Another CRPS Review Article -- Oh, and Jose Ochoa is A Turd!

Here's another one of those much-touted but essentially useless "review" articles. I know I am being super-crabby, but I figure *someone* was about to perish for lack of publications...

And yet, I reproduce the abstract and necessary link information here because...

[Hmm]

Well, because perhaps you, Dear Reader, are looking for just the type of global view that this article provides. I know that were you to rely on a summary article on CRPS from a decade ago, there would be scads of misinformation and some very tired opinions {blocks:blocks:blocks}. The work on inflammatory processes, alone, has dated such reviews and some foundational research has effectively silenced assholes like Ochoa.*

I suppose I ought to summon more basic human kindness, also, given that the authors' expected audience is one of cardiovascular specialists. Though I've not met anyone with CRPS whose disease began after a heart attack, I've read that this is not all that uncommon. It's not something I can wrap my mind around -- this involvement of internal organs.

{don'twannathinkaboutitdon'twannathinkaboutitdon'twannathinkaboutit}

Complex Regional Pain Syndrome: State of the Art Update
Current Treatment Options in Cardiovascular Medicine
ISSN 1092-8464 (Print) 1534-3189 (Online)
Authors: Patrick Henson, DO; Stephen Bruehl, PhD (Vanderbilt UMC)

Although the pathophysiology of complex regional pain syndrome (CRPS) is not fully understood, it appears to reflect multiple interacting mechanisms. In addition to altered autonomic function, a role for inflammatory mechanisms and altered somatosensory and motor function in the brain is increasingly suggested. Several possible risk factors for development of CRPS, including genetic factors, have been identified. Few treatments have been proven effective for CRPS in well-designed clinical trials. However, recent work suggests that bisphosphonates may be useful in CRPS management and that the N-methyl-d-aspartate receptor antagonist ketamine significantly reduces CRPS pain when administered topically or intravenously at subanesthetic dosages. Extended use of ketamine at anesthetic dosages (“ketamine coma”) remains a controversial and unproven treatment for CRPS. Spinal cord stimulation may be effective for reducing pain in approximately two thirds of CRPS patients not responding to other treatments, but its efficacy appears to diminish over time.

*Ugh. It's been a long while since I gave José L. Ochoa even the beginnings of a thought... The man is a turd. Yes, that's my considered -- and, believe it or not, quite reserved -- opinion. You cannot imagine the emotional pain someone like him causes to the newly-diagnosed who are out grazing among the available literature. He has made a living testifying against hundreds of people in workman's compensation cases and owes his soul to the insurance industry.

Some of you are going to pooh-pooh this woman's resistance to having her hand blown on by Dr. Ochoa. I can tell you that the pain from such a stimulus can be severe and may also launch a pain cycle that can last hours.

As for his "explanation"? You really don't want me to go there...






Addendum 3/22/2010 -- The citation below is from an appeal decision which, in part, deals with the "expert testimony" of Dr. Ochoa. The Third Circuit Court of Appeal found that his conclusions about "RSD" were not reliable or scientifically sound, and excluded his testimony.
I am only slightly nervous that Dr. Ochoa considers negative opinions about his capabilities to be "slander."

From: STATE OF LOUISIANA
COURT OF APPEAL, THIRD CIRCUIT
CA 08-1289
JANELL ERNST
VERSUS
DR. FLYNN A. TAYLOR, ET AL.

The trial court is granted broad discretion in determining who should or should
not testify as an expert. Cheairs v. State ex rel. Dep’t. of Transp. and Dev., 03-680
(La. 12/3/03), 861 So.2d 536. It is within the trial court’s discretion to decide if an
expert is qualified and competent to testify in specialized areas, and its decision will
not be overturned absent an abuse of discretion. Id. Louisiana Code of Evidence Article 702 provides for the admission of expert testimony “[i]f scientific, technical, or other specialized knowledge will assist the trier of fact to understand the evidence or to determine a fact in issue, a witness qualified as an expert by knowledge, skill, experience, training, or education, may testify thereto in the form of an opinion or otherwise.”

Expert testimony, like any other form of evidence, must be
relevant; it is subject to the La.Code Evid. art. 403 balance whereby its
probative value is weighed against the “danger of unfair prejudice,
confusion of the issues, or misleading the jury, or by considerations of
undue delay, or waste of time.” If its probative value is substantially
outweighed by these factors, the otherwise relevant evidence is
inadmissible.

McPherson v. Lake Area Med. Ctr., 99-1876, p. 8 (La.App. 3 Cir. 5/24/00), 767 So.2d
102, 107, writ denied, 00-1928 (La. 9/29/00), 770 So.2d 353.

The following four-part inquiry should be used in evaluating whether expert
testimony should be admitted:

(1) whether the witness is qualified to express an expert opinion, (2)
whether the facts upon which the expert relies are the same type as are
relied upon by other experts in the field, (3) whether in reaching his
conclusion the expert used well-founded methodology, and (4) assuming
the expert’s testimony passes these tests, whether the testimony’s
potential for unfair prejudice substantially outweighs its probative value
under the relevant rules.
Id. (quoting Adams v. Chevron, U.S.A., Inc., 589 So.2d 1219, 1223 (La.App. 4 Cir.
1991), writ denied, 592 So.2d 414, 415 (La.1992).

It is clear that Dr. Ochoa was called to testify that the diagnosis of RSD is no
longer an accepted diagnosis in the medical community, and therefore, Ms. Ernst
cannot be suffering with RSD.

Dr. Ochoa admitted that he never examined Ms. Ernst. He only reviewed her medical records. Dr. Ochoa explained that since the 1990’s the new nomenclature for RSD is complex regional pain syndrome I (CRPS I). CRPS II is a separate condition that exists when there is a definite nerve injury. He testified that CRPS I is a diagnosis when the patient complains of pain following an injury associated with moderate sensory phenomena. There might be changes in color and
temperature. There is no nerve injury, and the cause is unknown.

Dr. Ochoa testified that he had never diagnosed CRPS I because CRPS I is not a diagnosis.

There is no doubt that Dr. Ochoa is well-educated and trained. He obtained his
medical degree in Chile where he was born and raised. He studied for eight years at
the Institute of Neurology in London. He then came to Dartmouth Medical School
in New Hampshire where he ran the nerve and muscle clinic for ten years. Dr. Ochoa
then moved to the University of Wisconsin to teach neurology. He is presently at the
Good Samaritan Hospital in Portland, Oregon, and associated with the Oregon Health
& Science University. He has been in Oregon for twenty-one years. He has
published about 150 peer-reviewed articles and chapters in books used in teaching.
He now practices specialized neurology dealing with nerve disease, pain, abnormal
sensation, and sympathetic dysfunction.

However, Dr. Ochoa has not taken the neurology board certification examination and is not board certified in any field. Dr. Ochoa’s bias was called into question in the traversal of his qualifications.

He has testified in hundreds of cases. Only two of the cases in which he testified in
court were on behalf of the plaintiff. He admitted that most of his cases over the past
fifteen years had been sent to him by the defense. Approximately ninety-five percent
of the cases dealt with RSD.

However, it was also clear from his testimony that he offered no basis or other
scientific support for his conclusion that RSD was no longer a valid diagnosis other
than his own testing and his testimony that there were many doctors who supported
his conclusion. Dr. Ochoa did agree that there are physicians who disagree with the
position he has taken regarding RSD. However, Dr. Ochoa testified that any
physician who believed that RSD was a valid diagnosis was not a preeminent
physician.

Dr. Ochoa was also questioned about cases in other states in which the
courts have acknowledged that Dr. Ochoa had a reputation as being hired to refute
RSD claims. In regard to these questions, he opined that he had been slandered.

Dr. Ochoa could not offer any medical evidence, other than his own personal
studies, for his theories that RSD was no longer a viable diagnosis. No studies by
other doctors were offered in support of his conclusion that RSD is no longer a valid
diagnosis. Dr. Ochoa admitted that there were many medical books that recognized
that RSD, or CRPS, is a disabling condition. There was no evidence or testimony
offered to indicate that Dr. Ochoa’s conclusion is reliable or scientifically based.
Therefore, we find that the trial court erred in not excluding Dr. Ochoa’s testimony.
Accordingly, in conducting our de novo review, we will not consider the testimonies
of Drs. XXXXX or Ochoa.

Three Months Later: José Ochoa, *Still* A Big, Fat Turd

Do you remember the couple of posts wherein I called José Ochoa a turd?  No?  Well, you can read up on this poor excuse for a hackjob doctor here and here. 

Or you can keep reading this post, as I am about to call José Ochoa a turd one more time.  He's co-authored an eight-page article painting people diagnosed with CRPS as malingerers, as suffering from conversion disorder, or -- now isn't this kind of him to allow? -- as harboring "unrecognized pathology (lesions) of the nervous system."

He has built a lucrative career testifying about his [now very lonely] contention that CRPS does not exist. His forensic testimony has less and less influence as hard science advances, but his path remains littered with broken lives -- lives financially ruined, physically and emotionally devastated by his self-enrichment campaign.

Am I questioning the data he reports?  Not at all.

Do I propose canonization of people with CRPS, an affliction that only strikes the angelic, a syndrome often caused by work-related injuries, associated with legal action, and therefore never feigned by lazy dipshits? Nope!

I do protest the authors' simultaneous display of contempt for "the label" CRPS and their ready glee to paint all those diagnosed with CRPS with the same brush as those identified as malingerers.  In lieu of identifying the defects in the diagnosis process, they have assumed a character defect in the vast majority of real sufferers. 

It's tiresome, it's disgusting, and Ochoa needs to find a new way to invent scientific support for his true calling:  his own enrichment.

I am almost completely out of line in writing this blog post, but I really don't care.  I have not read the article I am maligning, would not spend the money to buy it or to subscribe to the journal, and have no basis for attacking the study results.

I am just mad that Ochoa has been published again, that he has found another means of advancing his loathesome small-mindedness and greed.

Don't get me wrong, I know that many doctors and most researchers are fully cognizant of his malicious intent. It's just that his energies would be better used -- and actually appreciated! -- were he to channel them toward, say, working with the IASP and their efforts to produce workable, effective diagnostic criteria for CRPS.  The data he is producing does nothing but make that endeavor even more worthwhile.  The better the diagnostic criteria, the fewer malingerers abusing the justice and health systems.

I am the last person to contest legitimate dissent, no matter the subject matter. But neither am I going to assert the rights of an academic who might, for example, publish work after work about the Holocaust as a fiction, no matter how well-documented. (I am not trying to aggrandize CRPS as a topic, that is just the first instance that came to mind. So let me add that neither would I debate The Texas School Board on textbook choice or history and science curricula!)

In the years 1997-2009, Dr. Ochoa has earned, according to his own testimony, between $300,000 and $400,000 a year -- over a 12-year period, he has made between 3.6 and 4.8 million dollars by denying the existence of CRPS. Given that there is no research that legitimizes his claim, it makes sense that he needs to publish something, periodically, that he can use to maintain his claim to be an expert. There simply is NO currently valid research to which he can point, beyond what he manages to publish.

God help the poor patient with CRPS whose unsuspecting family doctor refers him to The Oregon Nerve Center, to Dr. Ochoa. Hoping for treatment, these patients will instead be subjected to his pre-suppositions about their physical symptoms and psychological makeup.

The worst crime of all?  The delay in treatment -- which can obviate the possibility of a fairly easy cure -- that may result from Dr. Ochoa and his campaign against the existence of CRPS.

ABSTRACT
Neuropathic Pain Syndrome Displayed by Malingerers
José L. Ochoa, M.D., Ph.D., D.Sc. and Renato J. Verdugo, M.D., M.Sc.
J Neuropsychiatry Clin Neurosci.2010; 22: 278-286

Received October 27, 2009; accepted April 1, 2010. The authors are affiliated with The Oregon Nerve Center at Legacy Health Systems and the Departments of Neurology and Neurosurgery at Oregon Health and Science University in Portland, Oregon; Dr. Verdugo is also affiliated with the Department of Neurology, Faculty of Medicine, Universidad de Chile, in Santiago, Chile. Address correspondence to José L. Ochoa, M.D., Ph.D., D.Sc., The Oregon Nerve Center, Good Samaritan Medical Center, 1040 NW 22nd Ave., Suite 600, Portland, OR 97210; jochoa@nervesense.net (e-mail).

Among 237 patients communicating chronic pain, associated with sensory-motor and "autonomic" displays, qualifying taxonomically for neuropathic pain, there were 16 shown through surveillance to be malingerers. When analyzed through neurological methods, their profile was characteristically atypical. There were no objective equivalents of peripheral or central processes impairing nerve impulse transmission. In absence of medical explanation, all 16 had been adjudicated, by default, the label complex regional pain syndrome (CRPS). The authors emphasize that CRPS patients may not only harbor unrecognized pathology ("lesion") of the nervous system (CRPS II), hypothetical central neuronal "dysfunction" (CRPS I), or conversion disorder, but may display a recognizable simulated illness without neuropsychiatric pathology.
[You may read more HERE]








NOTE: The law firm had to take down this illustrious video because Ochoa sued them, saying it cost him revenue.  What a turd.  There's an excellent unbiased summation of the non-board certified Doctor Ochoa by the Third Circuit Louisiana State of Appeals Court HERE. As for what you would have seen in the video -- the patient being examined by The Turd asks him to be aware of the severe allodynia she has in her hand.  He proceeds to blow on it and also to pinch it -- saying, in what can only be the cutest SCOTUS reference of all time, that he was just removing the "pubic hair" that was somehow on her hand.  I say again:  turd, turd, turd.

Posted to YouTube by LawlorWinston | September 21, 2009, with this comment:

Here we see Dr. Jose L. Ochoa, a defense-retained expert, in a portion of his examination of a woman whom six other physicians, including another defense-retained expert have diagnosed with RSD/CRPS-1. The Plaintiff, who suffers from crippling neurological pain, has requested Dr. Ochoa not blow air on her affected extremities.

RSD is an abbreviation for "Relex Sympathetic Dystrophy", also referred to as "Complex Regional Pain Syndrome" (CRPS).

Dr. Ochoa has become one of the foremost experts used by Defendants in lawsuits involving RSD/CRPS by denying that this condition is an actual "diagnosis". His opinions have been stricken or otherwise disallowed as unscientific in at least three States.

[Trust me, I'd much rather be watching a video over at PTZ.  I keep waiting for Ochoa to be featured over there, but I guess Emilbus only has room for so many explosive pilonidal cysts.]

Jose L. Ochoa, M.D. Defies Entire Febreze Advanced Odor Eliminator Air Effect Line

Can't sleep, need to go to the bathroom, but cannot get my legs to work.  So I did what any reasonable person would do... I browsed rulings posted on Justia.com -- and due to some strange lurking noted earlier in the day, I did a search on the much loathed Dr. Jose Ochoa of the Oregan Nerve Whatever Whatever, his cover for the outrageous pimpitude in which he has engaged over these lo, so many years, causing pain, suffering, heartache, and financial devastation to hundreds of people with CRPS.

As I often note, but only after complete exhaustion of my penchant for scientific rigor, having done a skin-scraping, a DNA-analysis, and a whiff-test: Dr. Jose Ochoa of the Oregon Nerve Center for the Denial of CRPS ("so long as you're payin'!") -- is a turd.

Anyway, if you're ever scheduled to see this man about a potential case of CRPS, or are ordered to do so should you be involved in litigating a settlement, well...

1.  Be sure you show up to the IME with your own videographer.
2.  And please, for goodness' sake, wash up a bit first.  That way Dr. Ochoa won't need to blow on the supersensitive skin on your CRPS-involved hand, or pluck at it, in order to remove a stray pubic hair.

If you're my sort of nerd, the kind that enjoys watching televised school board meetings, and enjoys Robert's Rules as bedtime reading, this ought to keep you happy for an hour or so.

Forgive me for not going over the turdish ways of this doctor -- I lack the energy, and suppose that, like the poor, we will always be beset by Ochoas.  If you wish to see past emotional purging rages about his unethical, self-serving practices, just put "Ochoa" in the search box, up there in the upper left.

Anyway, here's the link to some fun reading, which concludes (I'm not giving away any great secret) that it's not so much people bad-mouthing Dr. Ochoa that has eaten into his nausea-inducing income levels as a hired gun for the insurance industry -- no, it's the fact that he can produce no plausible science to support his outmoded claims, and that he does nothing any longer but make juries and judges dizzy by an infernal self-referentiality.

ENTIRE DOCUMENT, downloadable pdf format
Signed on 2/7/13 by Judge Ancer L. Haggerty.


UNITED STATES DISTRJCT COURT 
FOR THE DISTRJCT OF OREGON 
PORTLAND DIVISION 

OREGON NERVE CENTER, LLC, an 
Oregon limited liability company, and 
JOSE L. OCHOA, M.D., 
Plaintiffs, 

v. 

LAWLOR WINSTON, LLP, a Florida 
limited liability patinership, 
Defendant. 

HAGGERTY, District Judge: 
Case No.: 3:11-cv-01433-HA

OPINION AND ORDER 
Plaintiffs, Oregon Nerve Center, LLC, and Jose L. Ochoa, M.D. ("Ochoa") filed a single 
tmi claim against defendant, a Florida-based law firm, for intentional interference with economic 
relations. Defendant seeks summaty judgment on plaintiffs' sole claim on several grounds, 
including lack of personal jurisdiction and plaintiffs' inability to establish the elements of their 
claim. The comi held oral argument on defendant's motion on Januaty 31, 2013, and then took 
the matter under advisement. For the following reasons, defendant's Motion for Summary 
Judgment [64] is GRANTED.

© 2013 L. Ryan

Jose Ochoa, Famed Medical Turd, Has Doppelgänger in Metro Atlanta

dop·pel·gäng·er

ˈdäpəlˌgaNGər/

noun

1. an apparition or double of a living person.

   "he has a doppelgänger named Donald, his invented twin brother"

*******************************************************************

I am beyond upset.  As is Heinrich, er, um, I mean, of course, Fred.  Let me start over.

You must be wondering about the title of this post: "Jose Ochoa, Famed Medical Turd, Has Doppelgänger in Metro Atlanta."  Please do not take the opening lines of this already gooberish bit of writing as an insult to your intelligence.  I know you know what or whom a doppelgänger is, and that the example Google chose to offer for correct usage -- that hilarious bit about the invented Donald -- is Gooberism at its most extreme.

First, Jose Ochoa.  If you don't know His High Turdishness, feel free to enter "Ochoa" in the upper left search box on this page.  Actually, I believe there is also search capacity on the right side of this page, as well.  We aim to enable here at elle est belle la seine la seine elle est belle. Here is the short version, in case you're getting so hot under the collar that me asking you to do something so small and [ultimately] time-saving as reading a bunch of old posts about The High Turd Ochoa has caused you to develop a rash on your poor overworked neck:  He's a doctor, or so people believe, who has made a large fortune testifying in workers' compensation hearings, or performing sadistic forensic "independent medical exams" for workers' comp or other large insurance agencies.  He specializes in making sure CRPS patients never receive appropriate medical care or desperately needed funds with which to buy food and pay rent.  His specialty is thus refined because inherent to his qualifications are numerous humorous articles which refute the very EXISTENCE of CRPS.  Unfortunately for His Turdishness, Big Science, Big Workers' Comp, and virtually all Big Insurance Companies, have left him in the dust, especially now that he can only use citations of his own "work" to bolster his baseless and hilarious claims.

Now, I've no desire to be sued by Jose Ochoa, and from the number of "hits" that articles about him receive that originate within 5 miles of his home base, he and his misled associates are constantly checking on his "turd" status here in Marlinspike Hall.  

"Hmm, I wonder if I am still a Turd.  Better check that helpful blog again..." [logs on to elle est belle la seine la seine elle est belle via a well-traveled link to his favorite laudatory post, "Three Months Later: José Ochoa, *Still* A Big, Fat Turd."]

There's an excellent unbiased summation of the non-board certified (in *any* medical specialty) Doctor Ochoa by the Third Circuit Court of Appeals in the State of Louisiana HERE. 

While I'm ranting, and I'll stick with that verb choice, despite its inaccuracies, I'd like to dispute the ugly rumors that I am just angry at being stuck raising an Ochoa Love Child with no support from my Baby-Daddy.  Doctor Ochoa and I have never had the opportunity to meet, speak, exchange emails or psychically teleport (in terms of matter, as well as thought, including his submicroscopic, sluggish spermatozoa and my plump, beautiful ova).  I know nothing of his personal life, beyond logical deductions of habits groomed by greed, and assume that he's happily married, and probably the head of some dynastic empire. I don't really know.  There is NO LOVE CHILD, so just stop repeating that. And if there were, you can be darned sure that Jose Ochoa would pay support for the poor thing... or my name isn't Retired Educator!  er, Profderien!  um, Channeller/Medium of Bianca Castafiore! oof, Definitely not that "L. Ryan" person!

Okay, so now you have the broad outline of my personal opinion of Jose Ocho, as well as that of the Third Circuit Court of Appeals in the State of Louisiana, that bastion of liberality. 

*** I just dropped by the general web site of the Third Circuit Court of Appeals and was RUDELY escorted out.  Let me share with you what I learned through ignorance, which, when of the law, is no excuse.  They have a freaking DRESS CODE: "All counsel appearing before the court shall be appropriately dressed in business attire. Men shall wear a coat and tie. No denim is allowed." Despite my assurances that my advanced and highly hoity-toity degrees were all related to French, literary criticism, and linguistics (though I might have blubbered "linguini," which would explain a few things) and that, as channeller of the Milanese Nightingale, Bianca Castafiore, my neon yellow beret and 1859 hot pink silk ball gown over red hightop, stiletto-heeled, punk tenny pumps were perfectly appropriate...

The next thing you might be curious about is how Fred and I got to Metro Atlanta from our usual location West of the Lone Alp in the land of Tête de Hergé.  Well, that's easy!  We "borrowed" one of Captain Haddock's miniature submarines and used the wormhole extending from the bottom of Our Algae-Plagued Moat to get to Atlanta's very creepy northern suburbs.  Since that's where my new ACA-provided MarketPlace HMO health insurance wanted me to go for my first neurological appointment for the accursèd CRPS spasms and CRPS-induced hypertension... who was I to complain about the minor inconvenience of hitching a ride through [?] a wormhole in a miniature submarine belonging to my cartoonish boss?

Captain Haddock.  Hey, is YOUR boss on Wikipedia?

Now, having resolved any possible qualms my more habitual readers might entertain about this post -- fear that the Turd Ochoa will breach the defenses of Marlinspike Hall with a warrant for libel or slander or false paternity claims, concern that we had to travel to the center of backward fake conservatism for medical care -- I can finally proceed to an explanation of Dr. Ochoa's doppelgänger.

Because I am Honest-to-God afraid of Dr. Ochoa's doppelgänger, I shall not name him.  Okay, his initials are RJW.  Roald Joseph "Joe Cargo" Wasserman.  Yeah, that'll do.  Dr. Roald Joseph "Joe Cargo" Wasserman, it is!

Roald Dahl (/ˈroʊ.ɑːl ˈdɑːl/;[1] Norwegian: [ˈɾuːɑl dɑl]; 13 September 1916 – 23 November 1990) was a British novelist, short story writer, poet, fighter pilot, and screenwriter.
Joseph Michael "Joe Cargo" Valachi (September 22, 1903 – April 3, 1971), Italian American, also known as "Charles Charbano" and "Anthony Sorge" was the first Mafia member to publicly acknowledge the existence of the Mafia. He is also the person who made Cosa Nostra (meaning "Our Thing") a household name.
The Wassermann test or Wassermann reaction (WR)[1] is an antibody test for syphilis, named after the bacteriologist August Paul von Wassermann, based on complement-fixation.

Because I believe in sharing as many spontaneous "excited utterances" as possible, I will now resort to copying-and-pasting a recent electronic wormhole transmission, because Fred and I are safely back at home in Captain Haddock's ancestral manor.  It may be slightly redacted.  But whose blog is it, anyway?

An Anonymous and Amazing Friend (I have a few!) wrote, having intercepted some rabid but innocent, off-the-cuff, breezy allusion to "NEUROLOGICAL RAPE":

Okay, what's going on with you????
Are you in HIGH pain????

You'd like her.  I sure do.  We are, in fact, sending a drone miniature Haddock Corporation submarine to her secret location as you and I "speak," Beloveds.  Why?  She's bringing PIE, a known curative for all that ails one.

It's a Marlinspike Hall rule, cross-stitched on a pillow even:  "You must answer all Anonymous and Amazing Friends' electronic or cross-dimensional communiqués, no matter how freaking painful it is to type or twitch your nose à la Bewitched."  What is not mentioned on the pillow is our true motivation 
-- "Keep your friends happy and they might bring you pie!"

Actual Official eDocument concerning the Doppelgänger of 

Famed Medical Turd, Jose Ochoa, in Metro Atlanta

Official Seal

hey.  i had made an appt yesterday that i was actually looking forward to, with a neurologist through my new insurance..  this guy does research at emory on movement disorders, and was a perfect match for my spasms and other CRPS weirdness.  

i made sure to send fred an email from the computer turret with the directions, as we have gone to this location once before and GOT LOST. we are sooooooo used to Tête de Hergé, and the miniature submarine trip through the wormhole is sooooooo disorienting! 

i also made sure we left a half-hour earlier than necessary, as we had to transfer from the captain's sub to a rental car and atlanta traffic is infamous. we got in the car, i asked fred if he had the directions, and he said, "don't need 'em, i know exactly where it is." of course, his eyes were spinning like lemons on a slot machine.  bless his bones!

first, there was a wreck on I-285, and I-285 is already a wreck!  look what wikipedia says about it, even:

Interstate 285 (I-285) is an Interstate Highway loop encircling Atlanta, Georgia, for 63.98 miles (102.97 km). I-285 is also un-signed State Route 407, and is colloquially referred to as the Perimeter. Suburban sprawl has made it one of the most heavily traveled roadways in the United States, and portions of the highway slow, sometimes to a crawl, during rush hour. It is also signed as Atlanta Bypass on Interstate 75 and Interstate 85.It is estimated that more than two million people use the highway each day, making it by far the busiest Interstate in the Atlanta metropolitan area.

but that was okay, we allowed for the time!  then we got lost, got confused, started screaming at the rest of the millions of drivers, who all screamed back at us, the nerve of those atlantans! 

we did not get there on time.  i was, they told me, 21 minutes late.  i tried to call them but due to the noise in the lamentable excuse for a car, that was not possible. they called the doctor to see if he would still see me and he said "no." we felt like dorothy and friends during their initial attempt to see the wizard of oz.

"Fred, I don't think we're in Tête de Hergé anymore."

Dang it!  Another secret photograph of me, Fred, and Sven Feingold going about our Daily Labors
 at Marlinspike Hall.  We have an Instagraph stalker.  Yes, I know I CLAIM to be a bedridden,
wheelchair-riding GIMP.  It's all a lie.  Read on!

i burst into tears, having been up all night for 3 nights in a row with spasms.  they get worse when the infection in my left shoulder flares and when i am under STRESS (worrying about brothers, nephews, mother-units, and my little buddies brayden and nolan -- and my big buddy, the outrageously large maine coon with separation anxiety!).  they said they would work me in with another doctor: Dr. Roald Joseph "Joe Cargo" Wasserman. 

"my big buddy, the outrageously large maine coon with separation anxiety"

they don't accept faxes at this neurological clinic (the building is under construction, the wiring hanging through plastic sheeting), so i had been told to bring my records from my former WONDERFUL neurologist. you remember him? the hawaiian-shirted, birkenstocked dude who diagnosed me in 2003, some 19 months out from CRPS onset? he had carefully selected the important parts of my long, well-documented records, studded with studies and exam/treatment results --  and also had written a wonderful summary for whomever the new neurologist turned out to be. 

Dr. Roald Joseph "Joe Cargo" Wasserman is whom it turned out to be.

diana, it felt like i was being RAPED.  (not literally, just neurologically!)  dr. m, my former neuro, NEVER touched me without permission or without warning me to do stuff like pulling up my pant leg or moving my arm.  yes, in the beginning, he HAD to do nerve conduction studies (EMGs) but even then, he was as gentle as humanly possible -- because he understood CRPS, he diagnosed it, he saved my freaking life!

well, no. he did not save my freaking life.  he told me, and this is something one never, ever forgets: "retired educator, you've been dealt a shitty hand."

to which i replied:  "aces over eights?"

at which he snorted coffee up his nose, and did not answer, eyes aglitter.  dr. m has cried in my presence a couple o'times through the years.  when i did clinical drug trials, when i did subanesthetic ketamine treatments for three months, to no avail.  oh, okay -- and when i told one of my patently bad knock-knock jokes...

Dr. Roald Joseph "Joe Cargo" Wasserman did not read the records, or even the summary.  for an hour and a half, he poked pins up and down both legs, my back, both arms, my face.  repeatedly.  then he used the effing reflex hammer, and did not believe that i had no shoulder on the left, and bone infection in both shoulders.  i have to hold up my left arm with my right to have it examined, and he would push my right hand off my left arm, making it fall.  repeatedly. (i just saw my beloved dr. shoulderman last week, the orthopedic surgeon who has seen me since 2005 and operated over 10 times -- and he saw infection in the SOFT TISSUE as well as the bone on the left side... and we decided to just pray for the next 6 weeks!  and i was to "rest that arm" after he injected it with anesthetics and steroids! 

so the bleeping ex-shoulder area HURTS even more than usual... and the CRPS in the lower arm is, consequently, flaring, and twitching.  twitchtwitchtwitch!) 

Dr. Roald Joseph "Joe Cargo" Wasserman kept asking about a damned "rash" and demanding, "why is this so painful?" 

like the fool that i really am, i kept repeating, "i've had CRPS for 12 years, that's why, and avascular necrosis, and infected bones/joints..."  and he would go, "yes, but i am barely touching you!" 

like the fool that i really am, when it got to the point where i could barely speak, i tried spitting out one-word important bits of information, like "ALLODYNIA" and "fgaweorjaoneonbyvwyqq"!

maybe it would have been more fruitful to save up one last bit of verbal heroics, and spit out an entire sentence, probably something from the Great Physician HimSelf: "Sometimes I am quite certain there's a Jertain in the curtain."

excuse me, all this one-handed typing is getting to me... let's take a Great Physician break and watch a short bit of YouTube entertainment.

okay... returning to the neurological assault.

so i stopped talking and basically tried to meditate my way through Dr. Roald Joseph "Joe Cargo" Wasserman's "examination." 

he deliberately ran into my right leg, that was extended over the edge of the exam table.  not once but several times.  he dragged his highly starched long white coat over both legs, again demanding: "how can that hurt so much?  why are you crying?" i asked for tissues, as i'm not fond of my mascara ruining my blotchy foundation, and snot running down to the chin is simply not fine. each time, i would transfer the tissue to my now claw-like left hand (handy for clutching things!), as there was a sneaking suspicion in my mind that i'd need tissue again in thirty seconds.  he would then pry the dirty tissue out of my left claw, throw it away, and then we would replay that little scene when next the snot reached my dimples. 

finally, because i had a bit of a fever (that would be the INFECTION!), high blood pressure (that would be the PAIN!), and his insistence that i see infectious disease specialists, orthopedic surgeons, and have a brain MRI (all of which has been done and done and done, by much better than RJW!), this highly organized Unsub began to insist that i needed to be admitted PRONTO.  
do not pass go, go directly to the hospital.  

and yes, i've been watching too many Criminal Minds ION Television marathons. fred and i can profile unsubs with amazing alacrity.  here, i'll prove it to ya!

UNSUB

• 27-35 year old white male
• enucleator (removes eyes) -> Usually enucleators are males with a diagnosed mental disorder, lack social skills, disorganized, sloppy, repeat offenders. They don't usually take the eyes. It's usually not about the eyes, but about what the unsub sees in them (delusional!)
• This unsub however is quite organized and strategic, and does take the eyes with him. (Possibility: trophy/consumption)
• Apart from the first victim he's very precise with taking the eyes -> might have some medical training (but will not have made a career out of it)
• Blitz attack - he lacks the social skills to charm his victims.
• Very likely to have been institutionalized/ halfway house/ treatment facility.
• Less than 48 hours between kills (he is escalating) No cooling off period will make it hard to get ahead of him.
• Area of 22miles between locations (usually the kill area is smaller)
• Leaves body in somewhat public area where he could have easily hidden it there - he is not afraid to get caught
• Used a trip wire -> game hunter. He may have applied for a hunting license.
• He waits until he is alone with his victims -> patient
• Killers usually get more sloppy when they escalate, this unsub only gets better.
• Drives a van or pickup that's easy to clean (his dad's)

heh heh.  i ripped that off from a fellow rabid unsub, i mean, FAN... of Criminal Minds. i ain't no freakin' enucleator, and i shore as shit ain't lackin' in any social skills.

there's more to tell about RJW but that's more than enough (i am SORRY to be dumping on you again, again, again, when you've got more than enough troubles of your own).

he did increase the dose of one of my meds.  he printed out my "discharge notes" and told me he wanted to see me again in 3 months (but expected me to end up in the emergency room by evening).  
i said, exiting my meditation silence, "thank you, doctor," revved up my power chair and found my sweet fred in the waiting room, snoring.

we went to the pharmacy on the ground floor.  then we thought to look at my paperwork and... we blew up. like balloons, pretty much.

the guy had diagnosed me with SHINGLES. "postherpetic neuralgia"! that's why Dr. Roald Joseph "Joe Cargo" Wasserman was asking about a rash, and was obsessed with my allodynia symptoms, which are just standard fare with CRPS neuropathic pain, but "present" in a much different way. oh, let's just cut to the freaking chase. shingles very rarely ends up creating gorgeous gams such as these:

this was.labelled "summer legs 2013" -- ha! 

aha, here's a video from 2011! the neuro rapist wouldn't accept that my "condition" was an old one, and not a recent attack of "postherpetic neuralgia."  and oh lordy, please don't think i am underestimating the pain and suffering shingles patients must go through, 'cause i am not!

sweet dobby still sniffs my feet, full of suspicion!  "where did my hooman get these butt-ugly thangs?"

so... we were in the pharmacy, so close to the parking lot and the car that would take us back to the miniature submarine dock, adjacent to the wormhole entrance that would return us to calm domesticity... i told fred to calm down, let it go, let's get the medication, and just GO HOME, where i could climb back into this blessed hospital bed, curl up, and recover.  with sweet dobby probably sniffing RJW's scent from my bed head to my gnarled tippy toes.

"no, we are going back up there, RIGHT NOW." 

the workmen putting up dry wall were all staring at him, but one of them proceeded to help us get on the right elevator!  even held the door as it started closing on the wheelchair! yet another hero to add to my hero collection!

we get to the 4th floor.  to the reception desk.  she says we cannot see the doctor, "he is out to lunch." [i start LAUGHING].  fred demands that she get him on the phone.  she finds a nurse, instead. i end up speaking to her after fred has finished the first detailed and footnoted explanation of the differences between shingles and CRPS.  she claims it was "a computer error." 

yeah, typing out "postherpetic neuralgia" just HAPPENED -- that's how computers operate, they just do whatever they feel like doing, those darned computers. 

surrounded by artificial intelligence.  

like a noose closing around a proffered neck, AI was tightening its grip... mwa ha ha!

there's more. the story continues into today, tuesday. RJW ends up calling my primary care doctor (not dear go-to-guy, but the HMO woman who, at our first meeting, said "our 17 minutes are up!").

her nurses are calling, telling me i MUST go to urgent care, i MUST check into the hospital, i MUST be seen, and yaddayadda. but the last nurse was GREAT.  she listened.  and she let me lie and say i was considerably improved and would come in tomorrow "if i wasn't completely better." 

mwahahahahaaaaaaa!

poor fred had a tooth pulled this afternoon, just got home. but at least he could have it done by one of the Haddock family servants, one of the stable workers who got his DDS in his down time.  so he is completely unable to run through the fruit orchard, vault the rock wall, and retrieve the BP medication that go-to-guy called in to the monastery infirmary.  such is life.

but writing YOU, a true friend, has likely lowered my sky high CRPS-induced hypertension just as well. 

plus, now you are sure to send pie.  cherry, please. deep dish? 

and i dearly want fred to sleep, rest, relax.  he woke me up this morning because he was yelling in his sleep.  gladly, when i asked if he had bad dreams, he could not remember any, just noted that he woke up "already tired." that breaks mine heart. 

i'd turn off the phone, but i want to be available for grader boob in the highly unlikely event that he might call. or that other shifty-eyed brother-unit!  how odd is it that we all detest the telephone so much?  ah, genetics!  no, that's not it.  ah, darwin!

that's about it. did i neatly tie up every loose end?  be sure to put that pie in a sturdy, waterproof box. the wormhole can be squirrely and ends, of course, in our algae-afflicted moat. we will post sven feingold's son, cabana boy, on Moat Pie Watch Duty.

god, i love you!

***** ***** ****** ***** ***** ****** ***** ***** ****** ***** ***** ******

THUS CONCLUDES THE EXPLANATION OF THE TITLE OF THIS LONG AND WINDING POST: "Jose Ochoa, Famed Medical Turd, Has Doppelgänger in Metro Atlanta." 

Any detail is fair game for the Final Exam!

Smile.

I Suwannee -- And Guess Who Is Still A Big Fat Turd?

CRPS is nothing if not weird.  I was hoping to catch some of that weirdness on video, thinking that it might help someone who is undiagnosed, or newly diagnosed, to get a glimpse of the possible "visuals" that go along with the syndrome/disorder/disease/krap.

It didn't show up as I was hoping it would, of course!

I wanted to capture something I've never seen or experienced before -- mostly because I think it's *impossible*.  My left wrist began burning and stinging, which is not, by itself, unusual.  What is unusual is that there is a space between my normal finger and upper palm involvement and the wrist area that's acting up.  Visually, that painless space in the palm of my left hand is white, with red at each of its ends.  There is documented nerve damage that follows the distribution of the ulnar nerve from little and ring finger (and half of the middle one) across the palm and partly up the forearm.  Well, okay, it deviates from the traditional, boring, established dermatome for the ulnar nerve in that it crosses the palm and goes up the opposite side of the arm. 

The wrist area is also swollen.

[I apologize, but along with often being unable to distinguish right from left, I've never been able to ably use helpful words like proximal and distal...]

Anywho... it's gone now -- the white space between two reddish-purple ones -- and I am back to what looks like a straight line, and what feels like an angled kind of pattern.

On the right, things are following the party line.  Extreme pain up to the elbow, extreme sensitivity to a point mere millimeters beyond that.  Sausage fingers and a line that looks almost drawn by a ruler below the knuckles, straight across, identical in length to the one on the left.  (The mirror effect of CRPS can be mind-boggling.  I have a DENT in both legs -- permanent DENTS -- that appeared several years apart and that are identical in appearance, placement.   Spooky.  In the old days, when people like Dr. Jose Ochoa, The Turd, evaluated people, he and his Trainee Court Monkeys decided that patients were deliberately binding their legs to achieve that lovely dented effect.  Yes, sigh, I will take a quick vid of it.  Warning -- it's ugly.  I'm ugly, by extension.  I miss my clothes, my legs, my figure, my unmarred face;  I MISS SHOES!  Especially red Italian shoes.)

Hmmm?  What?  Oh, right!  The dents ("fascinating!") are now memorialized below, in the bottom vid.  Blow in my ear, call me DimpleShin, and I'll follow you anywhere... 

Vic over at NeuroTalk wrote his assessment of Ochoa this way back in 2006:

Just a quick note:


Dr Jose Ochoa was once a highly respected writer and researcher who focused his work almost entirely on RSD. Then one day he saw the light: RSD is not a neurological disorder; try as he might, he was never going to be able to prove the unproveable.


Actually, the light he saw was a dollar sign. He was getting older and it was time to think of his golden years. He figured out that he could make a lot more money working for work comp lawyers and descredtiting RSD than by trying to prove it is something he knows it isn't.


He did the work. He was, and is, familiar with those who are still trying to prove RSD is what it isn't. He can go into a court room and advise work comp lawyers which questions they should ask, and he can testify knowledgeably about this disease.


By the time he and the lawyers are finished, they have made the doc testifying for the RSD patient look like either an idiot or a liar. It's easy, one simple question will do the job, it is the same thing I have challenged Forum members with for five years:


"Doctor, you say this is a neurological disorder. Can you provide this court with one example of scientific research - not an opinion you want us to believe - that even suggests that there is evidence of nerve damage in the etiology of RSD?"


He may try to duck and weave. He may try to tell the jury that nerve dysfunction is obvious in RSD. But in the end, he will have to answer that question. He will have to say; "No, there is no research showing that any nerve injury has ever been shown to cause RSD".


By the time they have reworded that question in a dozen different ways, and the doctor has had to admit a dozen different times that even though "everyone knows" RSD is caused by a nerve injury, no one can prove it. No one can even prove it is possible.


The doctor's credibility has been completely destroyed. The record has been filled with uncontradicted testimony that RSD isn't what the experts say it is. They haven't proved RSD isn't real; they didn't have to. Dr Ochoa is ready to testify that he studied RSD for years and in his expert opinion patients are either psychologically unbalanced or just plain liars.


By the end of the hearing, the RSD patient is sitting there in total shock. He or she has just seen any chance for compensation or treatment blown out of the water. She/he has just been described as a nutcase or a liar, and the expert as even worse. she/he is going to have to try to survive for the rest of his/her life disabled, in terrible pain, and without hope.


Is it any wonder that this this is called the "suicide disease"?


Do you Forum members who have been here or in other sites for very long ever ask yourself why any number of people suddenly stopped posting? There are names I still think about. Names that creep into my mind after I have turned the light out and prayed I would be able to sleep this time: Names and more names. Are they still alive? Did they turn out their light one night and then decide they could not face another morning?


I think about SamYamin. He wrote a goodbye post. Some concerned members started sharing bits of information and came up with enough to call the police. A few days after that goodbye post, Sam posted again: he thanked everyone for their concern and for saving his life, then told us he would be going into therapy and would not have access to the Internet for a while, but not to worry.


I didn't worry. I knew Sam had learned his lesson: Don't tell anyone. I knew Sam was dead.


I didn't pray for him anymore, you don't pray for the dead; you hope they knew Jesus and had asked Him to forgive their sins. If they did, there is no need for prayer, they are happier than I have ever been. If they did, I will meet them face to face in a little while.


And there is Andi; and Meg; and sunshine; and Heatherdawn. We rarely hear about those who committed suicide. RSD didn't kill them. They died of hopelessness. I miss them. We all do. And we all look at every detail; trying to find that one clue that should have alerted us. That something we should have seen; that if we had seen might have made the difference.


It won't do any good to say it; it hasn't helped me and it probably won't help you, but that clue probably wasn't there. If it was, it probably wouldn't have changed anything, nor will it be of much use the next time.


Hope is the last thing to go. Once it is gone, there is no reason to live. By the time we learn someone has lost all hope, it is too late. If we are to take any small bit of comfort from these tragedies, and it is too small to measure, it is that people who decide to die don't tell anyone. You tell someone while the hope is still dying, when you want someone to give you some reason to hope. Most of the time it works.


When I began this post I would never have suspected where it would lead. It went in an unexpected direction when I used the word suicide, and after rereading it, I see that if I can't understand why I wrote these words on this post, you probably can't either.


I delete a lot more than I post, and I would delete this; but something is stopping me. Something...something that outweighs the fear that some will think my words are out of line. That this isn't the right place or the right time.


I want to ignore that something, but I can't. All I can do is hope there is a reason that I don't understand now but may become evident later...Vic

A few months later, Vic added this to the thread:

Hi again,


I am usually a bit more organized, but what I wrote in my last post kinda threw me off stride: I didn't finish my comments about Ochoa, and there are still some things we all should know about this (I believe literal), butcher in a physicians lab coat. I still have to finish yet another post in which I'll present some views on the original topic.


About Ochoa: I don't know whether he is still malpracticing medicine, but if he is, forewarned is forearmed. I have some "abstracts" of "articles" he has written about RSD. They are actually more in the nature of advertisements aimed at insurance company lawyers: showing how well he can testify in their behalf.


If you live in Oregon and work comp orders you to see him for what in Kansas is called an "independent medical evaluation" (IME) [what it really means is intentional misrepresentation of evidence], I will be happy to provide your attorney with a critique of these abstracts.


Ochoa is knowledgeable and good with words, but like all liars his words expose the truth about him. What I wrote about his victims sitting shocked at the end of a hearing really happened to people I know, and I would enjoy doing my small part in preventing this from happening again, exposing his deceit, and paying the S.O.B. back for the damage he has done.


One of those abstracts describes a trip to the land of his birth: Chile. The problem is that this trip occured during the regime of Auguste Pinochet: the most brutal dictator in that country's history, and with the possible exception of "Papa Doc" Duvelier of Haiti, the most brutal dictator in the history of the Western Hemisphere since Spain left the area. He was a nasty man, responsible for the torture and murders of thousands of Chileans whose only offense was belonging to the wrong political party.


(Pinochet came to power with the help of our CIA; overthrowing a democratically elected president "we" (the CIA) didn't like, then murdering him).


Anyway, Ochoa went to Chile. Upon his return, he wrote about his experiences in a hospital ward full of RSD patients. He wrote that during the day, all of them exhibited extreme motor dysfunctions (jerking, falling, etc), but he suspected something was amiss: that these patients might be faking their symptoms.


He described secretly having video cameras installed; lo and behold! In the evenings, after the staff went home, the motor deficits vanished. They all walked around, talked, etc, and no one appeared to be in distress.


There are a few things wrong with this picture. Chile was and is a very poor country, where hospital beds are reserved for the rich, not the needy. Also, it would be difficult to find a large enough group of RSD patients in most cities in this country to fill a ward: Chile is probably no different.


Then there is the fact that RSD patients here are rarely (if ever) hospitalized for movement disorders or anything else related to RSD in this country; a land filled with beds and insured patients.


And Chile doesn't have any worker's compensation laws, so why would people fake a medical disorder? OK, some hospital beds in Chile probably had sheets, which I know are more comfortable than straw mats. But there are other disorders/diseases/syndromes/whatever that don't require as much effort to fake as RSD.


By the way, in this country, staff don't go home for the night leaving patients unattended; they are relieved by other staff. Oh, well, they may do things different it Chile. In fact, you can be damn sure they did things different in Chile.


Ochoa, however, is an expert in RSD and he found RSD patients. Is all this coincidence? Or could it be that he made it all up? That he lied.


Mike can correct me on this, but I suspect that any attorney with two brain cells to rub together would fight like Hell to introduce this abstract and then ask some rather cogent questions of the bad doctor....

I can't prove it, of course, but I would be willing to bet this shiny new computer my son gave me against a bucket of pig **** that none of the "patient's" he saw had RSD.


Like I said, he is knowledgeable and good with words, but someone who understands RSD would be able to blow him out of the water for a change....




Blowing Ochoa out of the water is not my purpose in life. If given the opportunity, I think it would be better called a necessay but extremely rewarding and pleasant diversion. We need to enjoy life's little pleasures wherever and whenever they appear...Vic

In the small area under his avatar, Vicc's status is now listed as "In Remembrance."  That's too bad, because I think we might have hit it off.  Pinochet held a coveted position on this death penalty abolitionist's List Of People Needing Extrajudicial Execution.

Due to a recent rise in moral ambiguities, The List is now nonfunctional and out of circulation -- but you can still get a bumpersticker...

Anyway, dunno what happened to Vicc but enjoyed his attempts to teach people of the futility in following the "sympathetic nervous system" bullcrap to its illogical conclusions and to offer in its stead a unifying theory -- that CRPS is all about Ischemia-reperfusion injury. Unfortunately, one can say the same thing about *that* that one can say about the SNS Party Line:  It is about IRI, except and unless when it isn't...

God's Thorny Donations (With Obligatory Cat Video)

Blood-red, ruby-red, cherry-red, my chipmunk cheeks are crimson.
Stippled and florid, these spotted swollen legs -- so violently inflamed -- are vehement, are ruddy.

"Ruddy is closer to red than to rose," intones one who ought to know.
My bolshy red ink comes to mind.

The synonym-driven blurb above is what greeted me when I popped open the spare laptop balanced on my belly, my first reflex upon regaining consciousness.  Other clues to recent activities included peanut halves, both whole halves and crushed halves, two brushes full of cat hair, several strands of which -- perhaps even amounting to a tress -- were up my nose, the ensuing histamine reaction having been the source of this rude awakening. A novel, cracked open to page 174, lay upside down on the pillow next to me, along with a telephone, a television remote control, and a licked-clean 6-ounce container of peach yogurt. That about sums up life as I know it.

Just joshing!

My face has been bright red or, at least, pleasingly pink, because my fevers have gone up a notch. I don't mind overly much because the other gift of the fevers has been an improved capacity for sleep.

I've been hitting and surpassing the temperatures that doctors say to report pretty early in the day -- peaking at around 11 each morning. I don't bother calling in about fevers -- haven't in a long time, even though achieving such fevers while on steroids is a rather remarkable achievement.

The decision to note them, but to ignore them -- absent three clear symptoms of impending death -- was codified at the end of my hospitalization in September. The day of discharge I felt about as bad as I felt the day of admission, and as I sat listening to the Infectious Disease Dood tell me to be sure and return to the Emergency Department if my fever registered above 100.7, the nurse's aide came in to take my vital signs and announced that my temperature was 100.8.

Infectious Disease Dood scribbled in my chart and started talking faster; The aide noted that my temp was up even after an earlier dosing with Tylenol; I started laughing and couldn't stop. When he had run out of the room and she had filled every available container with ice -- a favorite activity among nurse's aides, especially when I request "just water, please" -- I decided that fevers were insufficient cause for painful bumpy car rides or lame telephonic communications at odd hours to medic-types.

Besides, I often felt better with a spiking fever: energetic and focused, bright-eyed.

Until the last ten days or so. Note: I tend to say "ten days" whenever I really have no clue as to how long something has actually been occurring. I know that two weeks is inaccurate and that the change I wish to highlight has existed beyond a week, so "ten days" seems an acceptable bit of imprecision.

Right... So... The temps have gone up over 101 every day lately (What do you think of "lately" here? Does it work well with the "ten day" notion, that particular span of time?). Instead of energizing me, gifting me -- and hence, you -- with wit, I'm about as dull and listless as can be. Sleepy, pouty, and, to get us back on point, red-cheeked, and afflicted with synonyms.

Also, sweaty.

Until the last few days -- a temporal division about which I feel sure -- spasms and tics have also been part of the gift. Despite concerted attempts to emulate the Apostle Paul, to regard them as God's thorny donation to my imperfections*, there's been little ensuing delight in the weakness, difficulties, or hardships brought on by the violent jerks and stabbing electrical impulses flying up and down my legs and, rarely, forearms.

I've railed against this non-epilepsy before. Spasticity in CRPS is little understood, usually glossed over as just another symptom of a degenerative neurological disease -- or, if you are a turd-like individual named Ochoa, these scream-inducing fits are part of the fakery, evidence of people feigning misery in return for the spoils of attention and disability payments.

I shouldn't even continue to bring the bastard Ochoa up... and wouldn't, except that I've no discipline these days (at least not for the last ten or so!). Also, since the research into CRPS-related spasticity and movement disorders is smack-a-sweet-dimpled-baby-butt new, the investigators are also new to CRPS' sordid history, and cite him at least once, for thoroughness' sake, ignorant of his "expertise" in making money as a forensic expert in tort cases by claiming that CRPS does not exist, or testifying that patients have fabricated the symptoms, out to cheat workers' compensation insurance.

Workplace accidents account for many of the traumatic injuries that constitute the noxious event that can initiate CRPS, and so for decades, the only real public discussion of the disorder came in the courtroom, where injured workers sought compensation benefits, almost always without success. Ochoa profited from others' misery, and perpetuated it, in a manner that can only be described as obscene. Like Justice Stewart, I know pornography when I see it. Gladly, his voice has been mostly silenced, but the echos of the past are too often replayed. His opinions, unsupported by research, and evidently for sale to the highest bidder, continue to stigmatize patients with Ochoa's characterization of them as "illegitimate conscious malingerers and individuals with Münchausen’s syndrome."

Several rulings have directed that his testimony be discounted, as jurists, troubled by the lack of scientific foundation to Dr. Ochoa's ideas, and by the fact that someone called on to determine the presence or absence of CRPS had never, ever found the disease present, or issued an opinion in favor of the patient -- not once in hundreds of cases.

Ahem. Okay, so the man makes me nuts. I had rid myself of the Ochoa Plague largely by ignoring the citation of his contributions to medical bigotry. But as The Painful Jerks have become part of my everyday life, and as my doctors professed sympathy but little understanding, I found myself in the familiar position of having to do research in a subject far outside my area of expertise. Many of the papers on spasticity are written by academic researchers, not involved in the clinical management of CRPS, and uninterested in its exploitative judicial history. And so there he is again, The Turd, mocking me from the margins, quoted again in the text, even if just as an anachronistic oddity.

Baclofen worked for a period of time. It still works but just not well. Because I know that the Great Spasms can go on almost continually, I am grateful that Baclofen (or *something*) has reduced the incidence to just a few hours a day. Because I know that I can have both legs and both arms simultaneously flying through the air with the greatest of unease, I am grateful that baclofen (or *whatever*) has largely reduced that focus, most of the time, to one leg.

Is it really doing a darned thing? I don't know! And yet, like every day in recent memory, I am scheduled to take 60 milligrams of it, divided into 4 doses. It makes me loopy, dopey, but when I've stopped it, my subjective interpretation is that the spasticity is worse and more frequent.

Sometimes it is a funny annoyance and not so much painful as astonishing. You probably did not notice that I spoke of using a "spare" computer, a back-up laptop. The large mug of hot coffee with milk that my right hand jerked into the air last Wednesday has something to do with my current need for multiple machines. Sizzle::fry::Sizzle::fry

And Thursday, after two appointments and little sleep, Fred gifted me with pizza, double mushrooms, a wonderful treat that really hit the spot. I was dreaming of one of my favorite breakfasts, cold pizza and hot coffee, and heading to the kitchen to carefully wrap my leftover slices, when ka-blooey! The plate took off, launched like a freaking frisbee. My 4 slices landed upside down and were immediately subjected to fierce cat licking (else I'd have invented some sort of pizza sanitizer).

There have been instances of hot pots slung from stove top to floor, and a few unanticipated knife tricks. My legs have given out mid-trek to the bathroom and according to some legends, I appear to have kicked a few people.

I'm convinced I'm losing brain cells and plan to use the declining quality of these blog entries as proof.

Ha!

Part of that body of evidence? This video from last night, published below.  Clearly, my wayward brain is overloaded and misfiring, because it almost seems like my well-honed cinematic curiosity is now satisfied by the mere presence of one camera and one cat, taking improvisation all the way to the zoo, as it were.

I can match some of the tawnier and fluffier samples of fine feline fur found in my nasal passages this morning to the photogenic Buddy, a juvenile Maine Coon also known as The Freakishly Large Kitten.  He evidently shares my affection for yogurt. With his usual powers of concentration and his proven ability to stick his big little head into just about anything -- so long as food is his just reward -- Buddy goes after the few remaining molecules of peach yogurt with an enthusiasm that I deeply admire and vaguely remember from my own time among the living.

* 2 Corinthians 12: 7-10
Therefore, in order to keep me from becoming conceited, I was given a thorn in my flesh, a messenger of Satan, to torment me. 8 Three times I pleaded with the Lord to take it away from me. 9 But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will boast all the more gladly about my weaknesses, so that Christ’s power may rest on me. 10 That is why, for Christ’s sake, I delight in weaknesses, in insults, in hardships, in persecutions, in difficulties. For when I am weak, then I am strong.