Like a Can Opener in a Worm Factory

Observing. All Souls'. Candle lit; Seelkuchen eaten.

Reading. ( Rucka, Waitrose Cookery School, Stocks, Duncan, Ravindran )

Playing. Merrily pootling along with I Love Hue. Hatched my first dragon with Primal eyes in The Dragons Game.

Cooking. Two variations on a recipe: smitten kitchen's winter squash and spinach pasta bake and the recipe that inspired it, Ottolenghi's pasta and butternut squash cake. On the first day I definitely preferred the smitten kitchen version; on subsequent days I became increasingly convinced by the Ottolenghi. (You see, I had about twice as much of all of the ingredients as I needed, and the spinach definitely needed eating Imminently, and so I thought I'd make them simultaneously so we could do the side-by-side comparison and then freeze some...)

And then this evening I made another round of the wahaca autumn stew with pipián, this time with even wronger chillis but a sensible amount of herbs, and was delighted that it met with my mother's approval.

Eating. SCHWARZBROT with Lizard honey. Curries various courtesy of my father. Salads and lunches various courtesy of my mother. The dark chocolate & raspberry stars that are a Special Seasonal Treat. National Trust lemon drizzle cake. A RASPBERRY.

Exploring. THE NEW SITE FOR ADMIN: THE LRP. And this afternoon we went on an adventure to Anglesey Abbey, where the dahlias were alas gone but we found many many more cyclamen than we knew were there, and several things in the winter garden were at a different stage than I think I'd ever seen them before and were extremely pretty with it.

Creating. Carved a pumpkin for the toddler!

One of my assignments this semester is an exegesis of Psalm 139, and I figured it would be good to start by doing my own translation of it, which is how I discovered that in verse 15, which the NRSV renders "My frame was not hidden from you, when I was being made in secret, intricately woven in the depths of the earth." the verb used, קרם, means specifically to weave variegated, colourful material. I found this delightful.

ETA. Also, in verse 13, the bit which the NRSV renders "it was you who formed my inward parts" could also be read as "it was you who bought my kidney". This is also delightful, in quite a different way.

Today has been largely taken up by my first visit to the NEW SITE for Admin: the LRP...

... or at least, my first visit in something like twenty years, because it's the old Cottenham racecourse and I absolutely went to one (1) race there in My Misspent Youth. Sudden wave of déjà vu on the final approach to the grandstand, as the perspective shifted to YEP, THIS IS A PLACE I'VE BEEN.

There was Make Tent go Up. There was meeting. There was Make Tent Go Down. There was being given Objects. And there was A BAT that did some beautifully ostentatious swooping against the darkening dusk, and I am delighted.

I supplied knives and fine motor control; the toddler supplied art direction; the toddler's resident adults supplied outlines for me to cut around (and candles, and matches, and in fact all of the cutting of the tiny pumpkin).

I have, in the latest book, got to The Obligatory Page And A Half On Descartes, but this one makes a point of describing it as a "reductionistic approach".

The Thing Is, of course, that much like the Bohr model (for all that's 250 years younger, give or take), for many and indeed quite plausibly most purposes, The Cartesian Model Of Pain is, for most people and for most purposes, good enough: if you've got to GCSE level then you'll have met the Bohr model; if you get to A-level, you'll start learning about atomic orbitals; and then by the time I was starting my PhD I had to throw out the approximation of atomic nuclei as volumeless points (the reason you get measurable and interpretable stable isotope fractionations of thallium is -- mostly! -- down to the nuclear field shift effect).

Similarly, most of the time you don't actually need to know anything beyond the lie-to-children first-approximation of "if you're experiencing pain, that means something is damaging you, so work out what it is and stop doing that". The Bohr model is good enough for a general understanding of atomic bonds and chemical reactions; specificity theory is good enough for day-to-day encounters with acute pain.

The problem with specificity theory isn't actually that it's wrong (although it is); it's that it gets misapplied in cases where Something More Complicated is going on in ways that obscure even the possibility of Something More Complicated. The problem, as far as I'm concerned, is that it doesn't get presented with the footnote of "this isn't the whole story, and for understanding anything beyond very short-term acute pain you need to go into considerably more detail". But most people aren't in more complex pain than that! Estimates run at ~20% of the population living with chronic pain, but even if we accept the 43% that sometimes gets quoted about the UK, most people do not live with chronic pain.

There's probably an analogy here with the "Migraine Is Not Just A Bad Headache" line (and indeed I'm getting increasingly irritated with all of these books discussing migraine as though the problem is solely and entirely the pain, as opposed to, you know, the rest of the disabling neurological symptoms) but I'm upping my amitriptyline again and it's past my bedtime so I'm not going to work all the details of that out now, but, like, Pain Is Not Just A Tissue Damage, style of thing.

Anyway. The point is that I still haven't actually read Descartes (I've got the posthumously published and much more posthumously translated Treatise on Man in PDF, I just haven't got to it yet) and nonetheless I am bristling at people describing him as reductionist (derogatory). Just. We aren't going to do better if we also persist in wilful misunderstandings and misrepresentations for the sake of slagging off someone who has been dead for three hundred and seventy-five years instead of recognising the actual value inherent in "good enough for most people most of the time", and how that value complicates attempts at more nuance! How about we actually acknowledge the reasons the idea is so compelling, huh, and discuss the circumstances under which the approximation holds versus breaks down? How about that for an idea.

Sarah Russell of The Ostomy Studio, the person who made such an enormous difference to my general State Of Being just over a year ago via the medium of a private Pilates lesson pre-surgery, has just announced publication of the new Exercise and Physical Activity after Stoma Surgery best practice guidelines that she's been working on for literal years along with some amazing collaborators!

The principles here are the bedrock for the private lesson I had before surgery, and are also what I used as my foundation for rehab despite not after all needing to work with a stoma; I've not read them in full, but if you know folk they might be of interest to then please do pass the link on <3

Reading. Two things finished, various things picked up and put down again.

Ouch!, Kerr & McRobbie: the subtitle is Why pain hurts, and why it doesn't have to; it's indicative of my current preoccupations that I was actively surprised that it is not, in fact, about chronic pain, except in passing, in that it's mentioned in the introduction in the context of pains the authors have experienced, and then it just sort of... vanishes again. What it actually is is more-or-less a tour of the sociology of acute pain, from a variety of perspectives and contexts, and an invitation to reshape your relationship with pain, optionally via the medium of sports.

It's very much aimed at a general audience (by which I mean both "not people with any particular pre-existing knowledge about pain" and also "not chronic pain patients"), with the infuriating-to-me feature of having not an actual bibliography but instead a "selected references" section, i.e. any claims I wanted to actually check required digging and then guessing (and in one case working out that they were actively wrong about which year the thing was published in, at least for referencing purposes). I did nonetheless get some useful information and vocabulary out of it (I'm especially here for the pointer to the 3P approach to pain management), and it prompted another couple of articulations.

Overall: not a disrecommendation; plausibly a light read if you have, you know, a recreational interest in pain; verify any specifics you want to rely on.

The Old Guard: Opening Fire, Rucka et al. A's conclusion was Well It Was Better Than The Second Film; mine was ( mild spoilers? )

and would be very happy to see that show up in an extended cut of the first film. The library doesn't have the second volume and I think we're unlikely to seek it out.

DW catch-up: halfway through September!

Playing. Inkulinati, mostly watching A play and occasionally making Suggestions. Does not work as well as a Shared Activity as I'd hoped (annoyingly I think I'd need to play basically all of it hands-on myself in order to internalise mechanics and strategy, rather than being able to e.g. swap who's driving for every level) but I am enjoying it happening in my vicinity. Today we also read the PDF of the art book together, which I am not counting as Reading because it was mostly looking at the pictures in another context.

And after six months I GOT UNSTUCK ON I Love Hue! The Ascension/Air/1, extremely gratified that searching for it revealed someone who'd managed to complete everything but that, and bolstered by this knowledge I turned brightness all the way up and the phone upside down and FINALLY managed to sort out the yellows, on my nth attempt... in way fewer than the average number of moves. VICTORY.

Cooking. ( Read more... )

Good morning, afternoon, and evening!

We're doing some database and other light server maintenance this weekend (upgrading the version of MySQL we use in particular, but also probably doing some CDN work.)

I expect all of this to be pretty invisible except for some small "couple of minute" blips as we switch between machines, but there's a chance you will notice something untoward. I'll keep an eye on comments as per usual.

Ta for now!

Summary: nobody seems to have done the data analysis I actually want, because data collection is hard and then actually making it internationally comparable ditto, but the proportion of chronic pain cases that are primarily attributable to back pain Of Some Kind seems to be very roughly in the region of 20%-50%, depending.

( Read more... )

One of the things I'm sure I've come across repeatedly in the books I've read so far is the idea that a very high proportion of Chronic Pain Cases are down to either back pain or headache. This is important because back pain genuinely is something that has a massive nociplastic component, especially in the lower back, that is unequivocally worth treating (despite myself I remain grudgingly impressed with the Boulder Back Pain Study; and, to be clear, I do myself have a grumbly section of lower back following an injury a few years ago that I am practising all my Theories on!).

This is an Important To Me framing device because my point is that treatments aimed purely at nociplastic pain/central sensitisation cannot be expected to work as well for people with ongoing or recurrent tissue damage/injury... but why it's worth using some of these approaches anyway, with the understanding of the actual scope of what effects to hope for or expect. Which means I'd like to know where they're GETTING those numbers from.

( Mindfulness for Health )

( The Way Out (... long, bonus tangential rant) )

( The Painful Truth )

... aaaaaaand it is now definitely past bedtime so I'll finish Revisiting Books tomorrow. (My notes on Explain Pain, consistent with it being generally competent, are that it doesn't go anywhere near talking about what The Most Common Forms Of Chronic Pain are; might have a quick flip through when I'm next in the same place as my copy. Also couldn't find anything in Touch. Will be revisiting the current book, Ouch!, in the morning...)