Blog 27 - Happy Anniversaries, Unhappy ones too

 

Blog 27 – Happy Anniversaries, Unhappy ones too.

 

It’s now a year since treatment ended. Yet again I’ve re-read some of my blogs. I keep trying to re-read them to try to make them every-day events rather than extraordinary, epic, occurrences. But I can’t. I shudder. I weep. Which I never did at the time.

On the anniversary of the major surgery – to remove the lymph nodes and teeth, I had to go home from work. I still had no dentures. A year! A tear. A temper. Yes, Frank. A temper. A trauma. I spent the day in the company of a bottle.

In August Row and I went to Iceland for our 29^th wedding anniversary. An intriguing country. Confident yet apologetic. Old, yet not. Potentially explosive. We were happy to celebrate.

Later in August I got my teeth. I could smile again.

In September, Row and I celebrated her Dad’s 96^th birthday. A meal in Stratford-upon-Avon at the same restaurant as last year, the day before radiotherapy treatment began.

 

Late September I had a throat infection. As painful as when the tonsils came out. When I had my six-weekly review at the hospital they wanted to be sure it was unrelated, so sent me for an MRI scan with contrast. I shuddered when I went into the radiology reception at Lister hospital. I shuddered when I put on the gown. I shuddered again when they put in the cannula (did you know it means a little reed). It didn’t hurt at all. It just cast shadows of the hundred needles that were not so deeply buried in the past. I couldn’t afford to shudder when I lay on the table, when I had the mask fitted, when the machine engulfed me, when the motors started, when the noise began again and again and again. I had to keep still. For nearly an hour. Remembering. Shhhh now. Shhhh.

 

In October I reached the age of 60. Phew. My sisters and mum came to visit. Mum was 85 the day before. A fine weekend.

 

I had to wait until yesterday for the results.

Nothing wrong with the throat.

But there’s something.

Don’t worry.

Come back in two weeks. When we’ve had time to study the information.

Shudder.

 

Estonia

21st May 2014 we flew to Tallinn, capital of Estonia, using Ryanair from Stansted. Dave and Phil had played golf in the morning, then Terry and I met them for lunch in The Coach House, Potton. Peter, then Keith and Tony joined us briefly. Tripods, washbags, books and waterproofs re-distributed amongst the hold bags, then away we went. Tallinn  is a bijou airport. Emptying as we arrived - the last flight in for the day. 

 Outside is a decent view over a lake - we had plenty of time to look at this as our hire-van had turned up 12 hours earlier and unsurprisingly had gone home. Tony arranged for him and Peter to go by taxi to their office where the owner brought the mini-bus and business was done. Meanwhile the rest of us listened to Corncrake, watched Arctic and Common terns and also saw a Marsh harrier.

A 2 hour drive during which it didn't quite get dark, brought us to our hotel in Tartu at half past midnight. The receptionist was on duty, there were beers in the fridge and the rooms were airy and comfortable. A Thush nightingale serenaded us all night.

What about Estonia? Well, it is flat. Average height is 50m above sea level. Highest point is Egg Mountain at 318m. It's got Russia to the right, Latvia at the bottom, the Gulf of Riga and the Vainemari Sea to the left, and the Gulf of Finland at the top (these are all part of the Baltic Sea). Compared with the UK, which has a rising population density of 257 people per sq km, Estonia has a falling figure of 30.5. (By the by, in the EU, Iceland has the lowest at 3.2 and Malta the highest at 1327!).

The first morning we went to the Aardla polder complex to listen for and look at birds, from the ground and from the air. We found our first target bird - Citrine Wagtail and one I wanted - a Common Rosefinch. My photography isn't up to the standard of some of the others, so you'll have to wait for Terry's trip report, or better still, Blomers' video.

In the evening we went in search of our second target species - the Great Snipe. It lives with mosquitos.It's supposed to come out to play in the evening.

In flat, water-logged, fields.

When the sun goes down. 

But they didn't, so we went back to the hotel for a beer (you might have seen Blomers' beer of the day on Facebook). Early next morning, Tony and Keith went out to see what was about. The next morning, so did I and found this Thrush nightingale.

 

Singing

http://youtu.be/id3QJffhgWc

And a fuzzy Pied flycatcher.

 Later Keith showed me the a place where I saw my first Marsh warbler. But I missed out on the Barred warbler.

Later that day we went to find the third target bird, the Great spotted eagles.

These can sometimes, and only, be seen at the amusing Hollywood Hill.

Which happened to overlook where Great snipes aren't. And a cafe where the hamburgers are to die of. Oh, the Great spotted eagles weren't there - but we did see Lesser spotted ones.

Some people do live in Estonia.

Estonia is one of the least religious countries in world, with only 14% of the population declaring religion an important part of their daily life.

We stopped at a supermarket to buy food. In the carpark was a Nuthatch nest.

 On day three we went up north and stayed in a posh chalet

We went up north to see bears in this forest.

From this hide with 10 windows and 10 bunk beds and seven blokes and one long drop.

This is the view from the window. Can you see the Raccoon dog?

Raccoon dogs are canines from Japan and China, but where introduced to Russia for fur. They've spread a bit. We saw up to 8 of them. We also saw two foxes. And a Turtle dove, and some pigeons. Later it went dark. And we saw a bear - most of us were asleep, but the 1.30am shift woke us up. We were amazed at how large it was.

It went away about an hour later. Most of us were asleep again when the 6am shift saw a second bear. It was light by then. Fabulous!

The owners of the hides put out food. Honeycombs, marmalade sandwiches and animal carcasses. The latter two were underneath plywood boards that the other animals couldn't move, but the bear certainly could.

 The bear hung around for half an hour. That meant we could get a bit of shut eye. We weren't allowed to leave the hide until 8am.

There was one other chap who stayed in the two-man hide to the left, the dark brown one, apparently, had openings for lenses for photography.

 

The fourth day we went to a different wood.

Where a barmy bloke tramped us around telling us all about Flying squirrels.

We then went back to the chalet and had superb supper of wild boar.....

.....before going out again at 9.30pm to see a real live Flying squirrel emerge from a roosting hole in a tree, scoot up the trunk and jump (unseen) to another tree then away into the darkness. I didn't take my camera as I knew it would be just a few moments and wanted to make sure I was watching.

Next morning there was a wryneck.

We set off to the seaside and saw a female Montagu's harrier.

Then we saw the sea.

 And had a nice lunch.

 Before going, through a rainstorm, to do some sight-seeing in Tallinn before the flight home.

In Tallinn are new bits.

And old bits.

And picturesque bits.

In Estonia, I saw/heard 130 different species including 6 I'd not seen before. Well worth a visit.

Blog 26 - Phew

Blog 26 – Ultrasound - phew

I only mentioned it to a couple of people: I had an ultrasound scan done on my neck yesterday. I’m more than happy to say there was nothing of consequence to be found. I’d noticed a very small lump under the left side of my chin, no corresponding lump under the right side. I had a vague notion that I’d come across the lump before, but you know I then began to imagine that I was false remembering it so as to make it unimportant. But over the week my hand kept making it’s way to my neck to see how it felt. Some days I could almost feel that it was larger. So on my last checkup on 10^th April, I mentioned it. A finger of shock pinged my heart when the consultant said he wanted a scan done and he wanted to see me again for the results in two weeks time.

The ultrasound department in Lister hospital has moved up from the cellar to the main floor and is now clean and bright and, well, clinical. With a bright orange reception desk. It could be Ryanair. It has six ultrasound rooms. I wondered if there was Jazz in one, Classical in another. Perhaps White Noise in the third (Anyone remember the late 1960’s, cough, experimental band). My dad hated that music. I went into room 4. It was dim, and quiet. The nurse was welcoming. The doctor stood playing the keyboard of his laptop on the work counter. Like Rick Wakeman. But with the sound turned down. Pity. 

You lie on the couch and he squirts lubricant on your neck. Then uses his ultrasound wand to rub over the skin and watches the images on a screen that you can’t see. Every so often he presses a button and a still image is captured. “That’s fine” he says “Nothing to worry about”. But continues to check around the ear, across to the other side of the neck, down to the Adams apple. And back to the lump. “It’s your salivary gland that you can feel”. “Nothing to worry about”.

The question that formed would not come out.

Ah well, I can write it down and take it to the consultant next Thursday.

Do salivary glands change size?

I had another question about ultrasound. But the ultrasound doctor didn't seem particularly engaging. See the end of this tract to see how lucky I was not to ask it.

As you have come to expect, I've done a bit of reading....

Salivary glands (in humans) secrete stuff. Mostly the stuff just lubricates: Without lubricant you can’t swallow. But some stuff (amylase) begins the process of breaking down starch – so you can eat chips! Amylase is also used in home-brewing, converting starch into sugar, which is then converted into alcohol. The third stuff, from the Von Ebner glands on the tongue, dissolves food particles so that you can taste them. There are three pairs of main glands, by the ears, under the tongue and under the chin and up to 1000 further glands in the mouth.

The salivary glands of some species, however, are modified to produce enzymes; salivary amylase is found in many, but by no means all, bird and mammal species (including humans, as noted above). Furthermore, the venom glands of poisonous snakes, Gila monsters, and some shrews, are modified salivary glands. In other organisms such as insects, salivary glands are often used to produce biologically important proteins like silk or glues, and fly salivary glands contain polytene chromosomes that have been useful in genetic research.

Many anti-cancer treatments may impair salivary flow such as chemotherapy and radiation therapy. Radiation therapy may cause permanent hyposalivation due to injury to the oral mucosa containing the salivary glands, resulting in dry mouth or xerostomia, whereas chemotherapy may cause only temporary salivary impairment.

What is ultrasound. I hear you ask. Tee-hee.

Courtesy of Wikipedia.

Ultrasound is an oscillating sound pressure wave with a frequency greater than the upper limit of the human hearing range. Although this limit varies from person to person, it is approximately 20 kilohertz in healthy, young adults. Ultrasound devices operate with frequencies from 20 kHz up to several gigahertz.

Ultrasound is used in many different fields. Ultrasonic devices are used to detect objects and measure distances. Ultrasonic imaging (sonography) is used in both veterinary medicine and human medicine. In the non-destructive testing of products and structures, ultrasound is used to detect invisible flaws. Industrially, ultrasound is used for cleaning and for mixing, and to accelerate chemical processes. Organisms such as bats and porpoises use ultrasound for locating prey and obstacles.

My ultrasound question?

I remember having ultrasound treatment when I was recovering from a dislocated ankle. 6 weeks after my plaster came off. I was fortunate (I thought) to have private health care and so BUPA provided the physiotherapy. They used ultrasound to break down the internal scar tissue that formed when the torn muscles and stretched tendons repaired themselves. So I was going to ask the doctor if ultrasound should be used to break down the scar tissues in my neck that formed when the muscle, lymph nodes, nerve and vein where excised.

I've just been doing some research into ultrasound and physiotherapy. Here are a couple of quotes.

The frequently described biophysical effects of ultrasound either do not occur in vivo under therapeutic conditions or have not been proven to have a clinical effect under these conditions. This review reveals that there is currently insufficient biophysical evidence to provide a scientific foundation for the clinical use of therapeutic ultrasound …

There is nothing a cold slimy prickling ultrasound wand can do that a pair of warm hands can’t do way better.

So a masseuse it is then. You lie on the couch and she squirts lubricant on your neck.

Blog 25 - Cancer and sunburn

Blog 25 - Chemotherapy and Radiotherapy fall out with Sunshine

Sunshine is radiation. Radiotherapy is radiation. What’s radiotherapy for? To damage cells. Sunshine damages cells. If you’re having radiotherapy, you need your energy to repair cells, so avoid sunshine. (Cancer turns off cell repair in those cells that it has attached to, so irradiated cancer cells die, which is how we get rid of cancer, and the body replaces cells with new ones where it can, which is how we recover, after a while). Overexposure to the sun causes sunburn which is when cells in the base of the skin are killed (basal cells). When these cells rise to the surface of the skin, the skin turns red. If sunburn continues, more cells die and rise to the surface, which will flake, or blister or suppurate.

Why can some people take more sunshine than others? Because of the level of photo-sensitivity of the cells in their body. The repair rate of damaged cells and the tolerance of cells to damage (photo-sensitivity) – is governed by the number and quantity of up to 30 different proteins in the body. The more the better. If you are photosensitive, you probably have fewer proteins. You need to know your own tolerance to sunlight, measured in your own garden on a sunny day. 5 minutes to burn or 20? The SPF factor of a sun-cream tells you how many times longer you can stay exposed to the sun. (SPF. Sunburn Protection Factor, actually UVB protection factor – see later).

Chemotherapy, short term, and radiotherapy, longer term, can increase the level of photo-sensitivity of cells, and so you will not be able to spend as long a time in the sun as you used to. You should increase the SPF factor of your sun-cream accordingly (what the heck does accordingly mean!) – or experimentally if you want to try getting sunburn first.

Chemotherapy drugs that cause photosensitivity are dacarbazine, fluorouracil (by injection or applied to skin), masoprocol (applied to skin), methotrexate, mitomycin, and vinblastine. Alitretinoin applied to the skin may make your skin sunburn more easily.

Radiation therapy can cause radiation enhancement or radiation recall with some chemotherapy drugs, such as bleomycin, dactinomycin, daunorubicin, liposomal daunorubicin, doxorubicin, liposomal doxorubicin, fluorouracil, hydroxyurea, and methotrexate. Radiation recall can also occur with etoposide, idarubicin, interferons, paclitaxel, or vinblastine.

(Other literature also include tamociten, femara and arimidex)

Other factors related to cancer may cause or heighten photosensitivity including:

      Changes in your physical appearance because of cancer or cancer treatment. Hair loss can make it easy to sunburn the top of your head.

      Medications -- ganciclovir, some nausea medications (chlorpromazine, haloperidol, promethazine), quinolone antibiotics (ciprofloxacin, levofloxacin, ofloxacin, sparfloxacin, and others), sulfamethoxazole, and others

Here’s a fascinating and informative publication on the way skin reacts/recovers during and after radiotherapy.
http://www.ycn.nhs.uk/html/downloads/ltht-managingradiotherapyinducedskinreactions-oct2011.pdf - According to this document, Cisplatin is bad, too.

Sunshine is electromagnetic radiation made up of, inter alia, three groups of Ultraviolet wavelengths. UVA suppresses the immune system, damages the eyes and may lead to indirect DNA damage: UVB may lead to direct DNA damage and sunburn: UVC has the highest potential for biological damage, but can’t get through the earth’s atmosphere. (UVB is partially blocked, depending on the level of ozone above you). (The bodies defense against UVB is to produce melanin, which has a dark pigment and this diffuses UVB into safe radiation – i.e. heat – so if you've not got sun-cream on you’ll feel hotter than if you have!). (Yes, UV radiation has benefits, but that’s not for this article).

Ultraviolet (UV) light is so-named because the electromagnetic spectrum consists of waves with frequencies higher than those that humans identify as the colour violet. These frequencies are invisible to most humans except those with aphakia. Near-UV is visible to a number of insects and birds.

UVA, UVB, and UVC can all damage collagen fibres and, therefore, accelerate aging of the skin. Both UVA and UVB destroy vitamin A in skin, which may cause further damage. UVA is immunosuppressive for the entire body and is mutagenic for basal cell keratinocytes in skin.

Physical sunblocks reflect UVA and UVB from the surface of the skin. Chemical sunblocks prevent UVB penetration by absorbing it, they generally don’t absorb UVA. Each chemical within the cream absorbs a different range of UVB radiation.

UVA sunblocks typically contain either titanium dioxide or zinc oxide.

When buying sunblock, avoid synthetic chemicals that can further damage your skin and weaken your defense systems: Including 4-Methyl-Benzylidencamphor (4-MBC), Oxybenzone, Benzophenone-3, and Octyl-methoyl-cinnamates (OMC). Or synthetic preservatives like parabens and synthetic fragrance.

If you've got this far, read this http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3263051/
and find out about herbals and sunshine – flowing into some other fascinating herbal information.

Blog 24 – Sunshine

Blog 24 – Sunshine

You’ll not have read my last two blogs, because I didn’t tell you I’d published them. Actually there are three. The one about pain is quite interesting in a QI sort of way.

In Blog 23 I moaned a lot. I said I want to be well. Well now I feel well well. Row and I had a really good holiday in Spain at the start of this month. The weather up in the mountains wasn’t great, so that meant a lot of just chilling in the cortijo and some casual, drive thru birdwatching. Then we had a day at the seaside. 23c. And then to the golf resort at Desert Springs where 28 of us played in tee-shirt and shorts weather. It was a health giving boost bringing back positivity through partying and putting. And sunshine.

The soreness I mentioned has reduced. The range of movement has improved. The mouth is not so dry during the day. I like coffee and wine again. So bring me sunshine.

I said I want to be fit. Now I feel well fit. Whilst I haven’t done any exercise yet, I have been doing a lot of physical stuff around the house. I played three rounds of golf in Spain (I had a buggy) and two rounds of golf at home without buggy. I will get back on the bike when the weather improves. So bring me sunshine.

I said I want to be healthy. I do feel well healthier. I’m managing to eat most things now and have an appointment with the dentist in two weeks time. I did two and a half days at work last week and three full days this week. Whilst not there yet, I think my brain is getting up to speed.

And finally I said I expect more of myself. Well not now. I feel that I am exceeding my own expectations which is a huge, moralely uplifting, boost to my self-esteem; that has banished depression. So bring me laughter, all the while.

And it's goodnight from him.

Bring me Sunshine, in your smile,
Bring me Laughter, all the while,
In this world where we live, there should be more happiness,
So much joy you can give, to each brand new bright tomorrow,

Make me happy, through the years,
Never bring me, any tears,
Let your arms be as warm as the sun from up above,
Bring me fun, bring me sunshine, bring me love.

Music by Arthur Kent
Lyrics by Sylvia Dee
Published Bourne Music, 1966
Recorded by Brenda Lee, Jack Greene, Liz Damon's Orient Express, Willie Nelson, Chet Atkins, Mickey Gilley and others
Performed by Morecambe & Wise – conducted by Peter Knight

Blog 23 – Stalled recovery

Blog 23 – Stalled recovery

I think, perhaps more so, I feel, that this should be an uplifting, celebratory blog. I finished treatment, I’m not on medication, I haven’t got cancer, I’m doing a phased return to work, We’ve got a holiday booked for March and August and there are lots of other things booked or planned for the year.

Except that’s not how it is for me just now. “You’ve been through a lot”. I know, I’ve been through it and now I’m not going through it, so I want to be well. “That’s what you should expect”. No it isn’t. It might be how it is, but I expect more.

What’s wrong isn’t so terrible. What’s strangely wrong is that I’m complaining and depressed now when I was so positive through the bad times; after I knew that I had cancer and during the treatment and all its real misery.

So what’s wrong?

I want to be well.

There’s still some soreness in the head, neck, ear and throat. But that’s ok, it doesn’t need medication and is improving all of the time.

There’s restricted movement in the neck and throat. Apparently that could increase over time as the scar tissue continues to form and then afterwards when it starts to shrink. But that’s ok, physiotherapy exercises can help maintain and increase movement.

The saliva glands often stop working leaving a very dry mouth during the day and a very, very dry throat during the night. So carry a bottle of water everywhere.

The taste buds aren’t back to normal. For example, I don’t enjoy coffee any more and I can’t drink red wine. This together with the saliva problem, which means I can’t eat peanut butter or bread or cake or cheese; and the absence of teeth, which means I can’t eat crispy bacon or chew gum; means I don’t enjoy eating: And so I’m not putting on weight. It’ll be May when work begins to get false teeth.

The shoulder is now permanently sore, the soreness you get with stiffness after too much exercise or sawing oak beams with a handsaw. I don’t think this will improve. I hope to get so used to it that I stop noticing.

There’s restricted movement in my arm. Not as bad as I thought there might be. Although it will get worse over the next year. I’m not sure what the implications of this are. It’s not stopping golf, but I haven’t tried swimming yet (apart from anything, my trunks no longer fit, and the last time I swam with loose shorts they came off when I dived in to the pool). I’ve got physiotherapy exercises to counteract this.

And here’s what’s wrong. I’ve lost my motivation to do the exercises.

I want to be fit.

Three weeks ago I got some motivation and got on my bike. I quickly saw some improvement but then my motivation disappeared.

Three weeks ago I set up the wii fit but the batteries were flat and my motivation disappeared.

After a few tries, I did manage a full round of golf on Sunday, which was a great boost. So there is some light.

I want to be healthy

In the run up to treatment, I changed my diet and added supplements. This resulted in cleaner healthier skin, no dandruff, no athlete’s foot and increased well-being both mentally and physically. Now that my diet is poor things are deteriorating.

I did half a day’s work last Monday. My brain barely worked. It took ages to do the simplest of things – like working out my remaining holiday entitlement. And completely failed to do ordinary stuff, like booking a meeting.

What’s wrong?

I expect more of myself. I don’t want to take it easy. I want to tackle the things that I can and want to do, not avoid the things that I can’t or don’t want to do. These two might seem to be the same thing but the first is motivating and second is depressing. At the moment, I’m thinking the second. But I want to be the first.

Sorry about the rant.

Frank

Blog 22 - two parts: Belief and Pain

I’m not religious. I used to be. I was an altar-boy when I was 9. I went to priest training college for 3 years from the age of 11. But then I begin to think. And the belief in someone/something unseen that is interested in me doesn’t make sense.

It is a cause of great disquiet when people tell me that my cancer was God’s will. The belief that God could wish me ill would drive me insane.

I have no problem with people praying to their God for my well-being: Knowing that people are concerned about me adds to my strength of will. When I wish people well, I send positive thoughts; it is my equivalence to prayer. I believe that the energy output by our bodies is available for use by other living things. If you spend time with happy people, you become happy. If you spend time with bad people, you become bad. You can use positive thoughts to create positive environments. Prayers work in this way.

I have no problem with people rationalising their anxieties for my predicament through ‘blaming’ it on something else – even blaming it on my ‘sins’. But personally, I refuse to blame anything for my cancer. It happened. It is a natural occurrence.

The dichotomy of life is that cells both try to reproduce precisely and strive to change their existence – in case there is an advantage – although evidence points to the fact that most changes fail. When a cell divides in a different way than that type of cell usually does it can have one of three outcomes: It can make no difference – the cell continues to perform in the same way, it can fail (and so the cell dies) or it can work (the cell survives). In this last case there can also be three outcomes: It can make no difference (there is no change to the overall organism’s performance), it can work (the organism becomes better), or it can fail (the organism becomes weaker). The things we eat, drink, inhale, inject or otherwise absorb or ingest can change the make-up of cells. Another thing that causes change is radiation. Random radiation from the solar system is bombarding the earth at all times, man-made radiation is also penetrating people: Each ‘bit’ of radiation can cause any cell that it hits to change: That cell might die there and then; it might cease to divide; it might live and mutate.

Some of these changes in cell characteristics are good – they improve, say, eyesight or memory, they increase height or strength; some are so bad that they can be described as malignant – they cause damage; some can be described as cancerous – they both cause damage and prevent repair – Clever? Blessed? Sinful? Evil? No, nature. The changes mentioned here are not intentional – neither by me, by anyone hexing or blessing me, nor by any other outside agency having a concern for my welfare. As I said earlier, I do believe that positive thoughts can influence welfare - how, well I can't tell you - I suppose I better try to find out.

And the way I dealt with cancer? It was my choice. It was my determination. Bolstered by your prayers and best wishes and belief in me. This hasn’t been a test of me. This has happened to me, that’s all.

My recovery has been successful due to our positivity and the knowledge, experience and determination of the medical teams who looked after me – and crucially who managed the after effects of their treatment through pain control. 

Which leads me neatly into the second part of this blog:

Pain.

The 4 types of pain.

•         When cells are damaged, they produce large quantities of an enzyme called Cyclo-oxygenase-2. This enzyme, in turn, produces chemicals called prostaglandins, which send pain signals to the brain. They also cause the area that has been damaged to release fluid from the blood to create a cushion so the damaged cells don't become more damaged.
•        Pain also comes from physical pressure and from sensory stress. Probably both the same pain caused by reduced blood flow to muscles in the affected area.
•        Neuropathic pain:  E.g. neuralgia, is caused by dysfunction of the nerve cells. (This pain can also occur in cancer patients and more so following chemotherapy).
•        In women, menstrual pain is caused by the body deliberately releasing pain causing chemicals in order to cause muscular contraction of the uterus.

6 classes of pain treatment (apart from removing the source of the problem!)

• Opioids partially block pain messages getting to the brain, but also change the way the brain perceives pain. And also increases tolerance to pain.

Opioids are usually divided up into two groups:

·        Weak opioids - these include codeine, dihydrocodeine, and tramadol.

·        Strong opioids – these include buprenorphine, methadone, diamorphine, fentanyl, hydromorphone, morphine, oxycodone, and pethidine.

•        Salycilic Acids (natural and synthetic versions) affect the source of the pain by binding to the cylo-oxygenase-2 enzymes and stopping them from producing prostaglandins. Prostoglandins in the bloodstream can cause clotting, so Salycilic acid can reduce this. The acid also reduces the production of thromboxane, a chemical that makes blood platelets sticky which can block an artery.

There are over 20 types. They include: aceclofenac, acemetacin, aspirin, celecoxib, dexibuprofen, dexketoprofen, diclofenac, etodolac, etoricoxib, fenbufen, fenoprofen, flurbiprofen, ibuprofen, indometacin, ketoprofen, mefenamic acid, meloxicam, nabumetone, naproxen, piroxicam, sulindac, tenoxicam, and tiaprofenic acid

(Aspirin and ibuprofen can also reduce temperature).

•        Paracetemol: affects the volume of pain and lowers a high body temperature. Prostoglandins are also produced in the brain to enhance the perception of pain – paracetemol reduces this production in the brain but not at the source of the pain and does not reduce inflammation.
• 
  
•        Anti-depressants and anti-epileptics: For neuropathic pain.
•        TENS machine (transcutaneous electrical nerve stimulation).
•        Psychotherapy. Change perception of pain or reduce some sensory stress.

NOTES:

In medications, drugs can be single or combined. Usually an opioid with one of the others.

Aspirin: (From willow bark. First used in 1899. Salicin also occurs in myrtle and birch) Reduces fever and inflammation and blocks messages to the brain.

Morphine: (Opiate, from opium poppies.) Mimics bodies pain defences (see Endorphins). Relieves pain, relaxes muscles and causes drowsiness. Addictive.

Endorphins: (Discovered in 1970s at Aberdeen University). The body’s own painkiller defence mechanism.  Exist/released in the brain. Especially during exercise and acupuncture.

 The information on pain is my interpretation of literature: Do NOT rely on it: Seek the advice of experts if you are in pain.

Regards

Frank