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rtfMRI Pain Study - Pahavit's Universe — LiveJournal

pahavit
Date: 6-12-2009 11:41 PM
Subject: rtfMRI Pain Study
Security: Public
Tags:chronic pain, disability/medical, fibromyalgia, mental imagery, omneuron, rtfmri, scan, study
rtfMRI Pain Study


My first appointment with Omneuron for the rtfMRI pain treatment study in March was quite anticlimactic. They'd found that their initial control group was reporting improvements in their pain conditions without having received any actual real-time feedback during their rtfMRI scans (they received only fake, placebo feedback), so they needed a third control group that never got scanned at all. So I was in that group for 2 months, doing nothing. While that delayed my actual start date, it also guaranteed that once I started I'd be getting real feedback and not placebo feedback, and thus I'd be on a direct track for getting genuine benefit from it.

After the 2 months went by I then had a couple of preliminary appointments, filling out lots of forms, questionnaires and surveys about my pain levels. This was not pleasant, because my primary coping strategy has been to ignore my pain and distract myself from it. All those forms required me to pay full attention to my pain and evaluate it in some fashion, and as a result it became magnified in my consciousness. But it was a necessary part of the treatment study, so I bit the bullet and did it.

One of the research team told me that people who distract themselves from their pain are less successful in controlling it than people who actively engage with their pain. So that gave me some courage in giving it a go, that there will be a payoff for me down the line.

My next appointment involved a strategy session to experiment with various kinds of mental imagery for both increasing and decreasing my pain, and to come up with sensory ways of imagining those methods. This seemed almost counterintuitive to me -- why would I want to practice increasing my pain? Are they nuts?? But again, it has been found that pain control is more successful if people practice both increasing and decreasing rather than decreasing alone. It seems paradoxical to me, but research apparently bears it out.

For me, all I needed to do to increase my pain was to focus on it; that seemed to ratchet it up a notch immediately without doing anything else. I had more trouble finding a sensory mental image for decreasing it. The only thing I could find was something involving getting warmth or heat onto the area -- soaking in a hot bath, lying on warm rocks, feeling a furnace blowing heated air onto my back, etc.

Then at home I had to practice 60 seconds of increasing my pain, 30 seconds of resting, 60 seconds of decreasing my pain, and 30 seconds of resting, for 10 minutes, 3 times a week. Then I had to record in a workbook how much I got my pain to increase and decrease each time. I had to practice with my eyes open, since while being scanned I will have to be watching what's going on in the virtual reality goggles. I found that to be very distracting. It was so much easier to concentrate with my eyes closed, but I made myself practice with them open. I felt frustrated that I couldn't get my pain to budge much either up or down.

All this preliminary stuff was leading up to today, my first rtfMRI scan. It was about 90 minutes of getting some baseline readings, then 8 separate scans of increasing and decreasing my pain using the sensory techniques I'd been practicing. I received visual cues in the virtual reality goggles regarding when to rest, when to try increasing the pain and when to try decreasing the pain. The visuals plus the noise from the scanner made concentrating even more difficult for me; during my first scan I couldn't find a way to make my pain change at all either up or down, I was so distracted by the extra stimuli. But I got a little better at it during the next series of tests.

One of my initial assignments was to come up with a drawing or some kind of visual image to depict what my pain feels like. Since I can't draw at all, I put together this image in Photoshop.

I sure hope the strategies I'll be learning are up to that challenge.


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