Today I had my second rtfMRI scan, utilizing the sensory strategies I'd been practicing all week to increase and decrease my pain. And this time in the virtual reality goggles I got to see a flame that rose and fell according to how active the pain centers in my brain were. During the previous scan they identified the parts of my brain that activated when I increased my pain by focusing my attention on it and imagining being gouged by a pair of pliers (because that's kind of what the pain feels like all by itself). Their software converted this activity into an image of a flame, like a bonfire on the beach. It was remarkably realistic, including lots of little embers and sparks rising up from it. I was quite taken by it, but the technician told me a lot of people have been complaining about it. For some reason no one but me likes the little beach bonfire.
I was cautioned that there is a 5-second delay on the feedback, meaning that the flame would not react instantaneously to my brain activation. This delay is due to something called hemodynamic response, which involves the time it takes the blood to flow through the different parts of the brain. It is also due to the time the software needs to process the data and make the flame image respond. Basically, it means my brain is faster than the software. I'm so glad my brain is faster than something. This is as close to watching my own thought process as technology can currently get these days, so I was certainly willing to make a 5-second accommodation.
We got 10 separate scans done today. I was amazed at how readily I could make the flame climb really high during the increase pain phase; I was frustrated at how difficult it was for me to get it flame lower during the decrease pain phase once it was ramped up. I don't think the sensory strategy will wind up being the most effective for me in the end, because of how much trouble I had knocking the pain down by imaging warmth on the area.
During the final scan I could not get the increased flame to budge downward at all, so I cheated a little and used a non-sensory strategy to see what would happen: instead of imagining warmth soothing the pain away, I focused my attention on a different part of my body that wasn't in pain. The flame went way down, and even went out completely for a couple of seconds. Afterwards I found out that I had stumbled upon one of the up-coming strategies I'll be using, called the discriminative strategy, or shifting focus between painful and non-painful regions of the body. Perhaps that one will be more useful to me.
But in the meantime I have to practice a new strategy -- the affective strategy, or the feelings and emotions I associate with being in pain and not being in pain. To practice increasing my pain I'm supposed to think about a gigantic, looming obsidian rock and how frustrating, discouraging and depressing it is trying futilely to budge it. To practice decreasing my pain I'm supposed to think about a limber dancer, full of the joy of being in a healthy, flexible body, feeling warm and happy. This is imagery I came up with during my initial strategy session, prior to my first scan.
I wonder what my emotions associated with these new images will do to the flame? I'll find out at my next scan on Wednesday.