"Never accept anything for true that I clearly did not know to be such." - Descartes

Localizationism:

2011-08-26T21:07:00.000-07:00

Scientists, impressed with the discoveries made by Galileo came to believe all nature functioned as a large cosmic clock, subject to the laws of physics, and began to explain individual living things, including our bodily organs, mechanistically, as though they too were machines. This idea that all nature was a vast mechanism, and that our organs were machine-like, replaced the two thousand year old Greek idea that viewed all nature as a vast living organism, and our bodily organs as anything but inanimate mechanisms.

Don't forget to drink that wata

2011-08-26T20:52:00.001-07:00

Dehydration

Intense prolonged exercise produces metabolic waste heat, and this is removed by sweat-based thermoregulation. A male marathon runner loses each hour around 0.83 L in cool weather and 1.2 L in warm (losses in females are about 68 to 73% lower).^[10] People doing heavy exercise may lose two and half times as much fluid in sweat as urine.^[11] This can have profound physiological effects. Cycling for 2 hours in the heat (35 °C) with minimal fluid intake causes body mass decline by 3 to 5%, blood volume likewise by 3 to 6%, body temperature to rise constantly, and in comparison with proper fluid intake, higher heart rates, lower stroke volumes and cardiac outputs, reduced skin blood flow, and higher systemic vascular resistance. These effects are largely eliminated by replacing 50 to 80% of the fluid lost in swea

At this point I need to stop being ignorant and truly study my brain, my body, my pain, and the processes that take place in my nervous system that connect the wiring in my body for me to understand who I am and what I need to become in order for me to be who I want to be.

2011-08-26T16:11:00.000-07:00

Chronic pain has several different meanings in medicine. Traditionally, the distinction between acute and chronic pain has relied upon an arbitrary interval of time from onset; the two most commonly used markers being 3 months and 6 months since the initiation of pain,^[1] though some theorists and researchers have placed the transition from acute to chronic pain at 12 months.^[2] Others apply acute to pain that lasts less than 30 days, chronic to pain of more than six months duration, and subacute to pain that lasts from one to six months.^[3] A popular alternative definition of chronic pain, involving no arbitrarily fixed durations is "pain that extends beyond the expected period of healing."

Chronic pain may be divided into "nociceptive" (caused by activation of nociceptors), and "neuropathic" (caused by damage to or malfunction of the nervous system).^[4]
Nociceptive pain may be divided into "superficial somatic" and "deep", and deep pain into "deep somatic" and "visceral". Superficial somatic pain is initiated by activation of nociceptors in the skin or superficial tissues. Deep somatic pain is initiated by stimulation of nociceptors in ligaments, tendons, bones, blood vessels, fasciae and muscles, and is dull, aching, poorly-localized pain. Visceral pain originates in the viscera (organs). Visceral pain may be well-localized, but often it is extremely difficult to locate, and several visceral regions produce "referred" pain when injured, where the sensation is located in an area distant from the site of pathology or injury.^[5]
Neuropathic pain is divided into "peripheral" (originating in the peripheral nervous system) and "central" (originiting in the brain or spinal cord).^[6] Peripheral neuropathic pain is often described as “burning,” “tingling,” “electrical,” “stabbing,” or “pins and needles.” ^[7] Bumping the "funny bone" elicits peripheral neuropathic pain.

Under persistent activation nociceptive transmission to the dorsal horn may induce a wind up phenomenon. This induces pathological changes that lower the threshold for pain signals to be transmitted. In addition it may generate nonnociceptive nerve fibers to respond to pain signals. Nonnociceptive nerve fibers may also be able to generate and transmit pain signals. In chronic pain this process is difficult to reverse or eradicate once established.^[8]
Chronic pain of different etiologies has been characterized as a disease affecting brain structure and function. Magnetic Resonance Imaging studies have shown abnormal anatomical^[9] and functional connectivity, even during rest ^[10][11] involving areas related to the processing of pain. Also, persistent pain has been shown to cause grey matter loss, reversible once the pain has resolved.

Complete and sustained remission of many neuropathies and most idiopathic chronic pain (pain that extends beyond the expected period of healing, or chronic pain that has no known underlying pathology) is rarely achieved, but much can be done to reduce suffering and improve quality of life.^[14]
Pain management (also called pain medicine) is that branch of medicine employing an interdisciplinary approach to the relief of pain and improvement in the quality of life of those living with pain.^[15] The typical pain management team includes medical practitioners, clinical psychologists, physiotherapists, occupational therapists, and nurse practitioners.^[16] Acute pain usually resolves with the efforts of one practitioner; however, the management of chronic pain frequently requires the coordinated efforts of the treatment team

Chronic pain is associated with higher rates of depression and anxiety.^[21] Sleep disturbance, and insomnia due to medication and illness symptoms are often experienced by those with chronic pain.^[22] Substance abuse is highly prevalent in some segments of the chronic pain population such as those with chronic headache.^[23] Chronic pain may contribute to decreased physical activity due to fear of exacerbating pain

Chronic pain's impact on cognition is an under-researched area, but several tentative conclusions have been published. Most chronic pain patients complain of cognitive impairment, such as forgetfulness, difficulty with attention, and difficulty completing tasks. Objective testing has found that people in chronic pain tend to experience impairment in attention, memory, mental flexibility, verbal ability, speed of response in a cognitive task, and speed in executing structured tasks. In 2007, Shulamith Kreitler and David Niv advised clinicians to assess cognitive function in chronic pain patients in order to more precisely monitor therapeutic outcomes, and tailor treatment to address this aspect of the pain experience

Your conscious abilities

2011-08-26T16:07:00.000-07:00

ACTIVATING THE PARASYMPATHETIC NERVOUS SYSTEM:

YOUR BODY HAS NUMEROUS MAJOR SYSTEMS, INCLUDING THE ENDOCHRINE (HORMONE), CARDIOVASCULAR, IMMUNE, GASTROINTESTINAL, AND NERVOUS SYSTEMS. THE AUTONOMIC NERVOUS SYSTEM – WHICH IS PART OF THE LARGE NERVOUS SYSTEM-IS INTERTWINED WITH AND HELPS REGULATE EVERY OTHER SYSTEM. MENTAL ACTIVITY HAS GREATER DIRECT INFLUENCE OVER THE ANS THAN ANY OTHER BODILY SYSTEM. WHEN YOU STIMULTATE THE PARASYMPATHETIC NERVOUS SYSTEM, CALMING, SOOTHING, HEALING RIPPLES SPREAD THROUGH YOU BODY, BRAIN AND MIND.

RELAXATION: ENGAGES THE CIRCUITRY OF THE PNS AND THUS STRENGTHENS IT – IT ALSO QUITES THE FLIGHT – OR – FLIGHT SYMPATHETIC NERVOUS SYSTEM, SINCE RELAXED MUSCLES SEND FEEDBACK TO THE ALARM CENTERS IN THE BRAIN THAT ALL IS WELL. RELAXTION RESPONSE MAY ACTUALLY ALTER HOW YOUR GENES ARE EXPRESSED, AND THUS REDUCE THE CELLULAR DAMAGE OF CHRONIC STRESS.

YOU CAN TRAIN YOUR BODY AND BRAIN TO RELAX AUTOMATICALLY USING THESE FOLLOWING TECHNIQUES:

· RELAX YOUR TONGUE, EYES, AND JAW MUSCLES.

· FEEL TENSION DRAINING OUT OF YOUR BODY AND SINKING DOWN INTO THE EARTH.

· RUN WARM WATER OVER YOUR HANDS

· SCAN YOUR BODY FOR AREAS THAT ARE TENSE, AND RELAX THEM!

DIAPHRAGM BREATHING: THE DIAPHRAGM MUSCLE IS BENEATH YOUR LUNGS AND IT HELPS YOU BREATHE.

· ACTIVELY WORKING IT IS PARTICULARY EFFECTIVE FOR REDUCING ANXIETY.

· BREATHE IN SO YOUR CHEST BELOW YOUR STERNUM TRAVELS BACK AND FORTH HALF AN INCH OR MORE WITH EACH BREATH. REPEAT AS NEEDED.

PROGRESSIVE RELAXATION: FOCUS SYSTEMATICALLY ON DIFFERENT PARTS OF YOUR BODY, WORKING EITHER FROM THE FEET TO THE HEAD OR VICE VERSA. YOU MIGHT FOCUS ON LARGE SECTIONS OF YOUR BODY – E.G. LEFT LEG, RIGHT LEG – OR ON MUCH SMALLED UNITS, SUCH AS LEFT FOOT, RIGHT FOOT, LEFT ANKLE, RIGHT ANKLE, AND SO ON. YOU CAN DO PROGRESSIVE RELAXATION WITH YOUR EYES OPEN. OR CLOSED, BUT LEARNING TO DO IT WITH YOUR EYES OPEN WILL HELP YOU RELAX MORE DEEPLY IF YOU’RE WITH OTHER PEOPLE.

· IN ORDER TO RELAX A PART OF YOUR BODY, SIMPLY BRING IT INTO AWARENESS; FOR EXAMPLE, TAKE A MOMENT RIGHT NOW TO NOTICE THE SENSATIONS IN THE BOTTOM OF YOUR LEFT FOOT.

· OR SAY “RELAX” SOFLTY IN YOUR MIND AS YOU BRING AWARENESS TO A BODY PART.

· OR LOCATE A POINT OR A SPACE IN THAT PART.

· WHAT EVER WORKS BEST.

· PROGRESSIVE RELAXTION IS ALSO A GREAT METHOD FOR FALLING ASLEEP.

BIG EXHALATION: INHALE AS MUCH AS YOU CAN, HOLD THAT INHALATION FOR A FEW SECONDS AND THEN EXHALE SLOWLY WHILE RELAXING. A BIG INHALATION REALLY EXPANDS YOUR LUNGS, REQUIRING A BIG EXHALATION TO BRING LUNGS BACK TO THEIR RESTING SIZE. THIS STIMULATES THE PNS, WHICH IS IN CHARGE OF EXHALING.

TOUCHING THE LIPS: PARASYMPATHETIC FIBERS ARE SPREAD THOUGHOUT YOUR LIPS; THUS, TOUCHING YOUR LIPS STIMULATES THE PNS.

MINDFULNESS OF THE BODY: SINCE YOUR PNS IS PRIMARILY DIRECTED AT MAINTAINING THE INTERNAL EQUILIBRIUM OF YOUR BODY, BRINGING ATTENTION INWARD ACTIVATES PARASYMPATHETIC NETWORKS. IT MEANS TO BE FULLY AWARE OF PHYSICAL SENSATIONS. NOTICE THE COOL AIR WHEN YOU BREATHE IN, WARM AIR WHEN YOU BREATH OUT, THE CHEST AND BELLY RISING AND FALLING. OR THE SENSATIONS OF WALKING, REACHING, OR STRETCHING. FOLLOW EVEN A SINGLE BREATH FROM BEGINNING TO END – OR A SINGLE STEP ON THE WAY TO WORK – CAN BE REMARKABLY CENTERING AND CALMING.

IMAGERY: ALTHOUGH MENTAL ACTIVITY IS COMMONLY EQUATED WITH VERBAL THOUGHT, MOST OF THE BRAIN IS ACTUALLY DEVOTED TO NONVERBAL ACTIVITIES, SUCH AS PROCESSING MENTAL PICTURES. IMAGERY ACTIVATES THE RIGHT HEMISPHERE OF THE BRAIN AND QUIETS INTERNAL VERBAL CHATTER THAT COULD BE STRESSFUL. YOU CAN USE IMAGERY ON THE SPOT TO STIMULATE THE PNS, OR DO LONGER VISUALIZATIONS WHEN YOU’VE GOT THE TIME TO DEVELOP IMAGERY THAT WILL BE A POWERFUL ANCHOR FOR WELL-BEING.

BALANCE YOUR HEART BEAT: A REGULAR HEART BEAT HAS SMALL CHANGES IN THE INTERVAL BETWEEN EACH BEAT; THIS IS CALLED HEART RATE VARIABILITY (HRV). THE INTERVAL BETWEEN HEART BEATS IS CONTINUALLY CHANGING. HRV REFLECTS THE ACTIVITY OF THE AUTONOMIC NERVOUS SYSTEM. YOUR HEART SPEEDS UP A LITTLE WHEN YOU INHALE (SNS ACTIVATION) AND SLOWS DOWN WHEN YOU EXHALE (PNS AROUSAL). STRESS, NEGATIVE EMOTIONS, AND AGING ALL DECREASE HRV.

· BREATHE IN SUCH A WAY THAT YOUR INHALATION AND EXHALATION ARE THE SAME DURATIONS.

· AT THE SAME TIME, IMAGINE OR SENSE THAT YOU’RE BREATING IN AND OUT THROUGH THE AREA OF YOUR HEART.

· CALL TO MIND A PLEASANT, HEARTFELT EMOTION SUCH AS GRATITUDE, KINDNESS, OR LOVE.

· YOU CAN IMAGINE THIS FEELING MOVING THROUGH YOUR HEART.

Rib Attack - March 15th, 2011

2011-08-26T15:52:00.001-07:00

I was hurting really bad on Saturday afternoon. The worst pain I have yet to experience, I was literally bawling my eyes out. (even though I did not shed a single tear when I amputated my fingertip). The pain was concentrated around the area that my "floating" rib resides, and following the rib around the side of my body to the lower back area. The pain was vicious and extremely unpleasant, I spent about 7 hours at marin general with this pain, while they tried to figure out if I was dying or not. Turns out I was stable, but now there is a larger portion of numbed area surrounding the rib section that pulled out of the sternum. Plausable diagnosis: Floating rib agitation/possibly another floating rib could of pulled out of the sternum. Either was there is and was a lot of outward pressure pulling on my chest area.

After all that time at the ER they still have no idea what was really happening, but I suspect it had something to do with my nerves and nervous system. At one point it almost felt like a "chronic pain attack" and my breathing was shallow, my left arm started to experience odd sensations/shooting pains/numbing/tingling/ice cold to touch. All I know is the only thing that actually helped with the pain was morphine.

When I arrived at the ER I was at a 10/10 on the pain scale. When I left I was a 4/10 (3 vicadins and 1 shot of morphine over 7 hours). Now they want me to take even more pain killers.

I was at Marin General ER and multiple ER doctors confirmed my harrington rods were intact, the actual X-Ray ER tech told me he used to work for the hospital that claims the credit for the invention of the actual rods/procedure.
The rods and fusion are AOK! Thank you for your concern!

Floating Rib: Roughly 6 months after surgery one of my ribs on the anterior left portion of my chest (if you were looking through my eyes) pulled clean out of the sternum, and now floats in the general vicinity barely attached by soft tissue/cartilage to my sternum/other ribs. I'm not sure where it falls on the actual totem pole of the ribs placement, however I'm pretty sure its the rib lowest down on the sternum, and emits outward pressure on my chest cavity. That particular rib was the cause of all this pain, that much I am convinced of, and unfortunately this particular rib caused a lot of nerve damage back in 2004, so much so that now a completely numb portion of my skin covers it.

And now that numb portion has spread out farther left, now almost on the left side of my body. Following the rib around from center to side (to small of back). Also, that particular rib causes a lot of pain and discomfort on a daily basis, but never as bad as Saturday was. 10/10 on the pain scale, its been a long time since I've been there. My brain felt over loaded by pain. Even as I write this email I'm dosed up on oxycotton and cyclobenzaprine (muscle relaxer), and it still bothers me even with a Salonpas capsicum (icy hot magnified 10,000 times) patch on it. Never before have I ever felt such a discomfort, the outward pressure emitted by the rib was intolerable.

Solutions for the future

2011-08-26T15:50:00.001-07:00

Oh yea, and I discovered another fantastic book called: The Pain Survival Guide - How to Reclaim Your Life. By Dennis C. Turk and Frits Winter (American Psychological Association). You could consider this book a self help, but it is more of a guide. This book can help you form your own pain management program, and you can learn about the psychology behind your actions, specifically the ones that hurt you and the ones that heal you. I find it very interesting, and extremely helpful for providing my own pain management program. It also goes over the modern day form of medical pain management programs, and after reading that section apparently I have tried every thing in the book: Analgesic Medication, (no antidepressants fortunately),muscle relaxers, topical agents, surgery, (no nerve blocks yet, have you ever got one?), (no trigger point injections fortunately), thermal therapies, electrical stimulation or the TENS unit (which you can also have a trained acupuncturist do, I have yet to try but soon I will), chiropractic manipulations (which scare the crap out of me, I don't really trust them), acupuncture, biofeedback ( I don't know if you ever heard about this but I have, its very interesting, apparently it can help you two halves of your brain work better together).

And last but not least: Pain clinics and rehabilitation programs: Dr. Moskowitz at Pain Management Associates of Marin was the guy who turned me onto neuroscience and how our central and peripheral nervous system work together. Since my first appointment with him my understanding of the causes of my pain are completely crystal clear, and I now know what I must do in order to create what they call a neuro-plastic transformation. Getting there is the hard part, but now I have the time which is fantastic. This pain management program is a full time job, and it clashed with my last job, and I was unhappy and the I believe that manifested more pain in my body. Ultimately, I have figured out that I have a nervous system disorder that has altered my brain chemistry, essentially meaning my brain has learned pain very well, to the point where pain is a predominant signal in my central nervous system and conscious part of my cerebral cortex. In this scenario, what can happen is the body experiences pain when there is no painful stimuli. In order to revert the process, apparently I the patient have to rebuild my brain from the ground up. Shake off any bad habits (which is difficult), science has proved it is much easier to learn something new to replace the learned bad habit, instead of trying to unlearn the bad habit (that could cause me more pain).

This is why Dr. Moskowitz's calls it a neuroplastic transformation, because I literally manipulate the plasticity of my brain in order to promote a anatomical change in my central nervous system, in turn affecting my peripheral nervous system as well.

Since I have been in pain for the majority of my adult life, it has taught me very well that I truly have no limits. Scientists call limits, learned mental limits, meaning most humans truly believe they cannot operate beyond a certain set of invisible boundaries, mental limits, that actually limit your capabilities, mentally holding you back in the physical world. I have learned over time I can build on my limits, change my physical and mental limitations, too the point where I can do 26 miles round trip on a road bike and swim 1.5 miles in a day and still have enough energy for the rest of day. Its brain over matter in situations where the patient is experiencing chronic pain, because you can let the pain dictate your life to you and live it the way the pain wants you too. Or you can live your life in pain, and listen and learn from the pain, but still be able to do everything you want to do regardless of how much pain your in; because you have a pain management program that essentially dictates a balance between your brain and your body, ensuring you wont live in too much and not be able to do the things you love to do. It is crucial to maintain this balance.

Other books to read: Buddhas Brain - The practical neuroscience of happiness, love, wisdom. (Fortunately it is not religious in any way, I actually learned more about the nervous system with this book. Very practical and helpful).

Understanding Chronic Pain - A doctor talks to his patients. Robert. T Cochran Jr. MD - Very helpful in understanding modern day neuro-pharmacology, and also other patients experiences with pain. Not the happiest book, but realistic and helpful. Very smart doctor.

Chronic Pain is a Bitch!

2011-08-26T15:47:00.000-07:00

Trials and tribulations: 10 years of chronic pain fucks you up!

I found out for the last ten years I might of physically been attempting a neuro-plastic transformation, meaning you literally change who you are on an anatomical level in your brain. I found out this is the only way to truly conquer chronic pain, to turn a new page in your life and leave the pain behind! Pain, especially chronic pain, is all in your brain. Also, another side effect of long term chronic pain impairs your cognitive abilities - memory, feelings, math, science, english, etc, these processes all become compromised by chronic pain because in your brain the pain literally leeches outward into your brain map literally a map of your brain in regards to your processes) and starts taking over these processes (if you let it).

I discovered on my own, along with lots of cross referencing and consultations with multiple doctors, a combination of physical and mental stimuli in the right conditions can promote a neuro-plastic transformation in ones brain. Think of it as a form of cognitive therapy, you literally rebuild the brain the way you would like to you. Not in a spiritual sense, but that can help to. As you know by now, if acute pain persists for more than 6 months it is then considered chronic pain, and usually chronic pain stays with you for life. More often than not chronic pain patients require a pain management team to help them maintain an equilibrium / balance in brain and body.

I've been doing a lot of research into pain lately, and two very important doctors won the Nobel Prize for there breakthroughs in the field of neuroscience: Wall and Melzack proved that "pain is merely an opinion of the organisms state of health rather than a mere reflexive response to injury", in other words, pain is all in your brain! You receive sensory input from your peripheral nervous system, and that travels up to your central nervous system where your brain decides how to react. Unfortunately, pain is a very conscious part of your brain, for obvious reasons, it is not a motor reflex response. In other words, there is a pain gate theory where/when that allows you to let pain in, or close pain out.

Two things that I know of close the pain gates, opiates and acupuncture. It wasn't until recently that acupuncture was truly recognized by western doctors. They have discovered that acupuncture stimulates the peripheral nervous system, pulling your senses away from the pain, literally closing the pain gates, shutting down the connection between your nervous systems. In this way, I have been able to achieve the closest I've ever been to a pan free state. Combing this with mediation, physical stimuli, mental stimuli, all in the right conditions, you can promote a neuro-plastic transformation to literally change who you are on a anatomic level, and hopefully leave your pain behind you! This is what I have been trying to do for the last couple of months, ever since I started reading into neuroscience. I've been getting lots of acupuncture and it is fantastic, as long as you see the right person.

I have been on opiates since january 11 2011 (date of finger tip amputation), I built up a tolerance to hydrocodone and now im on oxycodone. A lot of the people in my family/friends tend to go "oh this drug is terrible for you, you have to get off this right away, or you shouldn't be on these" and so on, but unfortunately most people do not live in chronic pain and do not realize how unstoppable it can be.

I quit my job to maintain and build on physical and mental well being. I've made a lot of changes in my life in the last couple of months, all for the better. You should track down pain management associates of marin county if you can. I believe you will benefit greatly from the experience.

March 15th, 2004 - The day of days arrived

2011-08-26T15:34:00.000-07:00

March 14th, 2004: San Andreas High School - I completed 33 units of high school education in about 30 days by participating in an accelerated program for students. I received my diploma, and prepared myself for the following day.

March 15th, 2004: Sacramento, Shriners Hospital for Children - I arrived bright and early for my surgical appointment for spinal fusion. The surgeons were going to bring my scoliosis curvature down from 65 degrees to 25 degrees. The surgery took over 8 hours, and in the process of untwisting my spine and straightening it out with some vicious looking surgical instruments, the doctors made me an inch taller. The surgery was a success, it turns out I was not going to die a slow and painful death.

Pain of Pain - Dysphoria

2011-08-26T15:24:00.000-07:00

January 11th, 2011: My perception changed drastically on this day. I amputated my finger tip on a mountain bike disc brake rotor. At first the pain wasn't so bad, but as soon as the extent of my injury dawned on me, one quick glance at the stump told me I shredded right through the finger tip and took the nail off with it along with a chunk of bone from the tip. Fortunately, I lived about 10 minutes away from the Marin General Hospital and they were able to call in a plastic surgeon who patched me up. On our way out the door to the hospital, I didn't stop to think about skin grafts, but as soon as we got there the doctors asked me if I brought the tip of my finger with me but of course I hadn't. Fortunately, my good friend (who will always be remembered as the man who went back for the tip of my finger) went back to my apartment and found my fingertip stuck in the rotor. He brought it back to the hospital and they were able to salvage the skin and sew it on top of my stump. The following week was extremely painful, I spent most of the time elevating my finger above my head, watching movies, and taking lots of Oxycodone. The pain was almost unbearable, it felt like my finger was going to pop. Did I mention this injury occurred 11 days after I acquired health insurance? What luck huh?