How do I achieve early diagnosis and treatment

[trappedinsystem]

It has been almost 3 mos. since I fell on my left side and broke 5th metacarpal in left hand and sprained left wrist.  Had 2 pins during surgery and casted until 3-7-02 - both removed. Terrible swelling day after surgery, clammy, ice cold hand, foul odor, slimmy feeling on hand when washing could not get off or see could not reach the skin, pain, numbness, feeling of water drops moving under the skin in hand and wrist, felt twisting inside palm and pinky side of hand. Was recast at one point after cast had been cut - neither helped swelling for long.  When cast removed hand looked extremely swollen, deformed, thumb pushed into palm unable to make fist. Within 1/2 hour pain in left shoulder blade, eventually arm.  Next day stomach seemed to swell as did my left left leg, felt very heavy and sort of numb feeling all the way down and across bottom of foot. Sent to therapy for hand 3x week.  3rd week had constant aching in left upper arm from excercises and ability to raise left arm higher than shoulder lenght out to the side was dimishing. Dr. said once again I probably had RSD included shoulder therapy. This made hand better, arm worse. Had muscle/nerve test 4-5-02 - possible pinched nerve C4-C7 in neck. After test, headache for 4 days, blurred vision twice, tingling right side of neck and top of right shoulder and up right side of head in back causing immediate blurred vision. This week having MRI neck and brain. Why no tests on my arm should, hand? Dr. said RSD is mild, therapy helping, no test available. What I have read tells me need early diagnosis and treatment. HELP!

[CCF-Neuro-M.D.-JT]

Sorry to hear about your symptoms. From your description, it does sound like you may have RSD, especially with the swelling, pain, odd sensations, and temperature changes. You are correct in that RSD should be caught sooner rather than later as permanent bone and nerve changes can occur with chronic RSD. ALthough there is no test that says you do or don;t have the disease, the diagnosis is made clinically and with injection of the sympathetic ganglion (specific collection of nerves) with anesthetic to block the abnormal nerve impulses in your arms. Then they can see if this improves your symptoms. This should be done at a special pain clinic. If it is RSD, then serial injections to block the nerve input can help. Also, surgery to remove the collection of nerves can be done in cases that do not improve. Ask your family doc for a referral to a pain clinic to for further evaluation and management of your symptoms. Good luck.