Thursday, February 19, 2009

Phun with the Phantom

The brain is seriously amazing! Allow me to demonstrate.

I woke up with a pretty bad cold today so I went looking for some cough medicine. Strange thing was, my symptoms weren't on any of the labels: sore throat, running nose, killer pain in your leg whenever you cough, headache.

It reminded me that there are some really cool parts of this whole experience that are pretty fun to play with. In case you're just tuning in, I can still feel my foot... fully! My brain still thinks it's down there, just like the other one. This is called a phantom limb and it's pretty common.

After the surgery, my nurses thought it was funny to use that little spot where my foot used to be as a convenient place to drop my chart. Whenever the chart would "break the plane" where my limb used to be, my brain would go NUTS to the point that I would very nearly vomit.

I'm not complaining, it always made me chuckle!

The same thing would happen anytime I had my leg up on the "stump board" of the wheel chair and someone would walk "through" it. My brain would seriously freak out and my whole leg would tingle!

At first I figured this was just because I kept flinching but as time went on, I stopped flinching and I started to play. I still play.

Playtime includes kicking my phantom limb up against (and therefore through) a wall. This is so bizarre! No matter how many times I try this, my brain still has a minor panic attack every time.

I also play tricks with my real physical sensation. To understand this, you must first understand that when they did this surgery, they folded my calf muscle up and over the tip of the bone, then stitched it to the front of my leg. This has a really cool side-effect!

The nerves that used to be on the backside of my leg are now on the front of my leg. They've also moved about 4cms closer to my knee than they used to be.

This means that when I'm touching the "front" of my leg below the scar line, my brain still interprets the signal as coming from the back of my leg, a few inches lower than my physical limb. In other words, when physically touching the front of my leg, I feel it in a spot where nothing exists on the back of my leg, out in the middle of the empty space!

To really mess my mind up, I run my finger down the front of my leg above the scar, then over the scar line to instantly feel the touch sensation jump to the back of my leg!

When I run a finger along the scar line sideways, my brain really just shuts down all together, feeling one single finger tip touching the back and front of my leg simultaneously in some fifth dimension of time and space.

If that wasn't amazing enough, my brain is starting to re-wire itself to understand where the signals are coming from. It's starting to understand that when I feel the sensation at a certain spot, it's coming from the front of my leg, bottom of my leg, and back of my leg.

The neat thing is, this only works if I tap or bump the spot. If I just graze the spot with a light touch, my brain still misinterprets the location of the sensation.

The phantom pain has a really interesting side-effect as well. As you can imagine, when you feel pain but there's nothing there to feel the pain from, a little pain switch develops in your head to allow you to ignore the feeling. I'm learning now to apply this to my "real" pain.

Before, whenever I stubbed my toe, I would carry on like I'd lost an eye. Each time, I was SURE that this time, I broke it! Now when I stub my toe, my real toe that is, there's a brief second where my brain goes "hmm... pain... wait, that's coming from the right side not the left... so that's real pain... should I react? Meh, too late, just eat your cereal." I really love cereal.

This has taught me a new level of something I already knew academically: the brain has far more to do with pain than the body does.

I knew this to be true from climbing and other sports but hadn't ever completely overcome it. Now, I've found new life in my muscles. I'm able to push beyond that "lactic acid" burn now and work my muscles to a fatigue point. I'm learning to tell the difference between pain that I should pay attention to and pain that's just there as an early warning system.

Alright, one final magic trick! If you've read this far in such a long post, you get a reward. Please hold both hands out in front of you, put your palms face to face and intertwine your fingers, making a sort of "two handed fist". Squeeze those hands together hard! Now, keeping the rest of your fingers intertwined, point your index fingers firmly to the sky and don't let them touch each other. Hold that position, no cheating.

I'm going to make your fingers touch.

Your job is to resist me! Stare at them if you have to but hold them firmly apart and resist me while squeezing those hands together. Come on, try again, aren't you in control of your own mind and body? I'm not even there, why are they so much closer together?

If you've made it this far without them touching, you're a champ, so close your eyes and count to 60 holding those fingers firmly toward the sky and holding a tight two-handed fist.

Told you I could do it. How fun is that?


  1. I sometimes think you have too much time on your hands. (Hey, it's hard to type after squeezing your hands together in a two-handed fist for 60 seconds.) Thanks for sharing how truly bizarre our brains are.

  2. Michael,
    You’ve written a great explanation of phantom pain and the sensations that go along with it. I noticed after about 7 months or so, I was more aware of the muscle movements in my leg, and realized that my brain was starting to “get it.” I think of phantom sensations as cellular memory…that’s what I call it in trying to explain it. Now, the nerves when sent messages from the brain have to realize they no longer go to that foot but stop short. After getting off all the narcotic medications I also became more sensitive and aware of the sensations that were occurring. I like the games you play…sounds like a nice way to pass time.