A Special Dedication to Kate


My Dear Friend Kate,
This is for all you have done for the RSDS Gang and for how much you make 
this world a better place to live in, simply because you give of yourself to 
those in need.

Solace,
Sue Wolf Pugh
RSDS Dysfunctional GANG

This is the speech that I wrote on RSD, and I will be presenting it on 
Tuesday, September 19th! To those of you who helped me, I thank you very very 
much from the bottom of my heart! 
Love Always, Kate

Imagine that someone poured gasoline on your foot, lit a match, and set your 
foot on fire. Imagine the fear, the agony, and the intense pain you would 
feel as your foot was burning up. Your first reaction would probably be to 
put the fire out. But what if you couldn't? What if the initial flames 
ceased, but the burning sensation never stopped? Can you imagine living a 
life where your foot ALWAYS felt as though it were on fire? Its pretty hard 
to imagine, isn't it. Well, people do live this life, a life full of 
agonizing pain. These people have a rare neurological disease called Reflex 
Sympathetic Dystrophy, or RSD.  You've probably never heard of it, and until 
2 years ago, I was ignorant about this disease as well. But now, I feel as 
though I know a little too much about it. That's because I am one of the 
approximated 7 million people that suffer from this disease. I feel that one 
of the first steps in fighting this disease is to raise awareness about it. 
There could be millions of other sufferers out there. You or someone you know 
could be one of them, and not even know it. So I am standing here today to 
tell you what RSD is, what the symptoms and stages are, and the various 
methods and costs of treatment. 

RSD is a mysterious disease that affects the sympathetic nerve system. I must 
stress that there is no actual known cause for RSD. It is usually triggered 
by an injury, whether it be something minor like a bruise, a stubbed toe, a 
sprained ankle, a bone fracture…or something major like a stab or gunshot 
wound, burn, or surgery. Normally, when an injury occurs, an impulse is sent 
through the sympathetic nerves from the injury site to the spinal cord. The 
spinal cord then sends the impulse back to the injured site. However, when 
RSD is present, the sympathetic nerves send an abnormally high level of 
impulses back to the injured site. These impulses cause the blood vessels to 
constrict and alter the blood flow to the affected area. One doctor informed 
me that RSD is your body's way of trying to amputate the injured area, which 
for me was my left foot.  This impulse process results in EXTREME pain. This 
pain is just one of the many symptoms that leads to a diagnosis of RSD.

The presence of RSD is determined by ruling out other problems, and by 
evaluating the symptoms. The first and primary complaint is, of course, the 
pain. This pain can be described as a horrible, constant burning that comes 
from deep inside. This pain is far greater than what would be expected for 
the injury sustained, which makes some patients feel as though they are just 
crazy. There are many other symptoms which occur in three general stages. 

In the first stage, the onset of the burning pain occurs, and it is basically 
limited to the site of the injury. Also in the first stage Hyperasthesia 
occurs. Hyperasthesia is an over-sensitivity to touch and light pressure. 
Wearing a sock caused horrendous pain for me, and if someone so much as 
lightly brushed against the skin on my foot, I could not help but cry out in 
pain. My foot started sweating so much that I was going through at least 5 
pairs of socks a day. This increased sweating is known as Hyperhidrosis. To 
me, the worst part of this stage was the fact that my foot froze in a 
downward position, and no matter how hard I tried, I could not move it. The 
skin on the RSD affected area undergoes many changes during the first stage.  
It can go from warm, red and dry, to cold and sweaty.  This stage I just 
described has an average duration of 1-3 months. 

In the second stage of RSD, the pain becomes more severe and may begin to 
spread to the surrounding areas. Hair growth can either increase or decrease, 
and the nails become brittle. The unused muscles begin to waste and gradually 
become unusable. Also, osteoporosis may begin during stage 2. This stage may 
last anywhere from 3-6 months.

In the third stage of RSD, the damage to the muscles becomes irreversible. 
The pain may now involve the entire limb. Some people may eventually get RSD 
in the entire body, which is known as systemic RSD. Many who reach this stage 
of RSD may see treatment as futile. However, the chance of recovery greatly 
increases if RSD is treated quickly.

There are quite a few treatments available for those of us who suffer from 
RSD, all of which are quite costly. These treatments are experimental because 
there is no cure for this disease, and all of them are potentially 
dangerous.. Due to a lack of time, I'm only going to tell you about the most 
commonly used treatments. Various pain medications, steroids, nerve pills, 
and antidepressants are typically the first treatments prescribed. One common 
medication is Neurontin, which is an anti-seizure drug, that does help some 
patients. However, it did not help me at all. Other common forms of 
treatments are nerve blocks, which are used to deliver medications directly 
to the vicinity of the nerves responsible for the pain. I had a total of 7 
nerve blocks, each one costing about $1500. The first 2 I had are called 
Epidural nerve blocks, in which different medications are injected into the 
spinal sac through the usage of a VERY large needle. It goes through the 
space where the spinal nerves pass as they travel from the spinal cord to the 
rest of the body. These epidural blocks can cause your legs to be temporary 
paralyzed, and a sore back for 2-3 days can be expected. The epidural blocks 
proved useless in my treatment. However, I then had 5 lumbar sympathetic 
blocks, which significantly helped me. In these blocks, the medications were 
injected directly into the sympathetic nerve chain to the left of my spinal 
column.
 
Another form of treatment is physical therapy. I underwent 6 months of 
rigorous physical therapy, in which I re-learned the art of walking, and 
worked to regain the strength I had lost. The total cost of my physical 
therapy was over $7,000. While this intense physical therapy worked for me, I 
must stress that it is NOT for everybody. For some people with RSD, exercise 
is far too strenuous and can often times worsen the pain.   

There are other forms of treatment that I don't know as much about because I 
myself was never treated using them. Some patients have spinal cord 
stimulators implanted under the skin, which send out electrical signals in an 
attempt to block the pain signals. These implants cost about $30,000. Another 
costly form of treatment is a morphine pump, which drips morphine directly 
into the spinal fluid, and costs about $20,000. 

As you can see, RSD is a very costly disease, and not just because of the 
money involved. It causes physical and emotional pain for not only the 
patient, but for the patient's friends and family as well. I hope that you 
have gleaned some information about RSD from my speech today, because my main 
goal is to raise awareness in an attempt to fight this disease. If any of the 
symptoms I described sound familiar to you, do not just brush it off as 
nothing. Like I said earlier, if RSD is treated right away, there is a 
greater chance of preventing the spread of this disease. So if you, or 
someone you know may be suffering from RSD, please feel free to talk to me 
about it. Because together, we may be able to put the fire out. Thank you. 



 

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