FWD:Good doctor' helps woman deal with disease

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From: byrd45 (Original Message) Sent: 3/17/2007 10:22 AM



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`Good doctor' helps woman deal with disease

By Nick Schneider, ASSIGNMENTS EDITOR



Elizabeth Ochoa, who serves as executive director of the Greene County Alcohol and Drug Services office in Bloomfield, counts herself lucky that she's been blessed with what she called a "good doctor" who recognized a severe medical problem that afflicts her and knew what to do about it.

She's been diagnosed with Reflex Sympathetic Dystrophy, also known as Complex Regional Pain Syndrome - RSD or CRPD for short. It is a progressive disease of the autonomic nervous system with its key component being damage to a nerve, either major or minor.

RSD/CRPS Type I can follow a simple trauma (fall or sprain), break or fracture (especially wrist and ankle), a sharp force injury (such as a knife or bullet wound), heart problems, infections, surgery, spinal injuries/disorders, RSI's (Repetitive Stress Injuries), CTS (Carpal Tunnel Syndrome), Tarsal Tunnel Syndrome, injections, and even some partial paralysis injury cases.

Until late 2005 there was no way to test for or confirm Type I, commonly called RSD, and often times patients were doubted because of that.

"If I hadn't had a good doctor to tell me what was wrong with me I could have lost the use of my foot and then my whole leg," Ochoa recently revealed.

Ochoa said she was first diagnosed about three years ago after she had a serious ankle surgery.



"I was getting better and I was on crutches for several months and then all of a sudden I quit getting better and I started having this extreme burning like someone was pouring acid on my ankle. I mean it was really intense and it hurt awful," she recalled.

She consulted with Dr. Kevin Powers, a Bloomington podiatrist, and after he ran several tests, it was determined that she suffered from RSD.

"I said, `Can't you just give me a pill and fix it and maybe it will go away'. He said, `No this is serious. You could lose the use of your limb. You have to go see a specialist," Ochoa recalled.

Dr. Powers wanted to be certain it as RSD and Ochoa was referred to Dr. Raj Tewari, MD, who practices at Methodist Hospital in Indianapolis, and the diagnosis was soon confirmed.

"Basically what it (RSD) does is your central nervous system sends messages to your brain that the area that was injured or operated on is still injured or hurt. It breaks down everything. You have this severe nerve pain, burning and all of those things. It's really bad," Ochoa explained.

According to the American RSD Hope Web site, RSD/CPRS Type II involves definable major nerve injury. It was once known as Causalgia.

As many as 65 percent of RSD cases come from soft tissue injuries such as burns, sprains, strains, tears, bursitis, arthritis and tendonitis.

RSD is a mult-symptom condition affecting one, two or sometimes all four extremities. It can also be in the face, shoulders, back, eyes and other areas as well. It is an involvement of the nerves, skin, muscles, blood vessels - causing constriction and pain - as well as bones.

Anyone can contract it - but is more prevalent in women than men and can affect all age groups.

Medical experts says there is no denying the extreme pain associated with RSD.

On the McGill Pain Index - a medically recognized method to measure pain, RSD rates 42 on a 50 point scale.

"It (the pain) can be just so extreme that cutting off the limb (by amputation) doesn't do any good at all because the central nervous system still sends those messages to your brain whether it (the limb) is there or not and you will still have the pain," she said.

Soon after confirmation of her diagnosis, Ochoa was started on a series of injections in her lower back - into the spine - twice a week and got RSD into remission.

Ochoa, who has been in remission for about 18 months, was fortunate, because if RSD progresses to a certain stage you can't be helped. She is also thankful that her case was benefited by an early diagnosis which put her quickly in touch with someone who could address the illness.

"Doctors don't have a lot of knowledge about it (RSD). It doesn't reflect that they are a bad doctor, but there is just an urgency about it (the disease). If I had not gone to someone who could have diagnosed it, I would really be in big trouble right now. I come out of remission every once in a while and have to have shots in my back," she pointed out.

Since first going in remission, she has relapsed twice - once after gall bladder surgery and again after a kidney infection.

"Any time there is any kind of trauma to another other part of your body it can get you out of remission," Ochoa said. "But I had to start that series of shots again which have always been effective for me."

Recently, she had another scare following elbow surgery last fall.

About four months after that surgery, she again experienced the familiar burning and intense pain and knew she was again out of remission.

She immediately consulted Dr. Tewari and he advised her that she would again have to undergo a regimen of shots to avoid further complications.

This round of injections had to be carefully done with a six-inch long needle inserted through the front part of her neck into her spine. The injections affect her vocal cords - preventing her from talking for about eight hours afterwards. She also has experienced nausea with this new injection location.

"It's terrible, but I wake up in a few days and I'm better every time," she added with a big smile.

Ochoa said she's resigned to the fact that she'll have to live with RSD for the rest of her life and the chance of coming out remission is always looming.

She feels it's important for her to get her story out to the public in order to possibly help someone else who might be battling similar symptoms and unaware of what it is or what to do.

"If they know, then they can see about doing something about this before they are crippled for the rest of their life from it. They can get treatment and it will be effective treatment before it's too late for them," Ochoa said. "Once it gets to a certain point (untreated) there is no return."

She continued, "I don't want anyone to wind up crippled from it needlessly because no one knew the proper diagnosis, and no one knew the importance and urgency of being treated immediately. Because once you get past that point nothing is going to be effective."

Ochoa, a Bedford native, has worked in the Greene County alcohol and drug office since last August. She came back to Indiana after working law enforcement-<WBR>related jobs Corpus Christi, Texas, and Indianapolis. She most recently served in Washington, where she was a probation officer in Daviess County. She holds an elementary education degree from Indiana University.

Ochoa heads a program that has clients assigned by the two local courts as a part of sentencing orders handed down by Superior Court Judge J. David Holt and Circuit Court Judge Erik Allen on a variety of misdemeanor and felony charges involving drug and alcohol use and abuse.

She lives in Bedford and is the single mother of a 22-year-old daughter, Ashley and a 17-year-old son, Drew.

"People need to be educated about RSD because knowledge is power and it can save you from a lifetime of grief if you get in fast enough, get treated and get help for it," she concluded.


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