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After a life-changing diagnosis, RN is sharing her story to inspire others

Saturday, January 08, 2022

 

After a life-changing diagnosis, RN is sharing her story to inspire others


Complex regional pain syndrome (CRPS), a rare neurological disorder, is one of the most painful medical problems. A Wabasha woman facing the rare neurological disorder hopes her story of courage, bravery and healing will inspire others facing the journey.
A lower back injury caused by lifting two heavy gas cans over her head onto her parents’ boat landed Chelsey Springer in the Emergency Department late last summer. She needed a walker to help with balance and mobility.
“One morning, after still recovering from my back injury, I took my garbage to the dumpster without my walker. That’s when my back began to spasm,” Springer said. “Pain shot from my back down my leg. It made my knee buckle, causing me to twist my ankle and fall.”
Springer learned she’d broken a bone in her foot and badly sprained her ankle. Although she was disappointed by another setback, she expected a straightforward recovery.
The following weeks were excruciating. She wore a walking boot, used crutches and rested, but her foot and ankle remained swollen and discolored for weeks after her fall. She began to experience pain unlike anything she’d ever felt.
“My pain was a 10 out of 10. It was sharp and shooting like nails being pounded into my leg. When I would shave it felt like I was ripping the entire skin off my leg,” she remembered. “My leg would be numb but at the same time it constantly felt like burning pins and needles. A bed sheet brushing against my foot or ankle would send me into outer space.”
Springer, an RN at a non-profit in Wabasha County, wasn’t alone on her journey. Surrounded by supportive friends, family and colleagues, Gundersen St. Elizabeth’s physical therapist Elizabeth Nofsinger was also by her side. It was Nofsinger who noticed Springer’s ankle was bluish-gray and remained swollen and stiff.
Following her hunch, Nofsinger worked with Gundersen Health System’s pain management team in La Crosse to determine whether Springer’s pain was caused by CRPS. They confirmed the disease through a nerve block. Though devastated, Springer was also a bit relieved.
“Elizabeth and the pain management team listened,” she said. “It’s validating to have someone listen to you. Finally, I had answers that could lead to healing.”
The National Institute of Neurological Disorders and Strokes explains that most CRPS illnesses are caused by mixed messages between nerve fibers and the brain. A diagnosis usually follows a fracture, surgery or sprain. Springer’s injury was rolling her ankle/fracturing her foot.
Nofsinger works with Springer three days a week retraining her muscles and brain on how to walk. They’ve gradually transitioned from a walker to a cane. Nofsinger also uses mirror therapy. She places a mirror near Springer’s legs so that the image of her moving non-affected leg gives the illusion of normal movement in the affected leg. Through this process, different brain regions for movement, sensation and pain are stimulated.
“Physical therapists originally used this practice with amputees for phantom limb pain,” Nofsinger said. “We’re trying to retrain Chelsey’s brain. All the pain she’s experiencing is coming from her brain and her nerves.”
Nofsinger also relies on a smartphone app that tests Springer’s ability to recognize an image as a left or right limb.
“I just want my old life back. I want to be able to clean my apartment and do laundry without pain. I want to cheer for my nephews at their basketball and baseball games without pain,” Springer said.
For balance and stability, Springer walks with a cane.
“To be 35 and have to use a walker or a cane is a huge shift,” she said.
Springer said because this disease causes such sudden changes to those it affects, therapy is recommended upon diagnosis.
“I have learned coping skills like meditation and mindfulness to help with the pain,” she explained. “Elizabeth has been instrumental in coping with this news that instantly changed my life and affected my mobility.”
Springer received a second lumbar sympathetic block (LSB). The injection of a medication numbs a nerve and interrupts the pain signals it sends to the brain.
“In CRPS the sympathetic nerves couple with the somatic or non-automatic nerves and automatically fire off a pain signal. It can be incredibly painful,” explained David Dahl, MD, pain specialist at Gundersen Health System. Dr. Dahl also practices in Wabasha. “We inject a local anesthetic numbing medication on the sympathetic nerves to uncouple the firing so the patient gets enough relief to comply with physical therapy.”
Physical therapy is the main treatment for CRPS, according to Dr. Dahl.
Nofsinger plans to work with Springer for the next several months. While CRPS never goes away, it can become dormant or move into remission. And earlier treatment results in better outcomes.
Springer hopes that by sharing her story others will get quicker diagnoses and more treatment options will become available.
“Today, I’d rate my pain at about a three. I still have times where I have shooting, burning pain from my toes to my ankle and shin,” Springer said. “But it’s more of a nerve pain now. Although it’s always there, it’s a lot better than it was in the beginning.”

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