July 25th, 2009

rtfMRI: One-Week Follow-Up

rtfMRI: One-Week Follow-Up

Yesterday I had my one-week follow-up at Omneuron after my final rtfMRI scan. After filling out an interminable amount of paperwork, I met with a team member to discuss all aspects of the study. Not only were they helping me by finding mental strategies I can use to mitigate my chronic pain, but I was helping them as well by testing out their strategies over several weeks and 6 real-time fMRI scans.

The biggest issues for me were my concentration problems, and how hard it was to decrease my pain (getting it to increase was easy, though ). This particular type of chronic pain treatment might not be for everyone, though, which is why participation by people like me is helpful to them. They need to know the limitations of their treatment plan. It may turn out that it simply cannot work all that well for people like me who cannot concentrate worth a darn, and my participation will help tham determine that.

I have more homework to do over the next 2 months, though, when my next follow-up appointment is scheduled. I still have to practice the mental strategies that worked best for me, although not a strictly as I did while practicing for the actual fMRI scans. They need to track how effective these strategies are as a pain management tool over time.

Since it is very easy for me to get my pain to increase, I really don't need to practice doing that. According to the data, the most effective mental strategy for decreasing my pain is thinking about a day when I had little to no pain, and what that day was like, all the physical sensations and emotions, every possible detail as though I were reliving it (the evaluative strategy).

I cannot remember every detail from 5 minutes ago, so I'm not going to do well at remembering that particular day last summer when I had a rare no-pain day. So I'm probably not going to use that. I don't know why the data shows that one as the winning decrease strategy. Maybe that was the day I almost fell asleep in the scanner, and it was just my exhaustion that decreased my pain during the scan, not the actual mental strategy.

According to my own subjective experience while practicing, though, my most effective mental strategy for decreasing my pain was the discriminatory strategy, where I thought about the non-painful areas of my body vs. the painful areas, and the non-painful ones spreading into the painful areas and taking over. I will probably use that one when I'm practicing at home these next 2 months. I assume that deciding to use one strategy instead of another won't make a major difference, as long as I'm using some strategy to actively reduce the activity of my brain's pain center.

I also have another workbook to fill out, tracking the results of my practice sessions (ugh, I hated doing that the first time around). I also have to keep a weekly pain diary, which is a welcome change from the daily pain diary I had to keep. I understand how important it is to the researchers to have this information; I just wish it wasn't such a tiresome thing for me to deal with.

More importantly, I wish I were able to concentrate well enough to focus properly on these mental strategies. During the real-time functional MRI scans, I saw how the virtual reality flame rose and fell according to how I consciously activated and deactivated my brain's pain center, so I know it's possible to have some kind of control. I just wish my brain fog weren't so pervasive, making sustained concentration all but impossible.

Even if I can somehow create a half-assed version of a mental strategy to reduce my brain's pain center activity, I will consider that a success.