I had brief thoughts of writing about Robin Williams tonight. But that has been well covered elsewhere, so there's nothing I can really add to the subject. Rest in peace, Robin.
Tonight, we will have a short look at pain, and pain management.
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I was prompted to review the subject of pain upon reading the September 2014 issue of Men's Health magazine. A series of separate but related articles in this issue address various aspects of pain: what causes it, how it can be alleviated, and how some people are born without the capability to feel it. The website does not reflect the full content of the print magazine, at least not without a paid subscription.
Jim Thornton kicks the series off with A World of Hurt. He describes how, two weeks after hernia surgery, one of his testicles was throbbing non-stop. His doctor informed him that sometimes in such surgeries, scar tissue can form around a nerve ending, effectively entrapping it. The pain will go away, but in weeks, or perhaps months. The author relates that it took about 12 months to stop. Here we have a case of what amounts to a phantom pain: the root source of the pain is in one location, but the body feels it somewhere else. That must have been a bad year.
Researchers are continuously looking into ways to block pain through pharmaceuticals. Ziconotide is extracted from the venom of a particular snail, known as the magician's cone. They say it is "a thousand times more potent than morphine", but without the addictive side-effects. Problem: it is ineffective in pill form, because the digestive system destroys the active ingredient before it does its job. Currently, the only way to use ziconotide is through spinal injection, which is not entirely practical, for ongoing or home use.
The next article, The Agony Virus by Laura Beil, discusses a mosquito-born virus that is making its way toward the United States. This virus comes from Africa and Asia, and was found in the Caribbean about two years ago. It has spread from Saint Martin to Haiti, and the shores of South America. With so many people travelling internationally, it is only a matter of time, it seems, before it reaches the southern U.S. and begins to spread northward.
Known as chikungunya, this virus is a particularly nasty one:
Within hours of a mosquito bite, the chikungunya virus travels through its human host's skin and into the bloodstream, finally pitching camp in the body's fibroblasts. These are workhorse cells found in connective tissues throughout the body, abundant in skin, muscles, and joints. ... The body's immune system declares open war. This back-and-forth of cell death and vigorous defense leads to a rash plus muscle and joint pain. People typically recover in about a week, but many suffer longer, and some patients continue to complain of stiff joints for months or years.
One patient, a visitor to the Caribbean, had very intense pain:
A week later, the pain in Catherine's ankles was so excruciating that she had to support herself against a doorjamb and turn sideways to negotiate the three steps to her bedroom. She couldn't twist open a jar of jam.
In
The Man Who Feels No Pain by Oliver Broudy, we learn about brothers Steve and Chris, who feel no pain. Literally.
They were both born with a rare mutation in their SCN9A geene, leaving them incapable of feeling physical pain. Once a fight got going, their bodies never gave them a reason to stop. A punch in the face was just a rough way of getting someone's attention.
While you might at first think "how lucky!", it's not that simple. Pain is the body's way of telling you that something has gone wrong, and you should modify your behavior, and/or seek treatment. If you're incapable of feeling pain at all, you don't get the warning signals, In the case of these brothers, they engaged in risky behavior from a very young age. Jumping off roofs, brawling with each other until bloody, sticking keys into electrical sockets, and more. Broken bones were common with these two.
But Chris went deeper, darker, too much even for his brother Steve. Chris began drinking heavily, and behaving more recklessly. It all ended one day when their father discovered Chris hanging in the barn. His physical lack of pain didn't stop his emotional pain. And then it was too late.
The series of articles are well worth reading, via Men's Health magazine. There's much, much more detail in the articles.
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August 11, 2014
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