The term trigger points, which has been around for many years, refers to the pain elicited when pressure is applied over various muscles in the neck, shoulders, back, and buttocks. There is some controversy over what precisely is painful, but most would agree that it is something in the muscle. Rheumatologists, who have taken the lead in studying fibromyalgia (TMS), appear to avoid using the term, probably because of its association with other diagnoses through the years. I neither use it nor avoid it, for I have concluded that these points of tenderness are merely the central zones of oxygen deprivation. Further, there is evidence that some of these points of tenderness may persist for life in TMS-susceptible people, like me, though there may be no pain.
In the first chapter, the point was made that most patients with TMS will have tenderness at six key points: the outer aspect of both buttocks, both sides of the small of the back (lumbar area), and the top of both shoulders. These tender points, trigger points, call them what you will, are the hallmark findings in TMS, and they are the ones that tend to persist after the pain is gone. It is an important part of the physiology of TMS to know that the brain has chosen to implicate these muscles in creating the syndrome we know as TMS.
Patients sometimes ask if breathing pure oxygen will relieve the pain. This has been tried and, unfortunately, does not help. If the brain intends to create a state of oxygen deprivation, it will do so regardless of how oxygen rich the blood is.
Sayfa 77Kitabı okudu
...
Flowers may open, buds may blossom,
Bud and flower alike are vain;
Her days shall pass like a mournful story in care and tears and pain.
--July 12, 1836--
This edition is limited to 1000 copies in the United Kingdom of Great Britain and Ireland, its Colonies and Dependencies, and the United States of America
Oxygen-deprived muscles are painful for two reasons that are known and perhaps others that are beyond our ability to comprehend.
Muscle spasm is the first and most dramatic. It is responsible for the excruciating pain that people experience when they are having an acute attack, as described in the first chapter. However, once the attack has passed, the muscle is not in spasm. In the thousands of patients I have examined through the years, I have rarely found the involved muscles to be in spasm.
The second mechanism, suggested by Dr. Holmes and Dr. Wolfe in a paper published in 1952 titled "Life Situations, Emotions and Backache," published in Psychosomatic Medicine (Vol. 14, p. 18), was that the chemistry of the muscles was altered in these patients and that they experienced pain because of a buildup of waste chemicals from the metabolism of lactic acid.
Sayfa 76Kitabı okudu
The physiology of TMS begins in the brain. Here repressed emotions like anxiety and anger set in motion a process in which the autonomic nervous system causes a reduction in blood flow to certain muscles, nerves, tendons, or ligaments, resulting in pain and other kinds of dysfunction in these tissues. The autonomic nervous system is a subsystem of the brain that has the responsibility for controlling all of the body's involuntary functions. It determines how fast the heart beats, how much acid is secreted into the stomach for digestive purposes, how rapidly one breathes, and a host of other moment-to-moment physiologic processes that keep our bodies functioning optimally under everyday circumstances or in emergencies. The so-called fight or flight reaction that all animals share, particularly important in lower animals, is directed by the autonomic system. In order to meet the emergency, every organ and system in the body is properly prepared. For some systems it means total cessation of activity so that the body's resources can be mobilized to deal with the danger more effectively. Typically, most of the body's nutritive and excretory activities are shut down, the heart beats more rapidly, and blood is shunted away from less important functions so as to be available in larger quantities for systems that are crucial to escape or fight, like the muscles. The critical importance of the autonomic system of nerves is obvious.
Sayfa 71Kitabı okudu
‘’Düşündü İngilizcedeki ‘pain’ kelimesiyle Fransızcadaki ‘pain’ kelimesini düşündü. Biri ‘acı’ diğeri ‘ekmek’ demekti.’’
Başarmak İçin Dayanmak
What determines your success isn’t, “What do you want to enjoy?” The relevant question is, “What pain do you want to sustain?” The path to happiness is a path full of shitheaps and shame.
__________
Başarınızı belirleyen "Neyi yapmayı seviyorsunuz?" değil. Bunun uygun sorusu "Hangi acıya dayanmak istersin?" Mutluluğun yolu sıkıntılar ve utançla doludur.
Life is pain
Life is not fair
Please angels stay here
Take the pain
Take the fear
Çok sevdiğimiz Fareler ve İnsanlar romanına ilham olmuş şiir
“en iyi planları farelerin ve insanların sıkça ters gider.”
J.Steinbeck’e ilham olan bu cümle 18. yüzyılda yaşamış İskoç şair Robert Burns’e ait “Bir Fareye /To a Mouse” isimli şiirin bir dizesidir. Bu şiirin ayak izleri hem kitabın adında hem de olay örgüsünde net bir şekilde görülmektedir. Zaten kitabın orijinal ismi olan “Of Mice and Men”