Glia: all that and a bag of chips -- but what kind?

A fascinating study which further clarifies the role of those fascinating, complex, busy busy cells, the glia:

http://www.sciencedaily.com/releases/2011/12/111229131354.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fmind_brain+%28ScienceDaily%3A+Mind+%26+Brain+News%29

ScienceDaily (2011-12-29) -- New research indicates that glia cells are "the brain's supervisors." By regulating the synapses, they control the transfer of information between neurons, affecting how the brain processes information. This new finding could be critical for technologies based on brain networks, as well as provide a new avenue for research into disorders such as Alzheimer's disease and epilepsy.

This study indicates that glia regulate the speed of synaptic transmission, slowing or speeding up synaptic events according to what is needed. This means, for instance, that epileptic seizures, which are synaptic storms, relate to glial misbehavior.

The next question is, how? Why? What causes the glia to modulate a given transmission?

I'm looking forward to further studies on this.

CRPS, HPA axis, and a remarkable void in the science

I just went looking for scholarly articles linking chronic CRPS to the HPA axis damage that has been such a feature of my life. Though me, my cohorts and all my providers have been talking freely about this for years, there was nothing on PubMed and nothing of value in the Google search.

It's possible to chain together articles that make the point -- one on stress and adrenal function, one on stress and pituitary dysregulation, one on chronic neurogenic pain and hypothalamic oddness, one on constant pain as a causor of physiologic stress, and one on CRPS as a source of pain -- but academics get squirrelly when you make them link the logic. They don't want to think; it makes them feel exposed.

Nevertheless, me and my providers, me and my cohorts online, me and hundreds and thousands of people with chronic CRPS, have been taking it for granted all this time that there was a link -- because it is so bloody obvious that there is.

However, the studies don't exist.

The connection is obvious, but unwritten.

The data are sitting there, waiting to be captured.

The study subjects are right there for the recruiting.

It's like the topic is standing there with its pants down and its pockets full. An easy target -- and a rich one!

This is ridiculously obvious, and you know that all the subsequent work on CRPS and anything related to the adrenals, hypothalamus and pituitary would have to quote whoever documented it. Tenure, much?

Who wants to find the funding and put together a team? I would be happy to help. If I had the MD and the university contacts, I'd already be making calls. Please, whatever I can do to help, just let me know. Make it happen.

Scott Reuben and the poison in medicine's well

In a stunning piece of timing after yesterday's epiphany, this crossed my wire today:

"A Medical Madoff: Anesthesiologist Faked Data in 21 Studies" - Scientific American
http://www.scientificamerican.com/article.cfm?id=a-medical-madoff-anesthestesiologist-faked-data

"Beginning in 2000, Reuben, in his now-discredited research, attempted to convince orthopedic surgeons to shift from the first generation of nonsteroidal anti-inflammatory drugs (NSAIDs) to the newer, proprietary COX2 inhibitors, such as Vioxx, Celebrex, and Pfizer's Bextra (valdecoxib). He claimed that using such drugs in combination with the Pfizer anticonvulsant Neurontin (gabapentin), and later Lyrica (pregabalin), prior to and during surgery could be effective in decreasing postoperative pain and reduce the use of addictive painkillers, such as morphine, during recovery. A 2007 editorial in Anesthesia & Analgesia stated that Reuben had been at the "forefront of redesigning pain management protocols" through his "carefully planned" and "meticulously documented" studies."

More from the New York Times:
"Doctor’s Pain Studies Were Fabricated, Hospital Says"
http://www.nytimes.com/2009/03/11/health/research/11pain.html

And the Injury Board:
"The Fake Clinical Trials of Dr. Scott Reuben" http://cherryhill.injuryboard.com/fda-and-prescription-drugs/the-fake-clinical-trials-of-dr-scott-reuben.aspx?googleid=259290

It's hard to convey the total horror of the event described here. This physician scientist, who ran the pain clinic at one of my old hospitals, published research that became the cornerstone of pain treatment in the US and abroad. After 13 years of successful, peer-review-published, desperately important work, he recently admitted the following:

• Not one single patient was ever enrolled in key studies.
• There was absolutely no basis for the numbers he cited; he invented them.
• He was paid a great deal of money to come up with certain results, and that is exactly what he did.

The most influential part of his career was a fraud.

The countless studies founded on his widely-publicized fictions are therefore meaningless, under the rules of scientific evidence itself.

The degree to which we depend on medical science to save us when we really need it -- our helplessness at our times of greatest need -- require us to have some faith in the processes that deliver our care. This isn't just another massive fraud, it's a devastating blow to the cornerstone of healing in the modern age. How can educated patients ever continue to believe that our doctors have anything of value to offer us? How can honest physicians bear to let this situation exist?

He could not have chosen a worse field to work in. In medicine, sooner or later, every field has to rely on pain medicine, and he has fouled the well from which the widest number of patients must drink. Scientific American got it wrong: Madoff was a piker, next to this.

The science of pain control and pain management has depended heavily on garbage cooked by a liar, served by intellectual catamites and eaten by the brainwashed. From there, it was inserted into me and mine, who were assured that this was the best that medical science had to offer.

Too bad there was no actual medical science involved.

...I apologize for the strong language. Can you think of more precise and telling terms to use instead? I'd be happy to change them, if anyone can come up with something better.

There are administrative questions such as, whatever happened to peer-review? Who the hell was looking at his notebooks and other physical evidence of scientific work? Why did it take 13 years for a "routine check" at Baystate to break his cover? What on earth were the most important science editors in the world thinking? How many of them are still employed -- and why?

Those aren't trivial, but they are not what looms largest in my mind. I think of Debbie, and me these past few years, and other friends I can't name whose lives have been hopelessly distorted and sometimes horribly lost ... because modern pain research has been built on one psychopath's lies, which were funded and supported by a vast network of fellow liars, colluders, and the willfully blind.

It has sometimes occurred to me that the wrong people get sick.

Refocus on what works: In memoriam

Debbie died yesterday. She was a never-failing source of encouragement and intelligent support on one of my key online CRPS support groups.

She died on the table, while undergoing a medical procedure. I don't know exactly what it was, and given my respect for patient confidentiality, it's none of my business.

She's the first person to die of my disease, to whom I felt personally attached. Needless to say, it's sobering as hell.

I've written about the need to attribute deaths from this disease correctly. I'm preparing my own final papers. These thoughts are nothing new.

But today, they are biting deep.

I've recently become highly politicized over rights abuses and intolerable corporate stature in my country. I have privately -- and quietly -- become convinced that the US healthcare system is so completely predatory, so opposed to its own mandate, that it will never offer healing for anyone in my position.

Debbie's death has broken through my professional anxiety about appearing detached and scientifically sound. I have, at long last, become politicized about the most important subject in my life, after 25 years of personal and professional involvement up to my back teeth.

I have minimized my discussion here of what actually works. That dishonest omission has done us all a great disservice. I'm going to discuss what works, whether or not it's FDA approved, pharmaceutically profitable, or adequately studied.

Medical studies are a shining example of the fact that we inspect what we expect, not necessarily what we need. The fact that studies have not been done on most modalities, or not rigorously done in double-blind experiments, doesn't mean the modalities don't work.

It means the studies need to be done. Period.

Where I understand the mechanisms of action, I will explain them. Where studies don't exist, I'll detail what should probably be explored.

But I have had enough of silence. I will not die as Debbie did. I will not die on the table. I certainly will not die saturated with soul-destroying pharmaceutical-grade poisons, as so many of us do.

I will find a better way. I will find a way that works. I'll do my best to persuade others to study the modalities involved, and to fund the studies. My legislators will learn to recognize my name on sight, because their slavish debt to the pharmaceutical industry is absolutely intolerable and it's up to me, and others like me, to convince them of that.

I wish Debbie a painless and peaceful rest. I hope her extraordinary husband finds enough strength and comfort to manage life without her.

For myself, I want the intelligence, resources and strength to find a solid cure, make it happen, and spread the word.

No more silence. It's too much like consent or, worse, collusion.

I do not consent to the deaths of my friends.

With my eyes now open, I'll no longer collude.

Let's find a real way out.

Facial recognition is wholistic

This blog has been on hiatus as I've been dealing with a body-hostile healthcare system, insurance sociopaths and delusionally self-infatuated doctors, and I didn't want to take it out on the science.

This charming study turned up today and led me back here:

http://www.sciencedaily.com/releases/2011/12/111202155755.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fmind_brain+%28ScienceDaily%3A+Mind+%26+Brain+News%29

'ScienceDaily (2011-12-02) -- "Face recognition is an important social skill, but not all of us are equally good at it," says a cognitive psychologist. But what accounts for the difference? A new study provides the first experimental evidence that the inequality of abilities is rooted in the unique way in which the mind perceives faces.'

The brain uses a wholistic method for recognizing faces, whereas recognizing objects is more analytical -- meaning that the object is parsed out by the brain and assessed in chunks. Doesn't work well on faces, though.

One very pleasing, intelligent thing to note: these researchers concluded that the logical next step is to train people to use their brains more effectively -- not to look for yet another drug to fiddle with one part of a complex process and leave the patient more helpless than before.

My own facial recognition has plummeted with the evolution of CRPS, but it's a skill I acquired rather late in life. I'd always recognized people by the way they held themselves and moved -- a different region of the brain entirely. So I trained myself to recognize faces as such.

I'm not sure I could recapture that ability, but when a few other mental faculties are more predictable, I'm game to try.