Many moons ago, while stationed aboard the USS Mount Baker (AE 34) as a Navy Chief, I was struck by a military van and knocked off the road while running the physical fitness test on a Navy base.
It resulted in multiple fractures of my right hand’s metacarpal bones and the development of a rarely heard of disease called Reflex Sympathetic Dystrophy (RSD now called Complex Regional Pain Syndrome).
Before I explain what RSD is, I would like to frame it with the fact that there is no cure. At most, one may only wish (or pray) for long periods of remission…
In layman’s terms, RSD causes the Sympathetic Nervous System (SNS) to go into overdrive. The SNS is the nervous system mechanism that stimulates our body’s fight-or-flight response when you are injured. Among other things, these nerves raise your heart rate and provide excruciating pain to ensure that you are aware of the interruption to your homeostasis. You might wonder what the SNS might feel like with the addition of RSD?
First, long after your injury is healed, imagine that RSD will continuously transmit a “current injury” message to your SNS because RSD truly believes 24/7 you were just now hurt. This means that your past injury feels as if it has just now been insufferably injured − EVERY SINGLE DAY FOR WEEKS, MONTHS, AND YEARS.
Your previously-injured appendage will continue to weaken, minimal blood flow will cause the entire area to turn blue, hair will cease to grow, and the skin will become shiny in an unhealthy way. RSD is unrelenting and the chronic pain it creates is powerful enough to make you certifiably insane. This kind of insanity convinces you that walking out in to traffic would be better than enduring yet another day of pain over an appendage that has been healed for more than a decade.
This happened to me.
Simply put there was, is, nor will be anything “sympathetic” about my Sympathetic Nervous System.
Fortunately, the US Navy was apparently on the cutting edge way back when. They invested a great deal of time, expense, and effort to afford me a very broad (and therefore uniquely effective) biopsychosocial approach to recovery.
Initially, I was just given a heavy dose of morphine (in full transparency, I took morphine daily for over a decade). However, it became apparent that my health issue was far more complicated than a simple broken hand. My orthopedic doctor added mental health, occupational therapy, biofeedback therapy, coping skills counseling, and family counseling to provide me with the most optimal path to recovery. I was sent to Navy hospitals in several different states, as well as, civilian specialty clinics. It made all the difference in the world.
I experienced the Kubler Ross five stages of grief over the loss of using my right hand, the incessant pain, and likely loss of my career. In response, my doctors were ensuring that I had a toolbox of skills to cope with all of the above. It was sort of like that Mastercard commercial… the biopsychosocial approach was “priceless.”
Why was it priceless?! Because RSD is always there. Remember the “fight or flight” response? Whether it be yesterday, today, or tomorrow − any time I am scared, sleep deprived, taken by surprise, exceptionally stressed over an exam, or God forbid another injury to that area… the RSD will flare again. My arm will instantaneously feel on fire and begin to swell, as if I was just struck by the van all over again. It is overwhelming and maddening − it takes my breath away and significantly impacts my behavior, while outwardly others have zero indication of my physical distress.
In hindsight, I’ve decided that my nervous system isn’t very sympathetic. Although my “recovery” was arduous and took forever, I am eternally grateful for the coping skills the Navy’s healthcare system afforded me.
If this should ever happen to you I would highly recommend researching the following websites and making yourself aware of more constructive treatments than just the crutch of opioids.