When I walked into the room, I immediately categorized everyone who was sitting and waiting for the lecture to start into two groups – bright young medical students and old people in pain. I could have been wrong since I myself was a young person in pain, but regardless, as I looked into the audience I thought, “My people! I’ve found my people! Let’s turn off the lights and moan together!”
I attended a free seminar last Wednesday at the IUPUI student center called “Myths and Facts of Pain: Is it all in your head?” that is part of the IU Mini Medical School 2009. I heard about the series on a local radio show, Sound Medicine, after they did a segment about chronic pain. The lecture was free, and I work downtown anyway, so I decided to stop by. Plus, they had free snacks! The caterers were even considerate and included a veggie tray along with the brownies and cookies, a true rarity in modern society.
The first speaker was Dr. Palmer MacKie, Assistant Professor of Clinical Medicine in the IU Department of Internal Medicine with clinical interests in treating those with persistent pain. I learned several new things about chronic pain from his talk and his multiple PowerPoint slides, and even more of it went flying over my head splatting into the wall behind me.
First, as I’m sure it’s made absolutely crystal clear by this diagram, chronic pain and acute pain function differently in the central nervous system.
The left half of the diagram shows how the body is supposed to react to pain, and the right side of the diagram shows how screwed up your body’s response becomes during chronic pain. Even more depressing is the fact that the brain changes after you’ve been in pain a long time, a phenomena called neuroplasticity. “Plasticity” refers to the ability to change and “Neuro” refers to your brain. Your body learns how to be in pain. The common English translation of this is, “Jennette, you are totally fucked.”
Other interesting things I learned:
- Portions of your brain start to shrink over time if you’re in chronic pain. (I doubt this will make the feeling of constant pressure in my head go away, but maybe I’ll get lucky!)
- Our brains contain mu receptors which bind to morphine to make you feel better and combat pain. Men have a lot more mu receptors than women, the bastards. Seriously, a lot more. I don’t have the slide to show you, but it was like the difference between a blizzard and a few flakes of snow.
- Not only do men have more mu receptors, but women’s mu receptor response varies during the menstrual cycle, making your body’s ability to gobble up feel-good morphine vary depending on the time of the month. Again, the bastards!
- Dr. MacKai spoke about the difference between pain and suffering, which is probably worthy of a whole entry in itself. Basically, even if you are constantly in pain, how much you suffer from the pain depends on your emotional state, your attitude, your environment, and how much the ACC (anterior cingulate cortex) portion of your brain is lighting up to tell you to PAY ATTENTION! to the pain. This was driven home by the fact that listening to all this talk about pain made my headache seem worse.
There was another speaker after Dr. MacKai, but he was an OBGYN who was talking about pelvic pain. Thankfully I do not have pelvic pain, at least not yet, so I decided to grab a cookie and drove home in a windstorm that knocked out several traffic lights instead. After all, I had a headache, and there was only so long I could concentrate before I had to lie under the table.
During the lecture, Dr. MacKai asked the question, “How many people have been in pain for over…” and I started to raise my hand, “…10 years.” Then I put down my hand, turned around and saw several people with their limbs raised. At that moment I wanted to get up and give them all a hug and tell them, “I am so, so, so incredibly sorry.” Because I am so sorry for those people. Now when I see a man walking slowly with a cane in front of me, I don’t think, “I wish he’d walk faster,” I think, “He must be in a lot of pain.” At least I know there are a lot of us.
* BTW, I am not a doctor. I related this information as I best understood and remembered it, but it’s possible I made some errors because I do not fully understand the processes I wrote about.