutritional concepts and Enteral Nutrition ONLY)

6. Administration of feedings

• Bolus
• Intermittent
• Continuous

	Indications	Advantages	Disadvantages
Bolus	Noncritically ill patient Home TF Rehabilitation patient	Easy to administer Inexpensive Short administration time (usually 15 minutes)	Highest risk of aspiration, N/V, abdominal pain and distention, and diarrhea
Intermittent	Noncritically ill patient Home TF Rehabilitation patient	Flexibility in feeding schedule Inexpensive Feeding over shorter time allows patient more free time	Higher risk of aspiration, N/V, abdominal pain and distention, and diarrhea May require formula with more calories and protein
Continuous	Initiation of tube feedings Critically ill patient Small bowel feeding Intolerance of intermittent or bolus	Pump assisted Minimizes risk of high gastric residuals and aspiration Minimizes risk of metabolic abnormalities	Restricts ambulation Infused over 24 hours/day Increased cost (need pump)

7. Feedings started:

• In the past tube feedings that were hyperosmolar were diluted ½ strength - current recommendations are to leave the formula full strength and begin at a lower volume until tolerance is determined.
• Full strength if isotonic - DO NOT DILUTE ISOTONIC FORMULAS!
• Tube feeding is progressed until assessed nutrition goal reached
• If TF is diluted, do not advance concentration and rate at the same time

8. Tolerance

• Check gastric residuals
• Diarrhea
• Constipation
• Bloating and excess gas production

9. Sanitation

• bag and tubing is changed every 24 hours, but check your hospital protocol
• formula is administered at room temperature

TF should not be started until an X-ray shows the tube is in the proper place, then formula can be started
Head of bed (HOB) must be elevated at least 30° at all times.

Epidemiology of Complex Regional Pain Syndrome: A Retrospective Chart Review of 150 Korean Patients

J Korean Med Sci. 2008 October; 23(5): 772–775.

Published online 2008 October 30. doi:  10.3346/jkms.2008.23.5.772

PMCID: PMC2580014

Epidemiology of Complex Regional Pain Syndrome: A Retrospective Chart Review of 150 Korean Patients

Yun Suk Choi,^* Mi Geum Lee,^† Hyo Min Lee,^‡ Chul Joong Lee,^§ Ji Yeon Jo, Soo Young Jeon, Sang Chul Lee, and Yong Chul Kim

Author information ► Article notes ► Copyright and License information ►

This article has been cited by other articles in PMC.

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Abstract

Complex regional pain syndrome (CRPS) is a chronically painful and disabling disorder. However, no data are available even on the epidemiology of CRPS in Korea. This study was undertaken to retrospectively assess the epidemiologic characteristics of CRPS in 150 consecutive patients at a tertiary chronic pain center from March 2002 to February 2006. Information was obtained regarding patients' demographics, nature of injury, and treatment modalities. Seventy-one percent of patients had CRPS type I. The mean 11-point verbal numerical rating scale score at initial examinations and at the time of study were 8.0 and 5.7, respectively. Thirty-two percent of patients showed no change or increase in pain intensity during follow-up at our pain center. The mean duration of CRPS symptoms prior to our pain center evaluation and prior to the time of study were 27 months and 50 months, respectively. These patients had seen on average 5 different physicians before being referred to our center. This study shows that the majority of CRPS patients were referred to our center after more than 2 yr of symptoms. The clinical implication of such delayed transfer and strategies to avoid this problem are discussed.

Keywords: Complex Regional Pain Syndromes, Epidemiology, Treatment

INTRODUCTION

Complex regional pain syndrome (CRPS) is associated with topical pain, which develops primarily after trauma. The intensity and duration of CRPS are highly variable, though CRPS can induce serious impairment of the autonomic nervous system and of motor function, and consequently can result in diverse clinical outcomes.

The development of CRPS may be explained by various mechanisms, such as alterations in the central nervous system or by biofeedback from the sympathetic nervous system, but the underlying mechanism remains to be clarified. Although definite measures for the diagnosis and treatment of CRPS are being actively pursued (1, 2), as yet no objective diagnostic criterion nor a simple reliable test has been established. For this reason, it usually takes a long time to the final diagnosis of CRPS, which ultimately renders treatment outcomes worsened. Moreover, in Korea, not even epidemiological studies have been conducted as yet. Therefore, the aim of this study was to assess the epidemiologic characteristics of CRPS for the first time in Korean patients.

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MATERIALS AND METHODS

This retrospective study was approved by our institutional review board. The medical records of 150 consecutive patients diagnosed with CRPS at our pain center from March 2002 to February 2006 were reviewed and current patient status was determined using telephone interviews. At initial visits, all available prior medical data including neurological and radiological data were reviewed. 

Twenty-three patients were lost to follow-up and 7 had died, and thus, 120 patients were interviewed by telephone. Present pain intensity and the treatment modality regarded to be most helpful for alleviating pain were recorded. For each finding, patient percentages were calculated based on a responder basis rather than on total patient number.

Diagnoses were made in our pain center using the modified International Association of the Study of Pain (IASP) diagnostic criteria for CRPS (3). Many ancillary tests, such as, neuromuscular conduction, quantitative sensory, and autonomic function tests (including diagnostic sympathetic block), and infrared thermography and a 3-phase bone scan were usually performed at initial visits and during follow-up. Infrared thermographic results were interpreted as positive when the temperature difference between ipsilateral and contralateral extremities was ≥0.6℃ (4). Results of 3-phase bone scans were interpreted as positive when a difference in early blood pooling with or without an increase in diffuse bony uptake was observed (5).

The following details were available for analysis: patients' age, gender, type of CRPS, site of lesion, injury profile, pain intensities at presentation and at the time of study, duration of CRPS symptoms prior to our pain center evaluation and prior to the study, the number of physicians who had treated patients before referral to our center and their medical fields, the treatment modalities received, the treatment modality considered by patients to be most effective, and the presence of a history of spinal cord stimulation (SCS). Pain intensity was rated using an 11-point of verbal numerical rating scale (VNRS).

Data are presented as means±SD. Statistical analyses were performed using descriptive statistics.

RESULTS

Eighty-three patients (55%) were male and 67 (45%) were female (0.8: 1 female-to-male ratio). Patients' mean age at initial evaluations was 45±14 yr, and mean age at time of injury was 40±45 yr and 43±19 yr for male and female patients, respectively. CRPS developed most frequently in the third decade (22 patients) and in the fifth (22 patients) in men. The military personnel was 73% (16 patients) in the third decade. In female patients, CRPS developed most frequently in the fifth decade (18 patients), followed by the forth (16 patients) and sixth (13 patients) (Fig. 1). Seventy-one percent of patients had CRPS type.

Fig. 1

Distribution of cases by age and sex.

Mean VNRS scores at initial evaluations and by telephone interview were 8.0±1.9 and 5.7±2.5, respectively. Thirty-eight patients (32%) showed no change or increase in pain intensity during follow-up treatment. The mean durations of CRPS symptoms prior to our initial pain center evaluation and prior to the time of study were 27±52 months and 50±53 months, respectively, and 5±5 (range, 0-40) physicians were visited before referral to our center. Crush injury, surgery, and fall down trauma were common causes of CRPS (68 patients, 45%) (Fig. 2). Eighty-two percent of the patients complained of pain in one extremity only, and lower extremities (55%) were more commonly affected than upper extremities (27%). Eighteen percent complained of a pain in the face or chest. Seventy-five percent of patients had been treated by ≥1 anesthesiologist before being referred to our pain center.

Fig. 2

Types of injuries precipitating the development of CRPS.

The treatment modalities which were used at our pain center included physical therapy, pharmacotherapy, sympathetic blocks and/or chemical neurolysis, radiofrequency lesioning, intravenous infusion of ketamine or lidocaine, intravenous regional block, and spinal cord stimulation. Pharmacotherapy was the most common form of therapy (91 patients), followed by sympathetic block (42 patients), intravenous infusion of ketamine (36 patients), and/or nerve blocks (35 patients) (Fig. 3).

Fig. 3

 

The number of patients for each of the treatment modalities.

Seventy-six percent reported that sympathetic block or neurolysis including radiofrequency lesioning was the most effective treatment. Twenty-three percent of patients (24/108 patients) were implanted with a spinal cord stimulator (SCS). However, 38% (9/24) had their SCS removed during follow-up, but on the other hand, 21% (5/24) responded that they considered SCS stimulation the most effective treatment modality (Fig. 4). One patient received dorsal rhizotomy and a limb amputation, and 1 patient committed suicide.

Fig. 4

 

The percent of patients who reported this treatment most effective.

DISCUSSION

Little published data are available on the epidemiology of CRPS, and this study is the first epidemiologic study of CRPS that was conducted in Korea. Overall, the epidemiologic data collected during this study are similar to those of previous studies (6, 7). However, our data showed a female-to-male ratio of 0.8:1, which does not concur with the findings of other studies, which have found that CRPS more commonly develops in women at gender ratios of 1:2.3-1:4.5 (6, 8, 9). In the present study, the condition occurred more often in male patients aged 20-29 yr than in other age groups. Obligatory military service in Korea may have increased the risk of trauma in this age group. The mean duration of CRPS symptoms prior to presentation at our pain center was 27 months, which is similar to that found by Allen et al. (6), but longer than that reported by Sandroni et al. (7). It is known that a prior injury, e.g., fractures, contusions, sprains, and surgical traumas, is the main cause of CRPS (6). The present study also shows that injuries such as traffic accidents and falls are leading causes of CRPS and that surgical trauma contributed to a lesser extent, which concurs with that reported elsewhere (6, 7). In addition, in the present study, immobilization due to a splint, gun shot wounds, tooth extractions, injections, and pregnancies were all found to induce CRPS.

We found that a lower limb was affected approximately twice as often as an upper limb, which concurs with the findings of Allen et al. (6). However, Sandroni et al.(7) reported that CRPS developed more frequently in an upper limb than in a lower limb. Moreover, in this study (7) bilateral side involvement was observed in some cases as an early manifestation. The over-expression of symptoms in relation to the reward may in part explain this phenomenon.

In the present study, the type I: type II ratio was 7:3, which differs from that reported by a previous study which indicated that the incidence of CRPS type II was extremely rare except during a war (10).

In the present study, pharmacotherapy was adopted most frequently, followed by a sympathetic nerve block, the intravenous infusion of ketamine, and a spinal nerve block. According to patients' subjective reports on treatment efficacy, a sympathetic block and the intravenous infusion of ketamine were the most effective treatment modalities among those treatment modalities received. Sympathetic nerve block has been reported to be only effective at treating sympathetic maintained pain, although it has been described as a first choice therapy (11). In addition, it has been reported that sympathetic nerve block is also effective at ameliorating elevated skin temperatures, edema, or allodynia that develops within 6 months (11). The present study revealed that intravenous ketamine (an NMDA receptor antagonist) was clinically effective in 44% of patients. Correll et al. (12) reported that 76% of patients with CRPS who did not respond to conventional treatment achieved complete remission after intravenous ketamine administration and that 18% achieved partial remission. Moreover, they found that the therapeutic effects of intravenous ketamine lasted between 3 and 12 months and that it could be reperformed in recurrente cases, although it was also found on occasions to induce headaches and hallucinations. SCS reduces the pain via neuromodulation. Taylor et al. (13) concluded that SCS is effective in 70% of CRPS patients and more cost-effective than conventional treatments. In our previous report (14), 57% of CRPS patients rated SCS as having an excellent or good effect. In this present study, 23% of patients underwent SCS implantation, but 62% of them have been used SCS at the time of study and only 20% of them was the most effective treatment modality they had encountered. Based on the present study, the possible reasons for the high removal rate and relatively low satisfaction with SCS were delayed diagnosis and treatment, high initial cost, higher dosage of opioids, high initial pain score, inaccurate evaluation of the effect of trial stimulation, and too high expectation of the benefits of SCS. After covering the cost of SCS by the National Health Insurance System in Korea on August 1 2005, the incidence of SCS implantation has increased year on year, and this might well increase future satisfaction rates.

At initial examinations, the mean VNRS score of patients was 8.0, which is similar to that reported previously (15). The mean VNRS score reduced to 5.8 after treatment, but 32% of patients showed no change or further symptom aggravation. 

Although a considerable number of patients with CRPS experience spontaneous remission (7), CRPS became an intractable chronic pain in one third of our cases, and some of these required dorsal rhizotomy or limb amputation. CRPS is more successfully treated when patients are early diagnosed and treated aggressively, as the risk of intractable chronic pain increases as the time between symptom onset and final diagnosis increases (16). In the present study, treatment outcomes were thought to be poorer than in a previous study (7) because the time between onset and final diagnosis of CRPS was longer. This poorer treatment outcome may also be attributed to the fact that patients in the present study had relatively severe pain and a long illness duration. Therefore, we advise that patients suspected of having CRPS be referred to specialists or specialty clinics to ensure early diagnosis and treatment.

This study had some limitations. First, it was intrinsically limited by its retrospective nature. Second, some cases were lost to follow-up and finally, the study subjects analyzed were treated at one university-based tertiary chronic pain center.

In conclusion, the present study describes the epidemiologic characteristics of CRPS patients for the first time in Korea. However, the information gained is limited in terms of its general applicability to all Korean CRPS patients. Thus, we recommend that a nationwide study be undertaken with a view toward documenting the epidemiologic characteristics of Korean CRPS patients as a means of facilitating early diagnosis and treatment.

Go to:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2580014/

References

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2. Rho RH, Brewer RP, Lamer TJ, Wilson PR. Complex regional pain syndrome. Mayo Clin Proc. 2002;77:174–180. [PubMed]

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9. Veldman PH, Reynen HM, Arntz IE, Goris RJ. Signs and symptoms of reflex sympathetic dystrophy: prospective study of 829 patients. Lancet. 1993;342:1012–1016. [PubMed]

10. Hassantash SA, Afrakhteh M, Maier RV. Causalgia: a meta-analysis of the literature. Arch Surg. 2003;138:1226–1231. [PubMed]

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12. Correll GE, Maleki J, Gracely EJ, Muir JJ, Harbut RE. Subanesthetic ketamine infusion theraphy: a retrospective analysis of a novel therapeutic approach to complex regional pain syndrome. Pain Med. 2004;5:263–275. [PubMed]

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14. Lee CJ, Kim YC, Shin JH, Yoo SY, Shin HY, Kim YH, Han SS, Joh JY, Lee EH, Lee SC, Park JH. Spinal Cord Stimulation in management of intractable chronic pain: a 5-year experience. Korean J Anesthesiol. 2006;51:195–200.

15. Forouzanfar T, Weber WE, Kemler M, van Kleef M. What is a meaningful pain reduction in patients with complex regional pain syndrome type 1? Clin J Pain. 2003;19:281–285. [PubMed]

16. Wakasugi B. Pain clinic shindan chiryou guide. Nilon Iji Shimosha; 1994. pp. 43–49.