It Might Get Messy

And it is definitely painful. The Discovery-slash-Science Channel network has an excellent hour-long show on lethally toxic Australasian jellyfish—several species of box jellies and the tiny Irukandji jellyfish. During the filming, one of the researchers is stung on a minute spot of skin exposed through her wet suit. The result is hard to watch—despite maximum doses of maximally efficacious opioids, all she can do it hold on and rock herself through the incredible pain of the first couple days of healing.


Given how important pain-sensing infrastructure is to animal life, and how psychologically complex it can be in humans, pain actually operates via a relatively simple system. The sensory neurons themselves have only a thin myelin sheath, and the sensory ends are exposed. There are two neurotransmitting chemicals, one for intense pain, one for less. The thin myelin assures that the pain signal is transmitted rapidly to the spinal cord, where specialized pathways get the message to the brain.


Except for a few acute acts of pure stupidity (mostly when I was younger), the most pain I’ve experienced in my life was a couple years ago when my gall bladder was packed full of cholesterol nodules and playing havoc with my pancreas and liver. That was pretty serious pain. In the emergency room, waiting my turn for the harried docs and nurses to get the psychopath in the room to my right (including an armed guard with weapon drawn) and the broken leg in the room to my left under control, I ended up laying myself out on the concrete floor because the cool, smooth surface helped. Next NP that passed gave me a big-ass shot of morphine (actual, primitive morphine! Upstairs in the room, they went for the more sophisticated Dilaudid). Morphine and morphine derivatives handled the pain of both the dysfunctional glandular system and the surgery itself, no problem.


Which means the radiation burns in my mouth (I was gonna give you a photo, but believe me, you do NOT want to see them) are officially beyond help. I got opiate patches in multiple doses, opiate tablets and capsules, sedatives, liquids, and big buckets of every over-the-counter pain product available. These handle the “big” pain—the pounding ache of the rapidly-degrading tumors themselves, and the inflammation of the chemotherapeutic drugs—with aplomb. 


The radiation burns are a whole different category. The pain of the burns is sharp, hard-edged, and intense. It feels like a high-strength acid drip on each of the most charred spots (I know this because…well, remember those “acute stupidities when younger”?), constant and debilitating. Which has cascade effects, of course, on the remainder of my physiology and psychology. I find myself getting wound up and tense for no reason other than the grinding burns. I need to meditate deeply to get through the claustrophobic experience of being bolted to the radiation therapy table twice a day, and it takes several minutes of hard emersion in the pure mind to get past the mouth pain so I can still my panic.


Starting tomorrow, I got a week off from both radiation and chemo. The docs take things right to the limit, and they know when you’re gonna snap. I’m hoping that the burns heal enough with this week off so I can speak coherently and eat and drink via mouth rather than gut-stuck feeding tube. Then it’s back to treatment with a vengeance. First day back is two radiation doses and a full day chemo infusion. But I’m getting there. I think the docs are a little worried that two of the tumors—the basic big one at the base of my tongue and the parotid gland on the right side—haven’t shrunk as much as they’d hoped. They remain happy with progress—apparently their theory is that the tumors are so large that their loss requires necrosis and shedding of substantive quantities of dead tissue while they break down. I gather this is going to complicate the post-chemo-post-radiation treatment, add to the pain burden, and surgery will get a higher priority than they originally thought.


I’m good with that. Morphine takes care of surgical pain. Nothing takes care of radiation burns.


I leave you with this photo of my meds, essentially all of them intended, one way or another, to help alleviate pain. It’s a pretty impressive lineup of pharmaceutical products.

Once again I thank you all for stopping by and urge you to pass my information along to anyone who might give a rat’s ass. I got sucked into the maelstrom (how often do you get to use the word “maelstrom” in a sentence?) of 24/7 fight-for-life that I’m afraid I’m behind on letting people know what’s up. Give ‘em this blog address http://endoftheworldpartdeux.blogspot.com/, and if people need me in real time best bets are my google email address doctorateviper@gmail.com and texting my cell 443.812.8836. It is virtually impossible to talk on the phone…or even in person for that matter. Although I’m hoping I can use a phone for at least a few days during this week off when the radiation damage my partially heal. Remember if you’re interested to give a glance to http://docviper.livejournal.com/, http://theresaturtleinmysoup.blogspot.com/, and http://sustainablebiospheredotnet.blogspot.com/. I’ll get new material up on all the sits before this coming weekend.


Thanks again—I love you all!!!


Notes


Nice descriptions of various sensory receptors are available here:
http://www.innvista.com/health/anatomy/osenses.htm
although the site does not provide references.


The Wikipedia entry on pain is authoritative and well-referenced.