1 00:00:00,000 --> 00:00:09,600 Hello! Welcome back to another episode of Diagnosing a Killer, the mental breakdown. Break down. 2 00:00:09,600 --> 00:00:12,000 Having a breakdown. 3 00:00:12,000 --> 00:00:41,280 At this moment right now. Actively having a breakdown. 4 00:00:41,280 --> 00:00:44,320 How's it going? Hi! Hi! How are you doing? 5 00:00:44,320 --> 00:00:50,160 I just came back from a week being out of town and I've been home for like a couple of hours 6 00:00:50,160 --> 00:00:54,720 and you and I really haven't talked a lot. So this is like our first time talking in like a week. 7 00:00:54,720 --> 00:00:58,640 It's so funny too because I was I was riding around the car and I was like, 8 00:00:58,640 --> 00:01:03,200 I miss my sister. And then you come home and like barely even spoken to each other. 9 00:01:04,080 --> 00:01:10,640 Well just having the presence. It was a lot of fun but I was really ready to be home. I was just 10 00:01:10,640 --> 00:01:17,040 in a four person RV which is great but that couch is very uncomfortable to sleep on. 11 00:01:17,040 --> 00:01:19,440 It is. For more than like two days and I was there for like five nights. 12 00:01:20,720 --> 00:01:29,280 But happy to be home. Happy to be here recording for you guys. Thanks again for 50,000 plus downloads. 13 00:01:29,280 --> 00:01:35,360 Super excited about that. I do have just a couple of messages to read but if there's anyone here 14 00:01:35,360 --> 00:01:38,800 for the first time would you like to give them our social media handles? 15 00:01:38,800 --> 00:01:44,240 Sure. You can check us out on social media anywhere at diagnosing a killer other than X 16 00:01:44,240 --> 00:01:49,360 formerly known as Twitter which is at killer diagnosis. We also have a PayPal, Venmo and 17 00:01:49,360 --> 00:01:56,400 Cashrop all at diagnosing a killer. Our email is diagnosing a killer at gmail.com. I don't 18 00:01:56,400 --> 00:02:01,840 think we say that often enough. We're like email us. And it's like what the hell's your email? 19 00:02:01,840 --> 00:02:09,040 Yeah. So yeah. And then of course Patreon. We also have one of those. Tier two and three 20 00:02:09,040 --> 00:02:18,080 Patreon members get an exclusive unedited essentially for the most part. And ad free and no content 21 00:02:18,080 --> 00:02:24,160 warning episode, a bonus episode every month. And our tier one Patreon members that is the 22 00:02:24,160 --> 00:02:29,840 five dollar one. You also get ad free every month as well or every week. Excuse me. Twice a week. 23 00:02:29,840 --> 00:02:34,640 Twice a week. Awesome. Yeah. So we do have a good mental breakdown for you guys today but 24 00:02:34,640 --> 00:02:39,600 before we get into that I do just have a couple of messages to read. I haven't you haven't read 25 00:02:39,600 --> 00:02:45,520 these either yet so it's going to be new to you. We do have a new listener of ours that chose to 26 00:02:45,520 --> 00:02:50,320 remain anonymous but they messaged and said hey you two I'm a new listener and I immediately did a 27 00:02:50,320 --> 00:02:55,440 deep dive after like two weeks of casual listening. I listened to you all on my 14 hour drive to 28 00:02:55,440 --> 00:03:00,000 pick up a family member from mental health treatment yesterday. Wow. You're so funny and open-minded 29 00:03:00,000 --> 00:03:04,480 and I really appreciate all of the research and work you do. I've always been a true crime fan 30 00:03:04,480 --> 00:03:08,880 and obviously mental illness slash health topics are close to my heart. So this podcast is such a 31 00:03:08,880 --> 00:03:13,440 perfect fit for me. Also when I realized the two of you are sisters I immediately recommended you 32 00:03:13,440 --> 00:03:18,320 to my sister. Anyway rambly but I just wanted to let you know how much I appreciate you all and 33 00:03:18,320 --> 00:03:24,800 all you do. Love you. Bye. Love you. Bye. Thanks, Anna. Yeah such a nice message. We just love hearing 34 00:03:24,800 --> 00:03:30,720 from everyone, all of our listeners so it's great to hear how especially the mental health aspect 35 00:03:30,720 --> 00:03:37,200 of the podcast is really affecting people in a positive way. Yes and happy and healthy vibes to 36 00:03:37,200 --> 00:03:43,120 your family member as well. Absolutely. And then we just have another message as well from a listener 37 00:03:43,120 --> 00:03:48,160 Tara. Tara said just found this podcast and I'm obsessed. You two are freaking hilarious. Reminds 38 00:03:48,160 --> 00:03:54,160 me of myself and my sister who I lost in 2016 but still brings a smile to my face. We always said 39 00:03:54,160 --> 00:03:59,680 that's a big old bitch. Which cracks me up. She goes on much love and support from Seattle, 40 00:03:59,680 --> 00:04:05,280 Washington home of the Green River Killer aka Gary Woodridge. Oh my gosh. Yeah. So yeah awesome too. 41 00:04:05,280 --> 00:04:09,600 I responded and said you know Ken is going to Seattle and you know a couple months and 42 00:04:09,600 --> 00:04:13,200 she's really excited about it. It's just cool and especially when people tell us where they're from 43 00:04:13,200 --> 00:04:17,280 I love that because we just we have listeners in places that we don't think we do you know. 44 00:04:18,960 --> 00:04:23,440 Oh my gosh. Yeah we still have imposter syndrome. Thank you all so much for writing 45 00:04:23,440 --> 00:04:29,120 and we really appreciate it. It super brightens our day. Absolutely. Okay are we gonna get into 46 00:04:29,120 --> 00:04:36,080 this mental breakdown? First I think that we should mention the True Crime Paranormal podcast 47 00:04:36,080 --> 00:04:42,640 festival happening in July the 12th through the 14th that's kind of birthday weekend in Denver 48 00:04:42,640 --> 00:04:52,320 Colorado. Get your tickets and use our code DAK pod. Just DAK. Oh just DAK for that 15% off of your 49 00:04:52,320 --> 00:04:58,080 tickets. Yes super super excited about that. It's coming up way faster than we know it. I feel like 50 00:04:58,080 --> 00:05:04,800 we just found out we were invited to 2023's TCPA and now we're almost about to go to our second one 51 00:05:04,800 --> 00:05:09,920 yeah with all of our friends. With our friends. This year we have people we know when we have friends 52 00:05:09,920 --> 00:05:15,520 they're walking into it. So yeah definitely get those tickets and they actually just announced 53 00:05:15,520 --> 00:05:21,200 that there's going to be a almost like a stand-up comedy act there this year which is really cool. 54 00:05:21,200 --> 00:05:25,680 It's a stand-up comedy True Crime. Yeah True Crime's comedy stand-up. Yes. I think it 55 00:05:25,680 --> 00:05:28,880 sounds really interesting. It's gonna be fun. We're definitely gonna have to make time for that. 56 00:05:29,840 --> 00:05:36,800 All right so for this week's mental breakdown we are going to be talking about Phantom Limpain. 57 00:05:39,520 --> 00:05:46,720 Your face is lit up. Shocked. Yes. Okay all right. Phantom Limpain if you don't know what it is 58 00:05:46,720 --> 00:05:53,280 you are in for a good episode informational episode content warning this episode includes talk of 59 00:05:53,280 --> 00:05:58,160 amputation and other disabilities relating to physical pain. If this episode is not for you 60 00:05:58,160 --> 00:06:01,840 we encourage you to find another one of our episodes remember your mental health is very 61 00:06:01,840 --> 00:06:08,800 important and we love you. We love you. Bye. So yes Phantom Limpain I'm gonna say interchangeably 62 00:06:08,800 --> 00:06:14,000 Phantom Limpain and just Phantom Pain just for sake of remedy. Okay. It is defined as a painful 63 00:06:14,000 --> 00:06:19,760 perception that an individual experiences related to a limb or an organ that is not physically part 64 00:06:19,760 --> 00:06:26,160 of the body because it was removed or was never there in the first place. Okay so I've mostly 65 00:06:26,160 --> 00:06:33,120 heard of it described like by amputees. Yes. But organs too that's interesting. Very interesting 66 00:06:33,120 --> 00:06:39,120 and it can be also used interchangeably with terms such as Phantom Eye Pain if your eye were to be 67 00:06:39,120 --> 00:06:46,240 removed. Yes. Phantom Pain is typically reported following the amputation of a limb but may also 68 00:06:46,240 --> 00:06:51,440 occur during the removal of a breast, tongue, or even internal organs such as a kidney. 69 00:06:51,440 --> 00:06:56,560 That's so true yeah now that I think about it yeah that's that makes sense. Yeah. You would feel 70 00:06:56,560 --> 00:07:02,400 like even a breast reduction I've heard that you're like so used to holding your arms a certain 71 00:07:02,400 --> 00:07:07,520 way or something and it's like you're just your body is so used to that feeling yeah you just can 72 00:07:07,520 --> 00:07:14,480 still it's like a residual feeling. Yes definitely. The pain duration sensation and frequency varies 73 00:07:14,480 --> 00:07:21,520 from person to person. The pain can last for seconds hours days or even longer depending on the 74 00:07:21,520 --> 00:07:27,520 situation. While Phantom Lim Pain has been reported to affect an estimated eight out of ten people 75 00:07:27,520 --> 00:07:32,560 who lose a limb it is not to be confused with residual limb pain. Oh okay so that's what I 76 00:07:32,560 --> 00:07:37,840 was saying yeah residual instead of pain yeah. Residual limb pain affects the remaining part 77 00:07:37,840 --> 00:07:43,040 of the limb where the amputation occurred and is usually the result of a medical complication 78 00:07:43,040 --> 00:07:48,880 such as nerve damage or pressure on remaining nerves. I see. So just quickly differentiating the two 79 00:07:49,840 --> 00:07:56,080 residual limb pain is at the site of amputation and Phantom Lim Pain can essentially feel like it's 80 00:07:56,080 --> 00:08:02,480 farther away from that site. I see okay okay. Where the limb used to be. Instead of the nerves at the 81 00:08:02,480 --> 00:08:08,000 base of the amputation. Yes okay. Residual limb pain is estimated to affect seven and ten people 82 00:08:08,000 --> 00:08:14,560 with limb loss so just one less than uh estimated for. You said seven and ten? Yes as opposed to 83 00:08:14,560 --> 00:08:20,640 eight and ten for Phantom Lim Pain. Although the two types of pain are different from each other 84 00:08:20,640 --> 00:08:24,720 it is important for professionals to be able to distinguish which one is which 85 00:08:24,720 --> 00:08:28,880 because treatment plans and or medication will vary depending on the type of pain. 86 00:08:30,000 --> 00:08:34,640 Additionally these two types of pain can also occur at the same time. Oh really? Just keep that in 87 00:08:34,640 --> 00:08:41,440 mind yes. Okay. In the United States 1.7 million people live with limb loss each year and there are 88 00:08:41,440 --> 00:08:48,080 approximately 185,000 new lower extremity amputations that occur each year. Wow. That's just lower 89 00:08:48,080 --> 00:08:53,280 extremity. Yeah. Although amputations have occurred for centuries the first Phantom Pain 90 00:08:53,280 --> 00:08:59,520 sensation was recorded in the 16th century on French military soldier patients. Whoa. This was 91 00:08:59,520 --> 00:09:05,920 first recorded in 1551 by French military surgeon and is it ambrosia? Is that how you say that? 92 00:09:05,920 --> 00:09:11,840 Ambrosia salad. I looked it up and they both spelled the same so yes ambrosia. Sorry I don't 93 00:09:11,840 --> 00:09:18,560 know what with French. He would report that quote for the patients long after the amputation is made 94 00:09:18,560 --> 00:09:24,880 say that they still feel pain in the amputated part end quote. So again that was 1550 Huan. 95 00:09:24,880 --> 00:09:29,280 And it's not to say like things like that didn't exist then but it's just interesting 96 00:09:29,280 --> 00:09:35,840 knowing when the first recorded was. In the 19th century similar symptoms would first become 97 00:09:35,840 --> 00:09:42,560 identified as Phantom Lim Pain. This term was first coined by American neurologist Silas Weir-Mitchell 98 00:09:42,560 --> 00:09:50,640 in 1871. He would describe that quote thousands of spirit limbs were haunting as many good soldiers 99 00:09:50,640 --> 00:09:59,600 ever now and then tormenting them end quote. Fucking heat. Yeah. That what a way to say that. 100 00:09:59,600 --> 00:10:03,440 What a way to describe that because now it's like okay now we know it's like a neurological thing 101 00:10:03,440 --> 00:10:07,840 you know it could be the nervous system but he was like no like haunted limbs. Haunted spirit 102 00:10:07,840 --> 00:10:14,560 lens. Yes. Oh my god. Following an amputation the onset of Phantom Lim Pain most often occurs 103 00:10:14,560 --> 00:10:21,120 soon after surgery. This pain can feel like a variety of things such as twisting itching pressure 104 00:10:21,120 --> 00:10:26,560 or burning. Ow. Which sounds very painful. Following recovery there are many things that 105 00:10:26,560 --> 00:10:32,720 can cause Phantom Lim Pain to reoccur or occur for the first time. These triggers include things 106 00:10:32,720 --> 00:10:39,760 such as simple touch, sexual activity, exposure to cold temperatures, cigarette smoking, changes 107 00:10:39,760 --> 00:10:44,880 in barometric pressure and even simply using the restroom. Well that's all like nerves right? 108 00:10:44,880 --> 00:10:49,280 It's all your nervous system. Exactly. That's interesting. People can be often reluctant to 109 00:10:49,280 --> 00:10:53,520 express that they are experiencing this pain to anybody most likely due to the fear that they 110 00:10:53,520 --> 00:10:58,720 will be seen as crazy. You know that lens not there you know there's no way you could feel it. 111 00:10:58,720 --> 00:11:02,800 Yeah and like but again it's one of those things like how do you convince someone that it's not 112 00:11:02,800 --> 00:11:08,400 in their head. Exactly. Like. However it is much more common than people think and telling one's 113 00:11:08,400 --> 00:11:14,320 primary care provider as soon as it happens is key to getting effective treatment. Hmm. Phantom 114 00:11:14,320 --> 00:11:19,280 Lim Pain is most commonly felt in the parts of the body that are farthest away such as toes and 115 00:11:19,280 --> 00:11:24,960 fingers and less common on amputations of say a leg or an arm although this can occur as well. 116 00:11:24,960 --> 00:11:30,240 Not sure exactly why that is but it's like maybe because it's like you can see it more often because 117 00:11:30,240 --> 00:11:34,240 it's farther away from you. Yeah you have. As opposed to having it maybe on your shoulder. 118 00:11:34,240 --> 00:11:38,240 Right where you don't always it's like you can never not see your nose in the front of your 119 00:11:38,240 --> 00:11:43,200 face. Thanks for that. So is there it just makes you look at it. No I'm gonna look at it by research. 120 00:11:44,640 --> 00:11:49,120 Cross the head. Yeah I think you're right I think because we have such an association of looking 121 00:11:49,120 --> 00:11:54,080 down at our hands when we're doing something that that's probably more prominent in your brain. 122 00:11:54,080 --> 00:11:59,600 It's almost like an out of sight out of mind kind of thing. So what causes Phantom Lim Pain? 123 00:11:59,600 --> 00:12:03,520 And I'm gonna ask everyone to bear with me because there is a lot of medical terminology 124 00:12:03,520 --> 00:12:08,000 coming up and I'm gonna try my hardest to pronounce it correctly. I love when we have 125 00:12:08,000 --> 00:12:11,920 episodes like this because you you're the one that always challenges yourself I'll find another way 126 00:12:11,920 --> 00:12:19,840 to say it. I'm like I can read I can do this. So originally Phantom Pain was thought to occur 127 00:12:19,840 --> 00:12:26,560 due to neuromas located at the amputation site. A neuroma is typically a tumor or a tissue that 128 00:12:26,560 --> 00:12:32,320 develops as a result of amputation. However it seems to be more neurological and having to do 129 00:12:32,320 --> 00:12:37,360 with the nervous system. While experts believe that Phantom Pain results from a mix-up in the 130 00:12:37,360 --> 00:12:42,640 nervous system signals specifically between the spinal cord and brain there are many different 131 00:12:42,640 --> 00:12:47,920 theories of why this occurs. So the first theory we're going to talk about is called peripheral 132 00:12:47,920 --> 00:12:52,400 mechanisms. Okay. Kind of sounds like you know out of sight out of mind if you can see it. Yeah. 133 00:12:52,400 --> 00:12:58,640 It's likely to happen. This theory states that the neuromas formed at the amputation site show 134 00:12:58,640 --> 00:13:04,880 increased sodium expression and because of this an increased activity of fibers is caused. Just 135 00:13:04,880 --> 00:13:11,120 various fibers. These fibers are involved in pain and temperature sensation and can contribute to 136 00:13:11,120 --> 00:13:16,560 Phantom Pain. However it has been noted that the pain decreased once the fibers were able to be 137 00:13:16,560 --> 00:13:22,240 calmed down with blocking agents so this theory is not widely believed to be the full reason behind 138 00:13:22,240 --> 00:13:29,680 Phantom Pain. The next theory is spinal mechanisms. Peripheral and nerve injury can lead to the 139 00:13:29,680 --> 00:13:34,720 degeneration of fibers in the spinal cord and when this happens a different type of fiber can 140 00:13:34,720 --> 00:13:40,720 branch into the same area. If this happens the secondary fibers can be turned into noxious 141 00:13:40,720 --> 00:13:47,440 stimuli. What? So not good. Okay not good. This is kind of hard to explain but essentially if these 142 00:13:47,440 --> 00:13:52,880 types of fibers become noxious it can cause the original ones to do the same and this can lead 143 00:13:52,880 --> 00:13:59,520 to what is known as central sensitization. Central sensitization can affect the nervous system 144 00:13:59,520 --> 00:14:05,280 especially at areas that have had trauma to them. However patients with complete spinal cord injury 145 00:14:05,280 --> 00:14:10,400 have also experienced Phantom Pain so experts theorize that there must be an underlying central 146 00:14:10,400 --> 00:14:16,240 mechanism within the brain. That's very interesting. I know these things are so cool to me. I'm 147 00:14:16,240 --> 00:14:20,960 nerding out over here. So this is like essentially all the reasons why it couldn't be physical but 148 00:14:20,960 --> 00:14:25,520 why it's neurological. Yes or it's like these are like some people believe these theories but then 149 00:14:25,520 --> 00:14:29,120 there's like limitations to the theory like some people are like well no that couldn't be the whole 150 00:14:29,120 --> 00:14:36,480 case because of this. Right. The next theory is called central mechanisms. In much of the 20th 151 00:14:36,480 --> 00:14:41,600 century it was believed that no new central circuits could be formed in the adult brain. 152 00:14:42,400 --> 00:14:48,720 However experiments from the 1980s onward would cast doubt into this thought. In one example of 153 00:14:48,720 --> 00:14:54,400 this functional MRI studies in amputees have shown that almost all patients have experienced 154 00:14:54,400 --> 00:15:00,560 cortical remapping or a new cortical map growing after damage. Something in the brain. I'm not 155 00:15:00,560 --> 00:15:04,000 going to go into explain with that. Oh yeah it makes sense like remapping it's like you're 156 00:15:04,000 --> 00:15:10,400 having to retrain your brain on how to reconfigure like everyday tasks you know like just what you 157 00:15:10,400 --> 00:15:15,040 now know are your capabilities right. Exactly. I hope yeah I hope everyone's following I know 158 00:15:15,040 --> 00:15:18,560 some of these words. I was even when I was reading I was like oh my gosh how am I going to explain 159 00:15:18,560 --> 00:15:23,200 this in like layman's terms. It's like having to learn how to write again or how to speak again. 160 00:15:23,200 --> 00:15:29,600 Exactly. This theory goes further to state that after amputation cortical remapping leads to areas 161 00:15:29,600 --> 00:15:35,520 of the brain formally receiving input from the lost limb now able to be stimulated from the nearby 162 00:15:35,520 --> 00:15:41,280 cortical regions thus phantom pain. So it's like it's trying to connect with that part that's no 163 00:15:41,280 --> 00:15:47,440 longer there and it's like getting essentially like frustrated and hurting. Yeah. A limitation to 164 00:15:47,440 --> 00:15:53,040 this theory however would be that it has been shown mostly in upper extremity amputations and less 165 00:15:53,040 --> 00:15:59,200 in lower ones. It can also be found that the more severe the amputation the higher the amount of 166 00:15:59,200 --> 00:16:04,880 cortical reorganization will occur suggesting that if the amputation was from birth this theory may 167 00:16:04,880 --> 00:16:12,080 not stand. Yeah. Finally the neuro matrix theory is widely accepted as a reason behind phantom pain. 168 00:16:13,120 --> 00:16:19,520 In this theory initially coined by psychologist Ronald Melzak in the 1990s there is an extensive 169 00:16:19,520 --> 00:16:24,800 network connecting the thalamus which is the large mass of gray matter in the central brain 170 00:16:24,800 --> 00:16:30,560 and the cortex which provides direction for the rest of the body as well as the cortex and the 171 00:16:30,560 --> 00:16:36,240 limbic system being linked together. The limbic system is a set of brain structures that surround 172 00:16:36,240 --> 00:16:41,520 either side of the thalamus so they're all kind of in the same area. But underneath essentially 173 00:16:41,520 --> 00:16:47,040 like the top hemispheres so it's within like kind of behind your ocular cavity but more 174 00:16:47,760 --> 00:16:54,480 deeper in. Pretty like yeah pretty centralized in the brain. The main suggestion behind this theory 175 00:16:54,480 --> 00:16:59,120 is that since all of these things are linked and can tell each other how to react to stimuli 176 00:16:59,120 --> 00:17:04,240 there is a genetically predetermined network that will tell the body things that were once there 177 00:17:04,240 --> 00:17:10,320 are still there. This theory goes on to suggest that certain activities associated with pain will 178 00:17:10,320 --> 00:17:17,040 lead to the conscious perception of phantom pain such as maybe boiling water coming towards where 179 00:17:17,040 --> 00:17:22,240 your hand would be and your brain recognizes oh my gosh like that's painful. I burned myself. 180 00:17:22,240 --> 00:17:28,640 Yes. After limb amputation changes to the neuro matrix and neuro signature may be the 181 00:17:28,640 --> 00:17:35,280 cause of the phantom pain localized in the lost limb. Support for this theory is largely due to 182 00:17:35,280 --> 00:17:41,360 studies that show chordonomy failed to treat phantom pains. Chordonomy is a surgical procedure 183 00:17:41,360 --> 00:17:45,840 that essentially blocks certain nerves from receiving signals and therefore should stop 184 00:17:45,840 --> 00:17:50,480 pain from being localized to certain areas like a spinal block or something. So it's essentially 185 00:17:50,480 --> 00:17:55,600 just it's kind of interesting because they're experiencing this pain but the medication they're 186 00:17:55,600 --> 00:18:02,720 taking is kind of for the pain but it's specifically to numb it. Yeah it like tricks the nervous 187 00:18:02,720 --> 00:18:08,800 system into thinking that sorry that nervous like dead so now you can't feel the pain. Yeah and it's 188 00:18:08,800 --> 00:18:15,440 interesting that these are you know like you said blockers but they're pain medication. Yeah it's 189 00:18:15,440 --> 00:18:19,440 kind of interesting. I hope everyone's following me like I said this is this is definitely something 190 00:18:19,440 --> 00:18:23,600 that took me a while to kind of siphon out you know the best way to explain it. 191 00:18:28,640 --> 00:18:33,520 When I think about the latest trends I think Spencers. Spencers has been a mall must visit 192 00:18:33,520 --> 00:18:39,360 since its first store opened in 1963. From then Spencers has always stocked the most unique and 193 00:18:39,360 --> 00:18:44,560 buzzworthy products including but not limited to their wide range of Lotto lamps their body 194 00:18:44,560 --> 00:18:49,760 jewelry cases and of course their infamous wallet wall and don't forget about their 18 and up section 195 00:18:49,760 --> 00:18:54,720 dedicated to sexual health. Did I mention their humanitarian work? Spencers has been partnered 196 00:18:54,720 --> 00:19:00,160 with the ACLU for years in an effort to protect individual rights as well as other non-profits 197 00:19:00,160 --> 00:19:07,040 such as cancer. With over 670 locations in the US Spencers is the hottest place for trends even 198 00:19:07,040 --> 00:19:13,120 after 75 years. Click the link in the show notes to receive an exclusive offer today. Spencers 199 00:19:13,120 --> 00:19:14,800 life's a party and we're making it fun. 200 00:19:19,760 --> 00:19:24,960 So limitations to this theory come from its failure to explain why relief from phantom pain 201 00:19:24,960 --> 00:19:30,080 after treatment rarely eliminates it all together and how some people's sensations can 202 00:19:30,080 --> 00:19:35,040 spontaneously end while others will not have phantom pain at all. Yeah. So again those are 203 00:19:35,040 --> 00:19:40,960 the most widely believed theories for why phantom pain exists. That's incredible. We're gonna keep 204 00:19:40,960 --> 00:19:47,440 going. While phantom pain is a clinical diagnosis it is based on the signs and symptoms an individual 205 00:19:47,440 --> 00:19:53,120 describes. This being the case there are no specific laboratory studies or imaging findings 206 00:19:53,120 --> 00:19:58,800 that support its diagnosis. It's essentially like self-reported pain that the doctor just kind of has 207 00:19:58,800 --> 00:20:03,840 to be like okay that sounds like phantom pain. This yeah. However of course the doctor will 208 00:20:03,840 --> 00:20:08,640 perform a thorough exam to make sure this is the case before providing treatment because sometimes 209 00:20:08,640 --> 00:20:13,520 things like residual limb pain or phantom pain can be caused by a misfitted prosthetic or something 210 00:20:13,520 --> 00:20:19,440 like that. When it comes to treatment for phantom pain it is important that the doctor understands 211 00:20:19,440 --> 00:20:24,960 the severity of the pain and the history behind the amputation. One type of treatment that may 212 00:20:24,960 --> 00:20:31,360 seem logical is medication. Doses of pain meds needed usually drop substantially when combined 213 00:20:31,360 --> 00:20:36,080 with other types of treatment but are rarely discontinued completely. So essentially if you 214 00:20:36,080 --> 00:20:40,480 get on medication for it you're probably gonna be on it forever. Really? Yes. So this isn't like 215 00:20:40,480 --> 00:20:46,240 something you can like I don't want to say like seek therapy for but you know like physical therapy 216 00:20:46,240 --> 00:20:51,360 or anything like that. It just depends. It's really a case-to-case basis from what I've read 217 00:20:51,360 --> 00:20:55,920 and you know sometimes it'll spontaneously go away on its own like with no treatment. That's so 218 00:20:55,920 --> 00:20:59,280 interesting. And that's why there's all these different types of treatment because it gives you 219 00:20:59,280 --> 00:21:05,040 a bunch of options to try you know before you have to do you know I'll get to it but essentially 220 00:21:05,040 --> 00:21:11,040 the last resort treatment for it. And I'm sure that in every case is different because the individual 221 00:21:11,040 --> 00:21:15,600 is different. Their life experiences are different. The way that they process things are different 222 00:21:15,600 --> 00:21:19,840 and not only that but probably no two surgeries are exactly the same either. Exactly. So you're 223 00:21:19,840 --> 00:21:25,280 gonna have nerve pain and such as well. For sure. I mean you could even go as far to say as that 224 00:21:25,280 --> 00:21:30,240 having to do with the experience of the doctor you know the doctor could potentially make a 225 00:21:30,240 --> 00:21:34,320 mistake if they're still new to these types of procedures and leave that nerve damage behind. 226 00:21:34,320 --> 00:21:38,880 Yeah. Certain cauterizations all that other stuff as well. So going back to medication, 227 00:21:39,520 --> 00:21:46,240 anti-eleptics such as gabapentin, progabalin and topiramate have shown mixed results in clinical 228 00:21:46,240 --> 00:21:52,800 studies for treating phantom pain. Good job. Thank you. I'm really trying. Trisiclic antidepressants 229 00:21:52,800 --> 00:21:57,680 such as amitriptyline are often used to relieve chronic pain and recently have been used more 230 00:21:57,680 --> 00:22:05,680 often in an attempt to reduce phantom limb pain. I put PLP. Other medications such as ketamine 231 00:22:05,680 --> 00:22:10,960 are thought to work by reversing the process of central synthesization within the spinal cord 232 00:22:10,960 --> 00:22:15,600 and have been proposed as possible preventative for the development of phantom limb pain. 233 00:22:15,600 --> 00:22:21,200 They also give that to cats. Well ketamine is also a drug that people abuse. Yeah. It's like a 234 00:22:21,200 --> 00:22:28,160 horse tranquilizer. Ketamine. Terrible. It's called special K. Special K. Not that I know. 235 00:22:28,160 --> 00:22:31,920 Isn't that like Kellogg's cereal too, right? Isn't that called special K? Yeah. Thanks so. 236 00:22:31,920 --> 00:22:37,520 That's cute. Although the use of ketamine has been shown to reduce phantom limb pain, 237 00:22:38,240 --> 00:22:43,920 memmantine, a similar medication did not provide any benefit to patients. So again, 238 00:22:43,920 --> 00:22:51,040 not really proven to work. Lastly, pain relief may also be achieved through use of opioids 239 00:22:51,040 --> 00:22:59,600 Calcitonin and lidocaine. Woo. Bam. You got it. I did it. Another treatment that may be beneficial 240 00:22:59,600 --> 00:23:04,240 in treating phantom limb pain is what is known as mirror therapy. I'm sure you've heard of this. 241 00:23:04,240 --> 00:23:12,720 I watched Grey's Anatomy too. I was just thinking that Arizona Robins. Yes. This type of therapy 242 00:23:12,720 --> 00:23:20,960 was first invented in the 1990s by neuroscientist Valenia S. Ramachandran. That didn't sound 243 00:23:20,960 --> 00:23:26,320 French. I'm not sure exactly the origin of the name, but it was hard to pronounce. In this type 244 00:23:26,320 --> 00:23:32,160 of therapy, individuals place their opposite intact limb in front of a mirror and voluntarily move 245 00:23:32,160 --> 00:23:38,640 the limb, giving them the visual sight that their absent limb is also moving. This allows for illusions 246 00:23:38,640 --> 00:23:43,520 of movement and touch in a phantom limb by essentially tricking the brain into thinking the limb is 247 00:23:43,520 --> 00:23:49,280 still there. This type of therapy is beneficial for patients who experience phantom limb pain due 248 00:23:49,280 --> 00:23:54,480 to a clenching feeling and not being able to unclench or relax the phantom limb, almost like 249 00:23:54,480 --> 00:24:00,240 Charlie Horst. Yeah. The theory behind this type of phantom limb pain is that the phantom limb feels 250 00:24:00,240 --> 00:24:05,200 paralyzed because there's no feedback from the phantom limb back to the brain to inform it otherwise. 251 00:24:06,160 --> 00:24:10,480 Ramachandran believed that if the brain could receive visual feedback that the phantom limb 252 00:24:10,480 --> 00:24:16,320 had moved, it would become unparalleled, so to speak. Use of mirror theory has been shown to 253 00:24:16,320 --> 00:24:20,800 be effective in some cases, but there's still no widely accepted theory of how it works. 254 00:24:21,520 --> 00:24:26,080 This all got to be psychological. It has to be, right? And that's why I wanted to do this, 255 00:24:26,080 --> 00:24:32,560 because it's not only physical. It is really, I think, psychological. Yeah. In a 2017 study on 256 00:24:32,560 --> 00:24:38,160 mirror therapy, it was reported that patients were able to get relief from phantom limb pain on average 257 00:24:38,160 --> 00:24:44,000 for four weeks following the therapy. However, only about 15 true studies have been done on 258 00:24:44,000 --> 00:24:49,120 mirror therapy since it became known in the 90s. Yeah. So it's really not a lot of information. 259 00:24:49,120 --> 00:24:55,440 That was like yesterday. Yes. What was it? I know. I just like to say it because it makes me feel 260 00:24:55,440 --> 00:25:01,280 better. Yes. Same. Current theories on how mirror therapy works have come from studies 261 00:25:01,280 --> 00:25:07,120 investigating changes in the brain via MRI. However, the mystery still stands as to how it works. 262 00:25:08,480 --> 00:25:12,960 Another type that I'll just pepper in here is called graded motor imagery. It's essentially 263 00:25:12,960 --> 00:25:18,400 the same thing as mirror therapy. I don't really even know the difference. It's just, it's a different 264 00:25:18,400 --> 00:25:23,600 like healing time essentially is what they try to suggest, but this is so new. It's just like 265 00:25:23,600 --> 00:25:26,960 there's not a lot of information on it. Interesting. But I just wanted to pepper that in there. 266 00:25:26,960 --> 00:25:32,800 Pepper that in. The next type of treatment is motor execution with biofeedback. And that doesn't 267 00:25:32,800 --> 00:25:37,360 sound good. It doesn't sound good, but it's actually kind of cool. This is a newer therapeutic 268 00:25:37,360 --> 00:25:43,440 intervention that takes advantage of VR virtual reality. Patients wear VR goggles that allow 269 00:25:43,440 --> 00:25:49,280 them to visualize their phantom limb as intact. They are also able to participate in certain 270 00:25:49,280 --> 00:25:54,800 games or activities such as grasping an object or kicking a ball with their phantom limb. Wow. 271 00:25:55,840 --> 00:26:00,400 During this type of treatment, it is thought that essentially a match between the visual and 272 00:26:00,400 --> 00:26:08,080 somatic sensory systems occurs, which may lead to decreased pain. Numerous case studies have shown 273 00:26:08,080 --> 00:26:12,640 positive outcomes, but the treatment type is still needing much more supporting evidence to back up 274 00:26:12,640 --> 00:26:19,520 its strength. Lastly, deep brain simulation is a surgical technique and used to treat phantom 275 00:26:19,520 --> 00:26:25,040 limb pain. This is typically reserved for when the patient has tried most other options, as this 276 00:26:25,040 --> 00:26:31,920 is clearly an invasive treatment plan. Patients will first undergo PET and MRI scans prior to surgery 277 00:26:31,920 --> 00:26:38,000 to determine approximate trajectory of where the pain is localized. This surgery is carried out 278 00:26:38,000 --> 00:26:43,840 only under a local anesthetic, as the patient needs to be able to provide feedback during surgery. 279 00:26:43,840 --> 00:26:49,760 Oh, hell no. So a wake brain surgery, apparently. Hell no. The doctor would essentially place 280 00:26:49,760 --> 00:26:55,520 stimulatory electrodes in different parts of the brain until the patient says that their pain is at 281 00:26:55,520 --> 00:27:01,680 an all-time low. This is the spot where a permanent electrode would then be placed. Wow. That's 282 00:27:01,680 --> 00:27:07,440 fucking incredible. It's so cool, right? Following this, the patient would be put under general 283 00:27:07,440 --> 00:27:13,680 anesthesia, where the doctor would implant a pulse generator in their chest. Oh my gosh. So from what 284 00:27:13,680 --> 00:27:18,480 I can tell, and if anyone knows, correct me if I'm wrong, from what I can tell, it seems like the 285 00:27:18,480 --> 00:27:25,200 patient is then forward instructed to push on or manipulate that device when they feel pain to 286 00:27:25,200 --> 00:27:29,920 signal the electrode to start working in the brain. Because it's not just all the time. Right. 287 00:27:30,640 --> 00:27:38,320 So pretty crazy. But that's really fucking cool. Yeah. That's, oh my gosh, I said what I said where 288 00:27:38,320 --> 00:27:44,000 I was like, oh hell no. But you know, at the same time, if that's your everyday fucking life, bring 289 00:27:44,000 --> 00:27:50,720 it on. Hell yeah. To get rid of this pain that just doesn't go away. Oh my gosh, I can't even imagine. 290 00:27:50,720 --> 00:27:55,840 I think I would do it. I probably would too, as much as I said. Oh, I don't know. I would like, 291 00:27:56,480 --> 00:28:00,240 can you put the video camera out so I can watch you do it? Yeah. Oh no, I wouldn't want to see that. 292 00:28:00,240 --> 00:28:03,600 That's me. So we're different than that. When I get like a tattoo or like my blood drawn or 293 00:28:03,600 --> 00:28:07,200 something, I have to look away and you're like staring at it. I'm like, how do you do that? 294 00:28:07,200 --> 00:28:12,720 I have to. It's more of like a, like a, it is kind of like a mind over matter for me. I think that 295 00:28:12,720 --> 00:28:17,920 as long as I know how something works, I'm less afraid of it. So I definitely, like, 296 00:28:17,920 --> 00:28:24,880 I remember getting some of my teeth drilled when I was like 15 or 16 years old and they tried to 297 00:28:24,880 --> 00:28:31,360 put the mask on me, the laughing gas and stuff. And I felt too weird and I was like, I don't want to 298 00:28:31,360 --> 00:28:36,400 do that. And our doctor at the time was like, well, let me at least numb you with some Novocaine. 299 00:28:36,400 --> 00:28:45,440 I was like, no, just raw dog it. Thank you. I was like, at least let me know like how painful it is. 300 00:28:45,440 --> 00:28:48,960 Then I'll let you know if I can handle it. I don't like that. Yeah, you're weird. 301 00:28:49,920 --> 00:28:55,360 So go in there and just dig around into my brain. In a study on the effectiveness of deep brain 302 00:28:55,360 --> 00:29:01,840 simulation, all patients had pain relief following the surgery. However, while the intensity of pain 303 00:29:01,840 --> 00:29:09,360 decreased by over 50%, it was not eliminated altogether. So those are the available treatment 304 00:29:09,360 --> 00:29:15,840 options thus far. So when it comes to prevalence, phantom limb pain is estimated to be as high as 305 00:29:15,840 --> 00:29:22,400 80% among amputees. It is more commonly observed than adults, with less commonly being seen in 306 00:29:22,400 --> 00:29:28,000 young amputees or people who were born missing limbs. Do you think that's because, well, of course, 307 00:29:28,000 --> 00:29:32,720 like a birth defect would be different. That's how you grow up. And in children, do you think it's 308 00:29:32,720 --> 00:29:41,200 that children are malleable, if that makes sense? They're able to reprogram that part of their brain. 309 00:29:41,200 --> 00:29:46,720 I also think that it has to do with physical development. And a lot of kids experience growth 310 00:29:46,720 --> 00:29:51,280 pains in general. So they might not even recognize it to be that. They might just think it's a normal, 311 00:29:51,280 --> 00:29:54,400 I don't know, like I got growing pains all the time when I was getting older. Not to say that 312 00:29:54,400 --> 00:29:58,240 they're the same thing. But no, but that does make sense, though, that like you're you're just 313 00:29:58,240 --> 00:30:04,640 babies and children are just so resilient. You know, I mean, that's I unfortunately have an 314 00:30:04,640 --> 00:30:08,160 acquaintance of mine that said that her sister got into a really bad car accident, or says she's 315 00:30:08,160 --> 00:30:13,360 only 20. And it's like, she's gonna be okay, you know, she's gonna be able to mend those bones and 316 00:30:13,360 --> 00:30:19,600 still be able to, you know, get a not get over it, but you know, be able to go through the physical 317 00:30:19,600 --> 00:30:25,520 therapy. And I think, yeah, especially when you're in your late 20s or 30s or 40s, it's got to be 318 00:30:25,520 --> 00:30:30,320 way more difficult. For sure. I mean, even at like mid 20s, you know, I had surgery when I was 26, 319 00:30:30,320 --> 00:30:35,920 and it took me shit, almost a year to be able to run. I had hip surgery. It was very minimally 320 00:30:35,920 --> 00:30:40,240 invasive. Yeah. But I was like scared to run for almost a year because I didn't want to hurt myself 321 00:30:40,240 --> 00:30:44,160 because it was like, I feel like it just took that long. Yeah. Also, since like if you're like four 322 00:30:44,160 --> 00:30:50,320 or five, you know, yeah, for sure. And also, I'm sure that kids just don't report symptoms as often 323 00:30:50,320 --> 00:30:54,000 as adults do. And that's why this probably is the case. Kids are always going to want to run around 324 00:30:54,000 --> 00:30:59,680 with the other kids, right? So exactly. Exactly. I've said like 12 times this episode. Sorry, y'all. 325 00:30:59,680 --> 00:31:05,520 Exactly. So studies have shown that there are potential things people can do to prevent 326 00:31:05,520 --> 00:31:12,480 phantom limb pain from occurring in the first place. The first one is pre amputation pain reduction. 327 00:31:12,480 --> 00:31:18,160 This suggests that high pain levels before an amputation are associated with phantom limb pain, 328 00:31:18,160 --> 00:31:24,160 and that focusing on pain management before one's amputation may help reduce the risk. Of course, 329 00:31:24,160 --> 00:31:29,920 this is for planned amputations. You can't plan some of them. Right. Secondly is pre amputation 330 00:31:29,920 --> 00:31:34,960 counseling. This can be helpful in lowering phantom limb pain levels if the patient receives 331 00:31:34,960 --> 00:31:41,840 therapy prior to the amputation. Different types of anesthesia are also linked with lower phantom 332 00:31:41,840 --> 00:31:48,320 limb pain chances. Phantom pain is linked to general anesthesia, and the risk is actually lower 333 00:31:48,320 --> 00:31:54,240 with different types of anesthesia, such as a nerve block. And lastly, depression management after 334 00:31:54,240 --> 00:32:00,400 an amputation or removal of a body part is a way to lower the risk of phantom pain. Unfortunately, 335 00:32:00,400 --> 00:32:04,880 like I said, there are circumstances in which you cannot prepare for an amputation. So these 336 00:32:04,880 --> 00:32:10,000 pre planned things are not necessarily helpful. However, speaking with the professional following 337 00:32:10,000 --> 00:32:14,160 an amputation planned or not is beneficial to one's mental health. 338 00:32:14,160 --> 00:32:18,160 Yeah, I would agree. It's got to be really difficult to go through something like that and then 339 00:32:19,120 --> 00:32:25,680 just kind of deal with these pains or phantom pains on your own. And just, I don't know, 340 00:32:25,680 --> 00:32:33,840 there's got to be a lot of guilt or feelings of inadequacy or feeling like, 341 00:32:33,840 --> 00:32:42,800 you know, I can't speak for somebody's experience. But yeah, just overall, melancholia, honestly, 342 00:32:42,800 --> 00:32:48,400 and just feeling the maze. It's going to be hard to like, again, retrain your brain to do new things. 343 00:32:48,400 --> 00:32:53,520 Mm hmm. Definitely. And I think that this is, I mean, it's very true for everybody, but especially 344 00:32:53,520 --> 00:32:58,400 when an amputation kind of affects one's ability to do what they've done in the past, like let's say 345 00:32:58,400 --> 00:33:05,840 an athlete, you know, our grandfather was a race car driver in his early 20s, and he had a really 346 00:33:05,840 --> 00:33:12,080 bad accident that cost him his arm at the elbow. And as far as I know, he didn't race after that 347 00:33:12,080 --> 00:33:18,560 because of it or? I don't think he really did. I think he maybe he did a few. But he had a very 348 00:33:18,560 --> 00:33:24,720 successful career in HVAC. He did. And he was, you know, crawling around in the attics and stuff with 349 00:33:24,720 --> 00:33:31,600 the prosthetic. He loved the hook. The hook was his favorite. The hook was awesome. He, many, 350 00:33:31,600 --> 00:33:36,160 many years later, they were like, we can give you one with like fingers and shit. And he's like, 351 00:33:36,160 --> 00:33:40,240 hell no. Like, I don't want that. I like the way that this is. I don't want to have to relearn. 352 00:33:40,240 --> 00:33:44,800 Yeah. But what's interesting about that is I was thinking about that, of course, throughout this 353 00:33:44,800 --> 00:33:51,200 episode. And I wish that maybe we had had asked him questions about his experience with any phantom 354 00:33:51,200 --> 00:33:56,160 run pain if he had any. Yeah. You know, it's something that I really knew about until I was, 355 00:33:57,520 --> 00:34:02,160 I mean, honestly, until a couple years ago, I didn't really have experience with that. And it was 356 00:34:02,160 --> 00:34:08,320 just so normal to see our grandpa with a prosthetic that was our everyday life. And I didn't occur to 357 00:34:08,320 --> 00:34:13,280 me to ask questions because there was, in my mind, there wasn't anything missing. Right. And I never 358 00:34:13,280 --> 00:34:20,720 remember ever feeling like that, being like, oh, like, it's strange. You know, it was never strange. 359 00:34:21,920 --> 00:34:26,720 And it would be, yeah, it would be like only when a friend would bring it up. Oh, your grandpa only 360 00:34:26,720 --> 00:34:30,880 has one arm. And I'm like, he does. Oh, shit, I forgot. Yeah, I should have mentioned that 361 00:34:30,880 --> 00:34:36,320 right before he walked in, not knowing how an insensitive prick you are, you know, she's 362 00:34:36,320 --> 00:34:43,200 a piece of shit. Well, yeah, that's mostly phantom pain. The episode is not over yet because I do 363 00:34:43,200 --> 00:34:50,480 have some famous cases of imputes and experiences. I have a question. Absolutely. Before we get into 364 00:34:50,480 --> 00:34:58,880 that, I might have an answer. Or I guess it's more of a thought. How affirming having a prosthetic 365 00:34:58,880 --> 00:35:07,600 could be to somebody experiencing like dysmorphia, like body dysmorphia after losing a limb. And I 366 00:35:07,600 --> 00:35:15,440 wonder if that also helps with with some of that phantom pain as well. Yeah, it's when you get fitted 367 00:35:15,440 --> 00:35:20,880 for a prosthetic. And like you said, it lower half maybe not so much. Like if you were already kind 368 00:35:20,880 --> 00:35:28,640 of a runner, you would already and you had a prosthetic leg that you would be able to start 369 00:35:28,640 --> 00:35:32,480 running eventually. I mean, you have to have PT and stuff and getting known just because that's 370 00:35:32,480 --> 00:35:38,000 something that your body was already used to. Yeah, I think so. I'm not too versed on that topic, 371 00:35:38,000 --> 00:35:44,960 but I will say that maybe the prosthetic might be might be equated to something that someone with 372 00:35:45,520 --> 00:35:50,960 you know, body dysmorphia would do in order to cope. I'm not exactly sure. Yeah. But that's a 373 00:35:50,960 --> 00:35:55,520 good thought though. Saying that the two well, I mean, maybe core morbidly, but yeah, but how 374 00:35:55,520 --> 00:36:00,480 you could probably experience some type of just like you just don't feel like yourself, you know, 375 00:36:00,480 --> 00:36:05,600 if like you said, you were an athlete and you were a runner, how you know, losing a leg may be 376 00:36:06,480 --> 00:36:13,440 hugely challenging to accept and how a prosthetic might help with that dysmorphia a little bit. 377 00:36:13,440 --> 00:36:18,320 Yeah, for sure. And I think that the biggest thing is, I mean, in both instances is just 378 00:36:19,360 --> 00:36:23,360 to seek treatment, seek help, but from a professional because they can help you like walk 379 00:36:23,360 --> 00:36:30,800 you through like what the next steps could be. So again, these are not necessarily cases of phantom 380 00:36:30,800 --> 00:36:35,600 limb pain. But since it's so common amongst amputees, it's not far fetched to think that 381 00:36:35,600 --> 00:36:41,840 these people might have been struggling with it. So this is not necessarily celebrities, but kind of 382 00:36:41,840 --> 00:36:45,600 that have been open with their struggles of amputation or congenital amputation, which is 383 00:36:45,600 --> 00:36:53,040 being born without a limb. So number one is Rick Allen, the drummer of Def Leppard. In 1984, 384 00:36:53,040 --> 00:36:58,240 he was racing his Corvette when he lost control and crashed into a brick wall. The accident 385 00:36:58,240 --> 00:37:03,520 resulted in his entire left arm being amputated, but he would relearn how to drum with one arm and 386 00:37:03,520 --> 00:37:08,320 continue to tour with Def Leppard, which is sick. Still touring. Well, that's what we were saying 387 00:37:08,320 --> 00:37:12,320 just a second ago, you know, someone that I mean, you would drum with both arms, you know, 388 00:37:12,320 --> 00:37:16,080 originally, and then he lost an arm and he's like, fuck it, I'm gonna still drum, you know, 389 00:37:16,080 --> 00:37:20,800 I'm gonna figure this out. This is an absolutely no way shape or form. But did you know that his 390 00:37:20,800 --> 00:37:26,240 Funko Pop has one arm? What? Yeah. That's actually really cool. It's cool. I like that. I was 391 00:37:26,240 --> 00:37:33,840 not saying. Yeah. What a badass. Number two is number two. Number two, the Hatwood Henry. Jerry 392 00:37:33,840 --> 00:37:39,760 Garcia. He would grow up to become a founding member of the Grateful Dead. When he was five 393 00:37:39,760 --> 00:37:44,400 years old, he was helping his older brother, Chop Wood, when he accidentally got his finger in the 394 00:37:44,400 --> 00:37:50,320 way of his brother's axe. He would lose two thirds of his middle finger, but ultimately go on to 395 00:37:50,320 --> 00:37:55,040 become one of the most famous guitar players of his generation. So true. He was also known to 396 00:37:55,040 --> 00:38:01,680 give his fans that middle finger during his shows. LOL. Just a slight fuck you. Yeah. That's funny. 397 00:38:02,720 --> 00:38:09,360 Number three. Number three. Waylon Jennings. This country music legend had his foot amputated 398 00:38:09,360 --> 00:38:15,520 in 2001 following a battle with diabetes. He would continue on tour stating quote, 399 00:38:15,520 --> 00:38:20,720 Music definitely has healing powers. I was sick for a long time and I went back to playing music 400 00:38:20,720 --> 00:38:25,760 and I started getting better as soon as I did. End quote. He would unfortunately pass away the 401 00:38:25,760 --> 00:38:33,280 following year. Number four is Frida Kahlo. Really? What is Frida have amputated? Shortly before her 402 00:38:33,280 --> 00:38:39,360 death at age 47, Frida had experienced complications following a surgery that resulted in her right 403 00:38:39,360 --> 00:38:43,600 leg being amputated below the knee. That one. That's all I have about that one. 404 00:38:43,600 --> 00:38:51,680 Number five is Jim Abbott. Abbott would be born without a right hand, but remarkably would become 405 00:38:51,680 --> 00:38:57,120 an MLB player for the California Angels, New York Yankees, Chicago White Sox, and the Milwaukee 406 00:38:57,120 --> 00:39:04,320 Brewers between 1989 and 1999. We got a bad ass over here. Hell yeah. Number six, Ted Kennedy 407 00:39:04,320 --> 00:39:10,400 Jr. The nephew of John Kennedy was diagnosed with osteosarcoma in his right leg when he was 12. 408 00:39:10,400 --> 00:39:14,400 For those of you who don't know, that's bone cancer and he had his leg amputated as a result. 409 00:39:15,760 --> 00:39:22,000 Number seven and final one is very famous, Bethany Hamilton. She's featured on the movie 410 00:39:22,000 --> 00:39:26,080 Soul Surfer, which is one of my favorite movies. Well, it's about her. She's not actually in it, 411 00:39:26,080 --> 00:39:29,280 but it's a true story about her life. She does it all, ladies and gentlemen. 412 00:39:30,240 --> 00:39:35,440 Bethany was a very big surfer and would unfortunately lose her left arm in a shark attack 413 00:39:35,440 --> 00:39:41,280 when she was just 13 years old. By the time she arrived at the hospital, she had lost over 60% 414 00:39:41,280 --> 00:39:46,640 of her blood volume and was in a hypovolemic shock. Oh my gosh. She would survive and would 415 00:39:46,640 --> 00:39:51,280 go on to continue surfing and win multiple awards. That's incredible. Which is really incredible. 416 00:39:52,000 --> 00:39:56,320 But yeah, that's all I have for today. Very interesting. Thank you. It's a little different 417 00:39:56,320 --> 00:40:01,360 than what we've done in the past, but I think you're on to something. I think that's psychological. 418 00:40:01,360 --> 00:40:04,880 I think there's an aspect to that that has yet to be discovered or studied. 419 00:40:04,880 --> 00:40:10,080 I think so too. Like I said, it's called phantom limb pain. Obviously, it's physical, 420 00:40:10,080 --> 00:40:17,120 but totally psychological in my opinion. And even though it is neurological and nerves, 421 00:40:18,080 --> 00:40:22,160 it doesn't, we don't say just a diagnosis in the middle breakdown. We say, or just something 422 00:40:22,160 --> 00:40:25,920 we think is cool. Or just something we think is cool. Yeah. And of course, we're not medical 423 00:40:25,920 --> 00:40:31,040 professionals. We can't say that necessarily, but... Which is the classic. 424 00:40:31,040 --> 00:40:34,480 Got my finger waving in the air. Yeah. 425 00:40:34,480 --> 00:40:36,320 Whatever. Did you know? 426 00:40:36,320 --> 00:40:41,600 Did you know? Yeah. But I think you're right. I think in some cases therapy works. In some 427 00:40:41,600 --> 00:40:46,800 cases, medication works. In some cases, everyone is different. And that's, it's really incredible. 428 00:40:46,800 --> 00:40:51,200 Yeah, absolutely. Thank you guys so much for joining us. We hope you enjoyed this episode. 429 00:40:51,200 --> 00:40:56,800 Yeah. Join us on Thursday for another case and then be looking forward within the next couple 430 00:40:56,800 --> 00:41:01,680 weeks to that extra bonus episode for our tier two and three Patreon members at the end of the month. 431 00:41:01,680 --> 00:41:06,480 Yes. Anything else? That's it. Okay. We will see you next time. All right. Love you. Love you. Bye. 432 00:41:11,840 --> 00:41:16,240 If you want great tasting meals daily, but can't find the time to shop or even cook, 433 00:41:16,240 --> 00:41:21,840 we have the solution for you. Fresh meal plan is a convenient, easy way to create custom meals 434 00:41:21,840 --> 00:41:26,480 delivered right to your door. With hundreds of rotating meals each week, there's always 435 00:41:26,480 --> 00:41:31,600 something new to look forward to. Many of their meals are ready in three minutes or less, 436 00:41:31,600 --> 00:41:37,440 so you don't have to spend all night cooking. Just select your meals, heat, eat, and bon appetit. 437 00:41:38,080 --> 00:41:42,240 Click the link in our show notes today for an exclusive offer with Fresh Meal Plan 438 00:41:42,240 --> 00:41:57,120 and create the perfect menu for you.