1 00:00:01,480 --> 00:00:04,280 Speaker 1: Welcome to Stuff you should know, a production of I 2 00:00:04,360 --> 00:00:13,240 Speaker 1: Heart Radio. Hey, welcome to the podcast. I'm Josh, and 3 00:00:13,280 --> 00:00:16,560 Speaker 1: there's Chuck and there's Jerry over there, and this is 4 00:00:16,600 --> 00:00:25,400 Speaker 1: stuff you should know straight ahead. Both barrels blazon science, strange, unusual, 5 00:00:25,520 --> 00:00:29,840 Speaker 1: fascinating type stuff you should know. That's right, and uh, 6 00:00:30,280 --> 00:00:34,120 Speaker 1: both of us fresh from vacation. M hmm. I just 7 00:00:34,159 --> 00:00:36,360 Speaker 1: got to say. We took the first family trip to 8 00:00:36,360 --> 00:00:41,080 Speaker 1: Disney World and it was great. The oh that was 9 00:00:41,159 --> 00:00:44,080 Speaker 1: the first ever. Wow, I'll bet that was something special. 10 00:00:44,520 --> 00:00:48,240 Speaker 1: It was I haven't been in thirty five years myself, 11 00:00:48,320 --> 00:00:51,040 Speaker 1: and the same with Emily, and uh, it's remarkable how 12 00:00:51,080 --> 00:00:54,000 Speaker 1: much of the Magic Kingdom is exactly the same. But 13 00:00:54,520 --> 00:01:01,320 Speaker 1: then I realized that Disney h cultists diehards and appropriate. 14 00:01:02,160 --> 00:01:04,800 Speaker 1: They don't want anything different, so that that all made sense. 15 00:01:05,720 --> 00:01:07,920 Speaker 1: But it was great. My daughter was you know, you 16 00:01:07,959 --> 00:01:09,440 Speaker 1: never notice how you get down there. But I had 17 00:01:09,480 --> 00:01:12,160 Speaker 1: a feeling, because she's not a very fearful kid, that 18 00:01:12,200 --> 00:01:15,679 Speaker 1: she would ride stuff, and she rode everything that she 19 00:01:15,800 --> 00:01:17,640 Speaker 1: was big enough to ride, and then pride on the 20 00:01:17,640 --> 00:01:19,600 Speaker 1: things that she wasn't big enough to ride because she 21 00:01:19,600 --> 00:01:23,000 Speaker 1: couldn't ride. Yeah, like she did Space Mountain twice, she 22 00:01:23,040 --> 00:01:25,080 Speaker 1: did Tower of Terror. She she wanted to do the 23 00:01:25,080 --> 00:01:29,840 Speaker 1: Aerosmith ride at Hollywood Studios that she was bummed out about. Um, 24 00:01:30,800 --> 00:01:34,640 Speaker 1: which have you written that one so many times? Did 25 00:01:34,680 --> 00:01:37,840 Speaker 1: you realize you probably realized this the little video they 26 00:01:37,840 --> 00:01:40,320 Speaker 1: showed at the beginning of Smith in the Studio, that's 27 00:01:40,440 --> 00:01:45,000 Speaker 1: Ken Marino as the as the engineer. Oh no, I 28 00:01:45,000 --> 00:01:47,200 Speaker 1: thought you were going to talk about Ileana Douglas. I 29 00:01:47,240 --> 00:01:49,800 Speaker 1: had no idea. It was Kim Marino from that one 30 00:01:49,800 --> 00:01:53,320 Speaker 1: show from the eighties. Oh well, please, I mean he 31 00:01:53,360 --> 00:01:55,160 Speaker 1: was from this he was a co founder of the State. 32 00:01:55,240 --> 00:01:58,080 Speaker 1: But he's he's one of my comedy heroes. Oh that's 33 00:01:58,120 --> 00:02:00,800 Speaker 1: not who I'm thinking of. Then, yeah, Ki Marinos from 34 00:02:00,840 --> 00:02:03,000 Speaker 1: the State and you know, wet, hot American summer and 35 00:02:03,680 --> 00:02:07,800 Speaker 1: party down and he had he had literally no lines. Thought, oh, 36 00:02:07,800 --> 00:02:10,560 Speaker 1: there's Kim Marino's gonna do something funny. But he was. 37 00:02:10,680 --> 00:02:13,959 Speaker 1: I guess it was after the State and before he 38 00:02:14,000 --> 00:02:15,679 Speaker 1: had done a ton of other stuff, so he was 39 00:02:15,760 --> 00:02:19,440 Speaker 1: just bunching buttons. I thought it was very funny. But anyway, 40 00:02:19,480 --> 00:02:21,600 Speaker 1: we had a makes even funnier that he didn't have 41 00:02:21,720 --> 00:02:26,120 Speaker 1: a like any kind of maybe I kept waiting for it. Uh. 42 00:02:27,040 --> 00:02:29,800 Speaker 1: It was a lot of fun, though. Uh if we 43 00:02:29,840 --> 00:02:32,200 Speaker 1: went back, we would do it a little different. We 44 00:02:32,240 --> 00:02:35,000 Speaker 1: went to Universal Studios and tried to park hot but 45 00:02:35,040 --> 00:02:38,440 Speaker 1: it's too much to do in one day. And uh 46 00:02:38,560 --> 00:02:40,280 Speaker 1: we we did all the Harry Potter stuff but didn't 47 00:02:40,280 --> 00:02:41,679 Speaker 1: get to ride some of the big rides who wanted 48 00:02:41,680 --> 00:02:43,920 Speaker 1: to ride. Well, that's cool. I'm glad you guys had 49 00:02:43,960 --> 00:02:48,800 Speaker 1: a good time. It was wonderful and refreshing, and uh boy, 50 00:02:49,080 --> 00:02:51,880 Speaker 1: I think we both needed a little respite. We definitely did, 51 00:02:51,960 --> 00:02:54,639 Speaker 1: me and you. We went to Hawaii for tenth anniversary 52 00:02:54,760 --> 00:02:58,520 Speaker 1: or yeah, it was the first time we've traveled in 53 00:03:00,600 --> 00:03:04,880 Speaker 1: two and a half three years something like that first trip. Uh, yes, 54 00:03:05,680 --> 00:03:07,959 Speaker 1: it was something else, but it was great. See, I 55 00:03:08,000 --> 00:03:10,320 Speaker 1: went travel crazy after I got COVID for a while, 56 00:03:10,360 --> 00:03:12,920 Speaker 1: so I had gotten some trips in. You're like, I 57 00:03:13,000 --> 00:03:15,440 Speaker 1: only have a few days to spread this far and wide. 58 00:03:15,440 --> 00:03:19,400 Speaker 1: I better get out there. No. After I got it, Oh, 59 00:03:19,480 --> 00:03:21,760 Speaker 1: gotcha got you? After I recovered you know what I mean, 60 00:03:21,880 --> 00:03:24,000 Speaker 1: I know I'm with you. No, I I stayed inside 61 00:03:24,040 --> 00:03:26,240 Speaker 1: and scared, but this is so it was. It was 62 00:03:26,280 --> 00:03:27,760 Speaker 1: something like I was like I don't know how this 63 00:03:27,800 --> 00:03:30,720 Speaker 1: is gonna go, but it went really well. But we're back. 64 00:03:31,440 --> 00:03:33,840 Speaker 1: We're here to do a job, and this is You're right, 65 00:03:33,919 --> 00:03:37,080 Speaker 1: this is very old school stuff. You should know kind 66 00:03:37,080 --> 00:03:41,559 Speaker 1: of topic. I'm shocked that we hadn't covered it yet. Uh. 67 00:03:41,720 --> 00:03:44,280 Speaker 1: I think the reason that you're shocked is because we 68 00:03:44,280 --> 00:03:49,280 Speaker 1: actually have. We did. We did uh amputations. I know 69 00:03:49,320 --> 00:03:50,920 Speaker 1: we talked about it there because we talked about the 70 00:03:50,920 --> 00:03:55,600 Speaker 1: mirror box before plenty and then possibly talked about it 71 00:03:55,640 --> 00:03:59,320 Speaker 1: in limb reattachment I'm not sure, but definitely in amputations 72 00:03:59,360 --> 00:04:02,400 Speaker 1: we did. All right, Well, this finishes up the sweet enfolding. 73 00:04:02,640 --> 00:04:07,800 Speaker 1: I agree. So what's phantom pain? Well, so, um, shout 74 00:04:07,840 --> 00:04:09,680 Speaker 1: out to Olivia first of all for helping us out 75 00:04:09,720 --> 00:04:12,120 Speaker 1: with this. I realized that we didn't. We didn't acknowledge 76 00:04:12,120 --> 00:04:15,040 Speaker 1: that she helped us with the chow Chillibus kidnapping articles. 77 00:04:15,120 --> 00:04:18,080 Speaker 1: So sorry for that one too, So I want to 78 00:04:18,160 --> 00:04:24,840 Speaker 1: let that pass. But um, so this she she does 79 00:04:24,880 --> 00:04:27,200 Speaker 1: a good job like basically getting across like what phantom 80 00:04:27,240 --> 00:04:30,320 Speaker 1: pain isn't that we actually don't really know what it is, 81 00:04:30,360 --> 00:04:32,880 Speaker 1: but you can describe it as anyone who's had an 82 00:04:32,920 --> 00:04:38,600 Speaker 1: amputation about of those people um suffer some sort of 83 00:04:38,680 --> 00:04:41,440 Speaker 1: pain sensation, and it's a whole range of pain. As 84 00:04:41,480 --> 00:04:45,440 Speaker 1: we'll see. The problem is it's in that limb that's 85 00:04:45,440 --> 00:04:48,560 Speaker 1: not there anymore. It's not in the residual limb what 86 00:04:48,960 --> 00:04:52,080 Speaker 1: people colloquially called the stump. Yes, you can have pain 87 00:04:52,120 --> 00:04:55,920 Speaker 1: there too, that's called residual limb pain. This is phantom 88 00:04:56,040 --> 00:04:58,400 Speaker 1: limb pain where let's say you had your foot cut off. 89 00:04:58,760 --> 00:05:01,560 Speaker 1: You feel like they're is a nail being driven into 90 00:05:01,560 --> 00:05:03,840 Speaker 1: the bottom of your foot. The problem is your foot 91 00:05:03,880 --> 00:05:05,960 Speaker 1: is not there anymore, so you can't pull the nail out. 92 00:05:06,320 --> 00:05:08,240 Speaker 1: And hence we get to the meat of what the 93 00:05:08,279 --> 00:05:12,159 Speaker 1: big problem is with phantom pain. That's right. Uh, it 94 00:05:12,200 --> 00:05:15,359 Speaker 1: can it's you know, usually think of hands and feet 95 00:05:15,360 --> 00:05:17,760 Speaker 1: and arms and legs and stuff like that. But it 96 00:05:17,800 --> 00:05:22,600 Speaker 1: can be after amassectomy, it can be removal of testicles. 97 00:05:23,640 --> 00:05:27,400 Speaker 1: I know that's not exactly a limb. It depends on 98 00:05:27,400 --> 00:05:31,120 Speaker 1: how big it is. Oh boy, I did set it 99 00:05:31,200 --> 00:05:38,400 Speaker 1: up with that inflection of my voice, right of course. Uh. 100 00:05:38,839 --> 00:05:43,560 Speaker 1: There's also sort of a side affliction called uh, phantom 101 00:05:43,600 --> 00:05:49,640 Speaker 1: limb sensation simsation sensation, which is it's not exactly pain, 102 00:05:49,720 --> 00:05:52,920 Speaker 1: but it's like, you know, I feel like my foot 103 00:05:53,040 --> 00:05:56,400 Speaker 1: is moving that's not there. Or my hand feels hot 104 00:05:56,760 --> 00:05:59,200 Speaker 1: even though I no longer have that hand, or maybe 105 00:05:59,800 --> 00:06:02,800 Speaker 1: uh pressure or something like that, but it's not. Or 106 00:06:02,839 --> 00:06:06,040 Speaker 1: it may feel like swollen, or like when you're asleep, 107 00:06:06,080 --> 00:06:08,200 Speaker 1: I feel like my arm is stuck behind my back 108 00:06:08,640 --> 00:06:10,920 Speaker 1: and it's causing me great discomfort even though you don't 109 00:06:10,960 --> 00:06:14,440 Speaker 1: have that arm. That kind of thing. Yeah, and so 110 00:06:14,520 --> 00:06:17,159 Speaker 1: for a long time people have said, like, well, clearly 111 00:06:17,200 --> 00:06:19,800 Speaker 1: it's these people are nuts, it's in their head. I 112 00:06:19,839 --> 00:06:23,000 Speaker 1: thought it was as recent as seven that they finally said, no, 113 00:06:23,120 --> 00:06:24,800 Speaker 1: that's not the case. And we'll talk about some of 114 00:06:24,839 --> 00:06:28,560 Speaker 1: the historical view of it, but the upshot of it 115 00:06:28,600 --> 00:06:32,479 Speaker 1: is now we understand that people who experience phantom limb 116 00:06:32,600 --> 00:06:37,839 Speaker 1: pain are in fact experiencing pain in the same way 117 00:06:37,880 --> 00:06:40,960 Speaker 1: that you or I would experience pain in that same limb. 118 00:06:41,000 --> 00:06:43,479 Speaker 1: Like it's just as real to them as it is 119 00:06:43,520 --> 00:06:46,560 Speaker 1: to us. And it means that the brain's gone haywire. 120 00:06:47,040 --> 00:06:49,400 Speaker 1: And there's all sorts of ways it can manifest itself. 121 00:06:49,440 --> 00:06:52,960 Speaker 1: There's shooting spain, shooting pain, stabbing pain, it could be 122 00:06:53,000 --> 00:06:56,560 Speaker 1: cramping pain, pins and needles, which is bad enough, but 123 00:06:56,720 --> 00:06:59,279 Speaker 1: pain from pins and needles, which should be awful, and 124 00:06:59,440 --> 00:07:03,120 Speaker 1: it's you aunt, possibly scratch that sounds about as bad 125 00:07:03,120 --> 00:07:06,920 Speaker 1: as it can get. A crushing, pain, throbbing, basically, any 126 00:07:07,040 --> 00:07:10,800 Speaker 1: variety of pain that you could have experienced in that 127 00:07:11,400 --> 00:07:14,680 Speaker 1: um in that limb before it was amputated, you're capable 128 00:07:14,720 --> 00:07:18,920 Speaker 1: of experiencing it after it was amputated too. Yeah, and 129 00:07:19,000 --> 00:07:21,240 Speaker 1: Livia makes a good point here. And as you'll see 130 00:07:21,240 --> 00:07:24,760 Speaker 1: in the history part, there have long been philosophers and 131 00:07:24,760 --> 00:07:27,520 Speaker 1: and people like to think it scientists even that are 132 00:07:27,600 --> 00:07:31,240 Speaker 1: just fascinated with this curious syndrome. And it's you know, 133 00:07:32,080 --> 00:07:34,320 Speaker 1: it makes sense that people would be fascinated with it 134 00:07:34,400 --> 00:07:37,880 Speaker 1: like that. But it is a real problem. Um. It is. 135 00:07:38,400 --> 00:07:40,920 Speaker 1: It can cause people to not sleep, It can cause 136 00:07:40,920 --> 00:07:43,280 Speaker 1: people to not have the job that they want. It 137 00:07:43,320 --> 00:07:45,520 Speaker 1: can lead to suicidal thoughts. Like it is a real 138 00:07:45,560 --> 00:07:48,680 Speaker 1: affliction and not something that should be just treated as 139 00:07:48,720 --> 00:07:53,040 Speaker 1: a as an interesting curiosity, right, But it also is 140 00:07:53,080 --> 00:07:55,360 Speaker 1: an interesting curiosity. It's the tring that we need to 141 00:07:55,440 --> 00:07:58,880 Speaker 1: understand to help people with. But it's fascinating and the 142 00:07:58,920 --> 00:08:02,480 Speaker 1: reason why philosophers are so so you know, nuts for 143 00:08:02,560 --> 00:08:07,240 Speaker 1: it is because it proves that, like our subjective experience 144 00:08:07,280 --> 00:08:11,480 Speaker 1: of reality is not necessarily fully in line with reality. 145 00:08:11,600 --> 00:08:17,280 Speaker 1: It shows that we're capable of experiencing the unreal. Wow, 146 00:08:17,720 --> 00:08:22,120 Speaker 1: that was dramatic. I thought so too. Uh So, let's 147 00:08:22,200 --> 00:08:24,320 Speaker 1: you want to dive into the history a little bit, Yes, 148 00:08:24,800 --> 00:08:28,000 Speaker 1: and let's talk first, Chuck. I think at the beginning 149 00:08:28,040 --> 00:08:32,240 Speaker 1: about Ambrose Pare. Oh. Yeah, he was a French surgeon 150 00:08:32,480 --> 00:08:35,920 Speaker 1: in the mid sixteenth century. And this is one of 151 00:08:35,920 --> 00:08:39,559 Speaker 1: those kind of rare cases where someone from hundreds of 152 00:08:39,640 --> 00:08:43,680 Speaker 1: years ago describe something and had a handle on something 153 00:08:44,520 --> 00:08:47,800 Speaker 1: in in a pretty solid way. Like looking back, he 154 00:08:48,000 --> 00:08:50,920 Speaker 1: really was pretty close and a lot of the things 155 00:08:50,920 --> 00:08:53,880 Speaker 1: that he thought about phantom limpain and he was the 156 00:08:53,920 --> 00:08:56,560 Speaker 1: first dude to describe it, which is pretty remarkable. Yeah. 157 00:08:56,600 --> 00:08:59,040 Speaker 1: I mean we're talking the middle of the sixteenth century. 158 00:08:59,080 --> 00:09:01,920 Speaker 1: Like you said, that's that's crazy. That's a time when 159 00:09:01,920 --> 00:09:06,120 Speaker 1: people didn't really think that that the people working in 160 00:09:06,160 --> 00:09:10,000 Speaker 1: science for scientists, Like science kind of came later, according 161 00:09:10,040 --> 00:09:13,520 Speaker 1: to some people. And it's like, um, if we had 162 00:09:13,559 --> 00:09:17,160 Speaker 1: just kind of built on paradise understanding of it, who 163 00:09:17,200 --> 00:09:19,520 Speaker 1: knows how much further along we would be in in 164 00:09:20,040 --> 00:09:22,440 Speaker 1: you know, treating and dealing with that kind of stuff. 165 00:09:22,440 --> 00:09:24,720 Speaker 1: But um, it's, like you said, he had a really 166 00:09:24,720 --> 00:09:28,400 Speaker 1: good handle on it. He's he was the first to differentiate. 167 00:09:28,440 --> 00:09:31,640 Speaker 1: Remember how I said, there's like residual residual limb pain 168 00:09:32,000 --> 00:09:33,680 Speaker 1: and then there's phantom limb pain. He was the first 169 00:09:33,679 --> 00:09:35,600 Speaker 1: one to say those are two separate things. It's not 170 00:09:35,679 --> 00:09:39,199 Speaker 1: the same thing. Uh. He said that there's different factors 171 00:09:39,200 --> 00:09:42,079 Speaker 1: that can um set it off, like the weather, change 172 00:09:42,080 --> 00:09:45,120 Speaker 1: in the weather. Um. And then that there's different things 173 00:09:45,120 --> 00:09:48,120 Speaker 1: that could treat it, like sometimes massage around the residual 174 00:09:48,200 --> 00:09:52,600 Speaker 1: limb helps to what else. Uh. He also made the distinction. 175 00:09:52,600 --> 00:09:56,480 Speaker 1: You know we described the phantom limb sensations. He described 176 00:09:56,480 --> 00:10:00,520 Speaker 1: the difference there between the pain and the sensation. Oh yeah, Uh, 177 00:10:00,520 --> 00:10:03,160 Speaker 1: that's a big one. He also said, so he said 178 00:10:03,200 --> 00:10:07,360 Speaker 1: two things. He said that um either that his guests 179 00:10:07,640 --> 00:10:09,640 Speaker 1: for what was causing it was that either there was 180 00:10:09,720 --> 00:10:13,920 Speaker 1: some problem with the nerves in the residual limb um. 181 00:10:13,960 --> 00:10:16,359 Speaker 1: I think he said that he thought they were retreating 182 00:10:16,520 --> 00:10:21,120 Speaker 1: possibly or withdrawing, which makes sense in a weird way. Um. 183 00:10:21,360 --> 00:10:24,600 Speaker 1: Or he thought that it was that it originated in 184 00:10:24,640 --> 00:10:27,840 Speaker 1: the brain, not through some sort of psychosis, but through 185 00:10:27,920 --> 00:10:31,520 Speaker 1: some sort of you know, foul up in the brain, 186 00:10:31,600 --> 00:10:35,120 Speaker 1: like a glitch in the brain. And still today, as 187 00:10:35,160 --> 00:10:37,280 Speaker 1: we'll see when we're talking about this, our understanding, a 188 00:10:37,320 --> 00:10:40,000 Speaker 1: pan of limp pain basically boils down to those two, 189 00:10:40,240 --> 00:10:44,599 Speaker 1: those two general concepts. Yeah, it's pretty amazing and um, 190 00:10:44,800 --> 00:10:46,559 Speaker 1: we're not. Well, we'll get to that. I want to 191 00:10:46,600 --> 00:10:49,559 Speaker 1: save that. I don't want to spoil it. I mentioned 192 00:10:49,559 --> 00:10:54,480 Speaker 1: philosophers being sort of um delighted by this idea. Descartes 193 00:10:54,559 --> 00:10:57,080 Speaker 1: was one of them. In the kind of early to 194 00:10:57,120 --> 00:11:00,720 Speaker 1: mid sixteen hundreds, he talked a lot about Fannalm mimes. 195 00:11:00,760 --> 00:11:03,400 Speaker 1: He he was one of the people that was really 196 00:11:03,400 --> 00:11:06,160 Speaker 1: blown away by what he called non resemblance, which is 197 00:11:06,200 --> 00:11:09,880 Speaker 1: what you were talking about, your subjective experience not aligning 198 00:11:09,880 --> 00:11:14,120 Speaker 1: with reality. And he also thinks or thought it had 199 00:11:14,160 --> 00:11:15,800 Speaker 1: to do with severed nerves, so he was sort of 200 00:11:15,800 --> 00:11:19,760 Speaker 1: on the right track as well. And then the Scottish guy, 201 00:11:20,000 --> 00:11:23,800 Speaker 1: uh William Porterfield in seventeen fifty nine. He was a 202 00:11:23,840 --> 00:11:29,800 Speaker 1: physician that lost a foot and he had an actual physicians, 203 00:11:30,040 --> 00:11:34,120 Speaker 1: first person autobiographical take on it all and talked about 204 00:11:34,280 --> 00:11:37,520 Speaker 1: his toes, heel and ankle spelled with a sea which 205 00:11:37,559 --> 00:11:43,120 Speaker 1: is fantastic, Um, like experiencing pain and itching several years after. 206 00:11:43,280 --> 00:11:45,440 Speaker 1: I don't think we said it can start up to 207 00:11:45,760 --> 00:11:47,800 Speaker 1: like as in as short as like a week afterward, 208 00:11:48,440 --> 00:11:51,200 Speaker 1: and it can go on, you know, sometimes it comes 209 00:11:51,200 --> 00:11:54,680 Speaker 1: and goes. Sometimes it's persistent, sometimes it goes away entirely. 210 00:11:54,760 --> 00:11:58,480 Speaker 1: Sometimes it lasts forever. So um, it can really be 211 00:11:58,520 --> 00:12:01,920 Speaker 1: all over the all over the map. But his description 212 00:12:02,040 --> 00:12:06,679 Speaker 1: was at least a few years afterward, right, So um, 213 00:12:06,800 --> 00:12:12,080 Speaker 1: that was seventeen fifty nine, And that was almost exactly 214 00:12:12,080 --> 00:12:16,600 Speaker 1: two hundred years after Perry first identified phantom limb sensation 215 00:12:16,679 --> 00:12:19,360 Speaker 1: or fantom in pain. Um, And it just kind of 216 00:12:19,400 --> 00:12:22,640 Speaker 1: got lost from there. And it wasn't until the American 217 00:12:22,679 --> 00:12:26,120 Speaker 1: Civil War when a surgeon named Silas Weir Mitchell, who 218 00:12:26,160 --> 00:12:29,600 Speaker 1: I know, we've talked about. His name seems very familiar, um, 219 00:12:30,000 --> 00:12:33,920 Speaker 1: who took part in the removal of thirty thousand limbs, 220 00:12:33,960 --> 00:12:36,839 Speaker 1: not himself personally, but he was like among the battlefield 221 00:12:36,880 --> 00:12:40,400 Speaker 1: surgeons who took that total number during the American Civil War. 222 00:12:40,840 --> 00:12:44,599 Speaker 1: Thanks to advances in certain kinds of bullets and projectiles 223 00:12:44,600 --> 00:12:47,360 Speaker 1: that could really do some so much damage that when 224 00:12:47,360 --> 00:12:49,760 Speaker 1: they hit like a bone in a lagorant arm, like 225 00:12:49,800 --> 00:12:51,839 Speaker 1: you just were going to lose that arm or leg 226 00:12:51,920 --> 00:12:55,440 Speaker 1: to save your life. Um. He he had like all 227 00:12:55,440 --> 00:12:58,920 Speaker 1: this firsthand experience with these people who had just lost 228 00:12:59,000 --> 00:13:01,440 Speaker 1: a limb, and we're complained meaning about pain in the limbs. 229 00:13:01,480 --> 00:13:04,560 Speaker 1: So this this idea phantom limp pain kind of came 230 00:13:04,600 --> 00:13:08,400 Speaker 1: back to the four at a time when surgeons were 231 00:13:08,440 --> 00:13:10,520 Speaker 1: starting to talk to each other more and science was 232 00:13:10,559 --> 00:13:13,120 Speaker 1: starting to be practiced in a more methodical way, so 233 00:13:13,160 --> 00:13:16,160 Speaker 1: that the discovery of one person could be understood and 234 00:13:16,240 --> 00:13:18,319 Speaker 1: learned and built on by other people a lot more 235 00:13:18,360 --> 00:13:22,080 Speaker 1: easily than it was in the sixteenth century. Right. But 236 00:13:22,120 --> 00:13:25,840 Speaker 1: he took a kind of weird approach initially, uh and 237 00:13:25,920 --> 00:13:30,640 Speaker 1: that he wrote a fictional account, basically a fictional short 238 00:13:30,679 --> 00:13:34,120 Speaker 1: story called the Case of George Deadlow, and he talked 239 00:13:34,120 --> 00:13:37,760 Speaker 1: about a Civil War veteran who experienced fanom pain and 240 00:13:38,000 --> 00:13:40,560 Speaker 1: legs and arms that he had lost in the war. 241 00:13:41,320 --> 00:13:44,400 Speaker 1: And it ultimately led to a seance where he's communicating 242 00:13:44,400 --> 00:13:47,040 Speaker 1: with these limbs and then walks around the room on 243 00:13:47,080 --> 00:13:49,760 Speaker 1: these invisible limbs, and a lot of people thought this 244 00:13:49,840 --> 00:13:52,880 Speaker 1: was real and started sending donations in and wanted to 245 00:13:52,960 --> 00:13:56,680 Speaker 1: visit with this person and six years afterwards he was like, 246 00:13:56,760 --> 00:14:00,760 Speaker 1: maybe I should write, uh, something real and not fiction piece. 247 00:14:01,400 --> 00:14:03,240 Speaker 1: And he went on to do that, I think to 248 00:14:03,679 --> 00:14:07,559 Speaker 1: greater effect. Yeah, because he finally after six years he 249 00:14:07,600 --> 00:14:12,680 Speaker 1: stopped face palming, Like, Okay, it sounds like people a day, 250 00:14:12,720 --> 00:14:14,840 Speaker 1: doesn't it. Can't you see people a day sending in 251 00:14:14,920 --> 00:14:17,360 Speaker 1: donations to the guy who lost his legs but were 252 00:14:17,840 --> 00:14:20,960 Speaker 1: was able to walk around on invisible residual limbs and 253 00:14:21,000 --> 00:14:27,240 Speaker 1: a seance Facebook told him so so um so silence 254 00:14:27,280 --> 00:14:30,920 Speaker 1: where Mitchell finally creates what what you could kind of 255 00:14:30,960 --> 00:14:35,840 Speaker 1: point to is like the first um modern scientific paper 256 00:14:35,920 --> 00:14:39,640 Speaker 1: on phantom limb pain, and he estimated as high as 257 00:14:39,680 --> 00:14:43,200 Speaker 1: eighties six out of ninety of his um amputee patients 258 00:14:44,080 --> 00:14:47,400 Speaker 1: experience phantom limb pain. Not just phantom limb sensation, but 259 00:14:47,440 --> 00:14:52,040 Speaker 1: phantom limb pain. Um and uh that that is a 260 00:14:52,080 --> 00:14:54,440 Speaker 1: really high number. It's higher than average. But like I 261 00:14:54,480 --> 00:14:56,920 Speaker 1: said before, I mean in the neighborhood of a d 262 00:14:57,040 --> 00:14:59,280 Speaker 1: I think I've seen as high as eighty five of 263 00:14:59,280 --> 00:15:02,720 Speaker 1: people who of an amputated limb will experience pain to 264 00:15:02,800 --> 00:15:07,440 Speaker 1: some degree in that in that that phantom limb right, 265 00:15:07,560 --> 00:15:12,320 Speaker 1: And I think most people experienced sensation, right, I believe 266 00:15:12,400 --> 00:15:16,280 Speaker 1: that's correct. Yes, My understanding is more of the phantom 267 00:15:16,320 --> 00:15:21,160 Speaker 1: pain stuff. Though. Is phantom sensation more prevalent? Yeah, I 268 00:15:21,200 --> 00:15:24,280 Speaker 1: mean for sure. Okay, al right, well that makes sense too. 269 00:15:24,320 --> 00:15:27,200 Speaker 1: And that's just merciful, that's right. Uh. And for a 270 00:15:27,240 --> 00:15:30,280 Speaker 1: lot of years there was you know, up until like 271 00:15:30,320 --> 00:15:34,040 Speaker 1: the mid twentieth century, there were a lot of psychological 272 00:15:34,480 --> 00:15:38,440 Speaker 1: um or they were attributing this at least a psychological causes. 273 00:15:38,720 --> 00:15:42,280 Speaker 1: Earlier on, it was you know, doctors would say, oh, 274 00:15:42,320 --> 00:15:45,400 Speaker 1: you know, people who experienced this have one quote was 275 00:15:45,440 --> 00:15:49,960 Speaker 1: an unsatisfactory personality. Or they said they may be obsessive 276 00:15:49,960 --> 00:15:53,320 Speaker 1: people obsessed with things being wrong. They may be anxious people, 277 00:15:53,360 --> 00:15:57,760 Speaker 1: they may be overly dramatic. I know. But although up 278 00:15:57,800 --> 00:16:02,400 Speaker 1: until nineteen p but were arguing, doctors were arguing at 279 00:16:02,400 --> 00:16:07,680 Speaker 1: the Mayo Clinic that, uh, phantom limb pain sufferers, if 280 00:16:07,960 --> 00:16:11,600 Speaker 1: it was persistent, reflected a pre existing difficulty and adapting 281 00:16:11,600 --> 00:16:15,560 Speaker 1: to problems. Uh, and may be influenced by just knowing 282 00:16:15,640 --> 00:16:18,160 Speaker 1: that it exists, like well, yeah, I've read about this, 283 00:16:18,240 --> 00:16:20,800 Speaker 1: I'm I'm feeling that pain too. So if you if 284 00:16:20,800 --> 00:16:25,880 Speaker 1: you suffer pain, phantom limb pain. You are neurotic, easily suggestible. 285 00:16:26,200 --> 00:16:29,800 Speaker 1: Possibly you're you consider yourself a failure now that you've 286 00:16:29,840 --> 00:16:32,400 Speaker 1: lost a limb, and you're worried about disappointing your father 287 00:16:32,880 --> 00:16:36,200 Speaker 1: or mother who might be like overly concerned with sports 288 00:16:36,240 --> 00:16:40,520 Speaker 1: triumphs or beauty or something like that. And like I said, 289 00:16:40,560 --> 00:16:44,120 Speaker 1: I dug up a reference that said it was seven 290 00:16:44,160 --> 00:16:47,360 Speaker 1: when they finally did a meta analysis of all of 291 00:16:47,360 --> 00:16:50,520 Speaker 1: the literature and said, everyone, these people are not crazy. 292 00:16:50,760 --> 00:16:53,680 Speaker 1: Like for years they used to compare. It wasn't even 293 00:16:53,680 --> 00:16:56,600 Speaker 1: a comparison. It was like um, it was a tangential 294 00:16:57,320 --> 00:17:01,480 Speaker 1: um syndrome where if you experience phantom pain it was 295 00:17:01,560 --> 00:17:05,359 Speaker 1: tantamount to having psychosis. Like that's how they were treated. 296 00:17:05,760 --> 00:17:08,000 Speaker 1: And so for years and years people just knew, like 297 00:17:08,080 --> 00:17:10,119 Speaker 1: you didn't complain about your fanom pain or else, they 298 00:17:10,160 --> 00:17:13,200 Speaker 1: were going to give you electro convulsive therapy, maybe even 299 00:17:13,200 --> 00:17:15,600 Speaker 1: a lobotomy. It doesn't I didn't turn that up, but 300 00:17:15,720 --> 00:17:19,720 Speaker 1: I guarantee someone got a lobotomy for phantom limp pain 301 00:17:19,920 --> 00:17:24,000 Speaker 1: sometime in the ninet thirties or forties. That would not surprise. 302 00:17:24,080 --> 00:17:26,159 Speaker 1: I would put a lot of money on that they 303 00:17:26,160 --> 00:17:30,919 Speaker 1: would lobotomize, uh, domestic housewives for not wanting to do 304 00:17:31,000 --> 00:17:34,320 Speaker 1: dishes exactly. So you know, somebody with fanom limp pain 305 00:17:34,440 --> 00:17:39,000 Speaker 1: got that treatment. Uh. Should we take a break? Yeah, 306 00:17:39,560 --> 00:17:42,679 Speaker 1: all right, that was chuck full of information. Yeah, so 307 00:17:42,720 --> 00:17:45,200 Speaker 1: we can only go down from here. You know, let's 308 00:17:45,280 --> 00:17:48,040 Speaker 1: keep chucking it up. Chuck. All right, we'll be right 309 00:17:48,040 --> 00:18:12,600 Speaker 1: back to chuck it, chocking it. Let's chock it some more. 310 00:18:13,320 --> 00:18:18,159 Speaker 1: Hold its mouth open um. This is really interesting. Livia 311 00:18:18,400 --> 00:18:22,200 Speaker 1: dug up a couple of first person descriptions of phantom 312 00:18:22,560 --> 00:18:28,560 Speaker 1: uh pain syndrome. Is it a syndrome? Uh, I don't 313 00:18:28,560 --> 00:18:31,480 Speaker 1: know why I'm calling it that because of alien hand syndrome. Probably. Yeah, 314 00:18:31,600 --> 00:18:33,760 Speaker 1: The thing is, I don't I think it is a 315 00:18:33,800 --> 00:18:36,800 Speaker 1: syndrome because the syndrome is usually a cluster of seemingly 316 00:18:36,880 --> 00:18:41,080 Speaker 1: unrelated symptoms. So probably not. Look at you, smarty pants. 317 00:18:41,200 --> 00:18:42,800 Speaker 1: I can't remember what that was from. I think in 318 00:18:42,840 --> 00:18:46,480 Speaker 1: our albinism episode, I learned what difference between a syndrome 319 00:18:46,520 --> 00:18:49,040 Speaker 1: and a non syndrome. Yeah, okay, so it's recent. Don't 320 00:18:49,080 --> 00:18:52,439 Speaker 1: don't be too impressed. She dug up a couple of 321 00:18:52,520 --> 00:18:57,159 Speaker 1: Norwegian academics and one page and this is just to 322 00:18:57,280 --> 00:18:59,440 Speaker 1: let you know what what some of these people go through. 323 00:19:00,119 --> 00:19:04,359 Speaker 1: One of the patient described a phantom arm being stuck straightforward, 324 00:19:05,040 --> 00:19:08,200 Speaker 1: just sticking straight out from the shoulder, and basically every 325 00:19:08,240 --> 00:19:11,840 Speaker 1: time he walked through a door would go through sideways. 326 00:19:12,720 --> 00:19:15,280 Speaker 1: And you know, this is you hear something like this, 327 00:19:15,359 --> 00:19:19,320 Speaker 1: and it's this is a It's not like shooting, stabbing, 328 00:19:19,320 --> 00:19:22,600 Speaker 1: pain and pins and needles, but it's something that you 329 00:19:22,640 --> 00:19:24,840 Speaker 1: have to explain to everybody. It's something that you're living 330 00:19:24,880 --> 00:19:29,639 Speaker 1: with that uh, that people would see as abnormal, so 331 00:19:29,720 --> 00:19:32,840 Speaker 1: it causes psychological impacts, you know. Yeah, I mean if 332 00:19:32,880 --> 00:19:37,320 Speaker 1: you saw somebody with only one arm just turn and 333 00:19:37,359 --> 00:19:40,840 Speaker 1: go gingerly kind of sideways through a doorway for no reason, 334 00:19:40,920 --> 00:19:42,879 Speaker 1: yes it would it would be a little odd, you know. 335 00:19:43,400 --> 00:19:47,280 Speaker 1: But the idea of your arm never being down, I 336 00:19:47,280 --> 00:19:49,080 Speaker 1: mean that kind of goes back to what we were saying, 337 00:19:49,080 --> 00:19:51,800 Speaker 1: the difference between being fascinated with and the difference between 338 00:19:51,800 --> 00:19:53,960 Speaker 1: having to live with it. You know, like, just think 339 00:19:53,960 --> 00:19:55,760 Speaker 1: about what it feels like they have your arm up, 340 00:19:55,960 --> 00:19:58,840 Speaker 1: like just for a minute, or to imagine always feeling that. 341 00:19:59,240 --> 00:20:01,679 Speaker 1: And then the guy you mentioned, he was also in 342 00:20:01,680 --> 00:20:05,800 Speaker 1: that Norwegian paper you mentioned before, where um, there was 343 00:20:05,840 --> 00:20:08,040 Speaker 1: a patient who couldn't sleep on his back because he 344 00:20:08,119 --> 00:20:11,600 Speaker 1: felt like his arm was twisted behind him at all times. 345 00:20:12,160 --> 00:20:14,080 Speaker 1: And yeah, that sucks to not be able to sleep 346 00:20:14,119 --> 00:20:16,200 Speaker 1: on your back. That's like the money sleep right there. 347 00:20:16,920 --> 00:20:20,920 Speaker 1: But imagine feeling like your arms twisted behind your back 348 00:20:21,320 --> 00:20:25,320 Speaker 1: every waking moment and that you can't do anything about it. 349 00:20:25,960 --> 00:20:29,880 Speaker 1: That would drive you nuts. It's as simple as that. Yeah, 350 00:20:29,880 --> 00:20:33,520 Speaker 1: So those are like on this sort of lighter psychological side. 351 00:20:33,560 --> 00:20:37,000 Speaker 1: On the other end of the spectrum, another man who 352 00:20:37,560 --> 00:20:43,760 Speaker 1: I think lost both legs um was woken up periodically 353 00:20:44,160 --> 00:20:47,040 Speaker 1: thinking that the nail of one toe was growing into 354 00:20:47,119 --> 00:20:50,920 Speaker 1: the next toe. Uh. And another ampute said they felt 355 00:20:50,960 --> 00:20:54,240 Speaker 1: like the skin on their arm was ripped off, salt 356 00:20:54,320 --> 00:20:56,480 Speaker 1: was being poured on it, and it was thrust into 357 00:20:56,560 --> 00:20:59,800 Speaker 1: a fire. Right. And then other people report to Chuck, 358 00:20:59,880 --> 00:21:02,200 Speaker 1: this seems like something that would be easy to overlook, 359 00:21:02,240 --> 00:21:05,639 Speaker 1: that you know, having you know, consistent pain in this 360 00:21:05,720 --> 00:21:09,280 Speaker 1: phantom limb. Remind them that they have a phantom limb, 361 00:21:09,280 --> 00:21:12,199 Speaker 1: that they have like an an amputation, and that just 362 00:21:12,280 --> 00:21:15,919 Speaker 1: makes the whole thing that much more. Already distressing event 363 00:21:16,400 --> 00:21:19,960 Speaker 1: is consistently distressing, over and over again because it's just 364 00:21:20,000 --> 00:21:23,040 Speaker 1: a reminder of it, you know, right, especially if you're 365 00:21:23,080 --> 00:21:26,040 Speaker 1: trying to rehabilitate and move on with your with the 366 00:21:26,080 --> 00:21:31,159 Speaker 1: new normal, you know exactly. So, UM, we kind of 367 00:21:31,359 --> 00:21:35,439 Speaker 1: reached finally, like where we're at with our understanding of 368 00:21:35,840 --> 00:21:40,199 Speaker 1: phantom limb pain. And that's basically where we were in 369 00:21:40,200 --> 00:21:43,639 Speaker 1: the sixteenth century if everyone had listened to Ambrose Parey, 370 00:21:44,440 --> 00:21:48,680 Speaker 1: and that is that. Um, despite a lot a lot 371 00:21:48,760 --> 00:21:53,000 Speaker 1: of people getting amputations every year in the US alone, 372 00:21:53,760 --> 00:21:56,440 Speaker 1: I think there's something like a hundred and eighty five 373 00:21:56,520 --> 00:21:59,840 Speaker 1: thousand amputations every year, the vast majority of them due 374 00:21:59,880 --> 00:22:06,359 Speaker 1: to complications from vascular disease including diabetes. UM having a 375 00:22:06,440 --> 00:22:09,320 Speaker 1: whole bunch of troops come back from Iraq and Afghanistan 376 00:22:10,040 --> 00:22:14,560 Speaker 1: with amputations needing treatment and rehabilitation, and eight percent of 377 00:22:14,600 --> 00:22:18,680 Speaker 1: these people suffering phantom limp pain. We still don't know 378 00:22:19,359 --> 00:22:22,280 Speaker 1: what causes fami limp pain, what the basis of it is. 379 00:22:22,480 --> 00:22:25,160 Speaker 1: And that's despite thinking we did for a little while 380 00:22:25,200 --> 00:22:27,680 Speaker 1: there right like in the late nineties, early two thousands, 381 00:22:28,200 --> 00:22:30,600 Speaker 1: and we talked about it, and I think our amputation episode, 382 00:22:30,760 --> 00:22:32,600 Speaker 1: we thought we had a handle on it. And that's 383 00:22:32,640 --> 00:22:36,959 Speaker 1: since been challenged and possibly debunked. Yeah, and you know, 384 00:22:37,040 --> 00:22:40,960 Speaker 1: like we said with Parae, Uh, Michael Parree is that 385 00:22:41,040 --> 00:22:44,840 Speaker 1: his name you're thinking of? Michael Buble? I was thinking 386 00:22:44,880 --> 00:22:47,600 Speaker 1: of Eddie and the Cruisers. Maybe that's how I was 387 00:22:47,640 --> 00:22:49,800 Speaker 1: thinking you were talking about when you mentioned can Marino. 388 00:22:53,000 --> 00:22:55,359 Speaker 1: Oh man, they should remake that with Kid Marina. What 389 00:22:55,400 --> 00:22:57,960 Speaker 1: a funny movie that would be. Who is the guy 390 00:22:58,040 --> 00:23:00,199 Speaker 1: I am thinking of? I want to say it's like 391 00:23:00,280 --> 00:23:03,240 Speaker 1: a he was like a kind of like a dark 392 00:23:03,400 --> 00:23:06,000 Speaker 1: night kind of figure who would like help people and 393 00:23:06,080 --> 00:23:16,160 Speaker 1: maybe the fifties. Arthur Fonzarelli. No, No, I'll try to remember. 394 00:23:16,240 --> 00:23:19,320 Speaker 1: I'm gonna I'm gonna pro portion off like seven percent 395 00:23:19,359 --> 00:23:21,639 Speaker 1: of my brain just to be working on this this 396 00:23:21,720 --> 00:23:25,240 Speaker 1: problem while the other is focused on this episode. Okay. 397 00:23:25,680 --> 00:23:27,959 Speaker 1: You know what, It's funny that I said, Arthur Fonzarelli 398 00:23:28,080 --> 00:23:32,560 Speaker 1: because our friend of the show, Paula Tompkins and uh 399 00:23:32,880 --> 00:23:35,880 Speaker 1: sort of colleague pal in real life for us, he 400 00:23:35,920 --> 00:23:40,040 Speaker 1: mentions Arthur fonds Relli more than any other human I've 401 00:23:40,040 --> 00:23:44,040 Speaker 1: ever known in my life. Yeah. Yeah, in his in 402 00:23:44,080 --> 00:23:46,800 Speaker 1: his show Freedom and then conversationally on his other show 403 00:23:47,359 --> 00:23:50,080 Speaker 1: Stay at Hopkins with his wife Janie. He just he 404 00:23:50,320 --> 00:23:52,640 Speaker 1: it's a great comedic effect. He brings up Fonzi a lot. 405 00:23:52,760 --> 00:23:55,719 Speaker 1: It's pretty great. Well yeah, I mean, if you if 406 00:23:55,760 --> 00:23:57,840 Speaker 1: you want to get an easy laugh just bringing up 407 00:23:57,960 --> 00:24:00,560 Speaker 1: fond Yeah, he times it out. Well, this is really 408 00:24:00,640 --> 00:24:02,960 Speaker 1: well done, Like you just did it yourself. I feel 409 00:24:02,960 --> 00:24:06,480 Speaker 1: like I channeled up Paul of Tompkinson, so I can 410 00:24:06,520 --> 00:24:08,640 Speaker 1: tell you what the show is now if you want 411 00:24:08,680 --> 00:24:11,320 Speaker 1: to know. It has nothing to do with the fifties 412 00:24:12,320 --> 00:24:14,760 Speaker 1: dark night thing. I'm still not sure what that show is. 413 00:24:15,000 --> 00:24:17,320 Speaker 1: It's a show. I promise it's called Growing Pains. The 414 00:24:17,400 --> 00:24:21,160 Speaker 1: guy I'm thinking of is Ken Wall in the show 415 00:24:21,160 --> 00:24:25,040 Speaker 1: Wise Guy. Sure, he kind of looks like Ken Marino too. 416 00:24:27,480 --> 00:24:29,080 Speaker 1: If you put him next to each other, you'd be like, 417 00:24:29,119 --> 00:24:31,760 Speaker 1: don't be ridiculous. But if you see one at a 418 00:24:31,800 --> 00:24:34,560 Speaker 1: party and then went to another party down the street 419 00:24:34,640 --> 00:24:36,600 Speaker 1: and saw the other, you'd be like, gosh, you guys 420 00:24:36,600 --> 00:24:39,160 Speaker 1: look a lot alike. I remember Kinting Wall. I don't 421 00:24:39,200 --> 00:24:42,760 Speaker 1: know what happened to that guy. Maybe everyone figured out 422 00:24:42,800 --> 00:24:45,280 Speaker 1: he was a bad actor. Was he a bad actor? 423 00:24:45,440 --> 00:24:48,120 Speaker 1: I mean, come on, Wise Guy has a seven point 424 00:24:48,119 --> 00:24:51,200 Speaker 1: eight out of ten on I AMDB, really high these days. 425 00:24:51,359 --> 00:24:54,320 Speaker 1: Well that says it all. Yeah. Uh so I think 426 00:24:54,320 --> 00:24:58,200 Speaker 1: where I was headed before I got sidetracked was uh, 427 00:24:58,359 --> 00:25:01,000 Speaker 1: like you said, with Parade, they are still sort of 428 00:25:01,000 --> 00:25:03,480 Speaker 1: looking at two schools of thought, and you know, it 429 00:25:03,520 --> 00:25:05,240 Speaker 1: could be a who knows, it could be a combination 430 00:25:05,240 --> 00:25:08,879 Speaker 1: of both, but uh, you know, central nervous system stuff 431 00:25:09,440 --> 00:25:15,879 Speaker 1: and then um, you know, brain mapping and literal nerve 432 00:25:16,600 --> 00:25:19,359 Speaker 1: issues like you know, it could have. You know, the 433 00:25:19,359 --> 00:25:21,159 Speaker 1: first thing you're gonna do is put you into the 434 00:25:21,160 --> 00:25:24,080 Speaker 1: Wonder machine and see what lights up when you feel 435 00:25:24,080 --> 00:25:26,240 Speaker 1: that type of pain. And they have found that it 436 00:25:26,280 --> 00:25:29,080 Speaker 1: does show activity in parts of the brain connected to 437 00:25:29,119 --> 00:25:31,720 Speaker 1: the nerves of that missing limb. So that's a good 438 00:25:31,720 --> 00:25:34,600 Speaker 1: place to start. Uh. It could be thickening of the 439 00:25:34,680 --> 00:25:39,560 Speaker 1: severed nerve endings, um like after the operation, uh, making 440 00:25:39,600 --> 00:25:42,120 Speaker 1: things a little more sensitive. But there's still a lot 441 00:25:42,119 --> 00:25:44,720 Speaker 1: of debate on this, you know. Yeah, and that last 442 00:25:44,760 --> 00:25:47,480 Speaker 1: one is called the neuroma theory, and that is how 443 00:25:47,640 --> 00:25:51,680 Speaker 1: that was a leading um explanation for and it still 444 00:25:51,720 --> 00:25:54,560 Speaker 1: could be right. But there when they when they amputate 445 00:25:54,600 --> 00:25:57,800 Speaker 1: your limb, um, they're also amputating a lot of other 446 00:25:57,840 --> 00:25:59,560 Speaker 1: stuff than just like your leg there's a lot of 447 00:25:59,560 --> 00:26:02,800 Speaker 1: stuff that's still remains that is no longer intact, and 448 00:26:02,840 --> 00:26:06,400 Speaker 1: that includes nerve endings. Those nerve endings have lost their 449 00:26:06,440 --> 00:26:10,119 Speaker 1: attachment points, their end points, but they're still capable of 450 00:26:10,160 --> 00:26:15,439 Speaker 1: transmitting electricity through your your peripheral and into your central 451 00:26:15,480 --> 00:26:20,280 Speaker 1: nervous system. And so they actually seek connections and will 452 00:26:20,320 --> 00:26:23,199 Speaker 1: sometimes connect with each other and cause all sorts of 453 00:26:23,240 --> 00:26:25,560 Speaker 1: haywire stuff. And they are like, well, maybe that's what 454 00:26:25,800 --> 00:26:30,640 Speaker 1: phantom limb pain comes from, and it's entirely possible. It is. Well, 455 00:26:30,680 --> 00:26:33,399 Speaker 1: here's something that I had no idea. I knew a 456 00:26:33,440 --> 00:26:35,080 Speaker 1: little bit about this, but when I read this, I 457 00:26:35,119 --> 00:26:39,159 Speaker 1: was pretty uh dumb struck. H If you had like 458 00:26:40,359 --> 00:26:43,600 Speaker 1: a bad knee and then you had to have an 459 00:26:43,600 --> 00:26:46,919 Speaker 1: amputation from like the thigh down, you're more likely to 460 00:26:47,000 --> 00:26:51,680 Speaker 1: have phantom limb pain because you had that bad knee before. Right, Yeah, yeah, 461 00:26:51,760 --> 00:26:54,600 Speaker 1: that's a risk factor. I don't know if it's still 462 00:26:54,640 --> 00:26:56,639 Speaker 1: considered that, but it was for a long time that 463 00:26:56,720 --> 00:26:59,040 Speaker 1: if you had pain in your your limb, and we're 464 00:26:59,080 --> 00:27:02,439 Speaker 1: talking like in the hours leading up to your amputation, 465 00:27:02,520 --> 00:27:06,479 Speaker 1: even yeah, that that that your brain remembers that and 466 00:27:06,520 --> 00:27:11,120 Speaker 1: that yes, um, that's kind of evident, like your brain 467 00:27:11,200 --> 00:27:13,359 Speaker 1: never got a chance to work out that it was 468 00:27:13,400 --> 00:27:17,119 Speaker 1: no longer in pain, is just continuing on UM. And 469 00:27:17,160 --> 00:27:20,760 Speaker 1: there's they they've done studies of UM people who where 470 00:27:20,800 --> 00:27:23,400 Speaker 1: they give a local anesthetic to like just to your 471 00:27:23,480 --> 00:27:28,200 Speaker 1: leg and they really numb it and then they move it. 472 00:27:28,960 --> 00:27:32,040 Speaker 1: And then they bring you out of anesthesia and they say, 473 00:27:32,080 --> 00:27:34,800 Speaker 1: what what what direction is your leg moving in? And 474 00:27:35,040 --> 00:27:38,879 Speaker 1: almost consistently across the board, people report the way that 475 00:27:38,960 --> 00:27:43,680 Speaker 1: it was before it was moved when it was under anesthesia. 476 00:27:43,920 --> 00:27:47,040 Speaker 1: Does that make sense? So like you remember this kind 477 00:27:47,080 --> 00:27:49,720 Speaker 1: of stuff, and that actually kind of leads to another 478 00:27:49,880 --> 00:27:53,760 Speaker 1: theory of UM what causes fantom limb pains called appropriate 479 00:27:53,880 --> 00:27:59,240 Speaker 1: reception theory. So so appropriate exception is just your awareness 480 00:27:59,359 --> 00:28:03,440 Speaker 1: of where your limbs and extremities are in space. I've 481 00:28:03,480 --> 00:28:05,520 Speaker 1: seen it explained as like how you can close your 482 00:28:05,520 --> 00:28:08,520 Speaker 1: eyes and touch your nose. That's all appropriate exception. And 483 00:28:08,560 --> 00:28:11,280 Speaker 1: this this whole idea behind appropriate reception having to do 484 00:28:11,320 --> 00:28:15,200 Speaker 1: with phantom limp pain is that we do this because 485 00:28:15,359 --> 00:28:18,240 Speaker 1: we're able to like touch our nose with our eyes closed, 486 00:28:18,480 --> 00:28:21,119 Speaker 1: not just because we know where are our limbs are 487 00:28:21,119 --> 00:28:23,919 Speaker 1: in space, Because our brain is constantly keeping track of 488 00:28:23,960 --> 00:28:27,280 Speaker 1: it and has basically a general map of our body 489 00:28:27,320 --> 00:28:30,760 Speaker 1: at any given point. So if we lose a part 490 00:28:30,800 --> 00:28:36,120 Speaker 1: of that body, that brain map doesn't necessarily catch up 491 00:28:36,119 --> 00:28:39,040 Speaker 1: with it. So the brain map is still expecting signals 492 00:28:39,040 --> 00:28:43,600 Speaker 1: and is basically creating signals UM based on its expectations. 493 00:28:43,640 --> 00:28:46,720 Speaker 1: And that's the appropriate reception theory of of phantom limb pain. 494 00:28:47,760 --> 00:28:50,680 Speaker 1: It's interesting because it's almost as if some of these 495 00:28:50,720 --> 00:28:57,280 Speaker 1: theories point to the brain being less able, I guess, 496 00:28:57,320 --> 00:29:01,600 Speaker 1: less neuroplastic than they thought, right, yes, yeah, and well 497 00:29:01,600 --> 00:29:05,320 Speaker 1: that's the thing. So so the neuroplasticity. That's the leading, 498 00:29:05,400 --> 00:29:11,000 Speaker 1: most dominant accepted explanation for phantom limp pain, which is 499 00:29:11,040 --> 00:29:14,400 Speaker 1: that you're the part of your brain that was dedicated 500 00:29:14,440 --> 00:29:17,800 Speaker 1: to sensation and movement of your arm that has now 501 00:29:17,840 --> 00:29:24,240 Speaker 1: been amputated. It's being restructured, rewired, reconnected, and so you're 502 00:29:24,240 --> 00:29:26,960 Speaker 1: getting all sorts of weird cross talk and it's creating 503 00:29:26,960 --> 00:29:29,360 Speaker 1: the sensation of pain in a limb that's not there anymore. 504 00:29:30,000 --> 00:29:32,920 Speaker 1: That makes sense, and it's been accepted since I think 505 00:29:32,920 --> 00:29:37,760 Speaker 1: the nineties, UM, but it's been challenged recently by findings 506 00:29:37,800 --> 00:29:41,160 Speaker 1: that that show your brain's actually doesn't seem to be 507 00:29:41,240 --> 00:29:45,800 Speaker 1: restructuring itself at all. Yeah, there's a famous Ted talk 508 00:29:46,000 --> 00:29:50,440 Speaker 1: a researcher from cal San Diego named vs uh Rama 509 00:29:50,480 --> 00:29:55,960 Speaker 1: Shandron who he argues about neuroplasticity, and he's the one 510 00:29:56,080 --> 00:29:58,480 Speaker 1: that uses the mirror box, which is what you mentioned 511 00:29:58,520 --> 00:30:01,120 Speaker 1: at the beginning, which is the idea, and this is 512 00:30:01,160 --> 00:30:05,000 Speaker 1: I think in the nineties, where there's the box and 513 00:30:05,000 --> 00:30:08,920 Speaker 1: if you're a unilateral amputee, you would put your let's 514 00:30:08,920 --> 00:30:10,800 Speaker 1: say you've lost your right arm, you put your left 515 00:30:10,880 --> 00:30:15,000 Speaker 1: arm into one side of the box and the residual 516 00:30:15,080 --> 00:30:17,520 Speaker 1: limb and the other side of the box. You would 517 00:30:17,520 --> 00:30:20,600 Speaker 1: see your reflection as if you still had both those arms. 518 00:30:21,320 --> 00:30:24,920 Speaker 1: And the idea is that your brain sees this and 519 00:30:25,000 --> 00:30:27,200 Speaker 1: so it can it can map this out. But I 520 00:30:27,240 --> 00:30:30,680 Speaker 1: think they've done um studies and meta analyzes that have 521 00:30:30,760 --> 00:30:35,120 Speaker 1: found that if it does work, it's very short term. 522 00:30:35,160 --> 00:30:38,760 Speaker 1: It's not like the brain completely remaps long term. So 523 00:30:38,840 --> 00:30:43,080 Speaker 1: it's more like a salve than a cure. That's what 524 00:30:43,200 --> 00:30:45,760 Speaker 1: the studies have shown. But that's kind of surprising because 525 00:30:45,800 --> 00:30:48,040 Speaker 1: it was it was touted early on, is like a 526 00:30:48,320 --> 00:30:50,360 Speaker 1: like this is gonna cure it, and it makes sense 527 00:30:50,360 --> 00:30:53,720 Speaker 1: from a neuroplastic way, like you're you're allowing your brain 528 00:30:54,440 --> 00:30:56,400 Speaker 1: like do you remember I was just talking about how 529 00:30:57,040 --> 00:30:59,680 Speaker 1: it's possible that your your brain isn't caught up to 530 00:30:59,720 --> 00:31:02,560 Speaker 1: the idea that that limb is not there any longer um, 531 00:31:02,720 --> 00:31:05,000 Speaker 1: and so you're you think your limbs in a different 532 00:31:05,000 --> 00:31:08,000 Speaker 1: position the last position it was in, or it's in 533 00:31:08,040 --> 00:31:10,400 Speaker 1: the pain that you thought it was in. If you 534 00:31:10,400 --> 00:31:12,440 Speaker 1: could trick your brain with the mirror box to see 535 00:31:12,440 --> 00:31:14,680 Speaker 1: that thing and make your hand wiggle, or make your 536 00:31:14,680 --> 00:31:17,520 Speaker 1: brain think your hand is wiggling and be like, okay, good, 537 00:31:17,560 --> 00:31:19,880 Speaker 1: I'm not actually experiencing a pain. I can stop that 538 00:31:20,000 --> 00:31:22,400 Speaker 1: signal and you can go on with your married life. 539 00:31:22,680 --> 00:31:25,480 Speaker 1: It makes sense, and a lot of people accepted it 540 00:31:25,520 --> 00:31:27,440 Speaker 1: for a long time, but like you said, the follow 541 00:31:27,520 --> 00:31:31,600 Speaker 1: up studies and analyses have shown like doesn't really have 542 00:31:31,760 --> 00:31:34,320 Speaker 1: that long term effect like you would think. And then 543 00:31:34,360 --> 00:31:37,120 Speaker 1: on top of that, some of those m r I 544 00:31:37,320 --> 00:31:40,720 Speaker 1: studies that you mentioned a few minutes ago have actually 545 00:31:40,760 --> 00:31:44,200 Speaker 1: shown like, no, actually that region that was in control 546 00:31:44,240 --> 00:31:47,400 Speaker 1: of your left arm that's now been amputated, that region 547 00:31:47,400 --> 00:31:51,080 Speaker 1: of the brain is still fully capable of causing your 548 00:31:51,120 --> 00:31:53,280 Speaker 1: arm to function in whatever. There hasn't been like some 549 00:31:53,400 --> 00:31:57,520 Speaker 1: great reconnection where other like your tongue sensation has taken 550 00:31:57,560 --> 00:31:59,960 Speaker 1: over that part of your brain to become a super 551 00:32:00,120 --> 00:32:02,960 Speaker 1: tasting tongue. That's just not panned out in the in 552 00:32:03,080 --> 00:32:06,680 Speaker 1: the reviews, in the follow up studies. So we're back 553 00:32:06,720 --> 00:32:10,400 Speaker 1: to basically square one. We don't know what causes phantom 554 00:32:10,480 --> 00:32:13,320 Speaker 1: limb pain. All right. I think we should take another 555 00:32:13,320 --> 00:32:16,920 Speaker 1: break and we'll talk some about treatment when we come back, 556 00:32:17,000 --> 00:32:19,640 Speaker 1: including what I think we will If I can speak 557 00:32:19,640 --> 00:32:22,400 Speaker 1: for you, I think you'll agree some of the most 558 00:32:22,440 --> 00:32:28,520 Speaker 1: fascinating headway they're making, which is working with prosthetic limbs 559 00:32:29,680 --> 00:32:32,240 Speaker 1: to be more realistic, is also having effect on phantom 560 00:32:32,320 --> 00:32:56,240 Speaker 1: limp pain. All right, So we talked a little bit, 561 00:32:56,280 --> 00:32:59,600 Speaker 1: and hold on, hold on, I'm sorry, I'm sorry what happened. 562 00:32:59,720 --> 00:33:03,200 Speaker 1: As want to give an update here. You can probably 563 00:33:03,280 --> 00:33:07,880 Speaker 1: understand why I confused Ken Wall as the um lead 564 00:33:07,960 --> 00:33:10,440 Speaker 1: of a like a kind of a mid fifties like 565 00:33:10,560 --> 00:33:14,000 Speaker 1: Dark Night kind of helping people out, because Ken Wall 566 00:33:14,160 --> 00:33:16,920 Speaker 1: was the lead in the nineteen seventy nine grease or 567 00:33:16,960 --> 00:33:19,720 Speaker 1: flick the Wanderers. Okay, I knew he was in a 568 00:33:20,320 --> 00:33:22,960 Speaker 1: greaser movie. That's I think that's what I was confusing. 569 00:33:23,640 --> 00:33:25,640 Speaker 1: His hair looks good in a duck tail. I think 570 00:33:25,680 --> 00:33:29,920 Speaker 1: I had confused the Wanderers with the Um the eighties 571 00:33:29,960 --> 00:33:33,080 Speaker 1: TV show Crime Story as well. I think I conflated 572 00:33:33,120 --> 00:33:35,800 Speaker 1: all those. I don't know what that is. It was 573 00:33:35,840 --> 00:33:37,640 Speaker 1: a cool one. It was like, I think a mob 574 00:33:37,800 --> 00:33:42,360 Speaker 1: Vegas mob show. It was like a cop drama. What 575 00:33:42,400 --> 00:33:47,520 Speaker 1: was was Wanders like an Outsider's rip off. No, it's 576 00:33:47,520 --> 00:33:50,840 Speaker 1: a little more true. Outsiders was weird and avant garde 577 00:33:50,960 --> 00:33:53,760 Speaker 1: or um? I'm sorry, did you say outsiders or um? 578 00:33:53,840 --> 00:33:57,360 Speaker 1: What am I thinking of? What's the weirdness? The weird 579 00:33:57,400 --> 00:34:00,800 Speaker 1: one Warriors, That's what I'm thinking. Oh, oh, I'm thinking 580 00:34:00,840 --> 00:34:03,400 Speaker 1: of pony Boy. I think the Outsiders came after the 581 00:34:03,440 --> 00:34:07,400 Speaker 1: Wanderers and was probably something of an homage to that. No, 582 00:34:07,760 --> 00:34:13,040 Speaker 1: it was a book from way back. Okay, fine, we're 583 00:34:13,080 --> 00:34:17,879 Speaker 1: never going to get to I'm losing my stuff. It's 584 00:34:17,880 --> 00:34:22,879 Speaker 1: all kin Wall's fault. I think it's all Ca Marino's fault. Um. 585 00:34:22,920 --> 00:34:25,319 Speaker 1: All right, So what we were talking about before, and 586 00:34:25,320 --> 00:34:27,240 Speaker 1: we'll talk a little bit about some of the treatments, 587 00:34:27,239 --> 00:34:29,919 Speaker 1: But for my money, Some of the most fascinating work 588 00:34:29,960 --> 00:34:33,560 Speaker 1: going on right now is research that is trying to 589 00:34:33,600 --> 00:34:38,600 Speaker 1: help people use prosthetic limbs more effectively. One one, there's 590 00:34:38,640 --> 00:34:40,759 Speaker 1: a couple of different things they're doing. Well, there's a 591 00:34:40,800 --> 00:34:42,239 Speaker 1: lot of different things, but a couple of them are 592 00:34:42,239 --> 00:34:48,600 Speaker 1: targeted muscle reinnervation and targeted sensory reinnervation, which is either 593 00:34:48,880 --> 00:34:53,600 Speaker 1: using leftover motor nerves or leftover sensory nerves from that 594 00:34:53,680 --> 00:34:58,000 Speaker 1: amputated limb connecting those two muscles that lost their function. 595 00:34:58,640 --> 00:35:02,440 Speaker 1: And all of this in service of you know that 596 00:35:02,600 --> 00:35:04,600 Speaker 1: all the work they've done with prosthetic limbs to make 597 00:35:04,640 --> 00:35:08,080 Speaker 1: them smarter and like like, hey, you can you grab 598 00:35:08,080 --> 00:35:09,839 Speaker 1: a coffee cup in a different way that you would 599 00:35:09,840 --> 00:35:13,160 Speaker 1: grab a pillow, and you may be able to know 600 00:35:13,160 --> 00:35:15,680 Speaker 1: when something's hot or cold. Like the advances that they're 601 00:35:15,680 --> 00:35:20,000 Speaker 1: making is unbelievable. And some of these advances are helping 602 00:35:20,000 --> 00:35:23,319 Speaker 1: with basically telling the brain, now you've got a real 603 00:35:23,360 --> 00:35:25,440 Speaker 1: limb there again, and so you don't have that venom 604 00:35:25,480 --> 00:35:28,320 Speaker 1: limb pain. Yeah, I found this, um this one mention 605 00:35:28,440 --> 00:35:33,800 Speaker 1: of how apparently there's people who have prosthetics are faced 606 00:35:33,840 --> 00:35:37,879 Speaker 1: with this terrible choice where um, the prosthetic feels way 607 00:35:38,000 --> 00:35:40,960 Speaker 1: heavier than their limb ever did, even though the prosthetic 608 00:35:41,040 --> 00:35:44,320 Speaker 1: probably weighs less than their limb did. For some reason, 609 00:35:44,360 --> 00:35:46,880 Speaker 1: because it's foreign, it's not really part of their body 610 00:35:47,320 --> 00:35:50,640 Speaker 1: to their brain, it's very taxing to wear it or 611 00:35:50,680 --> 00:35:53,600 Speaker 1: carry it around or use it, and it can be 612 00:35:53,640 --> 00:35:56,879 Speaker 1: so taxing that it can it can increase their risk 613 00:35:56,920 --> 00:35:59,560 Speaker 1: of cardiovascular disease, of heart attack, of all sorts of 614 00:35:59,560 --> 00:36:03,279 Speaker 1: stuff like that, just by like over exerting themselves. And 615 00:36:03,320 --> 00:36:05,680 Speaker 1: then the other thing they could do is just not 616 00:36:05,880 --> 00:36:09,000 Speaker 1: use the prosthetic at all and lead an increasingly unhealthy 617 00:36:09,080 --> 00:36:13,080 Speaker 1: sedentary lifestyle. So these new prosthetics are are kind of 618 00:36:13,120 --> 00:36:17,200 Speaker 1: getting around that by recreating, as far as the brain 619 00:36:17,320 --> 00:36:20,640 Speaker 1: is concerned, a limb very closely. In the way that 620 00:36:20,680 --> 00:36:23,360 Speaker 1: you do that is like you said, UM, give it 621 00:36:23,600 --> 00:36:26,440 Speaker 1: senses that it used to have, like give it sensory 622 00:36:26,440 --> 00:36:31,319 Speaker 1: information from this limb. And what they're doing is information 623 00:36:31,400 --> 00:36:34,440 Speaker 1: from the from say like a prosthetic foot, just the 624 00:36:34,440 --> 00:36:37,120 Speaker 1: fact that it's receiving pressure from the ground. It will 625 00:36:37,160 --> 00:36:41,000 Speaker 1: send an electrical signal up through its cables to a 626 00:36:41,120 --> 00:36:44,759 Speaker 1: terminal where it's connected to the actual like like um 627 00:36:44,960 --> 00:36:48,400 Speaker 1: nerves and then muscle tissue also in your leg, and 628 00:36:48,440 --> 00:36:50,640 Speaker 1: it will send that on up to your peripheral nervous 629 00:36:50,640 --> 00:36:53,920 Speaker 1: system and into your central nervous system and your brain experiences. 630 00:36:54,239 --> 00:36:58,640 Speaker 1: This is so awesome, the sense that it's a pressure 631 00:36:59,000 --> 00:37:01,120 Speaker 1: from the bottom of your foot when you put that 632 00:37:01,120 --> 00:37:04,400 Speaker 1: that prosthetic foot on the ground. That's the level that 633 00:37:04,400 --> 00:37:07,880 Speaker 1: we're at at this point, which is amazing. Yeah, I mean, 634 00:37:07,920 --> 00:37:11,680 Speaker 1: I remember many years ago, it may have been one 635 00:37:11,680 --> 00:37:15,080 Speaker 1: of those episodes you mentioned where we talked about and this. 636 00:37:15,080 --> 00:37:17,120 Speaker 1: This was probably at least ten years ago, so I 637 00:37:17,120 --> 00:37:20,359 Speaker 1: imagine the strides since since then or even more that 638 00:37:20,800 --> 00:37:23,240 Speaker 1: you know, they've gotten to the point where you can think, 639 00:37:23,680 --> 00:37:27,000 Speaker 1: you know, grab coffee cup, and that prosthetic hand will 640 00:37:27,000 --> 00:37:31,319 Speaker 1: grab coffee cup. And the more lifelike that feedback is, 641 00:37:32,040 --> 00:37:34,160 Speaker 1: the more it seems like at least that it's going 642 00:37:34,200 --> 00:37:38,240 Speaker 1: to help alleviate phantom limb pain exactly, because that seems 643 00:37:38,280 --> 00:37:40,480 Speaker 1: to be one of the bases that they're figuring out 644 00:37:40,480 --> 00:37:43,840 Speaker 1: about phantom limb pain, is that these nerves um, whether 645 00:37:43,880 --> 00:37:47,560 Speaker 1: it's muscle tissue, nerves connected formally connected to muscle tissue 646 00:37:48,080 --> 00:37:52,920 Speaker 1: or axons, or some some type of nerve impulse carrying 647 00:37:53,040 --> 00:37:56,040 Speaker 1: material a nerve. I guess if you're not a total 648 00:37:56,080 --> 00:38:01,200 Speaker 1: weirdo and say things normally. Um, they they still want 649 00:38:01,239 --> 00:38:04,560 Speaker 1: to carry these impulses, so they're still accepting like impulses, 650 00:38:04,600 --> 00:38:07,600 Speaker 1: but they're just not cut out for the task any longer. 651 00:38:07,840 --> 00:38:09,920 Speaker 1: And what they're figuring out is like, hey, surgeons, if 652 00:38:09,960 --> 00:38:13,000 Speaker 1: you leave some muscle tissue attached, will come back and 653 00:38:13,080 --> 00:38:17,600 Speaker 1: attach the sensory cables from a prosthetic to that muscle tissue, 654 00:38:17,840 --> 00:38:19,640 Speaker 1: and we're going to be back in business. And the 655 00:38:19,640 --> 00:38:21,680 Speaker 1: brain is gonna think like, hey, I've got this. I 656 00:38:21,760 --> 00:38:23,480 Speaker 1: got my foot back, I got my leg back, I 657 00:38:23,520 --> 00:38:26,439 Speaker 1: got my arm back. To the braining, it's all the same. 658 00:38:26,480 --> 00:38:29,359 Speaker 1: It's still getting some sort of sensory information. It might 659 00:38:29,360 --> 00:38:31,840 Speaker 1: be kind of primitive compared to what you had before, 660 00:38:32,239 --> 00:38:35,080 Speaker 1: but from what I'm seeing, it's it's not necessarily we're 661 00:38:35,080 --> 00:38:37,520 Speaker 1: getting more and more advanced by the by the year. 662 00:38:38,360 --> 00:38:40,799 Speaker 1: Well yeah, and it's that muscle tissue that allows the 663 00:38:40,840 --> 00:38:46,000 Speaker 1: body to sense things like applied force or a sensation 664 00:38:46,040 --> 00:38:50,120 Speaker 1: of stretching, you know something. And not only are they 665 00:38:50,120 --> 00:38:52,960 Speaker 1: saying to surgeons like maybe we should rethink the way 666 00:38:53,080 --> 00:38:55,640 Speaker 1: we're doing amputations, but they're saying, we can go back 667 00:38:55,680 --> 00:38:59,080 Speaker 1: in and and attach muscle to the end of those 668 00:38:59,120 --> 00:39:02,319 Speaker 1: nerves for um amputations that happened years ago. And so 669 00:39:02,440 --> 00:39:07,319 Speaker 1: if you give these nerves something to do productive, they're 670 00:39:07,320 --> 00:39:10,240 Speaker 1: gonna stop looking for something to do. Basically that's actually 671 00:39:10,360 --> 00:39:14,359 Speaker 1: very unproductive and like causing phantom pain. And so that's 672 00:39:14,480 --> 00:39:16,520 Speaker 1: like you said that they think that that is not 673 00:39:16,640 --> 00:39:19,319 Speaker 1: they think like they're they're seeing quite clearly that that 674 00:39:19,680 --> 00:39:23,360 Speaker 1: helps alleviate and maybe cure as phantom pain. Just giving 675 00:39:23,400 --> 00:39:26,480 Speaker 1: these nerves a productive job yet again because they just 676 00:39:26,520 --> 00:39:30,719 Speaker 1: want to work so bad, but they got caught in half. Yeah, 677 00:39:30,800 --> 00:39:35,480 Speaker 1: it's remarkable, um on the less remarkable side treatment wise, 678 00:39:35,520 --> 00:39:39,719 Speaker 1: and this is I think just residual, you know. I mean, 679 00:39:39,760 --> 00:39:42,480 Speaker 1: that's a very forward weight, way, forward thinking way to 680 00:39:42,960 --> 00:39:45,600 Speaker 1: do things. I think with phantom limpain, which is this 681 00:39:45,719 --> 00:39:49,160 Speaker 1: prosthetic stuff that they're working on, the old school treatments 682 00:39:49,200 --> 00:39:55,120 Speaker 1: are literally like giving people pain drugs and giving people opioids, uh, 683 00:39:55,840 --> 00:39:58,719 Speaker 1: you know, muscle relaxers, beta blockers, stuff like that. And 684 00:39:58,760 --> 00:40:01,919 Speaker 1: I'm not poopooing medica asian if it helps people out, 685 00:40:02,000 --> 00:40:05,160 Speaker 1: but it does seem like a bit of an antiquated 686 00:40:05,200 --> 00:40:09,680 Speaker 1: thing to do is just to throw pain meds somebody's way, right. Um. 687 00:40:09,719 --> 00:40:13,439 Speaker 1: So there are other like non pharmaceutical techniques to one 688 00:40:13,480 --> 00:40:16,640 Speaker 1: of them is kind of like a low five version 689 00:40:16,880 --> 00:40:20,120 Speaker 1: of what you would get with a really advanced prosthetic. UM. 690 00:40:20,160 --> 00:40:22,960 Speaker 1: It's called TENS. It's been around since at least the eighties. 691 00:40:23,600 --> 00:40:27,360 Speaker 1: Um My mom was a hospital administrator later in her career, 692 00:40:27,360 --> 00:40:31,040 Speaker 1: and I remember we had pads of paper laying around 693 00:40:31,040 --> 00:40:35,160 Speaker 1: our house that had like pictures of TENS units on them. Yeah, 694 00:40:35,360 --> 00:40:37,560 Speaker 1: I guess the TENS unit supplier gave us some free 695 00:40:37,560 --> 00:40:43,880 Speaker 1: pads of paper. Um. So that's transcutaneous electrical nerves stimulation 696 00:40:43,920 --> 00:40:48,040 Speaker 1: and it's basically giving those nerves something to talk about 697 00:40:48,640 --> 00:40:51,719 Speaker 1: without them having to make it up themselves. But it's 698 00:40:51,800 --> 00:40:54,520 Speaker 1: just stimulating them with electricity, and they think that that 699 00:40:54,680 --> 00:40:57,720 Speaker 1: What happens is you're kind of overwhelming that pain signal 700 00:40:57,920 --> 00:41:01,680 Speaker 1: with a more robust elector cool signal that just turns 701 00:41:01,680 --> 00:41:04,600 Speaker 1: off that pain signal and it actually helps really really well, 702 00:41:04,719 --> 00:41:08,080 Speaker 1: tends helps a lot of people. UM, with back pain. 703 00:41:08,719 --> 00:41:11,359 Speaker 1: You you have you seen those like little um electrode 704 00:41:11,360 --> 00:41:13,040 Speaker 1: things that you can put on your lower back and 705 00:41:13,080 --> 00:41:15,200 Speaker 1: there's like a little looks like a beeper attached to it. 706 00:41:15,239 --> 00:41:17,960 Speaker 1: That's attends unit and almost doing is sending electrical input 707 00:41:18,080 --> 00:41:21,280 Speaker 1: pulses through your skin to your nerves and basically saying, 708 00:41:21,320 --> 00:41:26,200 Speaker 1: shut up, pain signals. Here's here's something, here's something bigger. 709 00:41:27,080 --> 00:41:30,719 Speaker 1: It's the Bonnie rate treatment. Yeah, let's give them something 710 00:41:30,760 --> 00:41:34,200 Speaker 1: to talk about. Or what was that ad? Move over something? 711 00:41:34,280 --> 00:41:38,439 Speaker 1: Now there's something leaner, Move over bacon, I think so. 712 00:41:38,520 --> 00:41:42,520 Speaker 1: But what was the product? It was sizzline, wasn't it. Yeah, 713 00:41:42,680 --> 00:41:47,239 Speaker 1: that's what was sezzelin. It was not good. I'll tell 714 00:41:47,280 --> 00:41:48,960 Speaker 1: you that. I don't even know what that was. Remember 715 00:41:49,040 --> 00:41:55,239 Speaker 1: stake ums You you like stake Ums, Well, it's the 716 00:41:55,400 --> 00:41:59,840 Speaker 1: it's the you know, it's the budget version of a 717 00:42:00,200 --> 00:42:03,320 Speaker 1: Philly cheese steak. Yes, and that's how I always ate 718 00:42:03,360 --> 00:42:06,560 Speaker 1: it too. But even still it's like, this is terrible 719 00:42:06,640 --> 00:42:13,120 Speaker 1: it Yeah I did it? Did? I like stak hms 720 00:42:13,120 --> 00:42:14,840 Speaker 1: for many years? Having said that, that was you know, 721 00:42:14,920 --> 00:42:18,400 Speaker 1: forty years ago. Um, And now you know, if you 722 00:42:18,440 --> 00:42:22,600 Speaker 1: make a homemade cheese steak, slice that ribbi, fold it 723 00:42:22,680 --> 00:42:24,080 Speaker 1: up and roll it up and slice it really thin. 724 00:42:24,239 --> 00:42:27,080 Speaker 1: Is that right? That's what you using some good Rubbi. Yeah, 725 00:42:27,440 --> 00:42:30,040 Speaker 1: flatting it out, pound it out, really thin, man, you 726 00:42:30,120 --> 00:42:35,279 Speaker 1: have come so far. You have arrived because I'm pounding Ribbi. No, 727 00:42:35,440 --> 00:42:38,640 Speaker 1: because you left stake Ms in the roof. You went 728 00:42:38,680 --> 00:42:42,160 Speaker 1: from steak ms to ribby. What else that? I think 729 00:42:42,160 --> 00:42:45,759 Speaker 1: there's a few more treatments. There's biofeedback, of course. Uh. 730 00:42:45,800 --> 00:42:48,040 Speaker 1: There are very simple things like just propping up the 731 00:42:48,080 --> 00:42:54,080 Speaker 1: residual limb, repositioning it, you know, being distracted. They say, 732 00:42:54,080 --> 00:42:58,920 Speaker 1: lifestyle changes like you know, yoga, meditation, music, stuff like 733 00:42:58,960 --> 00:43:01,959 Speaker 1: that you can can help, um, probably better than throwing 734 00:43:02,000 --> 00:43:04,960 Speaker 1: opioids at the problem. Yeah, and again I mean just 735 00:43:05,000 --> 00:43:09,400 Speaker 1: doing stuff like moving the limb, um, massaging it, um, 736 00:43:09,440 --> 00:43:12,560 Speaker 1: just just giving it some sort of other like very 737 00:43:12,640 --> 00:43:16,840 Speaker 1: real stimulation tends to help. But I mean, if you 738 00:43:16,880 --> 00:43:19,160 Speaker 1: feel like you can't sleep because your arms twisted behind 739 00:43:19,200 --> 00:43:22,920 Speaker 1: your back and it's like that constantly, especially if it 740 00:43:23,000 --> 00:43:25,319 Speaker 1: starts hurting like you get a Charlie horse like that, 741 00:43:25,760 --> 00:43:28,040 Speaker 1: nobody's going to blame you if you ask for opioid 742 00:43:28,080 --> 00:43:31,279 Speaker 1: to know like, that's that's that's the reason why this 743 00:43:31,360 --> 00:43:34,000 Speaker 1: is not just interesting that we it's an imperative that 744 00:43:34,040 --> 00:43:38,640 Speaker 1: we we understand it and learned to cure it fully agreed. 745 00:43:39,760 --> 00:43:44,400 Speaker 1: So that's it for phantom limb pain and phantom limb sensation. Everybody. Uh, 746 00:43:44,520 --> 00:43:46,560 Speaker 1: if you thought that was pretty neat, there's a lot 747 00:43:46,600 --> 00:43:50,560 Speaker 1: of interesting stuff to read about that, uh. Phenomenon. Not 748 00:43:50,760 --> 00:43:53,840 Speaker 1: syndrome though, we don't think Uh. And since I said 749 00:43:53,840 --> 00:43:59,520 Speaker 1: not syndrome, that means it's time for listener mail. I'm 750 00:43:59,520 --> 00:44:03,600 Speaker 1: gonna call all this just sort of an enlightening email 751 00:44:03,840 --> 00:44:07,640 Speaker 1: from a from a listener. Hey guys, longtime listener. My 752 00:44:07,680 --> 00:44:10,880 Speaker 1: first email to you was when you were working for 753 00:44:10,960 --> 00:44:14,920 Speaker 1: Discovery Channel. In the episode on albinism, you mentioned that 754 00:44:15,000 --> 00:44:19,280 Speaker 1: it's the barest minimum of parenting to explain to children 755 00:44:19,280 --> 00:44:22,600 Speaker 1: the scientific reasons behind why we have some variety in 756 00:44:22,680 --> 00:44:24,719 Speaker 1: the expressions of what it means to be human. And yes, 757 00:44:24,760 --> 00:44:27,600 Speaker 1: that is important. It's also important to teach children that 758 00:44:27,719 --> 00:44:31,360 Speaker 1: society creates is ms about these expressions, which served a 759 00:44:31,440 --> 00:44:35,439 Speaker 1: privilege or marginalized certain groups of people. My researches around 760 00:44:35,520 --> 00:44:39,000 Speaker 1: race and racism, so I'll use that as an example. Yes, 761 00:44:39,040 --> 00:44:41,120 Speaker 1: it is important to teach children what science says about 762 00:44:41,800 --> 00:44:45,440 Speaker 1: how variety manifests in the human body. Likewise, children need 763 00:44:45,480 --> 00:44:48,080 Speaker 1: to learn that racism exists, and that racism is a 764 00:44:48,160 --> 00:44:52,439 Speaker 1: social construct that is not biological. Just the former without 765 00:44:52,480 --> 00:44:55,719 Speaker 1: the ladder fails to prepare children to react appropriately when 766 00:44:55,719 --> 00:44:58,000 Speaker 1: they are faced with racism, and the same goes for 767 00:44:58,040 --> 00:45:00,959 Speaker 1: any ism. As I wrote almost a decade ago, still 768 00:45:01,080 --> 00:45:04,600 Speaker 1: use your podcast with my grad students. H. And that 769 00:45:04,760 --> 00:45:11,520 Speaker 1: is from Judd Judson laughter. He him his from ut 770 00:45:12,000 --> 00:45:16,080 Speaker 1: in Knoxville. Yeah, go Valls right up the road. My 771 00:45:17,960 --> 00:45:23,799 Speaker 1: I guess niece in law maybe Okay, I think nice 772 00:45:23,960 --> 00:45:27,240 Speaker 1: in law in law potentially just got into UM University 773 00:45:27,280 --> 00:45:30,120 Speaker 1: of Tennessee and she it's like her her dream, like 774 00:45:30,239 --> 00:45:32,359 Speaker 1: she wants to go study the body farm. Chuck, doesn't 775 00:45:32,360 --> 00:45:36,920 Speaker 1: that just see your heart? I love that. So congratulations 776 00:45:36,920 --> 00:45:41,000 Speaker 1: and thanks professor Laughter. Awesome name. That is a really 777 00:45:41,000 --> 00:45:43,160 Speaker 1: important thing to point out, and thank you for sharing 778 00:45:43,200 --> 00:45:45,680 Speaker 1: that with everybody. If you want to be like Professor 779 00:45:45,760 --> 00:45:49,200 Speaker 1: Laughter and share your awesome name and or awesome point, 780 00:45:49,760 --> 00:45:53,520 Speaker 1: you can email us It's stuff podcast at iHeart radio 781 00:45:53,600 --> 00:45:58,840 Speaker 1: dot com. Stuff you Should Know is a production of 782 00:45:58,880 --> 00:46:02,279 Speaker 1: iHeart Radio. For more podcasts my heart Radio, visit the 783 00:46:02,320 --> 00:46:05,360 Speaker 1: I heart Radio app, Apple Podcasts, or wherever you listen 784 00:46:05,400 --> 00:46:09,239 Speaker 1: to your favorite shows. H