Monday, November 28, 2011

A little bit closer..

I blogged a bit about my new space, Almost there. It's the time of year when I feel the most blah, and I feel blah, even though I do seem to have enough steam build-up-ability to get through the days. The weather's pretty good, above zero and dry streets, blue skies, so that helps, a lot..

Today it occurred to me I'd need business cheques, so I stopped in and got a new business account started. It also occurred to me I was going to need a phone for that groovy new phone number I'm supposed to be getting tomorrow, so I stopped in and bought one at the local Sask-Tel store. I got new business cards and new stationary and three signs, one for each outside door and one for my own door, ordered.

On the whole, a busy day and a fair bit accomplished.

Yet I feel so blah. On the inside.

I suppose it doesn't matter two slices of bread around the outside of a sandwich how I feel, inside. The miracle is, I can function OK. I can get up early on a Monday, go to the "gym", work out, come home, go out and do errands, on foot, remember things that need to be done, do them, come home and sit and puzzle over why it all feels so.. blah to me. I just do not feel any thrill inside about any of this. I think part of me is still disgruntled at myself for having caved 4-5 years ago with SAD, and for dragging it back to a place it thought it had escaped and would never have to go back to except to visit.

Whatever. I'll get through this. I usually do. None of it really matters, what matters is that I create a new frame around what it is I do, treat pain in other people, and get on with it, and not ruminate on any small bits of it overmuch. Because, really, none of it, in and of itself, matters much at all. In the treatment moments, when someone will come in, and I treat them, and they get that "aha" look over their face, that will make all of this worth it.

I could have just continued treating other patients for other people and letting those faces show me their "aha" looks. But you know what? I really do not like working for and around other people much at all anymore. I don't have much to say to them, I'm kinda-sorta not very interested in whatever it is they think they have to say to me, and I'm not especially interested in any deep bonding with any of them. The only thing I live for anymore is that "aha" look on my patients' faces. And I can arrange my life to have less intrusive interruption, more quiet space for "aha"'s to appear. So, that's why. That's my motivation. No-frill, no-thrill (for me) motivation.

In other news, I've been going to the "gym" every day. I've lost 25 inches, about 15 pounds. So that's nice. It would be nice if "feeling great" would kick in one of these days.

Sunday, November 27, 2011

Why Things Hurt: Lorimer Moseley TEDxTalk

Lorimer Moseley did a TEDx talk recently about 'why things hurt' - here it is - just 15 minutes long. Lorimer is great speaker - his snakebite story is legendary by now.

Friday, November 25, 2011

Almost there

Today I popped in to my new 'location', a room I've rented in a neighbourhood spa. I'm a completely independent operator, just renting a room there, not affiliated with the spa in any way; just paying rent.

It's been a slow process - the phone isn't quite hooked up yet. Sask-Tel has to be the slowest phone company the world has ever seen. I have had the room rented from Nov 1st, but getting a phone hooked up seems to take a full 3 weeks. The line won't be in until the 29th, in the afternoon. But once it is, I'll be able to move in.

The office store here in town outfitted me with a desk, a desk chair, some waiting room chairs, a file cabinet (three drawer lateral).  I have to keep patient files for 10 years in this province. Ten. YearsTEN!.. so I got a long file cabinet, which will hold many. But it's a good thing I have also outdoor storerooms off my balcony at home to use if needed.

Still to come: a treatment table. It won't arrive until in January sometime. It is an official osteopathic table, coming all the way from Belgium via Quebec, a company called "Gymna". I saw the bed in Whistler, in the trade fair at Congress in July, and fell in love. It has a head rest that bends completely down, completely out of the way, arm and shoulder pieces that can be moved away to allow full, comfortable, prone-lie arm-hang, nice high density foam cushiness, a heating option, some sort of thing you can stick in to rest your elbows on, and best of all, a foot rail that goes all the way round the bed, with which you can raise the bed up or down from any location. No more having to interrupt a treatment in order to find the stupid foot plate, which is always somewhere outside foot range and on the other side of the bed, which means you have to let go of your patient, interrupting the incredible insight into his or her physiology you've just wandered into, go back into regular brain mode, get up and go looking for it. Treatment interruptus. I'm really looking forward to this baby, I can tell you. Meanwhile, though, I'll be borrowing a regular no-frills massage table. Which, although not easily adjustable, will be just fine for a few weeks. It will be a terracotta colour.

Another thing I'm waiting on is a panel, a room divider, which will be moveable, covered in tasteful low-maintenance fabric, and will separate the 'office' part of the room from the 'treatment' part: such luxury.

Anyway, today I went in for the first time since the furniture was delivered last night. Ken, the office guy, had very kindly assembled the desk, and the chairs,  for me! Such a kindness.

The room has been repainted; it used to be some sort of turquoise, which I can't stand on walls, but now is a warm tan colour, much more livable. The desk is a rich reddish cherry colour, with drawers that lock; the floor is a heavy durable brownish lino or vinyl tile with reddish and tan patches. Yes, this will all work, I think. We will work on getting a window installed, to get in a bit of natural light; until that happens I'll have to use a lamp. We'll see how that goes. If a window doesn't appear, and a few years slip by, I'll have to move to somewhere with a window. There is a glass block window into the hallway which lets a bit of natural light in from the outside door not far away, but it won't be nearly enough.

I have the keys now, so it all feels a lot more real now.

Saturday, November 19, 2011


Just because it's tough out there and we're all here to help each other.

Friday, November 18, 2011

Not for sissies

It struck me today that being a human awareness inside a humanantigravitysuit or any sort of awareness inside any biological kind of antigravity suit is not for sissies. Which is why, I suppose, that defensive mechanisms evolved in the first place.

The nervous system is not monolithic.
I say this every day to patients, as I try to help them understand what the inside of themselves, the inside of their own operating system, is like.
I tell them a story about how it's like a farmhouse that might have started out as a simple cottage in the days before electricity, but that over the decades new bits were added, a second story, a garage here, a new wing there. Before long the original cottage was completely buried by additions. Had it been an actual farmhouse, the sensible thing would be tear it down and start completely over with new wiring and plumbing. However, as a nervous system, it didn't turn out that way: nature never got rid of anything neurological, it just added more layers over top.
So, now we have the original, probably the enteric system, autonomic system, and a bit of somatomotor, covered over by faster, bigger, more complex inhibition systems.

Skin is weird, because it comes from ectoderm, as do all the nerves. Neural crest cells make up all the nerves that go to and from skin, as well as - get this - they make teeth. Teeth. I read earlier today that teeth evolved from skin. Or at least, from neural crest cells in skin. Or, at least, outside the mouth, which makes good sense, if the whole point of life and its evolution is to transform energy from one form/state to another to reduce energy gradients. I mean, to transform other organisms into sources of energy, it's necessary to rip them into tiny bits to be digested.. teeth come in handy, whether inside or outside the "mouth"..

Exaptation accounts for a lot of the preservation one sees in nervous system function.

Seth Grant in Australia has built an entire career on studying synaptic proteins, some of which have been conserved from original yeast-like single-cell ancestors.

Take-home point: Nature does not toss out anything that has proven useful, especially when it has to do with the operating system, i.e., the nervous system.

So, we ended up keeping everything that was there from the beginning, and added on. Now we have brains five times bigger than they need to be to run a creature/humanantigravitysuit our size. They suck away 20% of all our metabolic energy. Even though they comprise only 2% of our physicality. A measly 2%. Sucks up 20% of the energy. Think about it. It's no wonder we get distracted.

So, I was thinking, to actually turn it around enough to pay inward attention to our bodies, themselves, the physical creatures we inhabit, with attention and awareness, is so different from normal life, so ... non-social, kind of, so... outside a culture that pays the body almost no mind except to dress it up, or have it relate socially. To go in there just to find out how it's feeling, just out of interest, is not really supported by this culture. This generic North American culture. This culture is anything but introspective. Anything but intero-spective.

So, I'm thinking it takes courage.
It takes courage to go in and check interoceptive systems.
No wonder, then, that cultural systems that appear to have successfully navigated these strange waters are adopted holus-bolus, for the most part - things like yoga, meditation, acupuncture - with no translation. They are interoceptive practices, and mostly non-verbal therefore, anyway, except for the packaging, which is usually spiritual veneer of one sort or another.

What happens when a nervous system is probed, even by the awareness it gave rise to? Well, it might be important to remember that in any given individual parts of the nervous system may not get along with each other perfectly. If you are an "I" illusion inhabiting a particular brain, and you decide one day that you want to probe your own interoception, and your culture has never supported such a notion or behaviour, you find yourself swimming against a tide. You either graft a system onto yourself or you go it alone. You may find yourself outfitting yourself in yoga pants and learning a lot of polysyllabic words in a foreign language, or learning mantras and about mandalas, or learning strange non-existent non-anatomical body systems. To go it alone is preferable in my opinion, but may still require some outside support from a patient observer/coach from time to time. Most people won't bother doing any of this stuff until such time as they are unfortunate enough to sustain a pain episode, at which time it will suddenly be the only way out of the cage.

No matter what, anxiety will be a feature. If you are exploring by yourself, you will learn that deep breathing will take care of a lot of the anxiety, and will smooth out the process. You have to make yourself keep going back, though, until the behaviour becomes pleasurable enough to motivate you by itself. You could think of it as getting to know your inner zoo, all the creatures your antigravitysuit evolved through on its way to becoming human. You have to be careful not to spook any of them. Or yourself.
If you use one of the cultural adaptations, you have to adapt yourself to them. Which is fine, I suppose, until/unless cognitive dissonance interferes. Which it may well do, sooner or later, Which is why I personally choose/recommend the go-it-alone method.

If pain has driven you into the corner of your own existence and has forced you to become interoceptive just to get through the day, I feel for you - I really do. Deep breathing will still help, plus it will be of use to find yourself a caring human primate social groomer who vows not to create more suffering for you to have to endure, but will stand by you as you find your way out of the gloomy forest of being lost inside your own physicality with a suddenly heavy humanantigravitysuit that doesn't work right, and a nervous system that no longer feels like "you", but instead feels like a bunch of alien creatures biting at you.

Tuesday, November 15, 2011

Our fellow vertebrate creatures

Saw this earlier tonight: Fin massage relieves stress in surgeonfish
Another piece supporting the idea that social grooming provides stress relief, in vertebrates, from fish to humans. (Still not sure about reptiles.)

Further to a manual therapy theme, George Takei, who played Sulu on Star Trek, and who posts plenty of whimsey on Facebook, posted this picture.  I do not know the original source.

It has manual therapy logo possibility. Rabbits are vertebrates. Humans are vertebrates. Vertebrates evolved social grooming. Manual therapy is human primate social grooming. I like the possibilities.

Saturday, November 05, 2011

Just because these links are so good

Check out Hyperbole and a Half (Allie Brosh's) blogpost on depression. 

Looking on the bright side, eventually everything changes, even old incredibly self-flattering and self-reinforcing institutions. Maybe it's true that there is a season for everything, that everything eventually crumbles, and that in and of itself, hey, that's not so bad.

More about empathy:
"They followed 891 diabetic patients for 3 years and conclusively showed that physicians’ empathy itself resulted in a 40-50% improvement in the measured results."