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Dottie's Story
This is the story of Dorrie Evanston, not her real name.
History: Dorrie Evanston is a 56 yr old female school teacher who, since 2005, has been on full disability. She was diagnosed with Small Fiber Peripheral Neuropathy in both feet in 2001, Idiopathic Progressive Polyneuropathy in 2006, Pain in Soft Tissue of Limb in 2006 and Reflex Sympatric Dystrophy/Complex Regional Pain Syndrome in both feet, ankles, and legs in 2009. The appearance of her legs from the knee down were very discolored; mottled red that turned to a much darker maroon as it moved closer to her feet where her normal skin color was no longer visible. Her ankles were swollen and did not have much range of motion. She said her pain level was 8 on a scale of 1 to 10. She could not tolerate shoes of any kind and only wears flip flops as her feet were so painfully sensitive no one, including her, could touch them without excruciating pain. Dorrie canít walk unaided because it is so painful and relies on support from her husband or her wheelchair. Her activities of daily living include sitting on the couch with her feet elevated in front of her, scrapbooking and watching television. The level 8 pain is common at some point every day and her list of medications is quite lengthy and at best, somewhat effective. Her pain management doctor has prescribed numerous narcotic pain meds for the past two years, however they offer little relief since the affected sympathetic nerves involved in RSD/CRPS do not respond well to pain medication. Since the diagnosis of RSD/CRPS in 2009 the complications from Dorrieís condition have progressed to a level usually seen in a person who has had RSD/CRPS for 8-10 years, not two. See Box 1 for an explanation of RSD/CPRS; Click here to see a list of her medications and the drug and device trails she has participated in and her medical history.
Initial Treatments: The first two 35 minute treatment sessions took place in the office of Dorrieís pain management doctor. Dorrie is lying on a treatment table dressed in shorts and a tank top and lying face up. I began on her neck for approximately 3 minutes, then her abdomen for the same amount of time to stimulate/activate her lymphatic system. I then began treating her legs, starting at the top of her thighs (proximal) and systematically worked my way down to her feet (distal). I repeated this procedure twice; once at the high frequency of 150hz, once at the low frequency of 20hz. I did not work directly on her feet due to the severity of the pain, however I did work down to, and around, her ankles.
After the session the mottling in her lower legs was much less pronounced and her normal skin color was more noticeable. While no circumference measurements were taken before and after the treatment, Dorrie, her husband, the pain management doctor, and I all agreed that her ankles and feet were much less swollen. Dorrie reported her pain level was 2-3 and commented later that this level of pain reduction lasted approximately 4-6 hours.
Current Treatment Protocol: I have been treating Dorrie twice a week since March 2, 2011. The treatment protocol is very similar to the initial treatment described above but now involves using three frequencies instead of two and is as follows:
Three minutes on the neck at Freq 150, Five minutes on the Abdomen at freq 62, Twelve minutes(six each) on the legs working proximal to distal at freq 150. Change frequency to 62hz; Three minutes each lower leg at freq 62. Change frequency to 20hz; Three minutes on the neck at freq 20, three minutes on the abdomen at freq 20, eight minutes on the legs (four minutes each) at freq 20. The amount of time spent on the legs has varied and at times I have spent one or two minutes longer at each frequency on each leg. Dorrie reports a pain level of 1-2 at the completion of every session with results lasting on average 10-12 hours. During this period she can walk unaided and has begun to perform some activities of daily living like walking the dog, which lasted approximately 10 minutes. She cannot remember the last time she walked the dog.