Latest Comments by tsmith1

tsmith1 1,225 Views

Joined: Sep 18, '04; Posts: 8 (0% Liked)

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    This is my suspicion as well and what does that say about the thousand of physicians giving this diagnosis. It hinders treatment from those that actually do have this disorder (I have actually seen about 3) due to raised suspicions from every case manager that sees this diagnosis.
    Unfortunately due to its vagueness and difficulty to rule in or rule out we are at the mercy of the IME doctors to get us out of paying for years of treatment due to wrongful diagnosis.

    [TQUOTE=FutureNrse]Strange, my old doctor tried to diagnose me with RSD and I was work comp auto accident. If I'm not mistaken, it stands for Reflex Sympathetic Dystrophy. It was a long time ago that I researched it, but my first thought was that it was a "disease of the day" kind of thing. To some extent the symptoms could fit anyone. Making it hard to disprove, which is probably the appeal of it for work comp doctors.
    When I finally found a good doctor, he told me to go home, look up the meaning of "dystrophy" and then try to see if I could apply it myself in any way. Naturally, I couldn't. I was rather furious that I had spent months being treated with Neurontin, which made me sick, for a disease that I didn't have. Furthermore, I founf info online stating that Neurontin hasn't beeen proven safe or effective for treating RSD.
    I don't have a lot of faith in diseases or disorders that are vague and hard to prove or disprove. They seem made-up, just an excuse for billing insurance, prescribing meds, and getting money from work comp.[/QUOTE]

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    Workers' Comp is very different from state to state. The comp board in your state should have some imformation. Talking to claims adjustors is also a great way to learn.

    RSD stand for Reflex Sympathetic Dystrophy. It is also know at CRPS or Complex Regional Pain Syndrome. It is a disorder of very vague symptoms such as mottling of the skin. temperature changes from one extremity to the other. shiny skin, exterme sensitivity to anything touching the area, just to name a few. People with this disorder almost always have a psych component but the patient may not have actually been diagnosed with any psych issues. The disorder always results from a very minor injury and there are NO definative diagnostic tests to diagnosis this. In fact most tests are negative when the diagnosis of RSD is given. The 2 main test are EMG and bone scan. The EMG will be negative with RSD but the bone scan usually shows uptake in the affected area, but a negative bone scan does not rule out RSD.
    Some people have gone as far as having limbs amputated to stop the pain but this is not the common case. Usual treatment is Neutontin and extensive physical therapy to make sure the patient doesn't stop moving the extermity.
    RSD does usually manifest itself only in the limbs but there have been some cases of doctos diagnosing the disorder in the back. There has also been some cases where patients say it moves from one limb to another. My personal opinion is that this is part of the psych component.
    There are some treatments out there involving lidocaine drips that involve daily trips to the hospital or actual hospitalization and run about $30,000. This disease can keep cases open for years longer then they should be and almost always carries a total disability with it. Sometimes leads to a permanancy.

    I hope this helps.

    Quote from sflohaug

    I am new to the field of Worker's comp. case management and wondered what RSD is? If you have any tips or resources that can enhance my learning of WC, I would be very grateful!
    Thank you,
    Sharon in CA

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    [QUOTE=buildingalife]I am returning to nursing after raising my children.
    I am interested in Case Management.
    Do you think it is possible to re-enter in this specialty?

    You can do case management outside of a clinical setting so that it only requires you to have maintained the knowledge and not the technical skills. These employers are only going to care about the knowledge base you possess and not when the last time you cared for a patient was.
    Try looking for case management positions that say "Telephonic" or "Field." These are usually offered by insurance or managed care companies.

    I hope this helps

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    I have never heard of this test and do not know anyone in the case management field that took such a test in order to get the job. I entered case management after only 4 years of clinical experience and have been doing fine. I didn't even know this type of test existed.

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    I am new to allnurses so here I am:

    RN, AAS working on my BSN. Have been a case manager since 1997. Started out in workers comp and have not moved on to auto/no-fault. I have handled almost every juridiction on the east cost and am current handling New Jersey. Mostly telephonic work, some field experience as well. Have had my CCM since 1999 and thought it was the most difficult test I have ever taken. Am looking to get into management at this point.
    Would never return to the hospital after doing case management. I love it!!!

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    I have two issues regarding RSD that I would like imput on:

    1) Has anyone else noticed that the diagnosis is given in work comp injuries almost all the time but with motor vehicle the doctor's seem to go out of their way to rule this out? Why do you think this is?

    2) I am also curious about opinions as to the validity of RSD as a diagnosis. Do you believe their truly is such a condition? How much of the condition is influenced by the psych component?

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    Quote from traumaRUs
    Personally I view this as extremely important but found out recently that my co-workers - other case managers don't. Interesting to find out what answers you get.
    I also view previous clinical experience as very important. How can a case manager do the type of critical thinking necessary to do the job without first hand knowledge of the diagnosis and how it is cared for.
    We recently had a case manager hired right out of nursing school. It was felt to be a political move because her mother was a district supervisor in the company and the job description specifically calls for clinical experience.
    I also fel badly if this nurse ever has to go into the hospital. Without use of the knowledge learned in nursing school, right after school, it will be hard to recover and be a good clinical nurse.
    Thank you for responding.

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    I am a case manager currently completing my Bachelor's degree and am working on an assingment for school.

    I would like to get opinions from current case managers as to the importance of having clinical experience prior to going into the case management field?