Dr Sanjay Gupta on the mysteries of chronic pain

Ed Mowery, the main founder and singer of a Death Metal group, suffered from unfathomable pain for decades: “It was 24/7, 365,” he said, comparing it to “lightning snakes in my legs and my nerve pain in my arms.

“Have you ever had a very bad burn when you cook? Imagine this really bad burn, multiply it, say, 20 to 30, then apply it from the neck. And above this burn, there were the lightning snakes in my legs and the crazy nerve burn in my arms. So there were several different types of pain at the same time.”

This is a rare condition affecting 200,000 people in the United States, called a complex regional pain syndrome, or SDRC. But doctors could not find any cause for that.

“There was nothing to indicate and said:” That’s why it hurts. “It was only a kind of implacable pain,” said Dr. Sanjay Gupta, better known as chief medical correspondent at CNN. A neurosurgeon and author, his latest book, “he should not hurt”, explores the mystery of pain – of the evils and banal pain, or atrocious pain as Mowerry suffered.

Many Americans hurt; The CDC says that around 20% suffer. And by writing the book, Gupta found that one of them was his mother – Damyanti Gupta, 83, who had a fall just in front of his front door.

“I had osteoporosis,” she said, “and I think one of my bones must have abandoned, I think, because I did nothing.”

Imaging has shown a compressed lumbar vertebra. But the pain does not appear on X -rays and MRI. “You know how they ask you, doctors tell me:” from one to 10, what is your pain? “I would have said 100,” said Damyanti. “You don’t really realize that you have it. I never realized that the pain can be so terrible. You don’t even want to live.”

“”I don’t want to live – Coming from my mother, it’s obviously really painful to hear, “said Dr. Gupta.” But he was also someone who had never complained of anything. So you had an idea of ​​the impact of this importance on it. “”

Surgery of the spine managed to repair the injured spine and Damyanti pain immediately increased from 100 to about 3.

The surprising source of pain

As a brain surgeon, Gupta sees patients suffering every day, but he personally felt serious pain when he was a child who thought he could jump on a tip fence. “I don’t know what I thought,” he said. “But I did not do it. And this tip of the fence went to the back of my skin on the side, and I went out just at the front. So, I was essentially pinned and impaled above this fence.”

While the shock dissipated, the future doctor – always on the fence – took note: “The pain began to come in waves. So, it was there, it was impression that someone sort of slam my back, but after a while, it was not much. Even at the time, it struck me like a really surprising experience.

Later he learned reason. “It took years to understand this,” he said. “The endogenous opioid system of my body – we have our own opioid system – it reacted, and it has reacted importantly. Because the body is just flooded with all these opioids and that improves my mood, it reduces my memory of painful experience, and obviously, it helps in global injury.

“These are endorphins, and by the way, endorphins – endo, which means comes from your body and morphine, from morphine – so it’s like the natural morphine of your body,” he said.

After years of suffering despite analgesics (including morphine), Ed Mowerry joined a clinical trial at the University of California in San Francisco, which not only found the source of these “lightning bolts” snakes “, but would make the headlines around the world.

The source of pain, said Gupta, was “the brain. It is difficult to conceptualize, I realize it. But Ed is somehow this guy in the daredevil. He had a lot of injuries during his life. I went to this super driver. It was at this moment that someone loses a member and he is still injured, even if this member does not exist. For what This happens exactly, we are not sure. “”

“Turn off” pain

Mowerry volunteered for a study on deep brain stimulation and pain, and three cycles of brain surgery. “I had knots that came out of my head,” said Mowery. “And I had 144 sons going to two computers. And I had a turban on my head. And I also had a lot more hair!”

Gupta said: “After weeks, they were able to draw this link between ED’s pain and these changes in the brain. And what they found with Ed was not only that they could begin to predict that Ed would have pain, they could quantify how bad this pain was, and they could even interrupt the pain by giving a small stimulation.

Gupta predicts that the story of Mowery is only the beginning: “What these doctors were able to do, they were essentially able to put these probes everywhere in the brain and leave these probes in a way to listen to Ed’s brain.”

Even now, a computer can recognize its pain to come – and close it.

This has changed life for Mowery, who talked about the clinical trial at the National Institutes of Health: “The last two days of testing, the signal has started to work and kill my pain,” he said. “I was out of myself.”

Although a small study, the implications to manage all kinds of pain are wide. As Gupta explains, the brain is the source of each feeling of pain, from a cut of paper to a broken vertebra, to “razor snakes”.

I asked Mowery, “Did you know when you registered for that, what are you registering?”

“It’s funny that you were asking this question, because when I discovered for the first time, I said:” There is no way. I don’t do three brain surgeries. You are not going in my brain. No question, “said Mowery.” And then a year and a half later, I was suffering so much, I didn’t care. “

“You seem very comfortable when you describe it like your brain,” I said.

“It took me a while to wrap my brain around the fact that it is a brain disease,” replied MowerY. “It took me a long time to say just, Oh, you know, all this is actually in my head. But it was not imaginary. It was real. “”

Today, Mowery is playing his music again and is looking forward to touring internationally with his group. “I have never lost hope,” he said, “because I knew something would happen to help me. And I think that is part of what made me go through all of this, it was my attitude towards all this.”

Read an extract: “It doesn’t have to hurt” by Dr. Sanjay Gupta

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History produced by Kay Lim and Young Kim. Publisher: Ed Givnish.

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