Tuesday, January 16, 2007

they'd think it important if he were their kid screaming in pain

We keep telling Lars there's really nothing wrong with him, like the doctors say, but he keeps right on screaming in pain.

"How do you know it's pain?" they ask. "How do you know it's GI related?"

[in low, cartoon-ape like voice]: Uuuuh gee, doc, I dunno.

Like I'm 35 years younger than I am, let's say about 6 or 7, and I've never really considered anyone else's feelings much before. Like I don't know what pain looks and feels like, in myself and in others. Like I don't know my son.

"If he's still able to sleep some, it really can't be that bad," they say. "If it were that bad, you wouldn't be able to distract him with 'just singing,'" they say.

Just singing? JUST SINGING???

Hello? Do they not know that pain perception is not an inevitable result of stimulation of pain receptors? That it's a complex phenomemon that can be changed by experience and by changes in ones immediate environment? And there is nothing that changes Lars' environment like music, no experience that he has responded to as consistently as he has to music, and specifically to singing. Do these docs not understand that music is accessed by all parts of the brain, and that music affects pain perception through its direct effect on the ability of the somatosensory cortex to receive pain sensations ascending through the spinothalamic tract following reception by sensors in the peripheral nervous system?

Do they not know the gate control theory of pain? Do they not know how something that activates only nonnociceptive nerves (like singing or rubbing a bumped knee) can inhibit pain? The pain seems to be lessened because activation of nonnociceptive fibers inhibits the firing of nociceptive ones. In other words, paying attention to something wonderful, like your mom singing, occupies part of the capacity of Lars' information processing system, so he's not fully attending to whatever is causing him pain, and this reduces the perceived intensity of his pain. In this case we can take advantage of Lars' inability to attend to more than one thing at a time...

AND do they not know that health is directly affected by the physiological way the body behaves when the brain is or is not experiencing pain? That rates of healing are much faster when pain is under control, than when it is not?

I understand, dear doctors, that you clearly don't give a "red rat's rectum" (thanks to CBT's late father for that one...) that our beloved son is completely miserable most of the time, or that we are going NUTS and loosing our voices. But don't you dare tell me that just because we happen to be EXPERTS at the ONE effective treatment we have for pain around here, that our son's clear expressions of pain--and he's expressing a good 16 hours a day--are therefore to be written off as some bizarre behavior that surely will pass as he ages.


On another note, Lars decided this morning that riding in the car today & sleeping at Perkins were just lovely and fine, and that while he was doing those things everything was hunky-dorey. How about we just spend all our time driving him back and forth to Perkins? Hey, I'd do it in a second. He's been miserable almost every second of awake time before and after our morning at Perkins.

Anyone with a singing voice and rocking lap to lend, come on over. (All voices are singing voices!)

1 comment:

Anonymous said...

My dearest wise friend,
I have never heard such a concise narrative on the physiology of pain and the clinical applications of music. Bravo for being so cerebral while being totally emotive.
Adoring both,
kathleen