Nerve signals gone awry

[cjsmith]

The places I have the most pain are the places that used to be served by the excised nerve. I'll step wrong or hit my forefoot wrong or put some kind of pressure on it that it doesn't like, and I'll get cold electric spikes or a burning sting. I'll feel it on the dead sides of my toes, in the little dead area in the ball of my foot, or deep inside right about where I imagine the nerve bundle used to run.

Phantom pain. This must be phantom pain.

The nerve bundle's stump is being stimulated in unprecedented ways in its radically changed and still rapidly changing environment. Are there things that cause minor electrical variations at that spot? Would pressure stimulate it? In any case, the nerve is sending random meaningless signals. The brain is trying to make sense of the transmissions it receives, using the only decodings it has ever known. There's no way for the brain to distinguish this from real pain. It's receiving the "correct" electrical signals for real pain.

There are other weird things. Sometimes there's a sensation deep inside my foot right where I imagine the incision to have been -- a sensation of a cold wind going across it. Except that spot's on the inside and the foot is wrapped up as well. There are tingles. There's a very deep ache, particularly in the left foot. That one might be real; it's kind of diffuse and I can't tell whether it's inside the dead area.

Nearly a year ago, when I considered this surgery for the first time (and opted for an attempt to kill these nerve bundles by chemical injection instead), I asked about the possibility of phantom pain. I was told most people who have this surgery don't have phantom pain after oh, a month or two. I don't know why it would go away but I am heartened by the idea that such a thing is likely.

I'm fascinated. I'm also taking a new look at the enormity and permanence of what was done to these feet of mine on Thursday morning. Amputees have phantom pain! Not people like me! But we've cut some nerves, though, and it makes sense that I could have something similar. Minor, low-risk surgery this may be, and I still know it was my best hope and thus don't regret doing it, but it does have some sobering implications.

Comments

[dizzdvl.livejournal.com]

When I had jaw surgery they cut through the nerves of my lower lip. For about 6 months I had no feeling there at all. (And I was drool girl, but that's another story.) Slowly it came back to probably 50% of normal. It works fine, but feels weird. And I completely understand those tingles. My gums have a weird itch sometimes that isn't an itch. But I have feeling and they cut through those nerves, but they healed back together.

But seriously, for 6 months I had no feeling and I was 16. People wondered why I couldn't get a date. Drool drool drool.
(It still happens once in awhile when I'm not paying attention, but don't tell anyone!) ;)

[cjsmith.livejournal.com]

Wow, it seems lots of people have experiences like this, and everybody's healing time is different. Some still have the numbness years later, some got better in a matter of months. Bodies are weeeeeeeeeeeird.

[dizzdvl.livejournal.com]

Yep, but at least there is a chance you will get feeling back. Dunno, but I would rather not feel my toes than be DroolGirl at age 16. But that's just me ;)

Sounds like you are getting around better. :)

[cjsmith.livejournal.com]

Yeah, so would I. Lots of things are rougher at age 16, and being DroolGirl (such a visible thing and on the face) had to be particularly trying.

[just-cyd.livejournal.com]

i had lots of tingles and twinges and sparks and even sharp shots of pain after my abdominal surgery in 2002. took about oh, i dunno, six months for it to really go away. i think it's all part of the physical healing process. must be tough for the body to look around and say "hey! didn't there used to be something there? WTF?? NOW what am i supposed to do??"

and either i've been a bad grrl lately, or i'm having sympathy pains for you -- i've got a nice ouchy spot on the ball of my foot.

[cjsmith.livejournal.com]

I've heard from quite a few people who've had odd things like this after surgery. I wonder if I've simply been very lucky before... well, ok, my abdominal was laparoscopic and really quite minor by comparison to most, so maybe I just haven't had anything major enough.

Take care of that foot, you! Baby it a bit when you're in the woods. You're in the DART area, right? So you at least *can* baby it?

[just-cyd.livejournal.com]

my post-op twinges were from the one where they actually cut me open. didn't have much of anything but pain from the laproscopy.

i'm taking my gym shoes along, and will wear them. i'ts been months since i've worn them, but i know i'll need the support of a sturdier-than-a-sandal shoe. and i had room for my lounge chair (http://www.target.com/gp/detail.html/ref=br_1_16/602-2829409-3530252?%5Fencoding=UTF8&frombrowse=1&asin=B0002262U8) in the car, so i'll be able to prop my feet up during my down time. and i'll make sure i get lots of down time!

[cjsmith.livejournal.com]

Excellent! Go you!

[quasigeostrophy.livejournal.com]

It makes sense to me you'd be getting some phantom pains since nerves have been cut/removed. I'm not medical, but it seems like a good analogy. My dad's amputation phantom pains took about three months or so to go away, and they did it in degrees, lessening to a dull ache at the last. Comparing the severity of surgeries, a month or so sounds about right to me. But what do I know? :-)

*hugs*

[cjsmith.livejournal.com]

Wow, so his went away too! How well is he getting around now, by the way?

I am baffled about why they'd go away, his or mine. After all, if the nerve ends... um, the nerve middles that are suddenly ends... are being triggered to send signals back, I'd think that would be a purely physical or chemical process, and it would keep occurring. Maybe the ends "heal up" somehow.

[quasigeostrophy.livejournal.com]

Dad's getting around very well. It's almost as if nothing ever happened. He gets a twinge once in a while, but not much pain at all anymore.

My non-medically-trained opinion as to why phantom pains go away is because they're actually a brain interpretation of missing/screwed up signals, and the brain eventually learns what's really going on and how to handle the situation.

[cjsmith.livejournal.com]

Good for him! That's wonderful to hear.

My non-medically-trained guess (with a bit of web research, which admittedly isn't enormously reliable) is that some phantom pain is a brain interpretation of *present and correct* signals, and those would go away only when the conditions around the nerve stump change so as to avoid producing those signals. I wouldn't be at all surprised if you are right as well -- I bet there's some of each.

[quasigeostrophy.livejournal.com]

Your guess makes sense, too. My dad regularly (about once a year) sees a neurologist (not for his foot, for his back and migraines) - I should have him ask.

[cjsmith.livejournal.com]

That'd be interesting! I'll ask my doc, too. She's not a neurologist, to explain the "how", but she's done a LOT of neuroma removal surgeries and knows what people experience.