DEAR DR. DONOHUE: I was diagnosed with reflex sympathetic dystrophy, RSD, in both hands after surgery on them. I never heard of it. Many people I talk with have never heard of it. What is it? How is it treated? They say it is inherited. Will you please explain it to me? – B.L.

DEAR DR. DONOHUE: I recently read that Paula Abdul has complex regional pain syndrome. Can you give me any information on it? – W.D.

ANSWER:
Reflex sympathetic dystrophy got the name because the sympathetic nervous system was believed to be a major player in it. We have no control over the sympathetic nervous system. It runs on automatic pilot and controls things like heartbeat, blood pressure and blood vessel constriction. Newer knowledge disputes the pivotal role of the sympathetic nervous system in RSD, so it’s now called complex regional pain syndrome.

A broken bone, a sprained joint, surgery, an auto accident, a heart attack, a stroke or a minor cut or injury initiates complex regional pain syndrome, CRPS. About three weeks after the original injury, new pain and swelling appear at the injured site. The pain is described as burning or throbbing and far out of proportion to the injury. Skin around the injury reddens and swells, and is sensitive to the slightest touch. If a joint is involved, it often stiffens. With the passage of time, muscles weaken, skin thins and pain persists.

CRPS is not inherited. It’s a dreadful complication whose cause has yet to be discovered and whose treatment is difficult. I didn’t know that Paula Abdul suffers from it.

A doctor, along with an occupational and a physical therapist, can devise a program of exercise and treatments that keep joints limber and restore muscle function. Pain relief is, of course, crucial. Medicines like Advil, Motrin or Aleve might be all that’s needed, but quite often stronger medicines have to be prescribed. Lidocaine skin patches have helped some. Neurontin, a seizure medicine, is also useful for pain control.

The Reflex Sympathetic Dystrophy Syndrome Association stands ready to help those afflicted with it. The number is 877-662-7737, and the Web site is www.rsds.org.

DEAR DR. DONOHUE: I am an 83-year-old female and in good health other than high blood pressure that is controlled with medicine. Recently I had a CT scan, which showed a noncancerous brain tumor. So far it has not affected me in any way. Please give me information on this tumor and its treatment. I am scheduled for another brain scan in six months. – A.L.

ANSWER:
Your brain tumor is a meningioma (men-IN-gee-OH-mah). It’s not a tumor of the brain itself, but it’s a tumor of the brain’s coverings, the meninges.

It’s called “benign” because it doesn’t spread. Usually, it grows very slowly. It can cause symptoms if it becomes so large that it puts pressure on the brain.

If a meningioma is not causing symptoms, it does not need treatment.

You’re getting all the care you need for this tumor. Your doctor is watching you and it closely. If the times comes that it needs treatment, it can be surgically removed. Sometimes radiation is given in conjunction with surgery. At age 83 and with no symptoms, chances are you will never need treatment for it.

DEAR DR. DONOHUE: I have heard of organ-cleansing diets several times in the past months. Some people I know have gone on these diets to cleanse the liver, kidneys and bowels. Some have bought books that describe the diet. One person used a product for cleansing that can be purchased online. Do you know if these diets and products contribute to health? – B.C.

ANSWER:
I firmly believe that nature made us in such a way that our organs and our digestive tracts cleanse themselves without our interference. Only if we become sick do our organs need outside help. Meddling with them unnecessarily is not a way to prevent illness.

Much of this cleansing desire comes from times gone by, when it was believed that the bowel was poisoning us with toxins. That’s not true. These are my opinions. You’re welcome to accept or reject them.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


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