Wednesday, August 8, 2007

Greased lightning! or my own personal biomedical experiment

I've been fairly quiet lately, mostly posting interesting quotes and comics, and I thought I would say why (only because part of the story is interesting). First, the boring part (do I know how to write a catchy lead-in, or what?). I've had a bit of writer's block. I've been working on a post that I think is pretty important to what I've been doing here, but I've been completely unsatisfied with the way it's turning out. I wanted to have it ready several Skeptics' Circles ago, but haven't gotten it quite right yet. Until I get the post out of my head.

The more exciting reason is that I've been sick. The illness that struck me is sort of cool from an academic sense, but really no fun to be intimately involved in. I was recently diagnosed with a neuralgia (I have to wait to get the full diagnosis - I still haven't seen a specialist yet). Neuralgia's are kind of cool, because of what they are:

The mechanisms of neuropathic pain are complex. Injury to peripheral nerves leads to hyperexcitability of peripheral nociceptors (peripheral sensitization). This in turn may lead to functional changes in central neurons that receive input from these primary afferents, causing central sensitization, which leads to further pain intensification (2). Pain evoked by nonnoxious stimuli may result from abnormal cross talk (ephaptic transmission) between axons. Decreased descending inhibition and sympathetic nervous system changes may also contribute to persistent nociceptive activity.
What this basically means is that for a variety of reasons, regular nerves that sense touch can either become hyperstimulated or they can cross-talk to other nerves that normally aren't stimulated. The result?
Neuropathic pain is usually described as burning, shooting, or similar to an electric shock. In many patients, it has a constant component on top of which appear paroxysms of shooting pain.
That certainly describes it for me. It's rather like what I imagine being hit by lightning would feel like. Except that it happens over and over. At its worst, it happens every five seconds (makes blogging tricky). At its best, it's happening several times a day. Which means when I'm ordering a latte, I can gasp and twitch a little, making the barista look at me a little funny.

How do they treat it? Anti-convulsants. Apparently there are similarities between epilepsy and neuralgia that result in inappropriate neuron firing. So physicians exploit this similarity to treat the disease. I'm currently taking gabapentin, which makes me feel a little drunk. Also makes blogging a little tricky, but here we go.

I also get to have an MRI, which I'm pretty excited about. If I can get a copy of it, I'll post it here later, so everyone can see my brain. In the meantime, I'm loving my gabapentin, and looking forward to seeing a neurologist. If the results are interesting, I'll keep you posted. Also, I'm going to try to keep working on the posts I've been trying to write, but I hope my (few) regular readers will forgive my absence.



ERV said...

Holy crap.

The Factician said...

Heh, yep. It's been a fun ride. Hopefully the next few weeks we'll get it all under control.