Monday, November 23, 2009

The Pain Culprits?

I've been at it again. In the last three years I've had short bouts of Fibro pain that has lasted a week, maybe two at max.

Throughout October and a decent chunk of November, I had one of the worst flare-ups I've had in a long time. I was actually bed-ridden for about 10 days with migraine after migraine and by day 3 there wasn't a single pill I could take that would do anything for me. I ended up going to the doctor on day 8, only to be told the same thing I'm always told: "Well, there's not a whole lot we can do for you given your sensitivities."

They gave me a shot of Demerol, because honestly, I would have tried anything to get rid of the pain and a steroid shot to...do whatever steroid shots do other than screw up your digestive organs.

As expected, I became physically sick. I curled up on my bed, paler than usual and certain I was going to soil my bedding in vomit. Pretty picture hm?

The next day I woke up with a mild migraine. Mild meaning I could still function but the damned thing was STILL there.

I asked my doctor previously about starting on Low Dose Naltrexone and/or medical marijuana. Now before you start thinking I'm some pot hound lemme just tell you... I'm desperate! I'm not looking forward to Marijuana, which used to make me feel more...stupid. But when I get a ten day migraine? I'll try anything!

I'm feeling great now, and have for a week or so but I've had a lot of catching up to do with manuscripts and the like.

And though the trip to the doctor's office was pointless from a treatment standpoint, it wasn't an absolute waste of time.

On the table in the waiting room, there was a magazine called Scientific American(http://www.scientificamerican.com/). In the November 2009 issue is an article in the Neuroscience section about the "New Culprits of Chronic Pain".

There's simply too much science in the article for me to be able to articulate or translate successfully. So I'm going to hit a few high points and then leave the research up to you, my friends. If you're interested in learning more.

The article is based on Chronic Pain. The subtitle reads: "Glia are nervous system caretakers whose nurturing can go too far. Taming them holds promise for alleviating pain that current medications cannot ease." By R. Douglas Fields.

Pg 50 Key Points by the Editors read as follows:
- Chronic pain that persists after an injury heals is often caused by overly excited pain-sensing neurons that signal without an external stimulus.
- Traditional pain drugs that target neural cells directly rarely quiet these abnormal pain messages because the neurons' heightened sensitivity is driven by a different type of cell called glia.
- Such cells monitor the activity of neurons and attempt to keep them healthy and functioning efficiently. But well-intentioned glial reactions to intense pain can at times prolong that pain.

Meaning...for a long time we've blamed the neurons and really they've just been forced into the pain job by the glia.

Here's another excerpt on pg 56 that might ring true with some of you as it has with me.

"A stunning discovery made in recent years is that glia play a role in causing opiate painkillers to lose effectiveness. Lina R. Watkins of the Univ. of Colorado at Boulder has demonstrated that morphine, methadone, and probably other opiates directly activate spinal cord glia, causing glial responses that counteract the drugs' painkilling effects. The activated helper cells begin behaving much as they do after nerve injury, spewing inflammatory cytokines and other factors that act to overly sensitize neurons. Watkins showed that the effect starts less than five minutes after the first drug dose.

By making neurons hyperexcitable, glial influence overcomes the normal neuron-dampening effects of the drugs, explaining why patients often require ever increasing doses to achieve pain relief. The same mechanism may also underlie the frequent failure of opiates to relieve chronic neuropathic pain when it is driven by reactive glia." R.D.F.


So what does all this jargon really mean?

I suspect more tests will be done until theory becomes fact, but if they really have discovered why we feel pain, we can become hopeful that they will find better and more efficient drugs. And of course, in this same article they cite tests that have been done and... here comes the real funny part of this entire post:

"Another existing drug, indeed an ancient pain-relieving substance that can work when many others fail, is marijuana, which has been legalized for medicinal use in some states. Substances in the marijuana plant mimic natural compounds in the brain called cannabinoids, which activate certain receptors on neurons and regulate neural signal transmission.

Two types of cannabinoid receptor occur in the brain and nervous system, however: CB1 and CB2. Activating the CB2 receptors induces the psychoactive effects of marijuana. Remarkably, the CB2 receptor that relieves pain does not appear on pain neurons; it is on glia."

Blah blah blah.. "I'm a wicked smart scientist talking a lot of jargon..." etc.

You get the point.

Another interesting part of the article: (And remember, these are just the ones I understood easily and feel okay about sharing but there is a TON of information in this issue. Try to back order it if you can.)

"Like heroin, opium and modern narcotics, such as OxyContin, morphine blunts pain by weakening communication among spinal cord neurons, thus diminishing the transmission of pain signals.

Unfortunately, the power of morphine and other narcotics to block pain quickly fades with repeated use, a property called tolerance. Stronger and more frequent doses are necessary to achieve the same effect. Patients with chronic pain can become addicts, compounding their misery with debilitating drug dependency."

Sometimes we know in our hearts that we're taking too much, too frequently and before we know it, nothing works but having nothing feels worse. This is a scary place to be.

BUT... this article is proof that we could see better, more effective, help on the horizon! This is good news, my friends.

I hope you're all well, and will excuse my lengthy absences from time to time.

All my best,
Gin

4 comments:

  1. That is interesting,thanks for taking the time to share.As for marijuana i think its another thing that affects different people differently.might be good for Migraines as a lot of problem with Migraines is rebounding and cycles of headaches.Interesting:)

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  2. chronic pain narcotic opioids are effective but very dangerous, should be taken with moderation and prescribed by a doctor, medicines like Hydrocodone, lortab, vicodin, norco, percocet, oxycontin, are even more commercial and very helpful to people with diseases such as fibromyalgia, chronic pain, Parkinson's, arthritis, should be restricted and controlled as in findrxonline said that the FDA does not permit free marketing for them.

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  3. My doctors at OHSU have long since told me the Glia cells are responsible for my pain and drug issues. I have had such bad flairs over the past year. Now my knee has blown out twice from slipping and falling. Due for surgery in January.
    Until then I have switched back and forth from Morphine to oxicotin. Morphine makes my vertigo way worse, yet takes the pain away. Oxicotin makes the pain more manageable but not gone. My vertigo is more manageable under this though. The relief is minimal but better than nothing at all. I have thought of medical marijuana, but thinking I would hit the same dead end, as I did pot in my early years and don't see it taking my pain away if opiates do not.

    I do hope some day my doctors at OHSU can be part of the research in finding a way around the Glia cell issue for all of our sake.

    Take care

    Teia Hassey

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  4. This is important research indeed. I remember reading about glia stuff in a Fibromyalgia Network Journal a few months back, but the point didn't seem to stick.

    Thanks for posting this and I'm glad you're finally on the other side of that nasty migraine/flare.

    Benia

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