#centralsensitization #trauma #neuroplasticity #meditation Even though I do not have a specific question and certainly no answers, I feel I need to open a conversation about central sensitization. This post began as a complex web of thoughts I had responsive to @Jeannie Di Bon's presentation on trauma (in the Resources folder), as well as to recent Zoom calls touching on this bizarre problem of central sensitization. What I am going to state here is anecdotal, based on my own personal history, but I think that my long and unusually deep 13-year history as a meditation adept in the Buddhist tradition may be interesting--not because meditation at that level and extent has helped, but because, frankly, it has not. First, trauma. I do recognize in my own life history much of what Jeannie shares from her own history in her trauma presentation. I had 5 surgeries before I was 10 years old (2 for crossed eyes that we now know was caused by EDS). I lived in a household with a father who was a severe alcoholic who was occasionally violent toward my much older half-sister. My parents divorced at my age 10. My father died from his alcoholism at my age 12 and his age 45. Even more traumatic, I was brutalized by kids in nursery school and elementary school for wearing a patch on my eye to train my eyes to be held straight. I was shy. At age 8 I developed daily migraine. At age 12 after my first period, I began experiencing complex and long-lasting migraine auras that resembled strokes. In my late thirties these aura were so bad that I was paralyzed on one side of my body and my eye had nystagmus for more than a month. From about age 12 I also suffered from anxiety. Later in graduate school I was diagnosed with severe agitated depression (MDD) and was told that I would have to stay on SNRIs for the rest of my life. Although the SNRIs helped dramatically, psychotherapy had no good effect whatsoever, and I always quit that. Although I had lower back pain on my right side when I was in high school and thereafter, it wasn't too bad. It was not until my 40s that that all-over pain cranked up. I thought it was from aging. My doctors didn't know what to make of this pain. One diagnosed me with fibromyalgia but put me on things that made it worse and triggered a nervous breakdown till I got off that substance. Others put me on vitamin D. Two migraine neurologists finally told me a few years ago that I probably had hEDS and that I definitely have all the classic signs and symptoms of central sensitization. In 2010, wanting to be able to fly on airplanes without anxiety and without medication, at a friend's prompting I took up Buddhist meditation. I soon was all in because the Buddhist model of reality and its psychology felt instantly like I had come home. I quickly advanced, with permanent and dramatic shifts in my sensory perception (seeing, hearing, feeling) in the ways that Buddhism describes as ending "fundamental suffering," meaning the restless subject-object duality that governs the default human attentional system. My second teacher excluded me from a scientific brain study of meditators because I was an "outlier," he said, meaning I was too advanced for the study. He encouraged me to write a book and become a dharma teacher. In 2015, what is known as rigpa, or trekcho, opened permanently. This is basically being in meditation off cushion, all the time, with few exceptions of being pulled off into reactivity. My MDD was cured. I went off SNRIs and never had a single moment of depression since then. I do have a few issues that cause worry, such as my son's driving out of state all night. But my mental health was the best it had ever been by far. My meditation teacher is also a psychologist, and I began doing somatic chakra practices, as well, with additional great effect. It is worth my saying, I think, that "meditation" does not permanently end psychological suffering: only the permanent attainments do that. Meditation can interrupt pain of all sorts, yes, but only temporarily. I am saying all this only to establish a bar here for "meditation" as an effective treatment for central sensitization, at least in my experience. For my pain continued to worsen as mental health dramatically optimized, the pain becoming severe and usually daily in 2019. So what happened in 2019? I was laid off from my corporate job as an editor, but I wanted to be laid off to start teaching the Dharma. I got sick later in the year with what was probably misdiagnosed as reactivated Epstein-Barr virus. I was well within several months, but then I had frequent migraine auras breaking through my preventive medication, which does in fact occur at the end of EBV often. That finally stopped after a few more months, but then I had bouts of recurring fatigue that was bad. My pain increased in intensity and frequency and diffusion over whole body. The pandemic began, but for the first year, I was actually super happy. I was at work on my book and home. I had all the material necessities uninterrupted. On New Years Day 2021, though, I injured my post-tibial tendon doing some mild bouncing in place, and this seems to have been the most CS-amplifying event. I went to PT for 18 months and could not get it to heal until I changed to a more aggressive PT. It still is not what it was, and this persistent laxity in the tendon causes arch pain and other pain unless I wear my Hoka stabilization shoes all the time. I couldn't exercise and became deconditioned. Even after I could walk about 20 minutes again, I had extreme DOMS from any such activity. I could not exercise without extreme pain resulting. The PTs had no idea what was going on. Then in May 2022 I became ill with a mystery illness that involved my sinuses and my stomach. I was disabled and had to stop working. I dealt with a cold and careless medical system that was unresponsive at best and gaslighting at worst. I was told it was my nerves. I was pestered into going on SNRIs again, which caused constipation and low mood. It was finally discovered that I had chemical gastritis and that my thyroid hormones were through the roof. So after losing most of 2022 to this crazy set of health problems, I was well again. Then in August 2022, my new migraine neuro diagnosed me with hEDS and linked that to my earlier information that I have CS. Now I am going to have breast reduction surgery July 11. I hate to see what this trauma might add to the pile, but I must have this surgery to correct heavy breasts that are contributing greatly to pain, misalignment, and even disordered breathing. The surgeon refuses to follow the EDS surgical protocols. Last night, after a good pain-free day, I had an attack of CS. These attacks are as though someone has thrown gasoline on me and then thrown a lighted match at me. The pain comes on instantaneously and sweeps my whole body, especially my limbs and upper back. It is a bizarre, mysterious pain presentation that just baffles me. I do have other kinds of pain, peripherally, but CS is the BIG PROBLEM. It has worsened as my meditation calm has strengthened and become almost permanent. The only things, so far, that help are ibuprofen, which I try not to take, and low dose of gabapentin. I am sensitive to glutamate, apparently have too much of it, and gabapentin therefore crushes the pain. I normally take it only at night, but my neuro is wanting me on it during the day now too. Is there no other way? Maybe it is only temporary, to break the vicious circle? I am sorry for being so lengthy. But the relation between trauma (physical and psychological) and chronic pain is unfathomably complex, apparently, and I just don't know which direction to go in beyond what I've tried. I don't want to be high on gabapentin during the day, but honestly I do most of my work at night when I'm on it because that is when I feel pain-free enough to work. And this means I don't go to bed at a sane time. I read a long article last night about CS. It said that this kind of pain is not somatic, nor is it autonomic. It is based in neuroinflammation and neuroplasticity, according to the article. Conversation, thoughts, welcome.
Posted by Jenny at 2023-06-04 21:37:52 UTC