With two days to go before the kids arrived, I tried to put myself back together. Stopping nabilone allowed my stomach to unclench and I was no longer dysphoric, which meant although my pain was as intense I didn't feel as hopeless. But I was bone weary from the lack of sleep, always my weak point.
First things first, I had to get a good night's sleep. I had some Phenergan (promethazine), a sedating anti-histamine, which I had picked up in England to help with jet-lag. I took 25mg. and slept, so I took it for the next few nights to get my sleep pattern back.
And I noticed that my pain was less. I was still on zytram, a slow release version of tramadol. But my pain was noticeably better. What gives? I looked up antihistamine and pain.
Histamine is part of the immune system's defence system. When faced with infection, histamine is released, causing small blood vessels to swell – inflammation. Along with prostaglandins and bradykinins, it is one of the chemicals the body issues when injured and one of the stimuli that starts the pain chain.p
We usually try and turn off inflammation with NSAIDs which inhibit prostaglandins. This the first line of action in chronic pain and arthritis. I can't take NSAIDs because my digestive system is damaged.
And the research turned up another clue to my intense pain: I have celiac disease, an autoimmune condition, meaning my immune system is hyperactive. It must have been churning out histamine full blast for years, certainly the 25 years it took to diagnose me. The inflammation also weakened my ligaments, exacerbating my back pain. Add the additional inflammation when I contracted h.pylori in Africa. This was not diagnosed for 10 months during which my back got markedly worse.
One final point about inflammation: stress! Our bodies' reaction to stress is not just fight or flight, but also inflammation. A study has shown “chronic psychological stress is associated with the body losing its ability to regulate the inflammatory response.” It made sense: my life from childhood has been very stressful, compounded later by eight years as the wife of a navy pilot, his civilian employer's bankrupcy and our later emigration.
So phenergan counters excess histamine and tramadol (zytram SL) works on how the brain treats pain. It acts similarly to opioids, which change the brain's perception of pain, and also inhibits the descending pain pathways. These neural pathways run down from the brain and turn down the pain signals coming up from the body.
Stopping the pain at the site
But what about the original site of the pain? Knowing we had more or less come to the end of the road, I started reading up the whole pain mechanism in the hope I could ask intelligent questions. Most accounts were too technical, but I found one excellent article by Jon Barron.
What particularly interested me was his suggestion of interrupting the pain impulse at the site of injury. Stop the “snowball effect,” whereby the initial chemicals released (histamine, prostaglandin and bradykinin) unleash substance P, which amplifies the pain signal on its way north to the brain. Whether the problem is inflammation or pain, the pain impulse can be interrupted either by decreasing the levels of the pain biochemicals or by blocking the pain nerves.
NSAIDs can block only prostaglandins and have no effect on the pain nerves. Acetaminophen has no significant effect at this level. Narcotics can block substance P, but don't decrease the levels of pain biochemicals. Not very encouraging. I had tried capsaicin cream which works on substance P, but found it ineffective and it gave me a cough.
Jon Barron suggests there is a three way solution which:
- Decreases the levels of pain biochemicals;
- Blocks the release of substance P; and
- Slows the pain transmission along the spinal chord.
He has put together a natural formula, which he claims does just that. For details, please read his article (link below). My reaction was disbelief. “Snake oil!” I exclaimed to my husband. How could it do do much with a few drops? How could anything work when so much had failed?
But what had I got to lose? $35 and some more hope. I ordered some of the “Essential Relief” oil. I applied a few drops, as instructed. I could feel a warmth as it penetrated, then I forgot about it – until I realized my pain had gone! A few days later I offered it to a girl friend whose arthritic toe was giving her gyp. We wnt out to dinner and halfway through the meal, Bill asked how her toe was feeling. Her jaw dropped. “I haven't felt it all meal – and I can bend it. Look!” We all peered under the table in awe.
I have been using Essential Relief for a month now – and it still works! I am doing more every day and getting up each morning eager rather than weighed down at the burden of just getting through the day, both our son and younger daughter have visited and were amazed at how much I can do compared with last year. My sitting is still iffy, but last night we went out for dinner and I sat for two hours without using a TENS and without having to rest most of the day beforehand.
It sounds too good to be true, but consider:
- I have no connection with the company
- I was very skeptical as was Bill
- If it is the placebo effect, why now, when I had little hope? Why not one of the many cures I tried earlier and had good reason to believe would work?
Histamine and pain – link
Opiods – link
Ascending and descending pain pathways – link
Give me Your Pain by Jon Barron – link
Capsaicin cream – link
Baseline Nutritionals, who supply Essential Relief – link