• Ask the Fitness Expert-
    What exercise can I do now that I have RSD?
  • Recipe of the Month–
    Summer Salad

I have a question about fitness. I have always been fit, but since my RSD has gotten so bad, I have not been able to exercise like I am used to doing. All I can do is the treadmill and bike. However, there are days when I can barely do this. I am having a real difficult time with my neck and shoulders; because of the pain, it is even hard for me to hold me head up. Can you tell me how I can continue using the treadmill and bike? I know I have to keep this up in order to stay out of a wheelchair. Any advice would be appreciated. Again, I have RSD and fibromyalgia.


Dear Jan,

Thank you for contacting me and I apologize for the tardy response. To begin, I must applaud your efforts to exercise and stay mobile. From my own experience and speaking with my clients, I know how difficult it is living with pain and staying active. Yet I also know how imperative movement is for our bodies.

My first advice is to readjust your thoughts regarding exercise. I have told many clients that what may have worked in the past may not be in the best interest for you now. Sometimes slightly changing your program can make a difference.

A good example of this would be Mary. (Mary is not her real name). Mary loved to run. Even after she injured herself and developed a serious ankle condition that caused intense pain, she insisted on running. Finally, she listened to her doctors and me. For the next few months, we did various strength-training movements that she began to enjoy. She has since incorporated this training into her normal exercise routine. Instead of running every day, which is how she used to define exercise, she now varies her workouts.

Treadmill and bike use are fine forms of cardiovascular activity. However, high-impact and long durations can cause more discomfort and be less beneficial for those living with pain. I suggest alternating between these modalities and strength-based body weight movements. Building muscle is very important when dealing with chronic progressive chronic pain conditions.

Just like Mary in the above example, please do not beat yourself up because you cannot perform the activities you used to. Take it slow and add modified push-ups and squats. Exercises that target your core are going to help your neck and back get stronger. While on your knees, push your body up. If this is too difficult, stand a few feet away from a wall. Place your hands on the wall and push your body. For squats, just practice standing up from a sitting position. Sit in a chair and stand up. Repeat.

Please keep me posted and if you have any other questions, send them to Rick at rick @nicole hemmenway.com.. Remember to speak with your doctors before beginning any new exercise routine.

—Rick Dyer, MS, CSCS, CPT, CrossFit Certified (FIT, Los Altos, CA)

Just to make you Laugh

"Ferris Bueller's Day Off"

As it is nearly time to return to school, I thought “Ferris Bueller’s Day Off” would be the perfect comedy to watch!

My Thoughts

Some of my favorite childhood memories revolve around summer. Whether my family went to Whispering Pines, Pine Mountain Lake, Arnold or Lake Tahoe, every year we would vacation with family friends. It has been tradition for as long as I can remember. Thinking about water balloon fights, evening games of tag (which we called ‘heats’), frequent bathing suit changes (I disliked the feel of a wet suit against my skin), Chambers punches (when I was older!), and looking for bears still brings a smile to my face.

It is amazing how memories can shift our emotions. As the past comforts me, the future excites me. I know I will create new moments that bring me joy. My wish is that each of you can reflect on your life and discover what fuels your happiness. What experiences, moments or rituals bring you peace?

As summer nears an end, cooler temperatures are hopefully on the way. While the weather has been mild in California, I know many of my fellow chronic pain survivors have had blistering heat, which only exacerbates pain levels. Please know that you have been in my thoughts. You all inspire me. I truly believe we empower each other with strength and courage when we unite. Thank you for being my inspirational heroes.

Believing in Miracles,

THE INvisible Project

For the past few months, I have been collaborating with CT Pain Foundation on a new chronic pain awareness project entitled INvisible Project. (www.invisibleproject.org)

The INvisible Project is a photojournalistic showcase of the day-to-day experiences of real people living with chronic pain. In order to reflect the widespread effects of pain, CT Pain Foundation partnered with photographer Syd London to make visible what oftentimes is hidden behind the walls of hospitals and bedrooms.

The goal of the INvisible Project is to create chronic pain awareness, empower survivors and generate change. Through visual images, the INvisible Project will contrast the fragility of the physical body with the determination and strength of the spirit.

It is a privilege to serve on CT Pain Foundation’s board of directors and work on such a powerful event. I invite each of you to visit www.invisibleproject.org, and spread the message. One hundred percent of the proceeds from the INvisible Project will help those living with pain. Please contact me if you would like more information!

Heroes of Healing

During the month of August, Heroes of Healing will undergo a new makeover. Please continue to visit www.heroesofhealing.com to see our new logo and new layout.


Before his car accident in February of 2005, Robert Hinton was a family man and a devoted dad. Working as a firefighter, EMT and medical sales representative, Robert took pride in his job. He had married his high school sweetheart and had two young daughters. He was happy, in love and planning for his future. Life seemed blissful, and Robert felt blessed.

Sadly, Robert lost the great life he had worked so hard to create following his accident. Hit from behind, Robert experienced severe pain in his right shoulder, neck, back and chest. A few months later Robert needed surgery to repair a labral socket tear in his right shoulder. Twelve nights after surgery, he awoke screaming in agony. It felt as if someone had poured gas on his shoulder and then lit a match.

Robert immediately scheduled a doctor’s appointment but the blood work, X-rays and MRI’s all came back normal. His doctor was perplexed as Robert’s symptoms worsened. His entire right side burned as his right foot became cold to the touch. Soon it began turning shades of blue, red and dark purple. Unable to work or collect disability, Robert was living a nightmare.

Finally, in June 2006, his doctor diagnosed him with widespread reflex sympathetic dystrophy (RSD). RSD is a neurological and chronic pain disorder that affects the skin, muscles, joints and bones. It causes the nerves in the body to misfire sending constant pain signals to the brain. As of today, there is no cure for this condition.

Robert’s pain is ongoing and torturous. The burning pain leaves him feeling as if a blowtorch is scorching his skin, eyes and internal organs. He suffers from horrific tremors. RSD has affected his ability to swallow, damaged his lungs and left him with a high resting heart rate. Robert now spends much of the day. There are even days when he cannot even use his walker so his mother-in-law has to watch his daughters. It devastates Robert to watch his girls grow up so fast because of his illness.

Throughout the years, Robert has tried various procedures and medications in order to obtain relief. He underwent weekly epidural nerve blocks for over fourteen months. Nothing helped.

Pain has taken a toll on Robert physically and emotionally. Losing his independence and ability to provide for his family has destroyed his self-esteem. He misses going on bike rides, seeing movies in the theatre or attending his daughters’ school events. Just being able to sit outside in the sun is a challenge. While Robert worries that he is a burden, he continues to push forward understanding that giving up is never an option.

Recently, Robert began ketamine infusions and boosters in Philadelphia. Ketamine infusions are a controversial new therapy for RSD patients where a ketamine IV is administered at an escalating dose while monitoring the patient's vital signs and level of consciousness. While it is difficult for him to travel the five-hour train ride from Rhode Island for his treatments, he has noticed a decrease in pain. For the first time since his pain journey began, Robert believes he has found a treatment that helps. As the ketamine has given him a small part of his life back, Robert goes once a month for a two-day ketamine infusion booster.

Robert has learned a lot through his pain. He understands the importance of living every day to the fullest, and appreciates the small joys in life such as coloring with his daughters. Robert has discovered his strength in the midst of pain. He knows he is not alone on his journey and still has faith that answers will be found. Robert is a courageous chronic pain survivor.

“I take life one day at a time, and sometimes, minute by minute. Even on my worst days, I know I will make it because I am strong and have the love of my family.”

Robert has created a RSD Fundraising and Awareness website, http://www.robertsfightwithrsd.webs.com. To offer support or learn more about Robert’s story, please contact him at his website or email him at robertsfightwithrsd@cox.net.

Nicoles Recipe of the Month

Summer Salad

A great, refreshing dish that is healthy and simple to make! I hope you enjoy, and would appreciate learning some of your favorite recipes. Bon appétit!


  • 2 cups cherry tomatoes – cut in halves
  • 4 ears roasted corn
  • ½ red pepper – diced
  • 1 avacado – diced
  • 3 tbsp chopped cilantro
  • Juice of 3 limes
  • Salt and pepper to taste


Roast corn in foil in 375* oven for 30 minutes; once cool, cut corn from the cob and place in large bowl with tomatoes, avocado, cilantro and red pepper. Pour lime juice and mix. Add salt and pepper for taste. Either serve immediately or refrigerate.


facts on pain
Pain affects more Americans than diabetes, heart disease and cancer combined.
-2006 National Institute of Health Statistic

Chronic pain is often defined as pain that lasts six months or longer.

More than 50 million Americans experience chronic pain that interferes with daily activities, according to the American Pain Foundation.

The American Pain Foundation describes pain as the fifth vital sign after blood pressure, pulse, respiration and temperature.

The American Academy of Pain Medicine states that the annual cost of chronic pain in the United States, including healthcare.

Helpful Links to Pain Resources


“Within each of us is a hidden store of energy. Energy we can release to compete in the marathon of life. Within each of us is a hidden store of courage, courage to give us the strength to face any challenge. Within each of us is a hidden store of determination. Determination to keep us in the race when all seems lost.” — Roger Dawson