I had a dream...

The Epsom salt I have been soaking myself in during the night time has done a good job helping me sleep...

Longer time in sleep results in interesting dreams...

I had a dream last night within which, I had to deal with waking up from a wonderful and shattered dream (and let's call it the secondary dream for conveniences’ sake).

In the secondary dream, the college that is not liable but responsible for my injuries grew to be one with conscience.

In that dream, the college came forward and, without the need to involve a lawsuit, provided me with a good 125 grant compensation for everything that has incurred as a result of one stupid collapsing chair in their facility. (Got money in my head I guess... lol :-x)

I was shocked to see the conscience side of the institution. (By the way, do you know “Without conscience is the titled of a book about psychopaths written by Dr. Robert Hare, an esteemed expert in psychopathy?)

Then, still in my dream, I found myself waking up from the secondary dream.

"It was a dream." I thought to myself.

After waking up from the secondary dream, I tried to find out whether there COULD be any truth to the dream and the efforts were insanely pointless and futile

The secondary dream must have represented my view of how justice could be done.

Although I knew such dream was just a dream, the sense of disappointments and perhaps the regret to having to wake up I experienced was no less than what I would feel when awake.

The process of coping with the awakening from the secondary dream reminds me of what I had to go through when coming out from the delusions of my initial psychotic episode-- where the promised excellent job, green card, wealth and fame were all nullified.

I tried to cope and I managed to cope with the shattered dream.

And, then, I woke up to this version of awakening.

Call me stupid but the lost of what was granted in the secondary dream still hurt.... even after I woke up from the dream where I was left dreaming about coping. (the unbearable lightness of my life I guess… lol)

Of course, what is represented in one's dream are often the unconscious and unspoken thoughts in one's mind.

Of course, I also would like to see one of the top training institutions for human services to walk the talk and model to its students what it is supposed to stand for and what it preaches (rather than solely through the methods misconceptions and mis-modeling lol).

Of course, I would like to get compensated for what the institution is wrong for, other than all the bullshit about how such a recovering process is instrumental for personal growth and transcendence.

One thing I really know for sure was that...

It hurts to wake up from that secondary dream and to having to live with reality or disillusion (yet, such a living is, at least, better than be in delusion).

And, I think, it also hurts having to live with the inevitable cognitive dissonances represented by the DASEIN of the esteemed institution… lol sighs

Yet, the thing I should really work on is to... stop dreaming... lol

3 months and a day

When I went to see my new physical therapist today, she told me that the treatment from now on would be focusing strengthening my muscles and increasing the speed... essentially teaching me to walk again.

It is been 3 months and a day and more since I last try to walk sideways. Although I now have master the art of tightening my pelvic muscles, some part of my body hasn't really gotten used to be used... and I was having difficulties lifting my feet up while trying to move my legs sideways at the same time.

The therapist told me that walking sideway and moving forward involve the same mechanism.

After trying out walking forward and comparing it to walking sideways, I knew it was not the same.

Some groups of muscles have not been trained or used for a while.

I need to reinvoke that part of kinetic memory... I guess, with practice, I should eventually find that "unterweg zum" walking sideway.

Could one forget how to walk like normal people?
Could someone who religiously walk to regain one's ability end up forgetting how to walk and how to control one's muscles involved in moving?

I don't know; yet, shall the above be not possible, why would there be need for rehabilitation? lol

At the same time, I know that, again, my life has shifted back to the state I was in 2 simply herniated disk and 3 stenosis before.

Be it my delusion or perception, I know that--- the same storyline is unfolding again-- people are going back to seek answers from the possibility of psychosomatization instead of focusing on my physical complaints.

Such is the burden of being the talented ratprincess.

To this date, I think I have given up on trying to persuade people that the implications of patients' psychiatric history extents far more than the naming of "psychosomatization" (God knows what it means and it covers essentially everything).

I will be the last person to say that my experiences have nothing to do with the psychosomatic thing.

However, let's not forget that these are symptoms of underlying problems involving the neurological system-- be it the dopamine or serotonin systems.

Back to the theory of human cognition, do me a favor, people, think "mental model"-ly than procedurally.

Think not-- psychiatric therefore psychosomatic.

Think rather about the feedback loop---

symptoms-> peripheral nervous system-> central nervous system & communications through neurotransmitters (fucked up in psychiatric patients) -> brain (fucked up in psychiatric patients-- and hopefully, me got no organic problem yet lol) interpretation -> central nervous system & communications through neurotransmitters (fucked up in psychiatric patients) --> peripheral nervous system -> (back to symptoms)

(And this is why mental model theory is so important... lol)

To hell, I finally have to say...

They are the experts and I am the one striving to develop the strength and stamina to walk, with excellent posture and better than before, one step more each day.

Yet, it was two months ago when I requested to be retaught to walk.

At the other place, they told me that my walking was fine and not much done in retraining me to walk like ordinary people.

Two months later, I am told that, when walking sideways, I am not moving it how ordinary people would move.

I am not walking right due to my psychiatric conditions?

I can't help but wonder... Would I be in the same state shall they have taught me how to walk two months ago?

Then, I come to understand what it feels to be a child failing in school.

Not knowing your alphabets might make it difficult for you to do things such as recognizing words or comprehending texts so as to learn more words through comprehension.

Not knowing the numbers might make it difficult to do addition, subtraction and more advanced things such as calculus.

Not knowing what you don't know also makes it difficult for you to work on getting rid of what you don't know.

It is easy to say... oh, the failing ones are just dumb (just like she is just mental).

Yet, above and beyond naming, now that it is the given that I am dumb and/or mental, what do you do to help me learn to read, to do math, and, to walk?

The funny thing is…

Based on what I have read so far, despite of the inconclusive findings in all other recovery-related factors, I haven’t found anyone recommend the use of stress to facilitate the recovery process—or it seems to be a consensus that distressing is beneficial….

Earlier in the night, I was checking out some craft items on ebay while thinking loosely about what happened today and all the other days within the past three months and a day. At some point, I came to the realization that the most anti-zen and stress inducing events throughout this time have mostly been associated with the repercussion of one type of information the doctors’ offices request me to provide-- the name of meds I am taking, Seroquel and Zoloft.

From a different perspective, it seems like my dealing with health professionals might actually be detrimental to my health. lol

So, in addition to the Zen moment kinda BS, what else do I do to relieve the stress?

New insight—ebaying… lol

Winds from 8 directions can't move me ....

"八風吹不動，一屁打過江"

http://www.ctworld.org/sutra_stories/story019.htm
(to view the automatic translation provided by google, click this link: story)

Since the stupid water boiling incident about a month ago, all the aches and pains got aggravated exponentially. The MRIs on my cervical and thoracic spins, later, led me to the realization that I am one of those people with the special talents in getting intensified pains for a week or two after the scans. Of course, other minor conditions such as rain, cold weather, events inducing stress and period also have the tendency to make things worse.

I have to adapt to the constant pains by putting myself into a state of relaxation in an instance--- whether I am sitting, walking, or riding on automobiles.

My years of training as a psychotic, or, perhaps, my congenital ability to be psychosomatic, both aid my ability to close my eyes, stop thoughts (keep my head neumocephalic) and feel my body relax from head down. I also laugh and call this the Zen moment.

The process is so very simple and straightforward.

I actually have to do a few of my version of biofeedback thing when trying to go through those thick books in ENGLISH (ya... I don't like to read especially when I have to read in English) about biofeedback and pain management that I borrowed from the libraries (ya... including those two heavy sets from Yale through interlibrary loan). Worse of all, the hard cover and almost thousand-page long of the book IS too heavy to carry and induce more stress and pains in my body (despite the fact that I do need training to build up my strength).

And, this is the reason why yours “doctor in education” state now... "thick books are no good for you body and for your head' since the interpretations of pains do incur extra amount of brain work in your head. lol

The Zen moments also help me to see things from a more distant perspective and with more clarity.

For instance, pains, aches and my difficulties to move are part of the recovery process. There is no need to induce more stress and anger in fighting these conditions. Rather, what I should try to do (based on the voices I hear) is to genuinely accept these conditions as part of my being... at least, and, hopefully, temporarily.

Thinking outside of my body also allows me to look directly at the phenomena as phenomena.

For example, when going for the initial evaluation with my new physical therapist at around 168th street today, the bus dropped me half way at 135th street because that's where it stops. Waited for over 30 minutes and after 6-7 other buses either stopping before 168th or with 135th, somehow, as their final destination, I finally got on another bus that stole 2 extra dollars from my pocket (the transfer should have worked on my metro card).

In pains, in discomfort, and in knowing I was to be late, I did get upset... At the end, the best thing I could do was to laugh it off as the poor princess' burden--- as some people might has why I didn't just spend 11 dollars to take a taxi to begin with... Yet, I saw intuitively that it was not the drivers' fault... it is the MTA's fault... lol

The answer to the 11-dollar question...

Well, it might have something to do with the fact that the contract of one job did not got renewed after August, on which the accident occurred, and God knows when the disability check is gonna start dropping till it finally drop, period... lol :-x

(And, did I sense something un-zen-ed in the above paragraph-- something like venting about un-zen-ed kinda feeling or perhaps the wish for vengeance for what lies before phenomena--- experiences with life's minor inconveniences bestowed upon me? :-O lol)

When in Zen moments, I am fully aware that I am at the level of:

"八風吹不動，一屁打過江."

Essentially, not at the level of being free of reactions.

My voices told me years ago that I am only human-- no need to suffer too much to get the adequate amount of cultivation to be upgrade to be a Buddha. lol

To be a human, I am entitled to react to the external world.

In addition, after my meeting with my psychiatrist this past week, it occurred to me that I could feel not fine although feeling good is my preferred state and the last thing I want to do is to suffer in life.

And, this is why, I decided to have a paradigm shift in my modus operandi again recently. When I feel shitty because I am all in pains, I will tell you I am in pain. However, after I shake off the annoying inconveniences resulting from the pains, I will tell you I am fine because I truly believe that's how I feel.

It is the reason why when I saw the library of the college wants to charge me 75 dollars for books borrowed for the job on which I got injured, I am determined to not pay a penny since the college owes me my neck, back, and now my overcompensated knees as well as the extra taxing on my beautiful brain. lol

It is the same reason why when I saw the words "Diversity & Citizenship Education in Global Times" as the title in an email sent from the college today, my immediate reaction was--- kicking me off the payroll after your damn chair rendered me disabled and in pains, what the hell are you talking about concerning diversity and citizenship education?

The "you", here, is not the scholars to be given the speech or the trustee who funds the event.

The "you" refers to the college that preaches social justice, ethics, morality, diversity etc while appearing to not doing what it preaches, at least based my biased perception.

Yet, who is the college-- a classic organizational dilemma?

What I am revealing to you here is the ”一屁打過江”moment.

And, yes, winds from 8 directions can't move me because only I can help me to move myself and really one step at a time.

And, after the "屁 (fart)" moment, let me reset my head back to Zen to get ready for my beautiful sleep. lol

And, by the way, I never put into writting here which college it is... lol

Beyond size and sensation... lol

I saw the neurosurgeon (ya, still not too bad looking… lol) today with the MRI for the thoracic and lumbar areas while the film for the cervical spine taken over 2 weeks ago is still yet to be found.

In one sentence, no surgery needed and the pains do not correspond too well with the anatomical evidence: herniated discs pinching with the one thoracic disk pressing down the space where the spinal fluid flows. Those other 4 disks in the neck.... the last time I checked... no one has seen them yet. lol

That still doesn't really answer my reported symptoms... pains, muscle spasms, as well as the resulting impacts on my mobility.

Stubborn like a donkey and five more disks after my conversion disorder, I got home and tried to google for some research associated with my atypical condition.

First thing I looked for a scientifically based article showing I am not the only person experiencing pains and disabilities more severe than what MRI results might suggest.

Following is the exact quote from an article by Karppinen et al (2001):

"finding a herniated intervertebral disc in an asymptomatic individual is clearly not an indicationfor surgery; similarly, a normal MRI in a patient with severe back and leg symptoms is not an indication of malingering or “nonorganic” pain."

Following is the link to a short description of the study:

http://www.chirogeek.com/002_Karppinen-2001-MRI-vs-Symptoms.htm#Intro

The most recent one citing this article was publish in 2007 by Jensen et al which found that, in a 14 month MRI follow up study for patients suffering from radiating pains, the recovery from symptoms might not go hand-in-hand with that observed in improvement of disk herniation and/or nerve root compromise.

Yet, not too many more after that 2001 article addressing the same issue and I guess it might have something to do with replication is not really the thing people value too well. In addition, I have to consider the possibility that the advances in the field of radiology might have found some ways to compensate these problems.

Following is the link to another article published all the way back in 1994.

http://www.chiroweb.com/archives/12/06/05.html

As you might expect, my congenital sense of curiosity (which could be perceived as either hypochondria or obsessive compulsive thinking) is not going to stop me here.... because of what I have been taught in school… lol

Now that physiology doesn't really always match up with symptomology.... what other mechanisms could explain these atypical symptoms involving real pains and difficulties in mobility?

Then, I came across this wonderful literature review for the biopsychosocial approach to chronic pains, which was published in the psychological bulletin (Gatchel, et al, 2007). In essence, pain is, to date, a mystical phenomena despite all the models proposed to demystify such occurrences.

As a paper published in the psychological bulletin, of course, the authors spent quite a bit of time discussing the contribution of emotions and cognitions in pains. In short, it is no good being depressed and anger; it is better being positive than pessimistic. In addition, humor, optimism and "benefit finding" are some of the resilient factors mentioned in the article.

The Nociceptive Process through which bodily events are interpreted by the brain as pains---

1. The traditional biomedical model of disease, which assumes an isomorphic relationship between pain and physical injury
2. The Gate Control Theory of Pain
3. The Neuromatrix Theory of Pain--- pain is the consequence of the output of the widely distributed brain neural network rather than a direct response to sensory input following tissue injury, inflammation, and other pathologies
4. Homeostasis, Allostatic Load, and Hypothalamic-Pituitary-Adrenal (HPA) Axis Dysregulation-- In short, all relevant factors contributes to the maintenance of conditions even after the original damage resolved or "in the absence of any objectively determined pathology".
   

And, of course, the neuroscience models of the pains.

For instance, the imbalance of neurotransmitters, neuromodulators, and their various types and subtypes of receptors, may contribute to the state of chronic pain. While much more has been written about the role of serotonin (5-HT) in Hyperalgesia (i.e., an extreme sensitivity to pain) , a recent study found that "the brain’s dopamine system is highly active while someone experiences pain—and that this response varies between individuals in a way that relates directly to how the pain makes them feel."

It is now starting to make sense to me.... to a certain degree.

Despite the resilient factors, what I have experienced as the pains and the ensuing consequences are the manifestation of a complex system involving the organic problems, the nocicepitive processes and my congenitally fucked-up serotonin and dopamine systems lol (oops... sorry, my dear serotonin and dopamine systems).

Then, when I was working on this writing.... I came to understand why the neurosurgeon thought my reported symptoms were over the limits....

Pains had intensified after the water boiling incident and got even worse after the Thoracic MRI scan last Wednesday. The humidity and rain also had not done much help....

When I woke up this morning (when the body is most stiff), I filled out the patient survey and reported what I felt then....

One of the question asked me how much work I have been able to do since the accident... I put down 90%.... since I have been out of work in June and the only thing I have done was to push through the legal documents for my immigration thing... Should have put down 100% instead actually since the only thing I have done is walking up and down the street trying to regain my walkability.... lol

When looking for the articles I found tonight, still in bad pains, I went through a lot of searches and finally narrowed down to a few of the articles... In addition, I actually read through them.

Then, this other question in the survey popped into my head... it was about how much the pains had affected my ability to read. My answer to that question was something like severely.

After going through these articles... I realized that my recall about the frequency of reading was correct since I have not done much reading since the accident.... and it might also have something to do with my dislike to be reading in English unless necessary.... lol

There goes the issue of validity and reliability of survey instruments and the annoying noises made by atypicals or outliers who think like me. lol

So, now that surgery, which was never an option for me, is absolutely out of the sight. Shall the etiology of my psychiatric do have a significant impact in intensifying my nociceptive experiences, shall it be the consequences of my trying to kick God’s ass and God’s kicking my ass back (lol)…. and, shall all other possible contributing factors, what could the professionals do to help me get myself better sooner?

It all boils down to…. for me, they are real pains, real spasms, and real problem I am facing with moving (even though, what is real? lol)

References

Dopamine and pain

http://www.med.umich.edu/opm/newspage/2006/dopamine.htm

Serotonins and pain

http://www.elsevier.com/wps/find/bookdescription.librarians/503936/description#description

The mystical concept of pains

Gatchel, R.J., Peng, Y.B., Peters, M.L., Fuchs, P.N., and Turk, D. (2007) The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychological Bulletin, Vol. 133, No. 4, 581–624.

Size and sensation (lol)

Karppinen, J., Malmivaara, A., Tervonen, O., Paakko, E; Kurunlahti, M., Syrjala, P., Vasari, P. and; Vanharanta, H. (2001) Severity of Symptoms and Signs in Relation to Magnetic Resonance Imaging Findings Among Sciatic Patients. Spine. 26(7):E149-E154.

http://www.chiroweb.com/archives/12/06/05.html

Tue Secher Jensen, Hanne B. Albert, Joan S. Sorensen, Claus Manniche and Charlotte Leboeuf-Yde, (2007) Magnetic Resonance Imaging Findings as Predictors of Clinical Outcome in Patients With Sciatica Receiving Active Conservative Treatment, Journal of Manipulative and Physiological Therapeutics, Volume 30, Issue 2, Pages 98-108.

From intensified nerve pains during MRI procedure

Finally, today is the day when I got the MRI on my Thoracic spine done.

And, again, the nerve pains got intensified like what happened the last two times when the test was done on my cervical spine and the lumbar area.

I figure that such occurrences must have something to do with the pains I experience when in automobiles, for instance, cars and buses with the engine on, be it moving or not, along my spine. It might also share the same mechanism when the pains were much severe and when cars playing loud music on the street 6 floors down could actually trigger the radiating pains at the major pain spots.

When I complained about the intensified pains and their association to MRI, I, of course, got the Ratprincess class of response…. (gotta be me crazy in the head lol :-O)

Being sort of annoyed by how hypochondria is often used to interpret my congenital right to know why things are happening etc, I did quite a bit of googling to see whether there are other people with similar complaint.

Then, I found this posted by someone else…

Expert: Alain Ortiz Date: 4/5/2007 Subject: pain during MRI
Question I was diagnosed with tendinitis (wrist) nearly two years ago and it has not gotten better, so they did a MRI to make sure it wasn't something else. the MRI caused me INTENSE PAIN. I have asked four of my doctors why that could have happened and they didn't know (although one told me a story of a coworkers husband whose wrist had spontaneously caught fire during his MRI) do you know of any reason the mri would have hurt so bad???

The only thing this posting proves is that, somewhere out there, someone had similar experiences… or, as you might say, share the same craziness. lol

Googling a bit more, I came across two other articles that sort of looked patients experiencing intensified pains during the MRI scan. For both articles started with the assumptions that anxiety and still position are the major contributing factors to the painful phenomenon although they did have a limitation section acknowledging that there might be factors otherwise not classified.

Then, my anti-psychosomatic mental model led me to this thought….

So this is why they say it is me crazy in my head--- grounded in scientifically based research studies with psychogenetic factors as the underlying assumption despite the fact that there might still be a lot more for us to learn about what strong magnetic field, such as that produced by the MRI procedure, could really do to the body.

Sonography and MRI of the Shoulder: Comparison of Patient Satisfaction
William D. Middleton1, William T. Payne1, Sharlene A. Teefey1, Charles F. Hildebolt1, David A. Rubin1 and Ken Yamaguchi2 1 Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd., St. Louis, MO 63110.2 Department of Orthopedic Surgery, Washington University School of Medicine, St. Louis, MO 63130. OBJECTIVE. MRI and sonography are both used to evaluate patients with painful shoulders. This study was conducted to compare patients' perceptions and satisfaction with both tests.
SUBJECTS AND METHODS. One hundred eighteen patients with shoulder pain and a clinically suspected rotator cuff tear underwent both MRI and sonography and filled out satisfaction surveys after both tests. Patients were asked the following questions: Did the test cause pain? If it did, they were asked to grade the pain on a scale of 1–10 (1, minimal pain; 10, severe pain). Did the test take too long? Would they be willing to undergo the test again? How would they grade their overall satisfaction with the test (1, poor; 2, fair; 3, good; 4, very good; and 5, excellent)? Which test did they prefer if both were equally accurate?
RESULTS. Sonography caused pain above the baseline in 39 patients, with an average pain score (mean ± SD) of 5.4 ± 2.3, and MRI caused pain above the baseline in 40 patients, with an average pain score of 6.1 ± 2.7 (p = 0.36). Two patients thought the sonography examination took too long, and 28 patients though the MRI examination was too long (p < p =" 0.002).">

I decided to, then, switch to key words to pain and strong magnetic fields--- only to encounter a study that found strong magnetic fields did intensify phantom limb pains in amputees…
OK… after all these, we are back to imaginary pains with physical basis--- (I never say that I am not crazy… remember)

Phantom limb pain induced in amputee by strong magnetic fields
William T. C. Yuh, MD, MSEE 1 *, David J. Fisher, PhD 1, Richard K. Shields, MA, PT 2, James C. Ehrhardt, PhD 1, Frank G. Shellock, PhD 3 1Department of Radiology, University of lowa Hospitals and Clinics, University of Iowa College of Medicine, 200 Hawkins Dr, Iowa City, IA 522422Department of Physical Therapy, University of lowa Hospitals and Clinics, University of Iowa College of Medicine, 200 Hawkins Dr, Iowa City, IA 522423Department of Diagnostic Radiology, Cedars-Sinai Medical Center, Los Angeles *Correspondence to William T. C. Yuh, Department of Radiology, University of lowa Hospitals and Clinics, University of Iowa College of Medicine, 200 Hawkins Dr, Iowa City, IA 52242 setDOI("ADOI=10.1002/jmri.1880020216") Keywords Biological effects • Neuroma, 42.369 • Safety

Abstract An amputee (traumatic) experienced increased phantom limb pain when exposed to the magnetic fields of two magnetic resonance imagers. With a visual analog scale used to measure pain, electric stimulation studies demonstrated that the residual limb was unusually sensitive to subthreshold (for muscle twitch) levels of current. The painful symptoms produced mimicked those experienced in the presence of the imagers.

To end my day’s journey, I used the key words vibration and pain…. and came across this thing called Dorsal Horn Reorganization…

Dorsal Horn Reorganisation - after a nerve injury, the central connections for each sensory modality (light touch, pain, vibration, temperature) unplug like a telephone exchange, and become reconnected to the wrong socket. Thus light touch and temperature modalities become painful.

Is this what is happening to me in addition to psychosomatization? Wouldn’t it be better if the sensory called pain could be interpreted as soothing comfort? And, would biofeedback make such a neurological misconnection a feasible option? :-O lol