Monthly Archives: January 2006

Study finds nerve damage in previously mysterious chronic pain syndrome

Contact: Sue McGreevey
Massachusetts General Hospital

Study finds nerve damage in previously mysterious chronic pain syndrome

Reduction in small-fiber nerves may underlie complex regional pain syndrome-I (reflex sympathetic dystrophy)

Researchers at Massachusetts General Hospital (MGH) have found the first evidence of a physical abnormality underlying the chronic pain condition called reflex sympathetic dystrophy or complex regional pain syndrome-I (CRPS-I). In the February issue of the journal Pain, they describe finding that skin affected by CRPS-I pain appears to have lost some small-fiber nerve endings, a change characteristic of other neuropathic pain syndromes.

“This sort of small-fiber degeneration has been found in every nerve pain condition ever studied, including postherpetic neuralgia and neuropathies associated with diabetes and HIV infection,” says Anne Louise Oaklander, MD, PhD, director of the MGH Nerve Injury Unit, who led the study. “The nerve damage in those conditions has been much more severe, which may be why it’s been so hard to detect CRPS-I-related nerve damage.”

Complex regional pain syndrome is the current name for a baffling condition first described in the 19th century in which some patients are left with severe chronic pain and other symptoms – swelling, excess sweating, change in skin color and temperature – after what may be a fairly minor injury. The fact that patients’ pain severity is out of proportion to the original injury is a hallmark of the syndrome, and has led many to doubt whether patients’ symptoms are caused by physical damage or by a psychological disorder. Pain not associated with a known nerve injury has been called CRPS-I, while symptoms following damage to a major nerve has been called CRPS-II.

Because small-fiber nerve endings transmit pain messages and control skin color and temperature and because damage to those fibers is associated with other painful disorders, the MGH research team hypothesized that those fibers might also be involved with CRPS-I. To investigate their theory they studied 18 CRPS-I patients and 7 control patients with similar chronic symptoms known to be caused by arthritis. Small skin biopsies were taken under anesthesia from the most painful area, from a pain-free area on the same limb and from a corresponding unaffected area on the other side of the body.

The skin biopsies showed that, the density of small-fiber nerve endings in CRPS-I patients was reduced from 25 to 30 percent in the affected areas compared with unaffected areas. No nerve losses were seen in samples from the control participants, suggesting that the damage was specific to CRPS-I, not to pain in general. Tests of sensory function performed in the same areas found that a light touch or slight heat was more likely to be perceived as painful in the affected areas of CRPS-I patients than in the unaffected areas, also indicating abnormal neural function.

“The fact that CRPS-I now has an identified cause takes it out of the realm of so-called ‘psychosomatic illness.’ One of the great frustrations facing CRPS-I patients has been the lack of an explanation for their symptoms. Many people are skeptical of their motivations, and some physicians are reluctant to prescribe pain medications when the cause of pain is unknown,” says Oaklander. “Our results suggest that CRPS-I patients should be evaluated by neurologists who specialize in nerve injury and be treated with medications or procedures that have proven effective for other nerve-injury pain syndromes.” She adds that the next research steps should investigate why some people are left with CRPS after injuries that do not cause long-term problems for most patients, determine the best way of diagnosing the syndrome and evaluate potential treatments.

“Investigations that identify the causes of disease are only possible if patients are willing to come to the lab and allow researchers to study them,” she adds. “We are tremendously grateful to these CRPS patients, whose willingness to let us study them – despite their chronic pain – allowed us to make an important step in helping those who suffer from this condition.” Oaklander is an assistant professor of Anaesthesia and Neurology at Harvard Medical School.


The study was supported by grants from The Mayday Fund, the National Institute for Neurological Disorders and Stroke, and the American Federation for Aging Research. Coauthors are Julia Rissmiller, Lisa Gelman, Li Zheng, MD, PhD; Yuchiao Chang, PhD; and Ralph Gott, all of the MGH.

Massachusetts General Hospital, established in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH conducts the largest hospital-based research program in the United States, with an annual research budget of nearly $500 million and major research centers in AIDS, cardiovascular research, cancer, cutaneous biology, medical imaging, neurodegenerative disorders, transplantation biology and photomedicine. In 1994, MGH and Brigham and Women’s Hospital joined to form Partners HealthCare System, an integrated health care delivery system comprising the two academic medical centers, specialty and community hospitals, a network of physician groups, and nonacute and home health services.

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Disabled mom, 3 children face bleak holiday

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The Mercury, originally uploaded by rsdscrpsnews.

Melanie was once employed full time, involved in her children’s school and a soccer mom on weekends. Now she’s disabled from a neurological disease called reflex sympathetic dystrophy syndrome.

She currently takes 28 medications a day, including Alzheimer’s medication.

“Financially, it’s very devastating,” Melanie said. She has days that she just can’t get out of bed.

The disease starts in the bones and spreads to the muscles. As it spreads, it leaves osteoporosis behind.

“It’s similar to MS in that it’s progressive and it spreads,” Melanie said.

She has three children, ages 16, 12 and 3. They try to understand her condition, but they remember mom the way she was before the disease.

“It’s a disease that’s very devastating and it’s led my children to be very angry and very sad because there’s no cure,” Melanie said.

Last February, she was fitted for a wheelchair. They switched her medication, and over the summer Melanie was able to walk again. But as the cold sets in, she again loses her ability walk.

“The weather plays a huge part in it,” Melanie said.

Melanie said she’s very grateful that she will be assisted through The Mercury’s Operation Holiday program.

“Birthdays you can kind of blink through and get by with one present, but with Christmas you can’t do that,” Melanie said.

“With the little one, she knows what Santa Claus is. You have to have Christmas,” she added.

Doctors say the only hope for Melanie is a spinal treatment that reboots the nervous system and sympathetic nervous system.

In the United States, it has been performed at only two hospitals.

“I tried once to get approved for it and my insurance company turned it down, saying it was medically unnecessary,” Melanie said.

She’s not giving up though. Melanie is scheduled to see a specialist that she hopes will help her convince the insurance company that she needs the $50,000 surgery.

It is to offer hope to families like Melanie’s that The Mercury began its Operation Holiday tradition 14 years ago.

Last year, Operation Holiday, a nonprofit foundation administered by The Mercury, served 171 families and 475 children. The mission of Operation Holiday is to provide some Christmas happiness for the children of families who may be going through tough times.

The program has served thousands of families in the Pottstown area since it was established.

Operation Holiday recipients are screened and referred to the program by a dozen social service agencies in the Pottstown area. None of the money goes to agency programs or to people who live outside the area.

This year, The Mercury is seeking to help more than 100 families who are struggling through tough economic times or dealing with the financially devastating effects of illness or misfortune.

But this program is not possible without the assistance of Mercury readers. You can help bring the joy of the season to your neighbors and their children by making a contribution, however large or small, to Operation Holiday.

All donations go directly to assist those referred to the program. There is no overhead, as volunteers coordinate distribution of the gift certificates and buy, pack and deliver the groceries.

The names of all those who contribute to Operation Holiday, except those who ask to remain anonymous, will be published in The Mercury between now and Dec. 25.

Operation Holiday contributions may be dropped off at The Mercury’s office at Hanover and King streets in Pottstown or mailed to The Mercury, P.O. Box 484, Pottstown, PA 19464.Checks can be made payable to “Operation Holiday.”

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RARE DISORDER: ‘Help us relieve our condition’

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RARE DISORDER: ‘Help us relieve our condition’

A SUFFERER of a chronic pain disorder is backing plans for a medical conference on her condition.

Kelly Green (24), from Turves, near Whittlesey, suffers from Complex Regional Pain Syndrome (CRPS), a severe illness which causes her immense suffering.

CRPS, formerly known as Reflex Sympathetic Dystrophy, normally follows an injury, and in Kelly’s case resulted from a fall down the stairs.

The condition causes intense pain out of proportion to the severity of the injury, which, over time, gets worse instead of better.

Now Kelly is supporting fellow sufferer Trudy Lapinskis, from Whittlesey, as she plans a national conference on the condition for medical professionals.

Kelly was diagnosed with CRPS in 2003 and is still struggling to come to terms with the condition.

She said: “I have been diagnosed with depression and I have been suicidal. My friend helps to care for me during the day now, because I get so low.”

She explained that, after banging her elbow, it bruised and swelled so badly that she went to casualty.

She said: “They couldn’t tell if I had cracked it because there was too much swelling.”

Kelly was sent home, but soon went to see her doctor about the constant pain.

Fortunately, she is registered with the same GP who had treated Trudy, and he immediately recognised the symptoms.

Kelly now takes up to 30 painkillers a day and has regular injections to stimulate the nerves in her arm.

Clare Osler (21) has taken on the role of carer for her best friend and moved into her March Road home.

She said: “I work in the evenings so I am around during the day for Kelly.

“We went to school together. Before she was diagnosed, she wanted to be a PE teacher and she played football for Leicester ladies’ team. Now, she can’t do anything like that.

Most of the time she doesn’t even go out. Her life has completely changed.”

Trudy, who has been supporting Kelly since her diagnosis, wants patients to get the treatment they need more quickly and thinks the medical profession needs to learn more about CRPS.

Trudy lost part of her left leg to the condition, after developing complications following an infection, and feels her foot could have been saved if her condition had been diagnosed sooner.

She said: “I definitely wouldn’t be in this situation now.

“I am trying to get Dr Robert Schwartzman, from America, to come to the conference because he is the best specialist on the condition in the world. I have met him a number of times and I think he could really help us.”
16 December 2005

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Mandrell returns to Ashland City to start 2006

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Louise Mandrell, originally uploaded by rsdscrpsnews.

Mandrell returns to Ashland City to start 2006

Sells theater in Pigeon Forge

By Gary Burton
Times editor

A country music entertainer will be leaving her theater in Pigeon Forge later this month to return home to Ashland City.

And, she said she can’t wait to get back to Ashland City.

“My husband and I can’t think of a better place to call home,” said Louise Mandrell, sister of Barbara Mandrell. “It’s going to feel great to be back.”

Mandrell and her husband, John Haywood, moved to their home on the southern end of Ashland City more than 12 years ago, but she hasn’t spent much time here.

She has been performing several nights a week at her Louise Mandrell Theater in the Smoky Mountains for more than eight years, but that comes to an end on New Years Eve.

She performs her last show that night before returning to Cheatham County.

The theater was sold earlier this year and the new owners allowed her to stay through the end of the year.

“I always tried to get home in Ashland City about once a week,” she said. “But it will be nice to be back home for good.”

She plans on continuing her music career in the Nashville area in some form of entertainment.

One reason for her decision to leave Pigeon Forge was her husband’s health.

“John has (reflex sympathetic dystrophy syndrome) and I felt I needed to be closer to him more often,” she said.

RSD affects the body’s nervous system. Mandrell said she took her husband to Germany for treatment and that he is improving.

“It’s in remission now,” she said. “But he still suffers from some of the side effects.”

Recent rumors around Ashland City regarding the sale of her Cheatham County home as a site for a proposed Dollywood theme park are just that she said – rumors.

“That’s not going to happen,” she said. “My husband and I have gotten a laugh at all the talk about it, but we are not selling our property for it to become a new Dollywood.”

Many people driving south on Highway 12 toward Nashville notice the Mandrell property because of the large cross on the hill overlooking her home.

“My husband put that cross on the hill as a gift for me,” she said. “It’s helped complete our home.”

Once she returns in January, Mandrell said she looks forward to meeting new local people and seeing old friends as well.

“I love it when people come up to me in stores or just walking down the street,” she said. “If anyone sees me around town, please come up and say hello. I love the Ashland City community.”

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Couple wins suit against Wal-Mart

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Tallahassee, originally uploaded by rsdscrpsnews.

Couple wins suit against Wal-Mart
Jury orders retail giant to pay $1.4M

By Juana Jordan

A Douglas, Ga., couple won a round in court against the world’s largest retailer.

A Tallahassee jury of four women and two men awarded Larry and Judy Boggs nearly $1.4 million in a personal injury lawsuit against Wal-Mart Stores for an injury Larry Boggs suffered at the Wal-Mart SuperCenter on Thomasville Road

“I think the jury did an excellent job,” said Larry Boggs from his home Wednesday. “But this really didn’t have to go that far.”

An attorney representing Wal-Mart would not comment on the case. The verdict was handed down Jan. 20.

According to Boggs, a Wal-Mart employee at the store struck his lower left leg with an electric pallet jack while he stood on the loading dock. Boggs, an independent truck driver, was delivering pet food for a private contractor to the store on Dec. 21, 2003.

“Wal-Mart promised within 24 hours after the accident to myself and to my wife that we wouldn’t have to worry about anything,” said Boggs, who said he sustained a permanent injury to his ankle.

But the store failed to keep its promise, he said. That’s why he hired a lawyer. Jon D. Caminez and Ian Brown with Caminez, Brown & Hardee in Monticello represented Boggs.

Larry Matthews and Tricia Stafford at Bozeman, Jenkins & Matthews in Pensacola represented Wal-Mart.

“They didn’t take care of anything,” said Boggs, who has been diagnosed with reflex sympathetic dystrophy, a neurological disease marked by burning pain, stiffness and swelling. He now wears a brace on his left leg.

In court, Wal-Mart argued against Boggs having RSD. The judge dismissed the claim, according to Caminez.

Boggs was awarded $94,493.26 in the case heard before Circuit Judge Janet E. Ferris. The jury also awarded him $402,000 for future economic losses and $800,000 for pain and suffering. Judy Boggs was awarded $100,000 for the loss of her husband’s services.

“We’re satisfied that justice was done,” said Jon Caminez.

But that doesn’t mean the case is over, he said. No final judgment has been made. Wal-Mart can still move for a new trial. And it could still appeal, if motions presented are denied.

Contact Reporter Juana Jordan at (850) 599-2321 or

Originally published January 26, 2006

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CMMC hires new doctor

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Daniel R. Lalonde, M.D., originally uploaded by rsdscrpsnews.

CMMC hires new doctor

Daniel R. Lalonde, M.D., a fellowship trained interventional pain management specialist, has been appointed to the Central Maine Medical Center Medical Staff. He is the first specialist of his type in the area. He has opened the Central Maine Pain and Headache Center, which is part of Central Maine Neurology.

He specializes in the evaluation and management of pain and headache disorders, including: chronic pain from failed back or neck surgery; reflex sympathetic dystrophy and sciatica; peripheral neuropathy; complex migraine and chronic headache; and facial pain.

A Lewiston native, Mr. Lalonde graduated from Bates College and earned his medical degree at the University of Texas Health Science Center at San Antonio.

After completing an internship with the Department of Medicine at Maine Medical Center in Portland, he served a residency in neurology at the University of Texas Medical Branch in Galveston, Texas. During the final year of his residency he served as chief resident.

Prior to returning to the Lewiston-Auburn area, LaLonde completed a pain management fellowship with the Department of Anesthesiology at Henry Ford Hospital in Detroit. He also served a cerebrovascular fellowship at the University of Texas Health Science Center’s Division of Neurology.

He is practicing from the offices of Central Maine Neurology at 287 Main Street Plaza, Suite 404, in Lewiston. The practice can be contacted at 795-2927 or 1-800-308-0460.

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19 January 2006
By Clinton Manning

FORMER foundry worker Jeff Smalley has won almost £1.5million compensation after a horror accident – but he would give back every penny to hold his wife again.

The 62-year-old has to have his left arm amputated after an explosion at work. The tragedy struck 25 years after another accident led to him losing his right arm.

He said: “It’s a lot of money but I’d give it all back in an instant if I could have my arms back.”

His wife Linda said the worst thing was not being able to have a cuddle with her husband.

“We always used to hold hands when we went out for a walk,” she said. “It’s really awful not being able to put your arms around one another.”

Jeff was working for James Maude & Co in Mansfield, Notts, when a sandblasting machine exploded in November 2001.

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He was blown off his feet, broke his leg and ripped his left shoulder apart. Doctors tried surgery to repair the damage but it didn’t work. Jeff developed chronic regional pain syndrome which meant his arm and fingers are hyper sensitive. He is due to have his left arm amputated next week. “He’s in that much pain the operation will be a blessed relief in many ways,” said Linda, who quit her job at Asda to look after Jeff.

“He can’t use it and he’s taking about 16 tablets a day and he has morphine patches which he puts under his arm. Some days he’s so drugged up he doesn’t know where he is or – if he’s lucky – he just sleeps.”

Losing the use of his arms has also affected Jeff’s balance – but he hasn’t lost his sense of humour. He says: “I’ve fallen down twice. Once I broke my nose and split my head open so badly it needed 10 stitches.

“I can’t put my hands out to break the fall so the first thing that hits the floor is my hooter.

“I looked as if I’d got a tomato stuck on the end of it.” For Jeff the pain is made worse by not being able to play with his four grandchildren. After his first accident in 1980, he taught himself to paint with his left hand and to ride a mountain bike, cycling 200 miles a week to keep fit.

And shortly before the accident he started taking the eldest of his four grandchildren out for a ride. He said: “The eldest, Nathan, started to come out with me at weekends. I was looking forward to getting all of them out on the bikes.

“But now I can’t cycle anymore and I’ve put on about three stone.” His painting, too, will be impossible after next week’s surgery.

In Jeff’s first accident, in 1980, he dislocated his elbow and shoulder in a fall. Although a relatively minor injury he developed the infection CRPS. His arm was amputated five years later and he settled out of court with the company for £36,000.

Although the firm – which has since gone bust – admitted liability for the blast it took a four-year fight by the Amicus trade union and its legal firm Thompsons to win the insurance pay-out. “The union’s been absolutely brilliant,” said Jeff, “and Peter Magee at Thompsons. I don’t know what we’d have done without their help.”

Amicus legal services director Georgina Hirsch said: “This is an absolutely tragic case.

“No amount of money will ever make up for Mr Smalley’s loss. But the outcome highlights the support trades unions can give to members injured at work.”

‘No amount of money can make up for this loss

Original Article @–will-of-iron–name_page.html