Wednesday, March 5, 2014

CRPS Update




I should let you, Dear Readers, know upfront that this is an update on the personal level -- although I've been doing a fair amount of reading "in the field," the reading is mostly above my head or personal interest stories.  Why share that with you when I can bitch and moan on my own?

Remember the fundamental principle here at Marlinspike Hall:  Whose blog is it, anyway?

Since life switched from our Renaissance King-sized bed to my single hospital contraption, decorated with an understated trapeze attachment in matte black, I've been in a steady decline.  Well, it's not much of a leap to needing to ask for a hospital bed to that assumption, eh?

Not that my Purple Prose Gratitude Journal is getting fat with loopy handwritten entries, but I will admit that when my body goes into spastic mode, the understated trapeze attachment softly jingles and jangles, calling up memories of one of my favorite Southern Tête de Hergé's front porches and its many gentle wind chimes. Those same spaz attacks bring waves of desire for the blueberry moonshine that also rise up in memory of that ivy-covered porch.  Ahem.

Many is the time I've sworn that it is the spasms that will one day make me paper my body with Fentanyl patches and mix up a chocolate pudding laced with lethal doses of a dozen sweet drugs.  If I did not think that a peaty single malt would make me lose the pudding, it'd replace blueberry shine as my favorite strong drink.

Ah, ha ha, just joshing.

In any event, I've now become the Manor Resident who grabs sleep where she can, and that usually is long after dawn.  This is something I intend to change, and soon, perhaps as soon as tomorrow.  Tomorrow may also see me pitching in to help the Genetically Indentured Manor Staff, as so many have taken vacation time to warmer climes.  A little vacuuming, mopping, laundry, poofing and fluffing never hurt anyone.

Fevers are up about a degree and I blame those mo'fos for my general decline.  A febrile state makes for great melodrama (Oy! I am burning up, as if in the very flames of Hell, and so on, and so forth) and laziness (Is that cat hair clinging to my electrostatic hospital bed rails?  Ew, gross.  SOMEONE should do a bit of dusting around here, damn it!).

But, fevers also are truly... tiring.  Mostly the parts where they're going up, and the parts where they're going back down.  The steady heat is not bad.  Kind of energizing, even.

CRPS is not causing the heat waves, of course, it's the untreatable osteomyelitis, perhaps a touch of lupus. And yet, CRPS so hates to be excluded, and so tends to get nasty during a persistent fever.  So it's spazspazspaz and burning neuropathic pain married to the deep ache of the bones.

I've mentioned before, or hope I have, that I employ more than a bucket load of drugs to handle these things. Heck, I got me a graduate degree at Berkeley, so you know I turn a quick eye to all that is alternative, complementary, or adjunctive therapy.  What works best is ice... until those medical sadists, the Physical Therapist Gangs, beat it into my head that cold is bad, bad, bad, wrong, wrong, wrong.  So I moved on, but how many times can you watch repeats of Downton Abbey?  So I began an incisive, lighthearted study and practice of mindfulness.

The initial forays into mindfulness for CRPS led to anaphylactic shock until my mentors made an adjustment and removed any references to the "happy place."  Once that was taken care of, it turned out to be pretty simple.

You don't run away from the pain.  Like a cat, and some dogs, you circle three times, wiggle your butt a little, and curl up smack dab in the middle of that pain.  There you stay until you're through it.  You don't speak much about it, beyond what may be necessary.  But you snuggle into it, stare at it, see it, observe it. Thank G_d, you don't analyze it (until pressured by such asshats as physicians).

For long term and unending severe pain, like mine, you mix in the occasional distraction, and that would be best defined as whatever works at the moment.  Mahjong, when played in a zen state, can be very effective. The vogue of marathon reruns of classic television might fit like a glove one day, and repulse the next. Law and Order SVU, for example, has no usefulness any longer in mindlessness/mindfulness sessions, whereas the Criminal Intent version, or the early original shows -- the variety pack -- are entertaining.

When mindless mindfulness is flat out denied by a pouting, infantile CRPS patient, that's when such an ingrate should opt for a comedy genre (literary or televised/streamed) or the infallible humor of felines.  Being fussed at by Marmy Fluffy Butt because you dared shift her tiny frame a few centimeters gets a belly laugh every time.  Dobby in a box is hysterical.  Buddy the Maine Coon cracks a person up just by facial expression. And all three have extensive nursing backgrounds.  A kitty massage is a better soporific than anything Big Pharma can dream up.

Music requires a careful touch.  The mp3 player yields mysterious tunes in shuffle mode, sometimes so eerily reflective of one's severe pain that it's simply not a decent option.  Unless, of course, you need to cry and have not been able to produce tears, either due to the constant dehydration from the constant fever, or due to the aridity of my heart.

Most of the time, though, music is a great aid to treating pain, especially in those 20-35 minute periods before the breakthrough meds kick in.  Also, when the dark is terrifying -- you know, when the threat of dawn edges into the window pane and you think: "No, not again, not another night of no sleep."  Then you must make yourself circle thrice, settle in, and call up Nina Simone and Eric Clapton, certain bits of Neil Young, ending with the Brett Dennen of around 2004.  That's this week's menu.  Last week saw more of the Decemberists, my beloved John Hartford, and the Wainwright family, Loudon, Martha, and Rufus.  I am finding great focus for my pain in Johnny Cash's American Recordings and the very sweet beginnings of Bonnie Raitt, from a very sweet album recorded in her parents' garage, with their supremely sweet jazz musician friends.  She sounds so wavery and young, so un-twangy, that knowing every bit of her later sounds is enough to make me weep.

I'm undergoing a good many variations in the CRPS experience, feeling stuff that I thought would never return, rapid cycling from red to deep purple, cold to hot, electric strikes that produce yips of howls. The everpresent, though, is what makes "suicidal ideation" something to ridicule.  The deep, deep pain, the burning bones that are somehow also ice. The "movement disorder" -- but we've covered that.

On the up-side, I have lost most of my decrepit fingernails and the regrowth seems healthier.

Where did I put that Purple Prose Gratitude Journal?

As for how it's going, breaking in my new Obamacare doctors -- last Thursday, I met the doctor who will be my Primary Care.  She put together a hasty Problem List.  I decided CRPS should top it, and so mentioned it first.

Blank look.

Okay, so I reverted to "RSD" and before I could unpack it, she said, hand waving in the air, "Oh, I know. Something Sympathetic Something."

I shot her a bright smile. "Right!"

And when they gave me their efficient printout record of our brief initial alliance, I saw that my primary problem was "CLPS." Fred giggled.

Sorry, loves, but I have to go.  I feel a need for Townes Van Zandt.  twitchtwitchtwitch.  I think I hear his clunky cowboy boots out on the Front Porch... and the gentle call of windchimes.












© 2013 L. Ryan

Saturday, March 1, 2014

REPOST: john trudell, courtesy of the family blog whore

First published on 2/24/2013

Tip of the hat, finger aside the nose, to TW, as I steal from his Valentine's Day post: "They Didn't Listen" -- and thank him for the find, and kiss the very center of his forehead.



Uploaded on Jun 27, 2009 by NancyRedStar·

"These Memories"


In the reality of many realities
how we see what we see
affects the quality 
of our reality 

We are 
children of earth and sky
DNA descendant and ancestor 
human being physical spirit 
bone flesh blood as spirit

We are 
in time and space 
but we're from beyond time and space 
the past is part of the present 
the future is part of the present 
life and being are interwoven

We are 
DNA of Earth, Moon, planets, stars 
we are related to the universal 
Creator created creation 
spirit and intelligence with clarity 
being and human as power

We are 
a part of the memories of evolution
these memories carry knowledge
these memories carry our identity
beneath race, gender, class, age
beneath citizen, business, state, religion

We are human beings
and these memories are trying
to remind us
human beings human beings
it is time to rise up,
remember who we are
~ John Trudell


Lyrics: John Trudell 
Music: Mark Matson & Hayley Hutt 
Vocals:John Trudell & Hayley Hutt 
Additional Vocals and Harmony:Deirdre Radford
Keyboards and Drum: Mark Matson 
Guitars: Byron Roberts
Produced and Engineered by: Mark Matson
Executive Producer: Nancy Red Star 




i don't think he likes it one bit but that's just too doggone bad.  someone in this family must be shameless, and i volunteered long ago ----->> if you love the land, this country, the solid comfort of the amazingly real, the white skull recognition of all that you forgot.... go read, revel,  and rest at TW's american idyll.

The Amazon Cloud Robbery

This is here because it is the only song from this album that will successfully load onto my Major Pain Management Treatment When The Manor Is Enveloped In Darkness And Swathed In Silence, that being my mp3 player.  Were it not a vaporous thing, mere wisps, I'd be tempted to shoot the Amazon Cloud.  Because I've tried everything...




Album: Peace (1999)




I've Tried Everything

The truth of life is the greatest gift
But I don't think, I can make it fit
And who would guess it would come to this
When I've tried everything

And I should know, but I can't explain
The endless noise sounding in my brain
Who would've thought that you could feel such pain
When you've tried everything

Ooh, you're a loser now
Yeah, you're a loser
Yeah, you're a loser now

La la la
La la la
La la la

I should be cool, but I'm burning hot
I should be good, but I fell apart
Don't look at me, now don't even start
'Cause I've tried everything
Yeah, I've tried everything

Ooh, you're a loser now
Yeah, you're a loser

Ooh, you're a loser now
Yeah, you're a loser now, now

Songwriters
LENNOX, ANNIE / STEWART, DAVID ALLAN



"You Have A New Follower!"



Twitter politely informed me, via email, that I had a new follower.  Still woozy from yesterday, I dove headlong into today's wooz by googling the name of this person, found him, found him, also, to be seemingly aboveboard and legitimate.  That's where most people would stop, having better things to do.  But by then I was in wooz up to my belly button and had consumed three scones.

I started looking at other guys using the same name.

The first laid me low in the land of woozy laughter.  He has a Wikipedia entry.  So gasp or something. No, a gasp might be excessive.  A brief intake of breath might be more appropriate.  His entry is just a stub, a mere nub, under the categories of "Israeli linguists, Israeli expatriates in Japan, Jewish Japanologists, Living people, Lexicographers, Asian linguist stubs, Israeli academic biography stubs."  

Slightly jealous, I found myself wondering if, one day, provided that I play my cards right and meet the right people, I might be a stub.

Listen to what Stub Man has done, how his life is beautifully wrapped in that exotic Asian yellowish orange tissue paper, secured with a miniature obi:

Jxxx Hxxxxxx (春遍雀來, ハルペン・ジャック) is an entrepreneur and linguist specializing in Chinese characters or Kanji. He is best known as Editor in Chief for the Kodansha Kanji Learner's Dictionary and the New Japanese-English Character Dictionary.
H is CEO of the CJK Dictionary Institute, offering electronic resources for Chinese, Japanese, and Korean dictionary data. Hxxxxxx is also a Fellow at Showa Women's University.
Hxxxxxx also is the founder and current Executive Director for International Development of the International Unicycling Federation. Hxxxxxx is a major contributor to the Lifeboat Foundation, a project which aims to build a space colony so that humanity can survive in the event of the Earth's destruction.

My actual new follower, of the same name, is also a wonder of a person, even if there's no mention in his pedigree of unicycling or 4-man bobsledding. He is an advocate for old people and the families of old people, who usually meet him at a point of crisis and agitation.  Elder Care, it's called these days, a subset in the economy of gerontology.  He hates bed sores and is apparently a knight whose shining sword swiftly slices through the sticky webs of red tape at nursing homes, "rehabs," hospitals, and inappropriate home health set ups.

I'm thinking of "following back," since I'm closer to the bed sore scene than the many Seas of Tranquility awaiting humankind after the zombies, werewolves, and nuclear disasters have sent us fleeing this benevolent home.

Funny.  In my wooziness following a long and difficult day yesterday, I immersed myself in Le Petit Prince, available now through the Gutenberg Project (isn't that wonderful?).  In fact, here at the end of today's wooz -- there's been a considerable time lapse between beginning and end of this fascinating entry, mostly spent sleeping and reading a newspaper, the real kind, that folds and rustles, and smells all newspapery -- I think Antoine de Saint-Exupéry developed the single most meaningful test of our individual lucidities, stripped of space colony escape pods and nursing home neglect, being fourteen or ninety.

And he was kind enough, before politely disappearing in the sky or in the sand or in the ocean, wherever it was he ended up, to make this single most meaningful test of our individual lucidities a test that cannot embarrass us.

Aren't people, generally, wonderful?



illustration from Le Petit Prince






© 2013 L. Ryan

Thursday, February 27, 2014

A Moment in Time

I love this photo.

It's of a friend and her horse, Flea Bag, as they round a barrel.

There's such a oneness in horse and rider, horse and friend, that the barrel had not a chance in this world -- they make that barrel about as inconsequential as spit.

Look at the lines!  The speed!  The trust!

I could do without the hat, would rather see girly curls in the breeze, but I'm told that, like the wind in those parts, it's something I just don't understand.  Something to do with "culture." Harrumph.



Please do not reproduce this photo.
If you do, Flea Bag will run you down.

On Barrel Racing


© 2013 L. Ryan

Physicists are killing the dream of suicide

Square, Cube, Tesseract
 "the tesseract is to the cube as the cube is to the square"
************************************************


I'll be straight up with you, Dear Readers.  I've been suicidal.  No, not mushy-mushy "suicidal ideation," give your belongings away trite and tripe, but stone-cold "I feel nothing compels me to stop any longer" days and nights.  Because anyone with a bad case of CRPS for longer than, say, three years, thinks about suicide every morning they are unlucky enough to wake up.  Morning, afternoon, evening, whatever.  And three years is equally arbitrary.

This is when I'm supposed to tell you what stayed my hand.

Except that nothing has.  It hovers, instead, shaking in midair.

Not even the usual stuff could stop me now.  That being::  the accrual of sufficient funds to support Fred in his final years, as he winds and wends his way around the grounds of these grand Haddock Family holdings. That being:  teaching him (or Sven, Bianca, or maybe even the Cabin Boy) to clear the kitchen counters, do the dishes, and put everything back in its place once clean and dry.  That being: paying off my debts so that my departure is not the kerplunk of a tiny pebble in our moat, but the gentlest surface addition of a dandelion parachute and seed, a complement to the naturally accruing muck of the moat.  Only I would think to think "Ah, le futur du dent de lion..."  But I have been neither perennial nor herbaceous.

That being:  the desire to know how things turn out for my family members and the people who fell into my gnobby spider's web and became my friends.

The old concerns of the novitiate died with my solemn vows -- I don't care who has to find me, who has to do the cleaning up, who has to make a phone call or two.  It's not that difficult, and no soul known to me would be shocked.  The even older concerns of the narcissist don't keep the heart contracting, the thought of how some would be hurt, some insulted, some angry, some mildly disappointed.  Will the truth of my life come out, every secret, every fault, every unknown success?  I murdered narcissism about a decade ago, with lapses, true, but that's no longer the darkest stain on my soul.  (The secret to getting out most organic stains is the oxygenating action of hydrogen peroxide.  And, by the by, an excellent help to CRPSers out there with feet that make passers-by cringe in revulsion?  One cup hydrogen peroxide and one cup Epsom Salts, diluted to an amount that seems practical.  Oh, but first take a handful of pain meds, say 25-40 minutes beforehand, because the use of an old toothbrush is required.  If someone really loves you, they'll do that part while you smack some gum and watch "Duck Soup.")

Again, what has my hand jangling so in a jello-shimmy just short of suicide, since nothing has changed the sieve envy of my mind?  Mine own anger, that's what.  Not yours, the possessive referring to none of you, Dear Readers, but the "yours" that designates the Usual Suspects, more precisely, the You the eye and mind of Keyser Söze would flit upon, briefly, not to concoct a credible story, but as the world's best annihilator of essence, a succubus of haloed ringlets of shades, lengths, and quality to rival Joseph's ridiculous coat, a precision parser of your particular sentence.  Everything is a circle, isn't it?

So now I must pretend.  Pretend that that is not my hand jazz dancing near hot flame, that that is not furor lighting up mine eyes, but joy at seeing you again.

It's nothing to do with being happy or not, or any other sentient commonplace.  I've explained, even, that it is not self-pity.  I recognize that there are people who suffer beyond my wilds.  I am sorry for them and do what I can, when I can, to alleviate their situation -- though usually that alleviation is so abstracted it will do the individual inciting it no good whatsoever.

I can see the goddamned glass is half full.  Three-quarters, even, if you press me, and if we can chat physics and the effects of modifying the shape of the eye's boundary.

Fred delights in the notion of a holographic multiverse.  Would you believe that I find most succinct the explanation given by the Physics section of About.com?  (Especially in comparison to the hair-raising versions Fred blurts out as he rocks in the green rocker by my bed!)  Here! I've stolen some of "About"'s explanation:

The holographic principle is a mathematical principle that the total information contained in a volume of space corresponds to an equal amount of information contained on the boundary of that space. This dependence of information on surface area, rather than volume, is one of the key principles of black hole thermodynamics.  
In Brian Greene's 2011 book The Hidden Reality, he suggests a tightly interlocked Holographic Multiverse:
the holographic principle envisions that all we experience may be fully and equivalently described as the comings and goings that take place at a thin and remote locus. It says that if we could understand the laws that govern physics on that distant surface, and the way phenomena there link to experience here, we would grasp all there is to know about reality.
Now, here is where "About" dumbs it down, and pretty much says what Fred, a-rockin', also says, but degarbled. Speech going back and forth in space, combined with smug glee, is not conducive to teaching. The sound is aimed all over the darned place, distorting the waxy protective vernix of my immature comprehension.

According to the holographic principle, there should be a physically-equivalent parallel universe that would exist on a distant bounding surface (the edge of the universe), in which everything about our universe is precisely mirrored.
What exactly does this mean?
Well, we live in a three dimensional universe. If you have a 3-dimensional region then the edge of that region would be a 2-dimensional surface. For example, if you have a solid rubber ball, the 3-dimensional object has a 2-dimensional spherical surface.
The holographic principle suggests that this surface would contain enough information to perfectly represent everything that takes place within it. Think of it kind of like a reflection on the surface (although this is only a useful analogy, the precise formulation of the holographic principle is a mathematical relationship based upon quantum physics).
If this highly-theoretical conjecture is true, then that means that our universe exists in two different forms, though those two universes are completely identical in every respect. As Brian Greene explains in his 2011 book, The Hidden Reality:
Our experiences here, and that distant reality there, would form the most interlocked of parallel worlds. Phenomena in the two - I'll call them Holographic Parallel Universes - would be so fully joined that their respective evolutions would be as connected as me and my shadow.

This is, in short, the origin of my anger.  I want to object, as if these worlds retained any proper respect for Robert's Rules -- using a diaphragm-controlled stage voice to call out, "Point of order!"  That would stop everything -- EVERYTHING -- until I could get everything -- EVERYTHING -- figured out.  Because my understanding, at this point, is that, while I may exist, how, where, when, and why I do has less force of impact than my dandelion fluff coalescing with our algae-rich moat water.

It seems that for my suicide to be a true thing, I must first strive to be one-dimensional, a pair of points whose surface has no dimension.

Rocking beside me a few days ago, happy as a clam, Fred marvels, to and fro, that we've found the Higgs boson and now he puzzles at its lightness.  Particle physics has gone red with the shame of its insufficiency to explain the 85% of matter that we cannot find, dark matter, and over the purple prose of the new fictive string in the narrative, that of supersymmetry, which posited an undiscovered doppelganger that is, for symmetry's sake, much heavier.  Elegant mathematics and no proof, string theory, and now... mucking up my suicide, extra dimensions, microscopic, and always, evidentiary failure of tests of "existing" models.

Fred sounds so content, excited.  Like one of those people who will live, old, bent, and aching within that contentment, and will greet death as a passageway, a chance to morph into some of that formulaic elegance, that chalk eeked out across green slate, erasable marker on white board, those old dreams, smashed to smithereens in search of God.

Physicists are killing the dream of suicide.


© 2013 L. Ryan

Friday, February 21, 2014

"The Beast in Me," sans commentaire

Nick Lowe
Written for, and about, Johnny Cash, his ex-step-father-in-law (for genealogy experts!)




The beast in me
Is caged by frail and fragile bonds
Restless by day
And by night, rants and rages at the stars
God help, the beast in me

The beast in me
Has had to learn to live with pain
And how to shelter from the rain
And in the twinkling of an eye
Might have to be restrained
God help the beast in me

Sometimes 
It tries to kid me that it's just a teddy bear
Or even somehow managed 
To vanish in the air
And that is when I must beware 
Of the beast in me
That everybody knows
They've seen him out dressed in my clothes
Patently unclear
If it's New York or New Year
God help the beast in me
The beast in me



Performance from the 1994 Montreux Jazz Festival

American Recordings is the 81st album by the country singer Johnny Cash. It was released in April 1994 (see 1994 in music), the first album issued by American Recordings after its name change from Def American, the album being named after the new label. In 2003, the album was ranked number 364 on Rolling Stone magazine's list of the 500 greatest albums of all time.
Cash was approached by producer Rick Rubin and offered a contract with Rubin's American Recordings label, better known for rap and heavy metalthan for country music. Under Rubin's supervision, he recorded the album in his living room, accompanied only by his guitar. For years Cash was often at odds with his producers after he had discovered with his first producer, Sam Phillips, that his voice was better suited to a stripped-down musical style. Most famously he disagreed with Jack Clement over his sound, Clement having tried to give Cash's songs a "twangy" feel and to add strings and barbershop-quartet-style singers. His successful collaboration with Rick Rubin was in part due to Rubin seeking a minimalist sound for his songs.
The songs "Tennessee Stud" and "The Man Who Couldn't Cry" were recorded live at the Viper Room, a Sunset StripLos Angeles nightclub owned at the time by Johnny Depp. "The Beast in Me" was written and originally recorded by Cash's former stepson-in-law Nick Lowe.[1]
The video for the first single, the traditional song "Delia's Gone" (directed by Anton Corbijn, featuring Kate Moss), was put into rotation on MTV, and even appeared on Beavis and Butt-head, Beavis asking if Cash was Captain Kangaroo. The album was hailed by critics and many declared it to be Cash's finest album since the late 1960s, while his versions of songs by more modern artists such as Tom Waits and Glenn Danzig (who penned a song called "Thirteen" specifically for Cash, in just twenty minutes) helped to bring him a new audience. American Recordings received a Grammy forBest Contemporary Folk Album of the Year at the 1994 Grammy Awards. The album cover was photographed whilst Cash was visiting Australia, at Werribee near Melbourne.[2]



Monday, February 17, 2014

Joshua Messier: Murder Victim at Bridgewater State Hospital?

Source and hat tip for spreading the awareness of this apparent murder to Patrick Tracey, author of "No Family Madder" blog.





From Patrick Tracey's blog entry, "Exposé Questions Death of Young Man":

Judge for yourself from this video showing the final moments of Joshua Messier’s 23 year-old life in state care.

After being restrained by all these big guards at Bridgewater State Hospital putting all their weight on him, you can see him turning blue and die.

Read for yourself today’s expose in the Boston Sunday Globe.

It begs the question: Was he killed by the state just for exhibiting symptoms of schizophrenia?


As the video suggests, the man with diagnosed schizophrenia–the most severe mental illness dealt with in psychiatry–is having a psychotic episode, hearing voices, seeing visions, when state prison guards subdue him, hands and feet, in four-point restraint.

Ten minutes later, turning blue as his guards chat to each other beside him, he’s gone.

The explanation of the prison guards transcends belief. They know nothing about schizophrenia. They’ve had no meaningful training in mental health disorders. This at the state of Massachusetts’ prison for the mentally ill. (Despite its name, Bridgewater State Hospital is a medium-security prison.)

No Arrest, No Reprimand

The newspaper couldn’t get to the bottom of why no one has been arrested, prosecuted or even reprimanded.

Internal Affairs cited two guards for putting pressure on a restrained inmate’s back, but that was it.

Why? Because the state medical examiner called it homicide, then changed her mind.

Why? We don’t know that either. She wouldn’t respond to the Globe investigation either, but it’s highly unusual to have homicide listed as the
cause of death with no additional court action.

The video shows medics were called when Messier’s pulse had stopped, and not before a crowd of guards  had been standing idly by, chatting as he lay dying.

In the surveillance video, two guards are also seen pushing down on his  back as he sits in handcuffs and leg irons on the bed, crunching his chest toward his knees.

The practice, known as suitcasing, is banned in Massachusetts prisons because it can cause suffocation.

The medical examiner called in for the autopsy found his heart had stopped beating during the guards’ effort to strap him down, but she couldn’t say exactly when.

Her autopsy also found internal bleeding on Messier’s brain, and blunt force injuries to his neck, torso, arms, and legs, suggesting that he was beaten before he was dragged into cell 13.

In the Globe piece, the prosecutor who won’t call a grand jury to consider a manslaughter charge comes across as the final word on weakling. Either that or a law enforcement authority trying to protect fellow law enforcement authorities, almost as a professional courtesy.

The bizarre unwillingness of Plymouth District Attorney Timothy J. Cruz to at least call a grand jury to decide if a trial is warranted is so unusual that it’s raising eyebrows.

Cruz claims the medical examiner told him she couldn’t tell exactly when Messier expired during the ten minutes that he was turning shades of blue in cell 13.

All righty, then. So when it comes to mental illness, it’s the age old story: Close the curtain and darken the room. Nothing to see here, folks. Just move along.

Read the rest of this blog entry HERE.

Saturday, February 15, 2014

Low Dose Naltrexone (LDN) in Recalcitrant CRPS

If you've heard of the drug Naltrexone, it's likely to have been according to its most known context, as explained by the good Wikipedia:

Naltrexone is an opioid receptor antagonist used primarily in the management of alcohol dependence and opioid dependence. It is marketed in generic form as its hydrochloride salt, naltrexone hydrochloride, and marketed under the trade names Revia and Depade. In some countries including the United States, a once-monthly extended-release injectable formulation is marketed under the trade name Vivitrol.
Yet, there is a movement calling for low dose Naltrexone clinical trials, as anecdotal evidence accrues that it is improving the quality of life for people with Parkinson's Disease, Crohn's, Multiple Sclerosis, and several cases of pancreatic cancer.

I tend toward skepticism but try to remember that Ketamine, which has proven useful to many CRPS patients, and others with unrelenting pain from things as diverse as advanced cancers to phantom limb pain, also came on the scene as the result of a single case study.

If you -- like me -- would like to read up on LDN therapies, a sort of clearinghouse of information is available through the efforts of doctors and researchers calling themselves "The LDNscience™ Team" HERE.


**********************************************************

This is the first article I've seen dealing specifically with CRPS and low dose Naltrexone.
Full text available online courtesy of SpringerLink

Journal of Neuroimmune Pharmacology
© The Author(s) 2013
Received: 7 November 2012
Accepted: 4 March 2013

Published online: 2 April 2013
10.1007/s11481-013-9451-y


Treatment of Complex Regional Pain Syndrome (CRPS) Using Low Dose Naltrexone (LDN)
Pradeep Chopra (1)  and Mark S. Cooper (2)
(1)Department of Medicine, Alpert Medical School of Brown University, 102 Smithfield Ave, Pawtucket, RI 02860, USA
(2)Department of Biology, Graduate Program in Neurobiology and Behavior, University of Washington, Seattle, WA 98195-1800, USA

Pradeep Chopra (Corresponding author)
Email: painri@yahoo.com

Mark S. Cooper
Email: mscooper@u.washington.edu

Abstract
Complex Regional Pain Syndrome (CRPS) is a neuropathic pain syndrome, which involves glial activation and central sensitization in the central nervous system. Here, we describe positive outcomes of two CRPS patients, after they were treated with low-dose naltrexone (a glial attenuator), in combination with other CRPS therapies. Prominent CRPS symptoms remitted in these two patients, including dystonic spasms and fixed dystonia (respectively), following treatment with low-dose naltrexone (LDN). LDN, which is known to antagonize the Toll-like Receptor 4 pathway and attenuate activated microglia, was utilized in these patients after conventional CRPS pharmacotherapy failed to suppress their recalcitrant CRPS symptoms.
Keywords Chronic pain Complex regional pain syndrome CRPS Reflex sympathetic dystrophy RSD Neuropathic pain Naltrexone Fixed dystonia Allodynia Vasomotor Ulceration Dystonic spasms Conversion disorder Functional movement disorder LDN

Introduction
Complex Regional Pain Syndrome (CRPS), formerly known as Reflex Sympathetic Dystrophy (RSD) is a neuroinflammatory condition that is characterized by a combination of sensory, autonomic, vasomotor, and motors dysfunctions. One of the characteristic symptoms of this condition is that the pain is out of proportion to the initial injury. Diagnoses of CRPS are often delayed because it is under recognized (Binkley 2012). If effective treatments are given early enough in progression of the disease, there is reduced chance for the spread of regional pain, autonomic dysfunction, motor changes, and negative sensory symptoms, such as hypoalgesia (Marinus et al. 2011). As CRPS progresses, it becomes refractory to sympathetic nerve blocks, conventional analgesics, anticonvulsants and antidepressants.

During neuroimmune activation, TLR4 (Toll-Like Receptor 4) is upregulated in microglia, resident immune cells of the central nervous system (Watkins et al. 2009). After transection of the L5 spinal nerve in the rat, TLR4 expression is increased in spinal microglia. This correlates with the rodent developing neuropathic pain (Tanga et al. 2005). From a post-mortem analysis of a CRPS patient, activated microglia and astroglia in the central nervous system (CNS) have been implicated in the generation of CRPS symptoms (Del Valle et al. 2009).

Activation of TLR4 in both microglia and CNS neurons augments the production of pro-inflammatory cytokines via the NF-κB pathway (Milligan and Watkins 2009; Leow-Dyke et al. 2012). NF-kB is a multi-functional transcription factor that is activated by c-Jun-N-terminal kinase (JNK), extracellular signal-related kinase (ERK), or p38 (Milligan and Watkins 2009). In activated glia and neurons, NF-κB activity promotes the production of pro-inflammatory cytokines and neurotoxic superoxides (Milligan and Watkins 2009; Leow-Dyke et al. 2012; Fellner et al. 2013), which act as mediators for neuropathic pain, as well as other neurological dysfunctions (Liu et al. 2000; Barbosa et al. 2012; Besedovsky and del Rey 2011). Pro-inflammatory cytokines, as well as the neurotrophin BNDF (brain-derived neurotrophic factor), induce enhanced excitatory tone and diminished inhibitory tone in nociceptive neural networks, leading to hyperalgesia or allodynia (von Hehn et al. 2012). Sustained TLR4 stimulation in microglial populations can also lead to neuronal injury and death (Fellner et al. 2013).

In rodents, the TLR4 antagonist, naltrexone, is able to suppress allodynia arising from bone cancer (Mao-Ying et al. 2012). In rodents, naltrexone is able to cross the blood–brain barrier, suppress glial cell activation, and reverse neuropathic pain arising from chronic constriction nerve injury (Hutchinson et al. 2008).

A recent study reports that low-dose oral naltrexone reduces pain in fibromyalgia patients (Younger and Mackey 2009). Low-dose naltrexone (LDN) refers to doses approximately 50-fold lower than doses of naltrexone typically given to patients addicted to opioids (Rea et al. 2004; Younger and Mackey 2009).
Opiate antagonists differ from opioids through a replacement of the characteristic N-methyl group with a N-cyclopropyl, N-allyl group. At low concentrations, naltrexone is able to antagonize TLR4 on activated glial cells, without inhibiting other opioid receptors in the CNS (Hutchinson et al. 2008). This allows endogenous anti-nociceptive pathways involving μ-receptors to continue operating.

A recent paper has reported positive benefit of ibudilast, an oral glial attenuator, for the treatment of neuropathic pain in several CRPS patients (Rolan et al. 2009). Below, we describe positive outcomes of two CRPS patients treated with low-dose naltrexone, in combination with other CRPS therapies. Low-dose naltrexone was utilized in these patients after more conventional CRPS pharmacotherapy failed to suppress their recalcitrant CRPS symptoms. Each patient met IASP criteria for the diagnosis of CRPS.

Here are two sets of photos from the article of the first case study, before and after treatment with LDN:

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Fig. 1
Advanced CRPS symptoms in Case 1. 4.5 years after onset of the disorder. a Allodynia and pronounced vasomotor dysfunction are present in the lower right extremity (photo taken 9/18/2008). b One week later, the leg has developed numerous ulcerations.

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Fig. 2
Case 1. Certain symptoms are attenuated following treatment with low-dose naltrexone (LDN) in a long-standing case of CRPS (6 years after onset). a Allodynia is greatly reduced in both legs after LDN. However, bilateral trophic changes remain in the lower extremities. Slight swelling is present in the distal portion of the right foot. Within 2 months of treatment with LDN, the patient was able to bear full body weight, and walk without assistance. Before LDN, the patient utilized a cane for 6 years. b One year after LDN treatment, the patient still has persistent long-term trophic changes in the skin of both lower extremities (taken 1/16/2013)

DISCUSSION
Causalgia, which is often a salient feature of CRPS, has long been viewed as having a neuroinflammatory etiology (Mitchell 1872; Sudeck 1901). Although centralized neuropathic pain has been connected to activated glia in rodents (Milligan and Watkins 2009), it is an open question whether the symptoms in CRPS in humans are linked to activated glia in the CNS. The positive responses of the two patients discussed above to LDN are among the first reported benefits of glial attenuators for CRPS symptoms. A prior study described moderate pain benefit to several CRPS patients enrolled in a clinical trial of ibudilast, another glial attenuator that is unrelated to LDN in its molecular action (Rolan et al. 2009).

The second case study addressed in this work is based on a teen who suffered from several other disorders, including  Ehlers-Danlos Syndrome. It's unfortunate (and, on a personal note, infuriating) but her instance, in particular, the evidence of "fixed dystonia" was glossed over as a probable conversion disorder.  That seems to be the state of things in areas of study that are a bit removed from clinical experience.

It's also important to recognize the limitations of all case study reports, and in these cases, there not being, for example, the exclusions and protocols of a clinical trial, both patients received a variety of concomitant treatments, and the methods of evaluation were diverse, and sometimes, lacking.

That said, it's something else for those of us with advanced CRPS non-responsive to treatment to check out. There is a large amount of anecdotal evidence/support among MS patients for use of Low Dose Naltrexone, but no sufficiently rigorous clinical trials to date.  It has also gained much support in the treatment of Crohn's disease, but again, more in popular media than scientific.

There have been accusations that LDN may fall into the frustrating category of "an unprofitable cure."

To read about both case studies and further discussion, click HERE.


Friday, February 14, 2014

dearest literate friends

Here follows a group email just sent to the people in my life whom I consider both important and of a literate, if not literary, bent.  It follows here because it occurred to me that some of my dearly beloved readers make up that group, but we don't habitually correspond.

Of course, some of you think I'm crazy, and I haven't been overly driven to dissuade you of that notion -- although this ought to do it:


dearest literate friends:

i am considering finishing the second chapter of my novel, after i rewrite the first, of course.  however, the monkey on my back is driving me batty.  therefore, this email, akin to a gentle overnight laxative made for women.

in reference to references some of you have repeatedly made (or thought), mostly in the form of formulaic admonitions, written in the guise or attitude of "wise, successful writer/person" to "naive, unpublished scrivener/person," i have found my own formulaic defense! 

to what references do i refer?  well, nicely put, my tendency to muddle and befuddle, to compound, to render complex what the poor reader needs reduced to the pure seasonal note of a finely reduced sauce, wherein what began as excess is reduced to mere teasing hints of possible meaning.  those references, spoken, written, smirked, thought, and printed on the occasional organic cotton tee.

why should i need a defense, as my detractors intend not to detract but to aid, smooth, glaze, and lovingly correct?  well, mostly because i am considering a return to a website fairyland full of know-it-all writers. i love them, they love me, but we will never, ever be family...

john dewey shall be my apologist, as foretold at my birth, and the announcement of his anachronistic endorsement of my efforts to creatively write will clear the cluttered path to my writing, and shoo away the nincompoops who cannot sit placidly in my messes of zen.

so here it is, my new signature "look," er, quote:

"I should venture to assert that the most pervasive fallacy of philosophic thinking goes back to neglect of context " --John Dewey

love,       
Clarice Lispector
(What? you were expecting John Dewey?)
lisa
loosa lee
profderien
monaghana
bianca castafiore
irene
eljay

© 2013 L. Ryan

Sir Gay on Comedy Central


First off, just to get it in, as it will make my more dedicated readers fall off their chairs -- I LOVE the LOVE of country that prevails among all the Russians interviewed.  I LOVE the answer given by the four or five gay men to the idiotic question, "Why don't you just come to America?"

Now, the important thing:

I want "in" on that hug... You know there's a good God, vibes of grace, and unfathomable heart in this world when you catch a glimpse of people like this Russian woman quoting "Angel"!

Angel: Well, I guess I kinda worked it out. If there's no great glorious end to all this, if nothing we do matters... , then all that matters is what we do. 'Cause that's all there is. What we do. Now. Today. I fought for so long, for redemption, for a reward, and finally just to beat the other guy, but I never got it.
Kate Lockley: And now you do?
Angel: Not all of it. All I wanna do is help. I wanna help because, I don't think people should suffer as they do. Because, if there's no bigger meaning, then the smallest act of kindness is the greatest thing in the world.
Kate Lockley: Yikes. It sounds like you've had an epiphany.
Angel: I keep saying that, but nobody's listening.

Tom Perkins: I've Got Your Million Votes Right Here (Genteel Gesture, Mine)

Tip o'the hat to Scarce at Daily Kos and to CNN Money for digging deep, journalistically, to find something redemptive to throw at the story --

The audience at the Commonwealth Club reacted with laughter. But Perkins offered no immediate indication that he was joking. Asked offstage if the proposal was serious, Perkins said: "I intended to be outrageous, and it was."
Perkins, the great wit, is author of the phrase "the war on the 1%," as well as his nervous twitch of an exposition thereupon in the WSJ on 24 January 2014: 



Regarding your editorial "Censors on Campus" (Jan. 18): Writing from the epicenter of progressive thought, San Francisco, I would call attention to the parallels of fascist Nazi Germany to its war on its "one percent," namely its Jews, to the progressive war on the American one percent, namely the "rich." 
From the Occupy movement to the demonization of the rich embedded in virtually every word of our local newspaper, the San Francisco Chronicle, I perceive a rising tide of hatred of the successful one percent. There is outraged public reaction to the Google buses carrying technology workers from the city to the peninsula high-tech companies which employ them. We have outrage over the rising real-estate prices which these "techno geeks" can pay. We have, for example, libelous and cruel attacks in the Chronicle on our number-one celebrity, the author Danielle Steel, alleging that she is a "snob" despite the millions she has spent on our city's homeless and mentally ill over the past decades. 
This is a very dangerous drift in our American thinking. Kristallnacht was unthinkable in 1930; is its descendant "progressive" radicalism unthinkable now?

Giving you a moment to recover from the shock of the abject cruelty of the SF Chronicle besmirching San Francisco's "number-one celebrity" as a snob... I hope that knowing Steel's net worth of $375 million will bring her enough electoral clout to somehow right that wrong may be of some comfort to you.

Clearly, though, Perkins doesn't read enough of the Chronicle, as SFGate (the e-version) covered Steel's altruism in sympathetic depth quite a few years ago. An excerpt on how her efforts to help battle homelessness began tells part of the tale:

But almost no one, except for the crew she worked with, her children and two close friends, had any idea that for 11 years, beginning in 1998, Danielle Steel would slip away from her Pacific Heights home under midnight shadows into a van filled with supplies to assist homeless people she sought out in the dark, dingy corners of San Francisco. 
Last month, the prolific author released three books: A novel, "The Sins of the Mother"; the paperback of a previous novel, "Hotel Vendome"; and a nonfiction title, "A Gift of Hope: Helping the Homeless" (Delacorte Press; 144 pages; $20), about her work with the homeless and her outreach foundation, Yo! Angel! 
"I started this during a very lonely, desperately unhappy time in my life," says Steel, in a drawing room of her home. "After Nicky (her son who committed suicide in 1997) died, I went to church and prayed for a way to help. Nicky was always very kind to homeless people, buying them a sandwich or a pack of smokes. And 'helping the homeless' is what kept returning to my mind." 
As a child, Steel's first vocational dream was to become a nun.

Hell's Bells!  Perkins should have some provision in his voting scheme for doubling, nay, TRIPLING, the number of votes that a 1%-er philanthropist / artist like Steel ought to receive.  Not everyone can see past the need for mental health reform, substance abuse rehab centers, and affordable housing to the overwhelming essentials of sandwiches, smokes, and thousands of small teddy bears ["The bears were magic. Somehow, with that single gesture, we had restored not only a memory of their childhood, but a tender part of their humanity that had been missing."]

When her love affair with the city on the bay ended, due to her discovery of embezzlement by a longtime associate, and the failure of her art gallery, Steel did what all dedicated philanthropists do -- she started several foundations and moved to Paris.

To be fair, and I rarely strive for that attribution, she did discover that there was a mental health problem among San Francisco's homeless people -- mostly, in her opinion, that they "are off their meds."

Ah, I seem to be wandering again.  That's what happens when those of us who pay no taxes -- because we live on private disability (and not that nasty, besmirchable public dole!) that keeps us below the poverty line -- are allowed a computer and free access to Google's Blogger.  We just jabber on and on, wasting everyone's time.  There's no rancor in me, nary a subatomic bit, because I started work on a novel based on life at a shelter for homeless men -- a project that, clearly, I now have to call off, both because I'm worthless as a citizen and even less effective as a writer.  I am, in every way that matters, no Danielle Steel;  I am bereft of apologists with Tom Perkins' incisive ardor and bucks.

So, Dear Beloved Readers, I shall endeavor to leave you today with a trail of gratitude bread crumbs, the last being to thank Crooks and Liars for the video...