Health, Fitness and Homeopathy

Our Family's Journey Through CRPS

An edited version of this essay was published by You&Me magazine.

“Do you remember where we were this time last year?” I ask my son as he sits on the brown leather couch in our living room, snuggling with Allie, our little Yorkie Schnauzer.

“No,” he responds, burying his nose deeper into Allie’s short summer coat.

“Wisconsin,” I tell him.

Cole holding Allie

Cole raises his head. His eyes grow wide as the meaning of what I’ve conveyed with one simple word, one place, is acknowledged.

“Don’t remind me of that!” he practically shouts, directly followed by his returning his attention to Allie and yelling, “Squirrel!” which never fails to cause the dog raise her head and ears to full attention and start searching for something to chase. Cole finds this hilarious. He is an eleven-year-old boy after all.

Cole does not want to remember or discuss the trauma he, and subsequently our entire family, went through for an entire year. The climax of that year was a surgery that took place halfway across the country in Wisconsin. Since his surgery, his recovery has been nothing short of astounding. No one looking at him on the baseball field today would know that most of last year he couldn’t walk and was in so much pain he missed most of fourth grade.

Cole would like to forget this ever happened, but I don’t want to forget. I had no idea that a perfectly healthy, athletic child could become disabled from what seemed like a very minor injury. I had never heard of Ehlers-Danlos Syndrome (EDS) or Complex Regional Pain Syndrome (CRPS) formerly known as Reflex Sympathetic Dystrophy (RSD) before he got hurt. Suddenly, I was forced to watch my child sink deeper into pain every day, unable to feel or move his foot, while I felt completely helpless. As a mother, and simply as a human being, I have never been so scared, so lost, or so horrified by how hard it can be to find help.

Cole is his football uniform

On October 22, 2013, Cole was at football practice and during a tackle was hit in the ankle by another child’s helmet. He sat out for a little while but then rejoined practice. His ankle was bruised and we iced it and gave him ibuprofen. We really didn’t think much of it at the time. Over the course of the week, Cole continued to complain about his ankle. We kept him out of football and told him to rest his ankle as much as possible. When it still wasn’t feeling better come Monday, my husband took him to a walk-in clinic to have an x-ray. We feared he might have a hairline fracture or sprain. If it had only been that simple. Cole was misdiagnosed with compartment syndrome and referred to an orthopedist. 

What followed was a month of doctors appointments, tests, repeated trips from our home in Rhode Island to Boston while we desperately tried to figure out what was happening to our son. Within weeks, Cole lost all feeling in his left foot and developed extreme pain from his ankle to his hip. He was evaluated by our pediatrician, an orthopedist, and two neurologists. He had blood work done and it came back normal. But the slightest touch to his leg caused him to writhe and scream in agony. The commutes back and forth to Boston were excruciating for him. Even with his leg propped on a pillow and blankets for cushioning, he not only felt every pot hole, but every seam in the road. So when doctors attempted an MRI, which required placing plastic cameras on his leg, there was no way he could stay still for it.

Several of the doctors that examined our son told us the pain was all in his head or that he was exaggerating it. I found out later, upon joining an online support group for parents of children with RSD, that this is a common response from doctors. I never doubted Cole’s pain. I have a vivid memory of Cole at about six-months-old, lying on his stomach in a few inches of water in the bathtub. He would put his face in the water, then raise his head, shake it back and forth and let out a roar. He repeated this a number of times before dropping his head too quickly, banging it on the bottom of the tub. He lifted his head and his lip was split and bleeding. He paused for only a moment, then smiled, shook his head and roared and kept going. This is Cole’s personality in a nutshell. If he says his pain on a scale of 1 to 10 is a 15, then it is a 15.

Eventually, Cole was diagnosed with CRPS and put on Gabapentin. Gabapentin is used primarily to treat seizures and neuropathic pain. I was surprised to learn that narcotics are completely ineffective in treating nerve pain. He was referred for physical therapy.

Cole’s physical therapy was absolute torture for him and everyone involved. My husband took Cole to most of these appointments, partly because being self employed his work schedule was more flexible than mine, but also because he had to physically restrain Cole while our physical therapist worked on Cole’s leg. I wasn’t strong enough to do this effectively, though there were times when my best had to suffice. Cole would hit, kick, and even bite during these appointments. In the beginning, part of Cole’s treatment involved running a thread up and down his leg to desensitize it. Cole described this as feeling like a chainsaw sawing his leg off.

The leg with tape has CRPS

For someone not familiar with CRPS, the concept of how much pain it causes is hard to wrap your brain around. The pain associated with CRPS is ranked higher than childbirth and amputation, and it can come without too many other medical factors presenting. To look at Cole’s leg, it was hard to see there was anything wrong. It was slightly off color and mottled but only if you were really looking for it. This makes it easy for people, even those in the medical profession, to brush aside how serious the condition is. Not only is there very little to see with the naked eye, there’s often nothing to see in blood work, x-ray, MRI or any other test performed, which leads to something else that’s difficult for an outsider to understand. Family and friends breathed a sigh of relief every time one of Cole’s tests came back negative. But the more and more tests showed nothing, the more and more panicked my husband and I became. Something was very terribly wrong and every time a doctor showed us Cole’s normal test results and said he was fine, we wanted to scream.

CRPS is a known medical condition, but finding treatment is all too difficult and confusing. What works for one patient often does not for another. Much remains unknown about this condition and how to treat it.  Unfortunately, parents need to be wary of the very people and places they rely on for medical treatment when it comes to CRPS and their kids. Emergency room doctors will attempt to physically examine your child, even though you explain it causes extreme pain for them to be touched. They just aren’t trained to deal with it. Cole would struggle to crawl under the gurney to hide from the doctors and nurses. This behavior persisted with every doctor he visited for months, adding evidence for some that what was wrong was a mental issue. Even more disturbing are recent stories  of children with poorly understood medical conditions being taken away from their families. Parents who refuse to accept a mental diagnosis for what they know to be a physical illness risk having their child placed in state care due to suspicion of medical child abuse.

How could these experts send us home with a child who was “fine” when he couldn’t go to school, woke up crying every day, had trouble sleeping at night despite the Melatonin or Ibuprofen PM? Every day he was regressing and withdrawing further under the strain of the relentless pain. He became less verbal, started refusing to work with his tutor and didn’t want his friends to visit. Alternately, he became more angry and violent. He would kick and punch us when we tried to change his clothes, give him medication or bring him to the doctor or physical therapist. He screamed and swore. He threw things and slammed doors, sometimes in the middle of the night, just to wake everyone up. He drew pictures of being blown up with his leg ripped off. He destroyed photos of himself and started lighting things on fire. Of course we tried counseling--two different counselors, neither of which helped. Unless we count the improvement in Cole’s behavior when we promised him that he would no longer have to attend if he stopped behaving so dangerously and abusively.

We are a family of four, two working parents and two boys, at the time this started, ages 9 and 12. Cole had to be removed from school at the start of November 2013 and did not return until after February vacation in 2014. We had to reach out to family and our former nanny to have someone home with Cole during the day. We left Cole in the same clothes for days at a time because changing them was a long and painful process. Our older son, Connor, never understood or was sympathetic to his brother’s plight. This added even more strain to our already very tense family dynamic. I tried repeatedly to explain to Connor that what his brother was dealing with was beyond any injury he had ever experienced but he never got it. They had always been two rowdy, active brothers and Connor could not accept the fact that his brother couldn’t even be touched or jostled in any way now. In Connor’s mind, we were overreacting and cared about Cole more than we cared about him. Cole didn’t have to go to school, could stay home and play video games and Connor got screamed at every time he touched him. We put Connor in counseling during this time as well. It did not help at all.

As the saying goes, “when it rains it pours”,  and it turns out Connor did have a point that he wasn’t getting enough of our time and attention while we were focused on dealing with Cole’s CRPS. In October of 2014, Connor was diagnosed with Osgood Schlatter’s Disease . Over the course of the past year he had been complaining of pain in his left knee as well and was forced to stop running track and swimming. He was seen by our pediatrician, an ER, a walk-in-clinic and twice by a pediatric orthopedist, and had two sets of x-rays. Everyone told us that Connor was fine, and since he was if he wasn’t involved in a sport, and because we were highly distracted, we shrugged it off as normal growing pains. It is also very hard as a parent to accept that your older child has developed pain in his left knee while your younger son is battling CRPS stemming from an injury in his left knee. While I was not inclined to believe the pain was in Cole’s head, I did wonder if the pain Connor was experiencing was psychosomatic or at least being exaggerated. Connor felt quite vindicated when he was eventually diagnosed at a local walk-in clinic. He was also referred to physical therapy to ease the strain on his knee by increasing his flexibility and strengthening his hips. For several months we had two children in physical therapy for a total of five appointments a week.

Cole wearing his leg brace

Between October 2013 and December 2014, my husband and I lived in crisis mode every day. There were some days, weeks, even a couple of months, where we were almost lulled into a sense of normalcy. Cole did manage to attend school between the end of February until the end of April. He had a brace that strapped around his calf with a base that slipped under the lining of his shoe. It held his foot in position so he could walk even though he still couldn’t feel or move his foot. His pain never went below a 6 and he was still in physical therapy three times a week. He experienced a major setback the first weekend of May after playing catch in the yard and throwing a tennis ball against the garage. CRPS might not appear completely debilitating when you see a child play outside like this. Cole looked like a normal kid playing outside that day, except for the brace on his leg. However, by that night he was in absolute agony again. He never made it back to school that year.

Cole’s physical therapist, pain doctor and pediatrician were key in treating Cole’s condition. Even when other specialists told us the pain was all in Cole’s head, our pediatrician was a voice of reason. “Cole does not respond to having a needle poked in his foot,” he told us, “You can’t fake numbness.” The pain doctor increased the Gabapentin the neurologist had prescribed. He put him on Ketamine for his pain flares and also Valium to counteract the irritability and violent behavior the Ketamine exacerbated. He took the temperature of both of Cole’s legs. The left was 18 degrees colder than his right, another sign that something was physically wrong. He added Low Dose Naltrexone to help with his circulation as well as the pain.

With the medications helping to lower Cole’s pain, the physical therapist was finally able to gain more hands-on contact with Cole’s leg--not that Cole cooperated, my husband was still physically restraining him, but he was less violent during the sessions--and tell us what the x-rays and failed MRI could not. His fibula was subluxing, actually dislocating,  80-100% out of joint. The hit to his ankle had popped his fibula in at the ankle and out at the knee. Not only was this painful on its own but it was also putting pressure on his peroneal nerve. The orthopedist had already told us that his peroneal nerve was somehow compromised--causing his numbness, foot drop, and consequently the CRPS--but now we knew what was damaging the nerve. It was also the pain specialist and physical therapist that told us they suspected Cole had EDS. A genetic test would later indicate he does not, but these tests are not definitive, so it’s hard to be sure.

After wearing a leg brace to enable him to walk, months of physical therapy, and attempting electronic stimulation, Cole was eventually referred to an orthopedic surgeon in Wisconsin who specializes in patients with EDS and CRPS and has experience operating on children. Cole had an allograft  to stabilize his fibula on June 10, 2014. He came out of surgery in a full leg cast and immediately wiggled his toes for the first time in eight months. My eyes sting with tears just remembering it. While Cole did have some pain after the surgery, I am sure now that it was simply post surgical pain and the swelling of his leg in the cast. His CRPS went away as soon as his fibula was stabilized and his peroneal nerve entrapment released.

During Cole’s surgery I took several weeks of family leave to travel out of state and then care for him our first week back home, but otherwise we were both juggling full time jobs and Cole’s medical needs as well as Connor’s. It took everything my husband and I had to go to work and care for our boys. We both had moments when we completely fell apart. One night I came home, exhausted from the previous night spent in the ER after long days at the office. My husband was leaving for work, Cole was in full on tantrum mode. I collapsed on the floor and started sobbing. Sometimes these breakdowns can be beneficial. I’ve never been one to cry and the sight evoked the first signs of compassion we’d seen from Cole in months. Another day my husband called me at work beside himself after a trip to the physical therapist. He told me he couldn’t keep going through this with Cole every day. He had scheduled an appointment for Cole to be seen by a surgeon in Wisconsin in three weeks. In the moment I was shocked, but we had definitely exhausted our options.

A number of my friends joked with me, that I must really need a drink at the end of the day. I rarely had the luxury. As any parent knows, you’re never really off duty. If your child is up sick in the middle of the night, that means you or your spouse is up in the middle of the night. Cole was in extreme pain all the time with the CRPS. If his pain flared, we had to be prepared to jump in the car and drive to the hospital. Even when we learned that the emergency room wasn’t able to offer us any help, we had to be prepared to deal with his incessant pain our own. The whirlpool seemed to help, so sometimes in the middle of the night we’d find ourselves drawing him a bath and helping him into the tub. We’d also keep doling out medication, Ketamine and Ibuprofen PM, in the incremental ways we’d been instructed by our pain doctor until we could finally get him to pass out. Blessedly, once he fell asleep, the part of his nervous system sending the pain messages would shut off, and he could stay asleep. But it would all start over full force the minute he woke up the next morning.

Cole after getting his full leg cast removed

Cole’s CRPS subsided immediately following his surgery, but the remnants of it stays with us. Once someone has experienced CRPS, that person has a predisposition to get it again following an injury. For this reason, Cole is prohibited from any contact or high impact sports, so football, soccer, basketball, hockey, as well as a number of others, are prohibited. He also can’t participate in any activity that can cause great strain or twisting of his knee, so no trampolines, skiing, snowboarding, skateboarding . . .  you get the idea. Unfortunately, Cole is now an eleven-year-old boy and the more he feels like his old self, the more he wants to participate in his old activities. I worry that one of these days, when I’m not looking, he’s going to jump on a friend’s skateboard and this could start all over again. I hold my breath every time he slides into base during a baseball game. It’s not a high impact sport, but that doesn’t mean he can’t get hurt. I’ve had people suggest that I pull him out of sports altogether and have him take piano lessons instead. Let me tell you, there’s a part of me that would love to put both boys in bubble wrap, but I can’t do that. Cole lives to run around and play sports. His first word was ball. Trying to take all sports away from him would make him miserable, and it would only make him more likely to take part in them when my back is turned.  

I was not at all prepared for the nightmare of CRPS, but my son did survive, our whole family survived it. I continue to read posts in the support group of all the children still suffering in pain and I can’t help that feel that part of Cole’s recovery was just blind luck. These parents are seeing the same doctors, trying the same drugs, treatments, and surgeries, but many have not been as fortunate. There were no clear cut answers or treatments for us to follow.  My husband and I found ourselves making medical decisions we always expected a medical professional would make for us. We had to keep researching, talking to other families dealing with CRPS, meeting with various doctors and experts until we finally found the answer for our son. We flailed the same way these other parents are still flailing and we got lucky. We dodged a bullet and we still aren’t sure what we did differently from a number of other families.

As I watch Cole snuggle on the couch with his dog, I still see the shadow of the pain that plagued him for eight solid months without mercy. I feel the temptation to force it from my mind, like I know he does, and pretend it never happened. I want to focus on all of the fun and joy that has returned to our lives; watching him play baseball, a summer just beginning and full of the promise of beach days and a family vacation. And I will. I will embrace the joy and the fun. I will also remember and tell the story of his pain. So when it happens again, to my son, or to someone else’s son or daughter, hopefully more people will know what CRPS is, and curing that pain will not be a long, tortuous process that takes months or years.

Work, School, Telecommuting and Sick Days

This cold and flu season has been quite horrific and is only half way through. Everyone in our family has been sick at least once. Both boys and my husband had the stomach flu in the fall. I luckily escaped that one. LT was just this side of being taken to the hospital for dehydration. He vomited at least a dozen times. And we've all had some sort of cold or sinus trouble. I started the year with a sinus infection. Both of the boys have been home with it over the past month and Blackstone has a post nasal drip that is seriously offending my beauty sleep.

Trouble is home sick again today. We started the morning with, "Mom, I can't breathe." Never a good start to a day. Trouble has asthma, but that's not the problem. His throat is so swollen he's having trouble breathing. After being well dosed with medication, he is now comfortable enough to be reading in the arm chair. This is coming on the heels of the note we received home from the truancy officer on Friday. Trouble has six unexcused absences this year. There are others that have already been excused. The only absences the school considers excused are a doctor's note, court date or death in the family. More than five unexcused absences warrants detention. More than ten and they send DCYF to your home.

Really, I think the policy is a bit overboard. I understand that school is important and that there is need to be concerned over a child's environment, but ten days in the course of a year is not that much. Especially, not when you throw in the fact that most of the country, RI included, is in the midst of a flu epidemic.

Trouble's unexcused absences are all sick days. If he has the flu or a cold and is home for a day or two, I often don't call the pediatrician. I know what he's going to tell me to do. I've been at this parenting thing for almost twelve years now. I don't freak out every time my child has a fever or tells me he can't breathe. I am not even all that phased by a temperature of 103 degrees, as long as I can get it drop in the course of an hour. And even then, I might reach for Belladona before I reach for Tylenol or Advil. Depends on how the child is feeling.

So I had to call the pediatrician this morning and not only ask for an excuse for today but also for the four most recent absences when he was sick. Sick enough to need to stay home, but not so sick that I had felt the need to call the pediatrician at the time. There's a part of me that is so frustrated by this. It just seems a waste of my time and my pediatrician's. But it's something I am going to have to get in the habit of doing each and every time Trouble is out, or even late to school due to illness. Late can be an issue for us too with Trouble's asthma. If I get him up in the morning and he needs to sit with the nebulizer for 20-30 minutes, we're not getting out of the house on time.

Five unexcused lates and absences can go by very quickly. It never really occurred to me that we were approaching that limit. At the beginning of the year, I thought we'd never hit that. But we did and it's not even halfway through the year.

Now when one of the boys is home sick, that means Blackstone or I need to be home too. LT hasn't had quite as many days out of school, and at the elementary level their hasn't been much concern over needing doctor's notes. LT really seems to shoot for weekends and school vacations for getting sick. He also doesn't have asthma to contribute to the sick time. Blackstone works out of the house, so he does stay home with the boys often. Some days, like today, he needed to be in the field, so I'm home. It's great that Blackstone can take so much of that on, but I know he doesn't do as good as a job tending to them when they're sick as I do. He's still going to spend the day working in the home office, just checking on them periodically. I have to call home to remind him to give them medicine, get them a drink and feed them. He will forget to do these things if I don't call. He also will not give them the correct medication or in the correct dosage. Recently he told me he had given LT Triaminic for his fever, which would be fine, he had a cold/flu, except there was no acetaminophen in the type of Triaminic we had. He hadn't actually given him anything for his fever and I had to explain the importance of reading the label on the medication. If it doesn't say it treats fever, if it doesn't have acetaminophen listed as an ingredient, then it's not for fever.

Almost twelve years we've had kids. He still doesn't know this. Of course, I've also known him to complain about falling asleep after taking Tylenol for a headache himself.

Hhhmmm. Which Tylenol did you take? The red one or the blue one? Yeah, the blue one is the PM to help you sleep, that would explain why you're so tired.

When I stay home when one of the boys are sick, I can telecommute into work, and I usually do. I do have four family sick days, which is more than most people have, but that's not enough to cover two kids. I could use vacation time too, but who wants to do that? And even when it's the beginning of the year and I have those four days, I still feel pressured to log on and work to meet deadlines.

I feel the pressure today, but I still can't make myself do it. I have been up getting ready (because I wasn't sure if I was staying home or not), caring for Connor, calling the school, calling the pediatrician (repeated busy signal), calling the pharmacy, emailing work, sterilizing door knobs, furniture, light switches and other frequently touched surfaces for four hours. I am tired. Maybe I'm coming down with something myself. More likely, I am just worn out. This mommy business is hard work.

It's time for a nap.


I'll Get You My Pretty

Warts have been a bane on my existence over the last couple of years. Maybe many of you have been lucky enough to avoid the pain and annoyance that comes with this virus and can feign superiority with an air of disgust while reading this.

I wish I was one of you. *sigh*

I never had warts as a kid. I had one plantars wart in my early twenties that I managed to get rid of with over-the-counter treatments. You know (or maybe you're lucky enough not to know), the Dr. Scholl's pad treatments. Blackstone, however, had a nightmarish ordeal with them through childhood and as a teenager. His hands are covered with scars from having them repeatedly frozen with nitrogen, the common treatment twenty years ago. I think he may still have nightmares about those constant visits where he endured the pain and listened to his skin sizzle. As he's gotten older, they have been much less frequent, so most of this he went through before we met.

Trouble has been lucky enough to escape this family trait. Warts are not considered genetic, they are a virus. But if someone in your family has that virus, I think it's safe to say that your odds of catching that virus increase. Personally, I suspect there is a genetic precursor of some sort at work here. Some people are more prone than others for an outbreak.

LT has not been so lucky.

His warts have been gone for about a year now, but that is after undergoing over year of treatment from a pediatric dermatologist. Freezing warts is now considered an antiquated treatment and most dermatologists and podiatrists will either strongly advise you not to request freezing or outright refuse to provide it. At least that has been my experiences with the dermatologist and two podiatrists I have dealt with.

LT started with a wart on his knee. I wasn't too concerned at first. I asked his pediatrician about this who counseled me that most warts will go away on their own over time. But LT being an active little boy is prone to skinning his knees. This caused the virus to spread quickly until he had a whole family of warts on his knee. So we started seeing a pediatric dermatologist. I couldn't go back and give you the names of the in-office and at-home treatments we did for months. LT had to go in to see her either monthly or every two weeks. This was time consuming and expensive. I don't need to explain to a parent how all these appointments add up: pediatrician, dentist, opthamologist, orthodontist. Between me and my two kids it seems like I'm taking time out of work every other week for one appointment or another. And because I had crappy health insurance and a $4,000 deductible, all of these appointments were out of pocket medical costs. Between LT's treatments and my own, it is no exaggeration to say I have spent thousands of dollars on warts over the past two years.

You really have to learn to advocate for yourself and your child, and this experience was no exception. After about six months of these visits I asked about a more aggressive treatment. Blackstone wanted them frozen because in his experience that was the only thing that worked. The doctor flatly refused and said it was ineffective and in her opinion painful and cruel. She would consider laser treatment if all else failed. This ended up being several more months of shots of yeast into his knee every two weeks which did nothing. We did consider switching him to another dermatologist, but the idea of starting over with someone new was not appealing either. The dermatologist also continually reminded us that we could just leave the warts alone and they would likely eventually disappear on their own.

LT's knee looked like a head of cauliflower. At this point my blood boiled every time someone told me to just ignore them. Every time he skinned his knee they continued to spread. They also weren't all that comfortable, LT found them embarrassing and wanted them gone too.  Though as the treatments progressed to needles and lasers he was less and less enthusiastic about these trips to the dermatologist. Bringing him became increasingly tortorous for all of us. He needed to be physically restrained during the treatments. It was truly awful.

In the end it took three laser treatments and the warts were completely gone. I realize that this treatment is expensive and for that reason only given once other treatments have been tried and found ineffective, but honestly, I think it would have cost the insurance company less if the dermatologist had just looked at the severity of his warts and done the laser treatment in the beginning. Given what I know now, faced with the same situation I would call every pediatric dermatologist in this state and neighboring states to find one I could convince to just given him the laser treatments without the previous months of trial and error which was a drain on our time and money and also resulted in a long, drawn out, traumatic experience for our son.

While LT was undergoing his treatments, I also started seeing a podiatrist for a plantars wart on my foot. He treated me every 2-4 weeks with an acid of some kind and thought he got rid of it. After a few months, it either came back or more likely was never gone and I started seeing him again. Again he thought he got rid of it, but really not. I treated myself for this one and managed to get rid of it. I figured I could do the treatment he was giving me on my own. I treated it with acid, waited for part of it to die, shaved it off with a sterilized razor blade, covered it with neosporin, gave it a day or two and repeated the process again. I wouldn't advise anyone to do this on their own, but after the frustration, time and expense I was completely fed up. Obviously, there is a risk of infection in doing this on your own, but I was careful and have a healthy immune system and it worked.

But I ended up with two more warts on my other foot that were kind of close to my toes. Their placement made treating them myself trickier. They were more difficult to access and the acid kept getting between my toes causing the skin to peel and itch. I asked my general practitioner for a referral but to someone other than they originally sent me. They took weeks to get back to me and referred me to a dermatologist. In order to get an early morning appointment I had to schedule three months out. In the mean time, I got a referral to a different podiatrist from my esthetician. I managed to get an appointment in two weeks. She offered me two types of treatments. One was more of a process that consisted of an acid treatment in the office and a perscription for me to keep using at home. The second was also an acid treatment but much stronger that contained (of all things) beatle juice. She warned me it would be painful and that my foot would blister, but I still opted for the second treatment. I just wanted the wart gone and appointments that went on for months and months were not an option. I have better health insurance now and no deductible, but I still have copays and I'm still taking time out of work for every visit.

The first treatment was painful but bareable. The pain only lasted a couple of days. Two weeks later at my follow up she did the same treatment again. Now, it doesn't hurt right away. It takes about 12 hours for it to really start to burn and then blister. The second treatment hurt like hell, probably because there was less wart to kill. I could barely walk for a week. The area blistered and turned purple. It was awful.

Three weeks later the wart still wasn't gone and I was facing another treatment. The acid/beatle juice potion/whatever-it-was was working and do I think that another treatment would have done it. But at this point I knew I was in for an even worse ordeal than the time before, so I told her to cut it out. I knew this would not be pain-free, but figured the wart was much smaller now and having it cut out would probably mean a shorter recovery period. She acquiesced and warned me that this would be painful as well.

Like dental procedures or any outpatient surgery I've had, it's not the procedure itself that hurts, it's the numbing shot they give you beforehand. Now, I've had similar shots in my gums, even in my labia, but when I tell you this was the most intense and searing pain I have ever felt from a shot like that I am not exagerating. I just about hit the roof. It took everything I had to keep my foot still. Even in childbirth I don't think I ever swore. This time I did. It was forty-five seconds of pure, unadulterated torture before the numbing sensation started to slowly take over.

After that it was pretty much cake. I never felt any pain during the procedure. It did hurt some in the days that followed, but nothing like the burning, blistering pain that went on for days on end.

The podiatrist asked me which was worse. Honestly, neither was pleasant. I also have no doubt that the minor surgery would have been much worse if the wart hadn't been shrunk by the previous two acid treatments. However, I am the type of person that would rather suffer through the intensity of the forty-five seconds than the long, drawn out, searing, but less intense pain that lasts a week.

For those of you that may encounter warts in your future, I hope I may have spared you some time and money. I'd say pain, but I don't think there's any sparing that when you're dealing with warts.

For those of you that never have the pleasure, you suck.


To Flu Shot or Not to Flu Shot

This is my pediatrician's stance on the flu shot.

The flu season and the unusual occurrence of so much flu illness in the summer has brought a lot of issues to the forefront. Pandemic preparation, health dept. preparation, and the media blitz while necessary and helpful, they create a level of anxiety that is not always so helpful.

I want you to know how grateful I am to have patients who maintain their focus and realistically evaluate their risk and alternatives. I will have the flu vaccine in the next 10 days and the H1N1 when it is released for anyone in a high risk group especially those with a chronic medical condition.

I just want to share some observations that relate to flu and viruses in general to help you make a decision, I hope, about getting the vaccines for your children. While all viruses are obviously infectious I think it is likely that because they are DNA/RNA they can be released out of our own cell structure under certain stresses. Herpes viruses like cold sores release sporadically. Chronic mono becomes active disease like chronic fatigue syndrome when the EBV virus is activated. Different stresses seem to activate and even cause new viruses. Getting chilled causes some to catch a cold .Sleeplessness decreases our immune strength, etc. In the past viruses seemed to have a season of increased activity, indicating weather plays one part in allowing a virus to take hold. Chicken pox and hand, foot and mouth disease used to be spring viruses. Diarrheal disease was mostly in the summer; cold and flu viruses were mostly winter viruses. With weather patterns changing things are shifting and flu appeared more this spring and summer than usual. I think we probably had H1N1 as early as April and May before reports of spread from Mexico. Certainly the flu-like symptoms of cases then were similar to those seem later.Viruses do tend to change or mutate. However, they still follow the trend that the elderly, the very young, those with a chronic medical condition are more susceptible to complications.  Because H1N1 was primarily a summer virus it might be too soon for it to mutate or do whatever it needs to do to become more active in the winter also. This is just a guess, but it doesn’t matter because there will be some other strain we still have to deal with anyway. People not in a high risk and even those who are but maintain a healthy lifestyle and diet weather the flu better. Adding the right homeopathic remedy adds to the success rate greatly.

I know it’s a small number but some people who get the flu vaccine get a bad reaction. This actually follows the homeopathic principal-if the vaccine is too strong or concentrated for some they get flu symptoms. Some of these reactions have been very significant with a downturn in a patient’s health for some time. Again this is a small percentage but I’m just uncomfortable recommending something when I can’t predict who it might affect adversely. If there were no other alternative it would be different.

With these latest outbreaks of regular and H1N1 flu, homeopathy has been just as effective as in the past. So, I feel homeopathy is still a viable safer alternative. Just like the standard flu vaccine not being perfect, neither is homeopathy, but at least it doesn’t cause any problems and it still works very well most of the time. I heard a tv interview with a man from the village in Mexico targeted as the epicenter of the original spread.  He reported arm, back leg bone pain 6 weeks after the onset. These are some of the symptoms of the remedy Eupatorium and indeed that helped a lot of patients this summer along with other remedies, such as China, Phytolacca, Gelsemium and Mercurious Vivus.

Oscillococcinum is a homeopathic remedy made from a patient who had the flu-the same idea as the regular vaccine but made homeopathically. So, you could proactively give it or Influenzinum(another brand of the same idea)1/wk or every other week at the beginning of the season and maybe 2/wk if there is a lot of exposure like at school or day care. Some people feel given 2/day during a case of the flu it helps get rid of it as well. Also keep on hand the above remedies. They can be used to treat according to the specific symptoms (see attachment).If you know from me if there is a remedy that seems to be helping the most with current active cases you can help prevent them by using those remedies in a 200c 1-2/wk.Remember Oscillococcinum dose is 15-20 pellets not the whole vial and remedies can be obtained at your health food store or  NE Homeopathic at 1-800-551-3611. 

Hope this is helpful---Dr.K

I can't see chasing something down that I'm still not sure about.  I am giving the whole family Oscillococcinum once a week.


Yoga (or Sometimes Laughable Impossibility)

I've mentioned now and again that I'm a yoga fan. I've been to some classes at the local Y, and Blackstone and I were doing a rather intense heated yoga class a few years back, right up until I broke my ankle. Since then I haven't done much in the way of group exercise period. For the last couple of years, most of my exercise has been done at home. When it's nice, sometimes I walk at lunch. Sometimes I'll even do the gym at lunch, but I don't want to take the time to shower and do the hair and make-up again, so I try to keep the intensity down when I do that. It's not my favorite way to work out, just too inconvenient.

These days, I usually work out before or after work, sometimes on the weekend mornings. We have a cross trainer in the bedroom, so sometimes I just do that while I'm watching TV. I also have hand weights and yoga mat. I'll record various exercise programs and do those, you know, change it up a bit. You can find just about any kind of exercise show on TV - aerobics, kick-boxing, yoga, belly dancing, hip-hop routines, step, pilates. I've been recording some of Namaste Yoga programs. They're a half hour and most of them are pretty do-able. Now, there are all different types and levels of yoga. I suppose I'm rather intermediate. I know a good deal of the common poses, my strength and flexibility is moderate. I cannot do hand stands or splits. Luckily, Namaste Yoga doesn't do too much of this. Though this morning they wanted me to stand in a modified tree position with one foot tucked up at my hip, then crouch forward touching the floor (already I'm stuck not being able to reach the floor, because the tightness in my hips is a major reason I do yoga in the first place, a rather common problem for women as they age, especially after having children). Then I'm supposed to lean forward, put my knees on my elbows and balance on my hands. I can't imagine how much yoga I'd have to do to get myself to this level. Probably way more than I ever intend on doing.

I want to stay flexible and strong, try to avoid loss of bone density, ward off weight gain. I'm not sure I need to be able to balance on my hands at this point in my life. At the moment, I couldn't do it if my life depended on it. And I'd probably do my body a great deal more harm than good.


Weighing In

I hate to talk about my weight. Not only when I've gained, but just generally hate to talk about it because I am so much more than what the scale says when I step on it. I've had numerous people comment about my weight lately. I finally feel like I'm getting my body back. Everyone from a woman I worked with a decade ago, my sister, and my mother-in-law have brought it up. My mother-in-law particularly seems determined to figure out how I've done it for some reason, not that the woman needs any weight loss secrets. She cornered Lissfull at one of the kids' birthday parties to ask her how I was losing the weight. I'm not sure what she expected to hear, "Yes, Diosa's taken up coke, but just until she reaches her goal weight."

I refuse to diet. I think the entire concept of dieting and weight loss in this country is fundamentally flawed. It causes men and women both, to have unhealthy attitudes toward food, their body image and their self-esteem. I was placed on Weight Watchers by my pediatrician, or rather, temporary pediatrician, when I was twelve. He labeled me as obese. Talk about crushing a young girl's self esteem. I'd never been thin, but obese? So I started on Weight Watchers and started losing weight. Everything went fine for a while, but after a few months I stopped losing. The pediatrician told my mother I must be cheating, but I wasn't. They restricted my caloric intake further. I was hungry. I still didn't cheat. I still couldn't lose anymore weight. I don't remember exactly how long I spent on Weight Watchers, somewhere in the vicinity of six months to a year. And while I did put some of the weight back on, it's not like at any time my weight was seriously out of control. At least not in my opinion.

Several years later, my mother took me to another doctor to have my height analyzed. I am four inches shorter than my sister and nine inches shorter than my brother. At 5'3" on a day after I've done yoga and stand my straightest, I do not have short genes. My height was stunted while I was on Weight Watchers. What the damn pediatrician or one of the counselors at Weight Watchers should have considered, is that a pudgy twelve-year-old girl could be getting ready to go through a growth spurt. A growth spurt that never happened because I wasn't eating enough to grow.

This does not mean I eat anything I want and ignore extra pounds. I do not use my height or my previous experience as an excuse for my weight. Maybe I'd be four inches taller, maybe I wouldn't. Doesn't do me much good to know either way now. If anything, it just means I have to work a little harder at it.

While I was in college, I spent several years teaching aerobics, and was physically in the best shape of my life. I got down to a size 8. The smallest I'd been ever. I ate very carefully. Lots of salad and grilled chicken. And I worked out an average of 7 hours/week. Not to mention the 30+ hours I spent waiting tables. And still, I was NEVER the thinnest girl in the room. But that didn't mean I wasn't the one with the best figure. Yeah, no self-esteem issues here.

Obviously, I don't have the kind of time to devote to working out that I did before I had kids. I get in about 3 hours/week usually. But when I'm sick, the kids are sick, we're moving, or there's some other stress sucking up my time, it might be not at all. And with the foods kids like to eat, it's easy to pop fatty, calorie-ridden food in your mouth without even realizing you've done it. Eating right and exercising takes vigilance, planning, and a lot of self-control. I do pretty well at it most of the time, but then there are those days . . . I know you know those days. The days when all self-control goes out the window. When you didn't have time to eat a proper lunch and now you're home and stuffing yourself with chips or whatever was the first thing you could grab. Or when you just don't have the energy to care. When you'd just as soon someone take a gun and put you out of your misery, as put down the chocolate.

But through all the years I've struggled with my weight, which is basically since I was twelve, or even earlier than that, I've learned that dieting is not where its at. The whole concept of a diet, where you deprive yourself for a period of time and then at some point stop and go back to eating like before, it doesn't work. We're completely inundated with diet ads, weight loss pills, the best new thing that's going to make you thin - and it's all a bunch of crap. The woman who trained me to teach aerobics, she was this tiny English woman, and she said something to me once about weight loss that's always stayed with me. It's there in the back of my mind every time I see an ad for a new weight loss drug or miracle program. She was talking to a number of us in the training program, many of us interested in losing some weight, and she told us, "There is only one way to lose weight." And I'm listening intently to what amazing secret she must have to offer us, because obviously she's figured it out. "You have to burn more calories than you take in," she told us. And it was sort of eye-opening for me. I mean, we all fundamentally know this. It's basic science, but somehow we still buy into all these crazy weight loss promises. So whatever the new hype is, the new diet craze, I always come back to that - There's only one way to lose weight - Burn more calories than you take in.

I don't mean to knock anyone who is dieting, because if you need some structure or support in losing weight, by all means, go out and get it. And if there is one weight loss program that does make sense to me, it is Weight Watchers. Because they'll teach you about appropriate portion size, about where those calories that are landing on your thighs are coming from. I still remember and apply the tools I learned at Weight Watchers more than fifteen years ago. And it's easy in our society where everything is super-sized, and it seems everyone's having a grande cappuccino with whip cream and muffin for breakfast, to not know where those calories are coming from. Bottom line is - everything you put in your mouth adds up.

But you're never going to be done eating healthy. It has to be a life-long commitment. I run into people that I haven't seen in fifteen years, and I'm not going to lie, there's some satisfaction when you see the former size 2 cheerleader has an ass bigger than yours now. But this is where I have the advantage. Because while other women find themselves all of the sudden struggling with their weight, I have years of experience on them. I have the weight management thing down. Losing those last ten pounds I want off, well I still haven't managed to do that. And while I'll keep working at it, a little bit at a time, I know it's not the most important thing in my life. I'm happy and I'm healthy. My weight does not get in the way of me living my life. My cholesterol and all that was so good from my check-up last year, they didn't even run any this year. I seem to be doing something right.

You shouldn't be put off by the life-long commitment either. It's a commitment to yourself, to your health, happiness and physical and mental well-being. When you're eating right and exercising, you just feel better. Your clothes fit better, you expel the stress and toxins from your body, you feel that great endorphin rush, and you can just move, sleep and breathe easier. Time is your friend. If you just keep at it, work it a little every day, you can find your rhythm.

So that's it.  That's my secret. I'll never be a size 2,  but I'm perfectly okay with that.


Falling into Homeopathy

I've never considered myself the earthy, crunchy type. Blackstone, yes, in some ways. But me, I'm a city girl born and bred. So the fact that I now find myself taking my boys to a homeopathic pediatrician is a bit odd. That I drive them out to the middle of no-where, down a dirt road to a hundred-year-old farm house for their office visits, well that's just bizarre.

I met Dr. H (H for homeopathy) way before he became our pediatrician, when he treated me for depression. He's actually pretty commonly known in the state. While a good percentage of people will look at me sideways when I tell them we use a homeopathic pediatrician, you never know when someone's going to say, "Oh, I've seen him," or "My sister uses him." Dr. H was recommended to me by someone Blackstone worked with at the time. My mood swings were pretty erratic, I was having trouble sleeping, had crying jags for no reason, and was generally all-around miserable. However, I didn't want to go on medication, it had that whole stigma for me and it's common knowledge most of that stuffs not good for your sex drive (at least that's what I'd read/heard). So, I'd been refusing to see a doctor about it. I was still teaching then, and I figured after I quit, it would get better. But then Blackstone asked me to see Dr. H., and I couldn't really come up with a good reason not to go, so I went. I spent a good 30 minutes or more being grilled about my physical, mental and emotional state. Everything from what I ate and drank, my sleeping habits to mood swings, energy levels, bathroom habits, and what I wanted to improve on. The concept behind homeopathy (in my own words) is that in order for the body to be healthy , your mental, emotional and physical health must be in balance. If any one of those areas if off, then they're all off. If your body is out of balance, if there's anything wrong, then that can be corrected by introducing the necessary minerals/remedies into the body.

After my thorough grilling, Dr. H put me on Aurum, which is a gold compound. Who knew my problem was that I needed more gold in my life. He also suggested I stop drinking coffee and not use anything menthol. I actually did go off coffee, one of several times in my life, and I took the Aurum and I felt better. I gradually started introducing coffee after a time, though less of it, and I kept taking the Aurum until I got pregnant. At that point I stopped because even though it is unlikely it would have caused any issues with the pregnancy and I had asked my OB and Dr. H., I figured if I could, I'd rather not be taking in anything I didn't need while I was pregnant. And funny enough, while pregnancy is known to make women moody and emotional, I was the most level I'd been in my entire life. I had slight case of post-partum after Trouble was born and went back on the Aurum again, which helped as it had before, but eventually I went back off and haven't felt I needed it since. But if I did find myself emotional, weepy, and lying in a puddle on the floor, I'd definitely use it again. Now, I DO NOT recommend anyone who has depression use Aurum, that's not how homeopathy works. I would suggest that you consider seeing a homeopathic specialist and have your own work up done, if you're looking for a less traditional means of treatment.

So you might think that since Dr. H is a licensed pediatrician and he had been a big help to me, I would have picked him immediately to be our pediatrician. I didn't. I was not into the idea of driving all the way out to the middle of no-where, and felt rather confident I could find a local pediatrician that would fulfill our needs. And we did have a great pediatrician. She was a lovely woman and a good pediatrician, but Trouble was not your ordinary baby, and modern medicine was not really being very helpful. He was a terrible nurser and had to be supplemented with formula. He spit up at least half of everything he ate, and by spit up, I mean projectile vomited after every feeding. He and I passed back a constant case of yeast infection/thrush while he was nursing. He constantly had skin irritations, baby acne, eczema and cradle cap. He was constipated since the moment he was born and we tried everything and took him to see every specialist. We gave him prune juice, aloe vera juice, caro syrup, goats milk, cod liver oil, olive oil, warm baths, thermometer and vaseline, suppositories, laxatives and enemas (and I'm probably leaving some things out). We drove him to a special physical therapist in CT once a month. We saw pediatric gastro-enterologist at Hasbro several times. Nothing helped. Everyone told us his constipation was a mental issue, not a physical one. And they were right, because once he had the mental capacity to choose between going himself and getting an enema, it got better. But before that happened it got so bad he'd only go once a week when we gave him the enema.

Add on top of this his inability to hold down an antibiotic, if you got him to swallow it, 30 seconds later he'd vomit it back up. He developed allergies and asthma, his eyes were so bad during spring they swelled so he could barely open them. By the time he was about six months old, we'd switched him to Dr. H., and that has worked well for us. Dr. H. may not be crazy about prescribing antibiotics or steroids, but he will when they're necessary. But seeing that these standard treatments didn't tend to work well for Trouble, I was fine with that. And when I call Dr. H. at 9 PM on Saturday night and tell him that if I don't a get a prescription of liquid steroid tonight, Trouble will be in the ER by morning, he calls it in that night and I'll have the prescription by 11. And LT, he's still yet to have been on an antibiotic in his life, and I'd like to keep it that way unless he really needs it.