WEBVTT - Are there people who can't feel pain? 0:00:00.240 --> 0:00:03.040 Brought to you by the reinvented two thousand twelve Camray. 0:00:03.120 --> 0:00:07.480 It's ready. Are you welcome to stuff you should know 0:00:08.080 --> 0:00:16.279 from house Stuff Works dot Com. Hey, and welcome to 0:00:16.320 --> 0:00:20.080 the podcast. I'm Josh Clark. I can feel pain with 0:00:20.120 --> 0:00:22.880 me as always A Charles W. Chuck Bryant and he 0:00:23.440 --> 0:00:29.120 hold on, dude, Chuck can feel pain as well. I 0:00:29.240 --> 0:00:31.560 just tested him. I wanted to make a hund percent sure. 0:00:32.240 --> 0:00:34.040 That's the second take though, and you didn't really have 0:00:34.080 --> 0:00:35.720 to do it twice. We could effaked it this time. 0:00:36.159 --> 0:00:39.280 I wanted a realistic response. Well that's real, Josh, pinch 0:00:39.360 --> 0:00:44.760 me hurt? Yeah, yeah, you could tell um you are right? Yeah, 0:00:44.760 --> 0:00:48.000 I'm fine. Okay, how you doing besides the throbbing forearm? 0:00:48.400 --> 0:00:51.360 I'm great, sir, and you I'm doing pretty good. Good. 0:00:51.560 --> 0:00:56.440 Everything's just peachy, including with my hair. Josh has a 0:00:56.520 --> 0:00:58.240 he goofed He shaves his head and he kind of 0:00:58.240 --> 0:01:01.480 goofed it so he looks like a a patient from 0:01:01.520 --> 0:01:04.280 some word where he had to surgery or something in 0:01:04.280 --> 0:01:08.480 his on his brain. I didn't goof my hair, that's right. Yeah, 0:01:08.760 --> 0:01:13.520 and I have an eastern black haircut now right. Yeah. Um. 0:01:13.560 --> 0:01:15.560 So other than that I'm feeling pretty good. You're right, 0:01:15.560 --> 0:01:19.120 So you felt emotional pain with your odd haircut. I did, which, 0:01:19.120 --> 0:01:22.960 by the way, Chuck, is different from physical pain. You 0:01:23.040 --> 0:01:27.640 knew that because of a yet to be released audiobook. 0:01:28.280 --> 0:01:32.720 That's right, it's forthcoming. It's a little teaser for everybody. Um, 0:01:32.800 --> 0:01:36.119 But there are actually people out there, Chuck, who cannot 0:01:36.400 --> 0:01:42.000 feel pain straight up, don't feel pain. It's amazing. It 0:01:42.160 --> 0:01:46.760 is very rare, but it happens. It is rare, Chuck. Actually, 0:01:46.760 --> 0:01:50.480 the only hard number that I've seen is UH sixty 0:01:50.680 --> 0:01:57.000 sixty reported cases worldwide, sixties since three. Actually, I've got 0:01:57.040 --> 0:01:59.440 thirty five in the United States as of now. Yeah, 0:01:59.480 --> 0:02:01.520 I've seen I saw that number as well. I've seen 0:02:01.560 --> 0:02:05.200 people who just plumb said, we have no idea how 0:02:05.240 --> 0:02:10.519 many could be under reported, especially with younger kids. UM 0:02:10.720 --> 0:02:15.720 with what we're talking about is called congenital insensitivity to 0:02:15.880 --> 0:02:20.120 pain with an hydrosis. Otherwise, we're just gonna call it 0:02:20.160 --> 0:02:23.200 SIPA for short, right, because that's much easier. And that 0:02:23.360 --> 0:02:27.320 is actually part of a it's a sub type of 0:02:27.360 --> 0:02:32.840 a larger disorder called hereditary sensory and autonomic neuropathy UH. 0:02:32.840 --> 0:02:36.079 And this is actually the type four SIPPA is type 0:02:36.080 --> 0:02:39.320 four s H s A N. Yes, and it's the 0:02:39.320 --> 0:02:42.600 most severe. Uh. Well, we'll get into what it all means, 0:02:42.600 --> 0:02:45.120 but it's the most severe. We will. Um. There's actually 0:02:45.320 --> 0:02:48.280 kind of a recent famous case of it. There's a 0:02:48.320 --> 0:02:52.680 British physician named Dr Jeoffrey Woods. You heard of him, chuck, No, 0:02:52.800 --> 0:02:55.799 But is he one of the g o F guys. Yeah, 0:02:55.840 --> 0:02:58.960 he's British. Yeah, he's spilled programmed with two ms in 0:02:59.000 --> 0:03:04.600 an e UM. But Dr Woods uh travels to Pakistan 0:03:04.680 --> 0:03:08.480 fairly regularly, and while he was there he heard about 0:03:08.480 --> 0:03:11.679 a kid who used to pass like thick needles right 0:03:11.680 --> 0:03:15.680 through his arm walking on hot coals. Uh, and showed 0:03:15.720 --> 0:03:18.320 no signs of feeling pain whatsoever. And he wasn't in 0:03:18.360 --> 0:03:22.200 the gym Rows circus. No, he wasn't, actually, but he 0:03:22.520 --> 0:03:25.000 probably could have done a lot better for himself than 0:03:25.080 --> 0:03:28.760 just on the streets of Lahore right. Um with Dr 0:03:28.800 --> 0:03:31.040 Woods heard about this guy and this little kid and 0:03:31.240 --> 0:03:33.880 was kind of interested and finally got around to trying 0:03:33.880 --> 0:03:36.320 to go see him. Right before he could see him, 0:03:36.360 --> 0:03:40.360 the kid, around his fourteenth birthday died. Actually, Um, he 0:03:40.480 --> 0:03:42.840 was he was. I don't know if he was dared 0:03:42.920 --> 0:03:44.440 or he was doing it for money or whatever, but 0:03:44.560 --> 0:03:48.160 he jumped off a roof and died. But Dr Woods 0:03:48.200 --> 0:03:50.320 got ahold of this kid's family and actually found out 0:03:50.360 --> 0:03:55.520 that a bunch of them have no sensitivity whatsoever to pain. Yeah, 0:03:55.600 --> 0:03:59.160 which is also called analgesia. Oh that's the other word 0:03:59.200 --> 0:04:02.240 for it. Didn't know that. Yeah, pain killers are called analgesics. 0:04:02.840 --> 0:04:05.000 So this would be like the state of not having 0:04:05.080 --> 0:04:07.800 pain or having reduced pain would be analges yet. But 0:04:07.880 --> 0:04:10.880 this isn't just reduced pain as a chuck, No, we're 0:04:10.920 --> 0:04:14.480 talking about no. Uh. You can feel pressure, but you 0:04:14.480 --> 0:04:17.000 can feel no pain. Uh. And you can feel no 0:04:17.720 --> 0:04:19.960 heat or cold. You can feel no temperature on your 0:04:19.960 --> 0:04:25.160 skin either. Right, that's the one with anhydrosis, Yes, exactly. Okay, 0:04:25.400 --> 0:04:27.840 let's talk about the pain part first. Let's talk about 0:04:27.839 --> 0:04:31.760 pain in general. Okay, how do how do we feel pain? Well, Josh, 0:04:31.839 --> 0:04:34.440 your your nervous system is where all this happens. And 0:04:34.560 --> 0:04:37.360 we're talking about your brain here. This is your brain 0:04:37.400 --> 0:04:40.560 on pain. Yeah, your cranial nerves, spinal cord, spinal nerves, 0:04:41.240 --> 0:04:45.159 and other things like your gangli and receptor sensory receptor 0:04:45.200 --> 0:04:49.280 stuff like that, and your nerves carry messages to your 0:04:49.279 --> 0:04:51.960 spine through your body to your spine. Spine carries it 0:04:52.000 --> 0:04:55.560 to your brain and the receptors. If you burn your 0:04:55.560 --> 0:04:57.760 finger or something will send the message up to the 0:04:57.800 --> 0:05:00.840 spine to the brain that says you got burnt, It hurts, right, 0:05:00.880 --> 0:05:04.520 and it sends a response message that moves your hand 0:05:04.560 --> 0:05:07.120 away real quick, touching a hot stove or something like that that. 0:05:07.360 --> 0:05:09.520 You can take it from here though, because your Mr 0:05:09.960 --> 0:05:15.920 Doctor guy Dr Clark, thank you chuck. Um. Actually, the 0:05:16.080 --> 0:05:19.400 sense of pain, the experience of pain is called no susception, 0:05:19.520 --> 0:05:23.279 right um. And this is the experience of physical pain 0:05:23.720 --> 0:05:27.400 as a response to noxious stimuli. And there's actually four 0:05:27.440 --> 0:05:31.800 categories of noxious stimuli. There's mechanical, electrical, thermal, and chemical, 0:05:32.320 --> 0:05:37.480 right um. And we have actually specialized uh nerve endings 0:05:37.560 --> 0:05:43.360 receptors called no susceptors that are responsible just for sending 0:05:43.480 --> 0:05:49.920 pain signals. They use peripheral nerves. Yes. Actually, as as 0:05:49.920 --> 0:05:53.000 painful as pain is, we have it for a reason. 0:05:53.720 --> 0:05:55.760 Like you said, you know you're touching a hot stove 0:05:55.839 --> 0:05:57.599 and your brain says, get your hand off of it, 0:05:57.880 --> 0:06:02.120 right um. We also all uh what one one theory 0:06:02.200 --> 0:06:06.120 of how we develop fear, which is good in and 0:06:06.160 --> 0:06:11.680 of itself as well, UM, is through direct conditioning. That's 0:06:11.680 --> 0:06:15.000 one of three ways we we learn fear responses is 0:06:15.000 --> 0:06:18.599 through direct conditioning. And part of direct conditioning is experiencing 0:06:18.640 --> 0:06:21.840 physical pain because once you've hit the hot stove, once 0:06:21.880 --> 0:06:23.920 you know that the stove is always going to burn 0:06:23.960 --> 0:06:27.120 you exactly, or if you're a dumb kid, maybe two 0:06:27.160 --> 0:06:29.160 or three times, but eventually you're gonna pick it up. 0:06:29.360 --> 0:06:34.520 Right now, what happens with sippa, as far as I understand, um, 0:06:34.560 --> 0:06:38.320 and actually did you notice as well? There's there's not 0:06:38.480 --> 0:06:41.400 a pet explanation of if you have SIPPA, this is 0:06:41.440 --> 0:06:43.840 exactly what happens to you. Yeah, well probably because it's 0:06:43.880 --> 0:06:46.520 so rare. Right. But when you think that if they 0:06:46.560 --> 0:06:49.520 could get this the group of patients together, they would 0:06:49.520 --> 0:06:52.359 find like, okay, well yeah, all of you people are 0:06:52.440 --> 0:06:55.960 lacking no susceptors. Uh So in some patients the no 0:06:56.040 --> 0:07:01.640 susceptors aren't there. In other patients, UM, the peripheral nerves 0:07:01.680 --> 0:07:05.960 that the nose acceptors are attached to, or uses the 0:07:06.000 --> 0:07:11.360 information highway UM aren't there, or else they're not innervated. UM. 0:07:11.400 --> 0:07:13.720 There's a lot of different ways that this this can 0:07:13.760 --> 0:07:18.840 come about. But it all results in this cardinal diagnosis 0:07:18.920 --> 0:07:22.400 or diagnostic tool of SIPPA, which is you feel no 0:07:22.480 --> 0:07:27.360 pain and you aren't responsive to temperature either. But nerve 0:07:27.400 --> 0:07:30.640 conduction is there, right, It depends on some of them. 0:07:30.880 --> 0:07:34.840 There's innervation and others the nerves aren't conducting, they're not 0:07:34.880 --> 0:07:40.760 capable of conducting. And specifically with anhydrosis, I think, um, 0:07:40.840 --> 0:07:44.640 there's no there's no innervation of the nerves in the 0:07:44.680 --> 0:07:48.640 sweat glands. So when you start to get hot, there's 0:07:48.680 --> 0:07:51.480 nothing sending your brain the message, Hey, you're getting hot. 0:07:51.520 --> 0:07:54.240 We need to start sweating so we can cool down. Well, yeah, 0:07:54.280 --> 0:07:56.200 we should go ahead and say that that's the A 0:07:56.240 --> 0:08:00.520 is anhydrosis and after the sip part, and that's the 0:08:00.520 --> 0:08:02.960 most sever your case, and that's when you don't sweat, 0:08:03.040 --> 0:08:07.440 which you know how I sweat. I know you definitely 0:08:07.520 --> 0:08:11.120 don't have anhydrosis. Remember at the aquarium, I sweated underwater 0:08:11.400 --> 0:08:13.960 in like forty degree water too. I mean there was 0:08:14.040 --> 0:08:16.440 like little chunks of ice floating on the surface of 0:08:16.480 --> 0:08:19.440 the water and you had cartoons sweat jumping off your 0:08:19.440 --> 0:08:23.120 forehead did so is I could handle the anhydrosis part 0:08:23.200 --> 0:08:25.720 or at least a slight version of that. I could 0:08:25.760 --> 0:08:29.640 deal with that, right. Uh, and this is our These 0:08:29.640 --> 0:08:33.560 are ekron sweat glands or ekron glands that are responsible 0:08:33.640 --> 0:08:37.560 for regulation of body temperature. So what they they found 0:08:37.559 --> 0:08:40.600 with the anhydrosis, it seems fairly uniform in that respect 0:08:41.040 --> 0:08:46.280 that we the a sip of patients don't have um innervation, 0:08:46.600 --> 0:08:51.200 meaning the nerves aren't becoming activated in their sweat glands. Yeah, 0:08:51.200 --> 0:08:53.920 and that's especially I mean it's bad enough to over 0:08:54.080 --> 0:08:56.360 you know, because you can overheat just as an adult, 0:08:56.400 --> 0:09:00.520 but it's really scary with babies with SIPPA because a 0:09:00.559 --> 0:09:04.120 baby can overheat and die like very easily. Well yeah, actually, 0:09:04.160 --> 0:09:11.120 I think of people who have SIPPA die before or 0:09:11.160 --> 0:09:15.440 by the age of three, and I think another quarter 0:09:15.800 --> 0:09:20.679 of those deaths are um from sepsis from an untreated infection. 0:09:21.360 --> 0:09:23.520 One of the things about not being able to feel 0:09:23.559 --> 0:09:26.760 pain is you can cut yourself and if you're a kid, 0:09:27.160 --> 0:09:30.120 you don't think, well, I'd better treat this cut. And 0:09:30.200 --> 0:09:32.880 at the same time you're not crying, so your parents 0:09:32.880 --> 0:09:36.800 aren't alerted, and so this cut can go untreated become infected. 0:09:37.360 --> 0:09:43.840 When they cut is infected, the bodies immunological response UH 0:09:44.160 --> 0:09:47.240 raises your body temperature. It can lead to a fever, 0:09:48.000 --> 0:09:52.040 and unchecked, this fever can actually lead to um brain damage. 0:09:52.520 --> 0:09:54.760 So a lot of patients with SIPPA who have made 0:09:54.760 --> 0:09:57.360 it past you know, three or so have some form 0:09:57.400 --> 0:10:01.400 of mental retardation. Yeah, they also saw where um. We'll 0:10:01.440 --> 0:10:03.240 get to the tips later, but since you brought it up. 0:10:03.280 --> 0:10:06.120 One of the tips for small kids as they will 0:10:06.160 --> 0:10:09.360 teach the child to recognize blood and teach them what 0:10:09.400 --> 0:10:11.760 that means. So if you see blood, you need to 0:10:11.800 --> 0:10:13.640 come find mommy and daddy real quick because you don't 0:10:13.640 --> 0:10:15.920 know you're hurt. But that's a bad thing to happen, 0:10:15.960 --> 0:10:18.200 So come come find mom and dad. Yeah, and I 0:10:18.240 --> 0:10:20.240 thought these tips that, like you said, we'll get to 0:10:20.320 --> 0:10:22.880 in a minute, or they were pretty clever, right, or 0:10:22.920 --> 0:10:27.960 come fine mom and mom or dad and dad. Chucky guy, 0:10:28.720 --> 0:10:30.920 I've been minded around here. Or just mom or just 0:10:31.040 --> 0:10:35.560 dad or uncle Charlie, who's uh grandma or grandma or 0:10:35.640 --> 0:10:40.360 grandpa and grandpa. There's all kinds of scenarios, A lot 0:10:40.360 --> 0:10:43.640 of know somebody the first person um to be legally 0:10:43.679 --> 0:10:48.319 pronounced a sexual was legally pronounced a sexual in the 0:10:48.400 --> 0:10:51.520 last couple of weeks, I believe. Really, yeah, it's true. 0:10:51.720 --> 0:10:58.080 Very interesting that. Yeah, Okay, where are we, Chuck, Let's 0:10:58.120 --> 0:11:02.920 talk about sipa. The medical history of sippa Okay, as 0:11:02.920 --> 0:11:05.280 far as I could find, it was first described in 0:11:05.679 --> 0:11:10.520 eighteen forty seven, uh and described as what is going 0:11:10.559 --> 0:11:13.640 on here? Yeah, exactly. And actually in the sixties. I 0:11:13.720 --> 0:11:16.559 read an article in nineteen sixty that was based on 0:11:17.280 --> 0:11:22.280 UM a hypothesis that people who feel no pain were 0:11:22.320 --> 0:11:26.160 actually it was actually a psychological disturbance. There's been such 0:11:26.200 --> 0:11:29.360 a massive affront to their ego that as a response, 0:11:29.800 --> 0:11:34.280 the response to their ego mounted resulted in a loss 0:11:34.320 --> 0:11:39.640 of the sensation of pain. That cat just can't feel pain. 0:11:39.760 --> 0:11:43.439 He's so out there, so far out. There is a 0:11:43.520 --> 0:11:46.679 doctor who was who was surveying this literature of UM 0:11:46.760 --> 0:11:51.200 certain patients, and he was describing like how the diagnosis went, 0:11:51.360 --> 0:11:53.800 the diagnosis went. And there's this one poor guy in 0:11:53.840 --> 0:11:57.680 the fifties who he was described as a pretty nice, upbeat, 0:11:57.800 --> 0:12:00.439 bright guy, and he goes to the doctor and it's like, 0:12:00.480 --> 0:12:03.079 I can't feel pain. And the doctors like, oh yeah, 0:12:03.360 --> 0:12:05.680 so you can see this half drunk doctor, right, he's 0:12:05.720 --> 0:12:09.360 got like a glass of scotch and a right and 0:12:09.559 --> 0:12:13.719 uh right, and the little reflective thing on his forehead. Um, 0:12:13.760 --> 0:12:17.360 and he ran this guy through a battery of tests, 0:12:17.400 --> 0:12:23.400 including squeezing his testicles, running an electrical current across his 0:12:23.480 --> 0:12:28.439 lower teeth, and Chuck, it gets worse, taking a skin 0:12:28.640 --> 0:12:32.760 and muscle biopsy without anesthetic. What did he do each 0:12:32.800 --> 0:12:35.520 of these? And was he like what about that? You know? 0:12:35.720 --> 0:12:39.080 I feel that? Can't you imagine like this? Doctors like, oh, yeah, 0:12:39.120 --> 0:12:46.920 that didn't yeah. Um, So the psychological idea was discarded 0:12:46.960 --> 0:12:49.880 pretty quickly. And now, because we're in the age where 0:12:49.880 --> 0:12:54.040 the genome has been cracked, it's all genetics, right, yeah, 0:12:54.120 --> 0:12:55.959 And I guess we should go ahead and mentioned too 0:12:56.000 --> 0:12:59.200 that they think they have narrowed it down to a 0:12:59.400 --> 0:13:03.599 mutation of the t r K A parentheses in t 0:13:04.080 --> 0:13:08.079 r K one gene, which appears to control nerve growth, 0:13:08.600 --> 0:13:10.880 but again they don't know for sure. They just think 0:13:10.920 --> 0:13:13.000 that might be the culprit, right, Chuck, that seems to 0:13:13.040 --> 0:13:16.840 be the likeliest UM candidate, because that gene actually is 0:13:17.679 --> 0:13:22.599 it's responsible for producing nerve growth factor, which goes and 0:13:22.760 --> 0:13:27.600 recruits UM neurons and nerves, isn't I guess it would 0:13:27.640 --> 0:13:33.079 be neurons uh to become no susceptors, and so that 0:13:33.160 --> 0:13:36.600 wouldn't happen, right, right, But they're kind of speculating still 0:13:36.600 --> 0:13:38.839 a little bit, right. Yeah, we still don't have an idea. 0:13:38.840 --> 0:13:44.920 I mean, sixty cases reported worldwide, thirty five in the US. Maybe, although, um, 0:13:45.160 --> 0:13:46.960 it does seem like it would be genetic, like that 0:13:47.040 --> 0:13:50.000 kid in the Little Horror Pakistan when he died and 0:13:50.000 --> 0:13:51.840 the doctor went to go see his family and found 0:13:51.840 --> 0:13:55.480 out he had siblings that had the same condition. Sure, Um, 0:13:55.559 --> 0:14:00.960 that suggests either something environmental close to the home or uh, genetic, 0:14:01.280 --> 0:14:04.120 And that's kind of what they're leaning to. That's the 0:14:04.160 --> 0:14:07.200 genetic part, right, Josh. They do think or do they 0:14:07.240 --> 0:14:10.960 know for sure that it's an autosomal recessive disorder. I 0:14:11.000 --> 0:14:12.880 don't know how they do, but that's that's how I 0:14:12.960 --> 0:14:16.400 take it, right, Which means that both of your parents 0:14:16.920 --> 0:14:20.280 must pass down a copy of this gene. So each 0:14:20.280 --> 0:14:23.560 one of your parents has this mutation and it's not 0:14:23.600 --> 0:14:25.480 related to gender or anything. But they do know that 0:14:25.520 --> 0:14:26.880 both of your parents have to give it to you, 0:14:27.720 --> 0:14:31.080 so that that's probably what makes it rare as well. Well, yeah, 0:14:31.360 --> 0:14:34.080 both of your parents have to have this really rare thing. Apparently, 0:14:34.120 --> 0:14:38.480 also it hasn't It doesn't affect every ethnic group. Oh 0:14:38.520 --> 0:14:41.480 really Yeah, but I was reading another study on this 0:14:41.600 --> 0:14:45.560 from I think two thousand and it was in I 0:14:45.640 --> 0:14:48.800 think Jerusalem or Tel Aviv, one of the two, and 0:14:48.840 --> 0:14:52.400 they got together a bunch of kids who had sippa 0:14:52.600 --> 0:14:55.960 and um, some of them were related, and they took 0:14:55.960 --> 0:14:59.440 a family history and found that I think nine of 0:14:59.480 --> 0:15:05.000 the thirt participants parents were first or second cousins. So 0:15:05.040 --> 0:15:07.040 I wonder how much that has to do with something 0:15:07.080 --> 0:15:11.560 too interesting? Yeah, very interesting? So should we talk about 0:15:11.960 --> 0:15:15.320 some of the problems. I mean, they're pretty obvious, but 0:15:15.320 --> 0:15:17.560 there are something that I didn't actually well, yeah, let's 0:15:17.600 --> 0:15:20.040 talk about raising a baby with sippa. How would you 0:15:20.080 --> 0:15:24.160 first start to recognize that your kid has sippa? Well, 0:15:24.680 --> 0:15:27.280 that's a problem because the first way you would probably 0:15:27.320 --> 0:15:31.520 recognize it is seeing witnessing an accident that should cause 0:15:31.640 --> 0:15:34.200 your baby to cry, and your baby doesn't cry. Right, 0:15:34.280 --> 0:15:36.960 that's like, did you have you ever heard the discovery 0:15:37.000 --> 0:15:42.240 of ether and nitrous ox side is anesthetics right here? Well, 0:15:42.280 --> 0:15:44.720 actually it happened in New York City, but a physician 0:15:44.760 --> 0:15:47.800 from our fair City name ms Dr Crawford Long. Yeah. 0:15:47.840 --> 0:15:49.680 I did a little book report on him when I 0:15:49.720 --> 0:15:52.640 was like the fourth grade. He was like our nineteen 0:15:52.720 --> 0:15:55.520 sixties Scotch and cigarette doctor, and that he liked the 0:15:55.560 --> 0:15:59.920 party and he noticed that people on in the depths 0:16:00.080 --> 0:16:03.560 of an ether bender would run into walls and gash 0:16:03.600 --> 0:16:06.920 their foreheads and not have any response to it whatsoever, 0:16:07.160 --> 0:16:11.680 aside from laughing hysterically. Right exactly, look at all this blood. Yeah, 0:16:11.720 --> 0:16:14.520 so there's there's a similarity there. And well for me 0:16:14.560 --> 0:16:17.040 to add that tangent, we have Crawford Long Hospital here too, 0:16:17.080 --> 0:16:19.760 I know, look at you with the sidebars. So, like 0:16:19.800 --> 0:16:21.480 I said, the first thing it will happen is apparent 0:16:21.520 --> 0:16:26.800 season accident and the child doesn't cry. Um, so you're 0:16:26.800 --> 0:16:28.880 gonna have some problems getting diagnosed. So because it is 0:16:28.880 --> 0:16:32.960 so rare. Uh. And in the meantime, the kid could 0:16:33.120 --> 0:16:36.760 end up with an infection and die of overheating or 0:16:36.800 --> 0:16:40.280 suffer some sort of brain damn. One of the other 0:16:40.280 --> 0:16:43.600 big problems with the baby is um when a baby tease, 0:16:44.240 --> 0:16:47.400 a baby just naws like crazy, but if they don't 0:16:47.400 --> 0:16:50.320 feel pain, they may gnaw like straight through their little 0:16:50.360 --> 0:16:52.720 baby finger without even realizing right, or their tongue or 0:16:52.720 --> 0:16:55.000 their lips. Those are common injuries as well, yeah, which 0:16:55.000 --> 0:16:58.040 is just awful. There's also um ice scratching. Yeah. Well, 0:16:58.080 --> 0:16:59.600 they said though on the teeth, they said that some 0:16:59.680 --> 0:17:02.400 parents it's elect to have the teeth baby teeth removed 0:17:02.400 --> 0:17:05.040 altogether and wait for the adult teeth to come in, 0:17:05.080 --> 0:17:07.600 at which they're in age where they can understand like 0:17:07.720 --> 0:17:10.000 don't bite through your finger. Yeah, but that's not good either, 0:17:10.040 --> 0:17:11.840 because then your child has no teeth and it makes 0:17:11.840 --> 0:17:15.240 it harder to eat and right, but it's like eat 0:17:15.600 --> 0:17:18.480 baby food for many many years, or she right through 0:17:18.520 --> 0:17:20.440 your tongue right right? You know? So what was the 0:17:20.480 --> 0:17:22.960 one you just mentioned? I scratching? Yeah, you know you 0:17:23.160 --> 0:17:26.159 if you are just rubbing your eye or whatever, you 0:17:26.320 --> 0:17:30.119 pretty much know when to stop. If you are a patient, 0:17:30.240 --> 0:17:32.760 a sip of patient, you don't know when to stop. 0:17:32.960 --> 0:17:35.640 I was reading about this five year old girl who 0:17:35.680 --> 0:17:40.000 blinded herself. She can still see shapes, I believe, um. 0:17:40.080 --> 0:17:42.960 But she had one eye removed and scratched the other 0:17:43.000 --> 0:17:45.560 eye and she was five and could barely see. She'd 0:17:45.560 --> 0:17:48.320 done it to herself. Well, another tips, since we're there, 0:17:48.640 --> 0:17:52.080 a lot of parents elect to have little baby goggles 0:17:52.320 --> 0:17:53.920 for their for their child, so they can't get to 0:17:53.960 --> 0:17:59.479 their eyes, which is sad. Yeah, um, hunger pains. This 0:17:59.560 --> 0:18:03.320 was interesting. They don't feel hunger pains, so eating isn't 0:18:03.359 --> 0:18:07.879 something they realized they should do. So uh they sometimes 0:18:08.160 --> 0:18:10.880 sip A patients will set a clock to remind them 0:18:10.920 --> 0:18:14.760 to eat or to use the potty. Right, Because one 0:18:14.800 --> 0:18:17.439 of the ways that you know that you have to 0:18:17.520 --> 0:18:20.800 go number one or go number two is from the 0:18:20.840 --> 0:18:24.800 discomfort involved. Your body is alerted like you need to 0:18:24.840 --> 0:18:28.679 evacuate your bowels, and so you go evacuate your bowels. 0:18:28.800 --> 0:18:33.440 But if you don't have any sense of discomfort whatsoever, Um, 0:18:33.720 --> 0:18:35.679 you aren't going to go to the bathroom. You can 0:18:35.760 --> 0:18:41.680 suffer constipation all manner of horrible results from that from 0:18:41.680 --> 0:18:45.359 holding it too long. Yeah for sure, Um, fractures are 0:18:45.400 --> 0:18:48.479 very common. Obviously. You can slam your hand in the door, 0:18:48.600 --> 0:18:50.760 won't feel the pain, won't realize you've got a broken 0:18:50.800 --> 0:18:53.480 hand and joints to This is something I hadn't thought 0:18:53.520 --> 0:18:56.879 of either. But consider this, like, how many times have 0:18:57.160 --> 0:19:00.480 either one of us moved in our chairs during this podcast? 0:19:00.880 --> 0:19:04.479 And the reason we're moving shifting is because it's become 0:19:04.600 --> 0:19:07.840 uncomfortable to lean on that joint, so we move and 0:19:07.880 --> 0:19:10.440 put the our weight on another joint. That's your body 0:19:10.480 --> 0:19:12.719 telling you to to shift, so you're not putting too 0:19:12.800 --> 0:19:16.080 much stress on anything. Right. If you don't shift, then 0:19:16.640 --> 0:19:18.679 all of that weight is on that joint, and this 0:19:18.760 --> 0:19:22.800 can actually result in charcot joints. These are joints where 0:19:22.840 --> 0:19:27.080 basically you can't feel pain. Uh, to develop charcot joints 0:19:27.080 --> 0:19:32.160 because when you it's the result of like a prolonged 0:19:32.200 --> 0:19:37.240 and repeated destruction of a joint or several joints, And 0:19:37.240 --> 0:19:40.320 what happens is like little bone fragments break off and 0:19:40.359 --> 0:19:43.439 then you have bone pieces grading in the joint, it 0:19:43.480 --> 0:19:47.159 fills with fluid and UH, there's definitely a point of 0:19:47.160 --> 0:19:52.679 no return that can lead to amputation, um limb replacement, 0:19:52.760 --> 0:19:55.720 that kind of stuff. Gez, Well, one of the since 0:19:55.720 --> 0:19:58.679 we're kind of doing the problem tip thing, one of 0:19:58.680 --> 0:20:01.399 the tips don't think we have so far. One of 0:20:01.400 --> 0:20:05.080 the things that they recommend is occupational therapy, so they 0:20:05.080 --> 0:20:08.320 can teach your child different ways to sit and do 0:20:08.400 --> 0:20:10.840 physical tasks to like put the least amount of stress 0:20:10.840 --> 0:20:13.800 possible on those joints, right or they may say your 0:20:13.840 --> 0:20:15.680 kid needs to be in a wheelchair a little more 0:20:15.720 --> 0:20:19.400 than than here. She is true and again very sad. 0:20:19.440 --> 0:20:22.040 This whole thing is just one of the most depressing 0:20:22.720 --> 0:20:26.159 rare disorders I can think of. Uh, if you have 0:20:26.200 --> 0:20:30.399 a baby that has um SIPA, you should probably do 0:20:30.600 --> 0:20:34.080 a regular check over your child, like you need a 0:20:34.080 --> 0:20:36.280 baby proof the heck out of your house. Like it's 0:20:36.320 --> 0:20:38.840 baby proof anyway, but you really need to go overboard 0:20:38.880 --> 0:20:42.159 with softening corners and things like that, making sure the 0:20:42.200 --> 0:20:45.359 stove and anything dangerous isn't accessible the knife drawer, that 0:20:45.440 --> 0:20:48.360 kind of thing. But um, you should also check your 0:20:48.520 --> 0:20:50.520 check your child for until they're old enough to do 0:20:50.560 --> 0:20:53.240 this on their own, check them for injuries, you know, 0:20:53.280 --> 0:20:56.160 a couple of three times a day. Also, um, because 0:20:56.200 --> 0:20:59.320 of the anhydrosis. Uh that a lot of families opt 0:20:59.400 --> 0:21:03.320 to move to cooler climates just you know, to protect 0:21:03.320 --> 0:21:07.280 against overheating. Yeah, and um, Katie Lambert wrote this article 0:21:07.600 --> 0:21:11.000 of stuff you miss in history class are cohorts And 0:21:11.119 --> 0:21:16.040 uh Katie supposed that as far as getting exercise, which 0:21:16.200 --> 0:21:18.520 you know everyone needs, that swimming might be a good 0:21:19.160 --> 0:21:20.399 good thing for them to do. And that kind of 0:21:20.400 --> 0:21:23.199 made sense to me. Yeah, but have you ever like 0:21:23.359 --> 0:21:27.760 swam and sweat it underwater? Well you know it? Well, yeah, 0:21:27.920 --> 0:21:30.440 but now I I wondered about that because I mean, 0:21:30.440 --> 0:21:33.680 if you think about it, if you are sweating underwater, 0:21:33.760 --> 0:21:36.560 then your body's saying you need to be cooler than 0:21:36.640 --> 0:21:40.920 the ambient water temperature. So it could still lead to trouble. 0:21:41.200 --> 0:21:44.399 I guess getting cool water and maybe don't swim so 0:21:44.480 --> 0:21:47.000 much that you're gonna be sweating could be my advice. 0:21:47.480 --> 0:21:50.639 Dr Chuck's advice. That's good advice, Dr Chuck. Although the 0:21:50.640 --> 0:21:54.400 water is a good medium because it's easier on the joints. Yeah, well, 0:21:54.400 --> 0:21:56.920 I think that's why she recommended it. Sure, Uh, there 0:21:57.000 --> 0:22:01.399 is no cure, no that that has happened yet, and 0:22:01.440 --> 0:22:03.760 it's so rare that it's it's one of these things 0:22:03.800 --> 0:22:05.840 it's hard to get a cure when you don't have 0:22:06.680 --> 0:22:09.560 anyone to test it on. Yeah, although Chuck, don't you 0:22:09.600 --> 0:22:13.760 think the advent of stem cells will probably cure everything? 0:22:14.880 --> 0:22:17.199 I hope so. Well, I mean think about it, it's 0:22:17.240 --> 0:22:20.240 a if it's a genetic flaw measually that means that 0:22:20.280 --> 0:22:23.560 an enzyme or protein isn't being produced, so you just 0:22:23.920 --> 0:22:27.399 use stem cells to generate that enzyme or protein and 0:22:29.160 --> 0:22:32.159 R Clark no more sippa. There are a couple of 0:22:32.200 --> 0:22:35.399 websites should we go ahead and plug those. Gift of 0:22:35.440 --> 0:22:38.560 Pain is a website set up by a family whose 0:22:38.640 --> 0:22:41.600 daughter has SIPPA, and if you want to have your 0:22:41.640 --> 0:22:43.320 heart broken and learn a little bit, you can go 0:22:43.440 --> 0:22:46.680 visit there and help. Roberto dot com is another one 0:22:47.119 --> 0:22:51.520 that details a young boy with SIPPA and Chuck. Also 0:22:51.680 --> 0:22:55.240 there is, from what I understand um, a pretty good 0:22:55.240 --> 0:22:59.960 documentary called A Life Without Pain by director Melody Guild 0:23:00.280 --> 0:23:04.400 and it's about SIPPA. Huh, it's supposed to be pretty cool. 0:23:04.440 --> 0:23:07.639 I haven't seen it, but anybody interested, we want to 0:23:07.720 --> 0:23:14.560 rent that? And I say look for a pain podcast 0:23:14.600 --> 0:23:16.320 in the future. I think we should do one on 0:23:16.400 --> 0:23:18.720 pain Josh and Chuck's House of Pain. Do you know 0:23:18.760 --> 0:23:20.680 how many times I'm gonna pinch you during that thing? 0:23:21.520 --> 0:23:23.800 It's gonna be rough, hopefully no more than once. It 0:23:23.840 --> 0:23:26.240 will be more than once, all right. If you want 0:23:26.280 --> 0:23:28.800 to learn more about SIPPA, type in c I p 0:23:29.040 --> 0:23:31.080 A in the handy search bar at how Stuff works 0:23:31.160 --> 0:23:42.359 dot com. That means it's time for listener mayle yes sir, exactly, Chuck, 0:23:42.560 --> 0:23:46.119