drugs

Last week I was prescribed pregabalin, a drug that targets nerve, or "neuropathic" pain. This is intended to mask my sciatica, a condition that makes my left leg feel like there's a very long, fine saw running up and down the outside of my hip, thigh, calf and ankle. The prescription takes the total number of pills and tablets I take to 25. Every day.

I am going to photograph the tablets I take in interesting settings, and post them on Instagram, as a little insight into and record of my painful life.

The house of pain

Last night I asked a question on Twitter: is the pain from severe lower limb cramp the same as labour contractions?* This led me to ruminate on the concept of personal pain. How does anyone know that what they feel as pain is the same as what their friend, mum, partner or colleague feels?
I think I’ve experienced quite a lot of pain. I’ve had ballet teachers sit on my back to force me deeper into the splits; deep tissue massage on torn hamstrings. I’ve danced en pointe, with 40N/cm² of force going through my toes, until they have bled. I’ve trapped a nerve in my hip and been woken up at 3am with cramp that feels like my left foot is trying to break itself in half. It once happened in the kitchen and I reached for the bread knife.

For as long as I can remember, I’ve had headaches nearly every day. Until my early teens I thought this was normal – low level pain in your head is just what happens from being alive. But once I became old enough to articulate my perceptions, I realised this frequency of pain would never be tolerated by someone who hadn’t experienced it all their life. I guess something chronic becomes normal after a while.

Once I had suffered three “ice pick” headaches age 16, I finally went to the doctor. Ice pick headaches do exactly what they say on the proverbial tin: they feel like a cruel, demented tormentor is driving an ice pick into my brain. They are excruciating, but mercifully last only three seconds (on average, for me). I reassure myself that it can’t be as painful as the contractions I might, one day, experience during labour. But I don’t know what labour feels like, so last night I asked people who do know how it compares to severe cramp, to create some sort of gauge.

But how do I know what it feels like to have an ice pick driven into my brain, really? Is what I feel as an ice pick being driven into my brain the same as what “Mike” in this case study feels? How do my ice pick headaches compare to the cluster headaches, nicknamed “suicide headaches”, that my friend Dawn endures? What is our language for comparing pain? Is it just comparing one type of pain to the other, like I tried to do on Twitter?

The Wellcome Trust-funded London Pain Consortium, which I sincerely hope has the internal name “House of Pain” and a mandatory afternoon coffee break where researchers Jump Around to escape the post-lunch slump, is looking into it. They will use hi-res fMRI and diffusion tractography imaging techniques to look at what is happening in the brain, both what it’s doing and where, during induced and existing pain. Though, rather than shoving a sharp, pointed object up someone’s nose, they will be using extract of chilli peppers to cause pain.

Image of neuronal tracts in the brain created using a type of diffusion tractography called diffusion tensor imaging. Credit: Nuada Medical/Wellcome Images.

The study looking at existing pain will compare diabetic neuropathy patients: those who have pain and those who don’t. Their existing anxiety levels will be measured to see if it contributes to pain. This is especially interesting. Maybe anxiety, and maybe anxiety specifically about pain, leads to worsened personal experience of pain? This is my particular hypothesis, not theirs, but it will be interesting to see where their research goes.

I should say that I’ve distilled the above explanation of their research from a rather jargon-filled summary and as I’m not a neuroscientist or the best science writer, I might not have done this very well. So two things: please correct me in the comments, and, London Pain Consortium: please put some decent public information on your website. Mun-Keat Looi wrote a feature that looks at their chronic pain research on the Wellcome Trust’s website and Barry Gibb produced this video for the same. But they shouldn’t rely on external science communicators to explain their work to a large swathe of the public (one fifth of Europeans suffer chronic pain) who are, like me, very interested to know what the House of Pain is getting down to.

*I addressed this question to “mothers” and later regretted it. I realise that women who now have children are not the only ones to have experienced labour contractions. They occur during abortion and miscarriage too. Twitter does not allow for much expansion and I wanted to address my tweet to someone to increase the chance of it being noticed and answered, but I did not mean to exclude anyone with first-hand experience of this kind of pain.

Dance, dance, dance

My life as a ballerina began at age 4, when Mum took me and my bouncing blonde curls to a Saturday morning class at the Villenuva Dance Academy. I will always think that sounds like a school for dancing ice-creams.

Ballet age 4 is all about good toes, naughty toes, and various mimes that transport you far away from being a four-year-old with bouncing blonde curls. Once upon a time I was a naughty imp stealing apples from a garden, or a graceful swan soaring high. Sometimes, us little ballerinas had to be a witch who drinks a deadly potion, but I was scared that pretending to die meant dying in real life, so I never was the witch.

Forever ready to put on a show (with brother Jonathan)

Growing up meant more serious exercises: tendus, fondues (dancing cheeses?!), grand battements and jetés. Age 11, I was selected for a special advanced class for students with "distinction". I wore pointe shoes for the very first time. Dancing en pointe is painful, thrilling, and so very grown up. Though the lasting legacy is that I have baby-sized feet: at 5 feet 9 inches tall I wear size 4 shoes, because dancing on your tippy-toes four days a week during puberty doesn't allow for much growth.

Being an adolescent ballet dancer is tough. Suddenly, you're too big, your legs are these great long levers that you're supposed to lift at impossible angles to your protesting body. Training for my second major exam, I tore my left hamstring, and six months later, the right. Thus ended my career as a ballerina. (Although it was always clear I would be too tall. Even Darcey Bussell, a "tall" ballerina, is only 5 feet 7. And anyway, I was too "clever" to go into dance, a career in science beckoned...)

The injuries, and subsequent back problems, were tough, frustrating, but made be want to dance even more. To overcome my injuries would be a great achievement. Age 17, I won the Senior Prize for Achievement at the renamed Poole Academy of Dance. My trophy was a treasure for one year, and then I had to give it back, and leave for University College London.

UCL owns the Bloomsbury Theatre and as such has thriving arts societies: Dance, Drama, Stage Crew, Musicals. I joined Dance. Going to university coincided with, or perhaps forced, a darker side of me. Out went the blonde curls, in came jet black, poker straight locks and gothic tendencies. My studies of the history of madness led me to learn of the mediaeval witch-hunts and then I thought: why not, finally, dance the witch? So in 2005 I choreographed Sabat, named after the witch's gathering, for the UCLU Dance Society show. If I thought dancing en pointe was grown up, conceiving and birthing this expression of my imagination was almost ancient. Three ballet dancers and five tap dancers envoke the persecution of women that was rife for three hundred years.

Click the image to see the video of Sabat on YouTube

It's six years since I performed that dance. Five years since I went to a ballet class. Boyfriends, work and apathy get in the way, don't they? But it's no excuse. So on the 117th anniversary of game-changing choreographer Martha Graham's birth, I went back to the barre, back to ballet class. Today I can hardly walk as my muscles scream out in protest once again. But I'm not going to stop. Ballet is not just in my bones, but in my ligaments, my tendons and my muscles. And since three years ago, tattooed into my skin.

Ballet dancer tattoo on my left wrist, inked November 2008.

I'd love to hear about anyone else's experiences of going back to dance as an adult, or even starting from scratch. I'm going to adult classes at the Central School of Ballet because it's just round the corner from my new office. But there are loads more studios around London offering classes for grown-ups: Danceworks, City Academy and Expressions to name a few. Many more across the country, I'm sure.

The comfort of a chiropractor

I wrote this last year while recovering from a week-long illness. I decided not to publish it then. But due to the recent spate of posts along the lines of "don't call me stupid", exploring why some people might be drawn to alternative medicine, I thought it was timely to post about my experience at the hands of a chiropractor.

I've been ill for a week, so my thoughts have naturally wandered to medicine. My drug of choice has been giant chocolate buttons. Not strictly a medicine, but the bright purple packaging, the crack of each button in my crunching teeth and the sweet sugar rush is so comforting. This reminds me of chiropractic: a questionable treatment, but in my experience, a big comfort.

I was thirteen years old and training for a major ballet exam when I tore my left hamstring. Six months later, I tore the right. Scar tissue formed, the tight muscles resulted in chronic back pain. My dad took me to local chiropractor and family friend, Beth, who had treated his bad back.

Who loves the feeling of making their knuckles pop? This is what spinal adjustment, the technique chiropractors employ, feels like. This kind of immediate relief is very important for a teenager whose dreams of being a ballet dancer have just been ripped apart. I had no idea that chiropractic was founded on pseudo-science. Why would I? I grew up in a typical Daily Mail household where little was questioned. And would I have cared? Probably not. After weekly sessions of adjustment, massage and ultrasound treatment, I could dance again.

It was possibly, and probably, the more standard techniques of deep tissue massage and ultrasound that healed my aching body. A physio at the nearest hospital could have treated me in the same way. But Beth was a family friend and known in my local community. When my dad took me to a practitioner who had helped him, I felt cared for. My Dad was looking after me. During my sessions with Beth, I chatted about my university plans and she even helped me choose what to study.

Personal recommendation, community spirit and desperation are all reasons why people, including myself, have gone to see the chiropractor. Not because they are stupid, defiant, or even ignorant. Because sometimes it's just where they end up, steered by family, friends and promises. And when those promises turn out to be true, when the treatment seems to work, then the cycle continues.