>End of the episode


An episode is something that starts at a time, place and circumstance, has a particular relevance and then ends. The brain organizes reality in episodes, events framed in time and space and that mean something.

In the organism, there is a complex process routine that is exquisitely controlled. From time to time something unexpected happens. That something may be an adverse event: an infection, a tear, lack of oxygen … There is cell death, necrosis. Alarms go off, defensive resources are mobilized. The area becomes inflamed, painful, hot, swollen, ruddy and out of order. Everything happens quickly. Every second counts. The deployment has mechanisms of positive feedback, of a haddock that bites its tail and grows. The priority is to end the state or agent responsible for necrosis. Necrotic cells are highly toxic and necrotizing. We must end them too. Once the necrotizing danger is controlled, repair comes. We must recover the damaged. It’s not always perfect, but the patches are effective and sufficient.

Pain protects the repair process. Once completed, pain becomes an obstacle. The tissues need activity to recover the normal condition and, in order to do that, the brain must remove the perception of pain, authorize and promote reuse, not penalize it. The danger has passed. Everything should go back to normal. End of the episode.

There are many necrotic episodes that trigger the acute phase reaction (inflammation) normally, but that leave the alarm on. The brain does not grant approval for the repair and continues penalizing the use. The pain is still there indefinitely in the form of a problem. The area is functionally seized with total disability. There isn’t any episode. There was a beginning but no end is granted.

– I have a herniated disc.

There was a time when the disc had been torn and the nucleus herniated, invading the space occupied by a nerve root. The alarms went off. It hurt, the joints were blocked, protector, alternative motor programs were activated,… but within days or weeks the site was reorganized, the necrotic remains were removed, the tear was mended and ready for the movement, necessary to restore function and architecture. Maybe the brain didn’t see it that way. It didn’t regain confidence and continues to deny the end of the episode, the license guarantees.

– Well, you had an episode of a herniated disc, but it is repaired, finished. You should move without fear. The recovery of the structure and function is not possible without movement. The acute-phase defense programs should be turned off. Your brain must know that losing a point joint between two vertebrae is not the end. Your brain should promote normality. Otherwise the lower back will become an absurd vicious circle.

– Yes, but it hurts, I’m locked, rigid, I can’t do anything.

– You are still in acute phase, as if your disc had just been ripped. It’s already cooled down, repaired. If you don’t go back to activity, purpose, confidence … you will never go back to normal.

The management of defensive processes by the immune and nervous system contains the danger of poor regulation. An acute episode becomes chronic, not necessarily because it left  after-effects but because it hasn’t been considered as finished when it should.

Chronic pain is often a response of warn, triggered reasonably by an acute necrotic event that fear maintains unreasonably active. There is no physical vulnerability, but simply fear to going back to normal. The brain does not trust the repairs. It doesn’t event know they exist.

– You haven’t driven the car again.

I have an accident

– Yes, but that was a few years ago and you brought it to the garage to have it repaired.

Citizens continue to use the present to tell about the real past and the imagined, feared future.

>The right to inflammate


At my office, I show an image of some firemen extinguishing a fire and ask the patient:

– Which one represents inflammation: the firemen or the fire?

The answer is, invariably: “the fire!”

Inflammation means lighting a fire, producing a flame. An inflamed tissue is hot and red, and sore and swollen. Firemen de-inflammate, they put out the fire. Hence, they are anti-inflammatories … Elemental.

– Well, they aren’t. Firemen represent inflammation. Agents that aim to prevent the spread of the fire.

Words, when not adequate, play tricks. The term inflammation is absolutely inadequate, disruptive, pathological. It should be erased.

Inflammation is a defensive response that protects healthy tissues from something destructive and repairs the damaged.

The idea that inflammation is a destructive fire that must be stopped with anti-inflammatories is widespread.

The compulsive and compelling application of ice exposes the error of considering inflammation something destructive that must be fought.

Certainly, the firemen cause damage in their fighting rage against flames, but no one thinks about calling the police during a fire to report some men that destroy doors and make a mess with water.

There may be a case of an excessive action of the firemen. They can destroy the living room to put out a fire on the corner of a curtain.

It can also happen that firefighters flood the house every time we turn on the fireplace.

There are some firemen that take excessive actions and kill flies with guns or that do not give permission to make good fires. There are excessive and unnecessary inflammations, but firefighters do not set things on fire, they put it out. They are inflammating agents … “Inflammation”, damn word! This way it’s impossible to understand it…!

Pain is part of the inflammatory status: tumor, redness, heat and pain…

Anti-symptom brigades try to avoid swelling, redness, heat and pain. They assume that firefighters are always excessive and unnecessary, even if there’s a fire.

The body needs this inflammatory response (firemen) quickly and decisively to put out any necrotizing, destructive fire and it also needs to measure its response. There is no inflammation without an anti-inflammation. Prescribing inflammatories and anti-inflammatories would make the same sense.

– You’ll have to take these inflammatories so it heals faster. Its temperature will rise, it will swell, it will hurt and it will look like a tomato.

There are some who argue that inflammation was necessary in the old days in the savanna when surviving carried being wounded day-to-day. In the comfortable life we have now, inflammation is excessive, inadequate, and must be contained, like high blood pressure. It can be, but first we have to take the measure of each one’s inflammation to see if it’s excessive.

– They said I have a high inflammation. I’m taking anti-inflammatories…

Tissues of the embryos don’t burn when they break. They regenerate. New cells are produced. With cellular development and maturation, tissues lose their regenerating power and resort to inflammation to repair themselves. It’s not the same, but the repairs are not completely bad: aesthetically poor and with their function somewhat diminished, but they still work.

Until proven otherwise, inflammation is timely and measured. It must be respected. If someone has a pathological inflammation response, the inflammatory rage must be controlled, allergy and hiperergy, using anti-inflammatories.

There is an obsession to discredit the self-management of the body. Everything it does is wrong. Everything is deregulated, it’s too much or falls short… Defensive, neural and immune systems are incompetent and need a professional’s correction that, at a glance or by simple hunch, feels that everything is swollen, wrongly swollen, excessively inflamed.

The sufferers feel swollen. They feel pain, so there is inflammation.

– There are sirens of firefighters, so there are firefighters. There are firefighters, so there is fire. Changes in weather should burn the house, because I can hear the siren…

– Are you saying that firefighters are inflammation, incendiaries?

– Yes, they are. Damn fire, blessed firefighters! Blessed inflammation despite that damn name!