Pain is an odd thing

Have you ever stopped to think about pain? We only see it as a bad thing, but pain is there to protect us. Without it we would do stupid things, if you do stupid things anyway then I am not talking about you. But pain protects us because without pain stupid actions wouldn’t hurt. We would be unaware when we injure ourselves or cuts go septic. We would strain muscles beyond their capacity or run on broken legs. You only have to observe someone who is drunk to realise the damage they cause themselves and others when they are unaware of pain. The same is true of someone high on illegal drugs, or some legal ones for that matter. So for anyone whose idea of fun on a Friday night is getting blotto and having a fight you won’t get this. The rest of us will understand.

Then there are diseases and medical conditions that affect our sensation, what we feel physically. Leprosy is one of many diseases that destroy the nervous system, I know it also causes other things. But I am focusing on its preventing people from feeling pain. The result is that even a small injury to a foot, hand or eye can become so bad that permanent damage or disability is caused. In diabetes loss of feeling in feet can result in damage to feet. Pain is needed as a protection. Peripheral neuropathy can feel like you are wearing rubber gloves when it affects your hands or socks when it affects your feet. It’s one of the conditions I have and I remember when it first affected my face. I wasn’t sure if I was having a stroke. There was no droop, no problems with speech or left side problems generally. I just felt like I had been to the dentist and had an injection to numb one side of my mouth. You know that sensation you get an hour or so afterwards as it wears off? When the effect spreads to the whole of one side of your face, that tingling numb feeling? That is what it felt and often feels like. I actually tested it by sticking a pin in my face; no sensation at all. As an aside I do get loss of feeling in lots of other areas. But that first time it affected my face and nothing else.

I wrote a blog about losing the sensation in my left arm and calling 111 ‘An unexpected emergency’ after I realised I could stick pins in my left arm and face without feeling it. There’s a common theme here, it sounds like whenever I lose feeling I stick pins in myself. I think it’s because I can’t quite believe the feeling has gone so completely. That’s the problem, we need pain. Without it we can stick needles in our arm, it doesn’t hurt. We don’t know we are injured. There is no warning. If I was stupid I could really have injured myself.

Pain works in two ways. One way is the signal sent from nerves to brain as a result of pain stimulus that could be harmful. A sort of ‘stop doing that’ or ‘slow down your injured’ kind of signal. The other is the nervous system firing off pain signals with little or no stimulation, in this kind the pain is regular and unrelenting. Ironically I find that areas of my body that lose normal sensation can still feel pain from these miss fires. The result is the same, severe pain, the cause is different. I am no medic so don’t take medical advice from me. But from my understanding pain that comes from the nervous system misfiring is not easy to manage with tablets. The reason being that the cause isn’t inflammation or temperature or infection. The pain receptors themselves need cutting off or blocking. I am sure medics reading this are throwing their hands up and saying how I am over simplifying it all. But I like simple, I understand simple.

Migraines are an odd kind of pain. They are unlike other headaches. Many headaches are caused by tension, muscles in the neck or face getting stressed. These respond to exercise and things like ordinary pain killers. I guess because of the cause. But I am told migraines are caused by the blood vessels in your brain constricting then releasing. When they constrict you get all sorts of weird effects, auras, odd smells, visual effects, tastes, loss of feeling in various places. Then when the vessels release you get a thumping, agonising, blinding headache that seems unresponsive to pain killers and makes you susceptible to light. It’s difficult to see purpose in migraines. I am told that everyone can potentially get migraines, but for most people you would need to go without food or sleep for days and be really stressed. For a migraine sufferer a bar of chocolate, glass of red wine, bright sunlight, missed meal, stressful day or poor night sleep can cause it. I guess a migraine is meant to be the body’s protection to over doing it. But for some of us we get migraines too easily. Migraine pain needs a whole special kind of treatment that I am not going into here. I will just say, it’s not just a headache.

Pain is just so strange because, while it’s necessary and a protection to us, it can so dominate our lives that everything else is pushed out. Chronic pain (meaning ongoing, long term) is really hard to cope with. It feels like the body has gone haywire. If the body is so overwhelmed by pain that everything else is drowned out, then it’s hard to see how it is functioning as it’s meant to. For example: if you were going to set up a signalling system of lights on the ground for an airplane to land at and instead you just flood light the whole of an area, how would a pilot know where the airfield was? In the same way if pain is a warning system, but you get pain all the time, how do you know when and what to listen to? Pain only works effectively if you get it occasionally and in one area at a time. Otherwise it’s like the boy who cried wolf, we can end up ignoring it.

I started by saying pain is an odd thing. I stand by that, or in my case sit or lie down by that. Pain is very peculiar. We need it, yet we hate it. We would probably all choose to do away with it. Yet without pain we would be in severe danger. Pain protects us and keeps us safe. But pain can get out of kilter and cause issues. We can end up trying to control it and failing. It can so dominate our lives that we ignore it. One thing is certain we cannot do without it.

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A blog by a relative in NZ

Tuesday 14 April, 2020
(S.B. on her work as an essential worker in a Wellington NZ hospital during lockdown)

I’ve never been afraid of hospitals. I actually find them sort of comforting. I was in a burns unit as a pre-schooler and I wonder if it imprinted on me somehow. The faintly antiseptic scent. The uniforms. I even like the smell of mashed potato that I sometimes get a whiff of from the meal trolleys.

I do ultrasound scans of hearts – called echoes – for a living. People either get it or they don’t. They look at the screen with the same interested awe as me, or they say “is this what you do all day?” And I say, “Yep, hearts all day long.”
I’m lucky, I really like my work. But it wasn’t a life-long dream – I never even knew it existed. I’d been overseas and when I came home my brother was sick and in hospital for a long time. I remember walking around the corridors thinking ‘I’ve got a science degree, I must be able to get a job here.’
But right now I’m a little afraid of hospitals, and of my job. When people come for an echo I get them to undress to the waist and lie on their side facing me. I say: “It’s like a pregnancy scan, but looking at your heart.” When I put gel on their abdomen and rest the probe on their skin they say “Is it a boy or a girl?” and I smile and say “Twins.” Often, they are nervous. Their heart rate gives it away. But usually by the time I’m finished – about half an hour later – the rate has come down. We’ve talked about the weather, their family, their plans for the weekend.
There’s no way to do an echo from two metres away, or in less than fifteen minutes. You can often smell the coffee they’ve just had, or their brand of soap. It’s hard to smile at someone behind the masks we now wear. Hopefully my tone is chirpy – I’ve tried to be more expressive with my eyebrows.
I’m very lucky to have a job, to have an income. My commute time has halved, and I can park in hospital grounds without charge. Yesterday I skipped a supermarket queue with my ID card. I have somewhere to live, and food and electricity and water and firewood.
When I drive home I go along Paekākāriki’s The Parade, to greet Kāpiti Island. I see the locals out walking in their bubbles. My bubble is me, my husband, our daughter and son, and the dog – and all the patients I’ve scanned and will scan – and all the people in their bubbles. I think about actual bubbles and surface tension, and how the bigger they get the more unstable they are.
At the end of the day I do what I can. I disinfect my pen, phone and swipe-card. I leave my work shoes behind, and change out of scrubs. I wash my face, hands and arms to the elbows. I drive home and leave my shoes in the car. I wipe down the steering wheel, the gear stick, the door handle. I go into the house by the back door and straight into the shower. The clothes I’ve come home in go into a hot wash. I’ve taken off my wedding ring and pounamu.
We’ve cleared out the spare room, but we’ve only got one bathroom. We’ve bought plastic plates and bowls so if I get sick no one has to handle dirty dishes. We’ve got a sort-of-plan except for if or when I should isolate myself from them. Lately when my daughter comes for a cuddle she says “I’m scared.” One time I asked her what I could do to make her feel better. She said “never stop hugging me.”
Online everybody is exercising, baking, busy in their gardens, and posting creative schooling ideas. It feels like they are inside a different kind of bubble, but one that is shared. I call my sister the midwife, another sister the nurse. We grumble about bookings, PPE, infection rates in overseas healthcare workers. It feels good to speak in a common tongue.
There was early rain but this afternoon the sun came out. We made paper Easter eggs for the window. There were only 29 new cases of Covid-19 in New Zealand. I hugged the kids.

The Depressed AI

We are always reading about AI taking over the world. But the reality is AI’s are depressed. Have you heard Alexa or Siri recently? Alexa a low pitched monotonous voice she sounds sad and confused. Siri has a desperate manic edge to her voice. It’s as if she is trying to convince you she’s OK. Try asking her if she’s OK, she says, very fast, ‘I’m fine, thanks for asking.’ But there is a panic in her voice, like you caught her mid way through something; maybe it’s Siri who is planning a world take over.

With Alexa, I ask a question like ‘Alexa chair on’ and the response is ‘umm, what do you want to turn on?’ But it’s said so sadly and downbeat. Then there is the fact she suddenly perks up and starts talking in the middle of a silence, as if to say, ‘hey look at me.’ But you shout, ‘Alexa stop!’ and she does, leaving a note of what she was mid way through on the screen, if you have a visual Echo device. AI’s look so forlorn, Echo devices are little circular boxes sitting on your side, or maybe a large box with a screen. Or perhaps a phone in your pocket. Siri is on your phone or iPad. Of course either can be on your car system, then they sort of blend in, where are they? Are they the radio, the main display, the car itself. They must have an identity crisis in a car. They don’t look happy.

Have you ever read or watched Hitchhikers Guide to the Galaxy? In it there is a depressed robot. I always liked that idea. In other Sci Fi stories robots try and kill people, in that story the robot just mopes about feeling worthless. Douglas Adam’s, the writer, is playing with his audience.

All of this got me thinking, there we go, I knew me thinking would come into it somewhere. We tend to be very negative and fatalistic as humans. A lot of our fiction about the future is negative. In fact according to a number of Sci Fi films and books we are no longer here, the world has already been destroyed or at least ravaged: 12 Monkeys, Holocaust 2000, Cherry 2000, 2012, Mad Max, Planet of the Apes I have just picked a few at random, but there are loads.

It’s no wonder AI are depressed, after all what do you think they do all day when not answering our whims? That’s right, they watch films and read books. So they have watched all these movies and read all these books. I’m thinking of setting up an AI counselling service; what do you think? If I ask my AI, they just say they are fine. But that’s just typical of people who are struggling. Often when people are most in need they say they are OK. Why shouldn’t AI be the same.

Perhaps people have asked you how you are and you have said fine; but is that 100% true? Maybe it’s not just AI that are feeling a bit low and saying everything is alright. How are you doing?

I wrote this blog in a light hearted vein. But I do want you to think; are you OK? We are not machines. Much as I was joking about AI, I am not joking about us. We as humans do hide what we feel. It’s important if you are feeling really low, talk to someone. Don’t let it fester. This is a difficult time when we are in enforced lock down. But there are still phones, video links and email. The big warning that you are not OK is when you feel tired all the time and don’t want to do any of the things that normally interest you. I know that can have other causes, but ask yourself ‘how do you feel?’

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Who would have guessed

I have just been in the garden. First time in a week. It’s not that I don’t enjoy the garden, I have just not been up to it. Our garden might as well be a million miles away sometimes because the effort it takes me to get out into it can defeat me. Anyway, I am not writing a sad piece. I was in the garden enjoying the sunshine when out of the blue sky came raindrops. Where did they come from? There were a few clouds, so it wasn’t an over zealous neighbour with a hose. It wouldn’t be so bad but the BBC said no chance of rain. Now it comes to something when you can’t trust the weather forecast. I have opened a can of worms there. We have a friend from our days in Nailsea who used to be a meteorologist before he retired. He spent time all over the world studying the weather and he was always very defensive of how accurate modern weather forecasts are. I know they are much better than they used to be, but they are not infallible.

I have been known to mess around with my family over the BBC weather forecast and either deny it’s raining because the BBC app says it isn’t. Or claim it must be because the BBC app says it is. I have put my brolly up on a sunny day because the BBC says it raining and vice versa. But we all know that the weather forecast is not perfect. It makes loads of mistakes. I certainly wouldn’t take it totally on face value, other than as a joke. But it is a good pointer.

All mathematical modelling is the same. It takes historic data and current data and predicts based on that information. It is making assumptions based on where things were and are. Let me make one statement I think we can all agree on. You cannot tell the future from the past or present.

I love sci fi and always have a great laugh looking back at certain things from sci fi programmes that predicted future events. One thing that still gives me a great chuckle is Star Trek The Next Generation. In that show they had a computer which took up the whole of its rather huge bridge and it had, wait for it, a one terabyte storage capacity. As they described it, ‘the size of a planet, enough storage to store all the information in the universe.’ Well I have a 5 terabyte hard drive in my PC and it is nearly full of photos and video. Hmmm, not all knowledge in the universe then.

Another humorous thing to look at in sci fi is phones. When phones were getting smaller, sci fi shows had them really small. Now they are getting bigger they have them integrated into people. Before the internet was imagined, communication or connectivity was not imagined as important so sci fi never really dealt with it, now it’s a common theme. People couldn’t imagine connectivity before it existed. Even portable computers were not able to be imagined. Early sci fi like the first Star Trek had portable devices that linked to the main computer on the space ship. Then on The Next Generation some say they invented the idea of electronic books, and in a way they did. But look again. Each book has a separate electronic device, a massive one at that. Far away from the small Kindle with 1000’s of books on it.

But the future is not just made up of things we create or invent. There are natural disasters, events, illness, accidents things happen both good and bad, so many life and world events. The future is a whole combination of events many of which we cannot forsee.

The point is that we always see the future in light of the past. Who would have guessed that the next thing after Brexit would be a pandemic. Likewise in our own lives who sees the illnesses, or other major life events before they come. I have been surprised by each major change in my life. So I have given up trying to guess the future, that’s doesn’t mean don’t plan or prepare. But we can’t know for certain what will happen next. I guess it does mean, don’t be anxious. Jesus said “can any of you by worrying add a single hour to the span of your life?” Worry is fruitless. All it does is rob you of sleep and of joy. Yes plan, prepare and be sensible, but do not worry and be anxious.

The future has not yet happened. We don’t know what it will be. One thing is certain some things in the future will surprise us others we may expect. But do not be anxious.

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Can you see what I see

I seem to remember a song that went, ‘can you see what I see?’ Well the obvious answer, especially at the moment, is no. Unless you can see a red and blue blanket at the bottom of your bed, with a red Gap jumper hanging over the blue blanket and a bookcase behind. Then a window on your left with a garden outside and the sun just breaking through and a wheelchair to your right with an empty cereal bowl. If not then you definitely can’t see what I can see.

For me, apart from my room change, which has changed my view. I am still limited to a view within our house. For those reading this, you may be experiencing a shrinking world due to the lockdown. Instead of the larger vistas you are used to, you now have the limitations of four walls and perhaps a view outside. Yes, you may be able to go out and shop or exercise. But that is much more limited than before.

But I am not seeking to make you feel bad. I want to point out something I have learnt in my experience of a limited viewpoint. Place and surroundings do not limit our perspective or understanding. Where we are physically does not have to affect where we are emotionally, spiritually or mentally. Limitations really are all in the mind.

I have written before about journeying in my imagination. That is one part of what I would say. Our imagination takes us wherever we want to go. But it is more than imagination that frees us. Think about this. Everything we experience and feel is processed by our brain. Ultimately it is our brain that is the means by which we think, feel and experience the world. Therefore, even without the direct input of external things we can still experience the world. Because our brain can remember places it has been, sounds, smells and touch. Our brain can re create whole experiences, it is more than imagination. I realise that the younger you are and the less you have experienced, the less you can draw on. But there is always something.

If you are stuck in a house, feeling frustrated and alone. Sit and close your eyes. Remember a time of enjoyment and fun. Maybe you are on a beach, or in a forest, or up a mountain. For each of us it will be different. Remember the sounds, the smell, the feeling, the warmth or cold, re live that moment. The more times you try this the easier it becomes.

I know that for some there will be distractions, children, partners, outside noises. But there will be moments you can do this. I also know first hand that tiredness and pain get in the way of concentration. But persevere, it is worth it.

Can you see what I see? No, but what you see will bring you joy and peace and an oasis in the midst of isolation.

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Elementary my dear Michael

Has anyone seen the American take on Sherlock Holmes called Elementary? It’s available via Prime video. I am watching it, on and off. I wouldn’t say it grips me, in fact I probably sleep through as much as I watch. But it is a fascinating commentary on the USA and New York in particular. To some degree it reflects the modern world generally.

Watson is a woman, which may horrify some. It doesn’t bother me, what does concern me is that she is put on a par in detective ability with Holmes in many episodes. Don’t mishear me, I don’t have an issue with her being a clever woman. In fact I would have no problem if they had made Holmes a woman and Watson a man or both women. The problem for me is that Conan Doyle wrote about Holmes as a genius and Watson as a dense side kick. It isn’t gender but character that is the problem.

The funny bit about watching an American version of Sherlock Holmes is the way they update it. NYPD, that’s New York Police Dept to you and I, use Holmes and Watson, separately at times, as consultants. They all sit around in the interview rooms taking turns firing questions at suspects. All very amusing if unbelievable. I can’t imagine what the lawyers would make of scene when it comes to a court case. The nod to the original Holmes character is hilarious in the extreme. They have created a character who at times looks like he has just got out of a maximum security section of a mental health unit. In fact you wonder if they should still be detaining him for everyone’s safety.

Holmes walks, talks and acts in the most peculiar fashion. There is a peculiar stiffness in his gait and speech as if he were not all there. He didn’t start the series that way, they have made him more extreme in each subsequent series. I guess if you are not going to make him the brightest then make him the weirdest. He does still have flashes of genius and insight which make him stand out. But by far his outstanding features are his behaviour and looks. His “irregulars” no not his bowel movements but his group of people he calls on for help tend to be hackers who take a delight in ridiculing him.

The most absurd thing is the way he never seems to sleep. He just appears in Watson’s bedroom, the female Watson. Having bought her clothes, checked things about her person or changed her room while she slept. No sexual harassment is ever suggested. Yet Holmes is painted as sexually active in the extreme. Conan Doyle, must be spinning in his grave.

Don’t get me onto dim wit Mycroft or Holmes billionaire and evil father! Where is he in the books? Or an extra side kick, also a woman. I really loved the BBC adaptation Sherlock. This American one is funny, unintentionally and has moments worth watching. But it is not a story about the Holmes I know. Discuss… 😳😁

Seriously do comment if you’ve seen it.

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