February 29, 2004 1:11 AM   Subscribe

I cried when I hurt myself, until I met the girl who felt no pain.
posted by Oriole Adams (35 comments total)
That's a really dangerous condition and a great reminder of why pain is a good thing. She really sounds like she's in bad shape, but you can see why if she couldn't feel any pain at all, even if she was bleeding.

I wonder how long she'll actually live. I've heard that people that can't sense pain often lose their limbs at an early age by doing stuff like sleeping funny on an arm or leg all night, cutting off the supply of blood to the point the limb is dead by morning.
posted by mathowie at 1:28 AM on February 29, 2004

isn't that pretty much what leprosy does? damage the nerve endings so that when people get injured, they don't know and thus their extremeties get infected and deteriorate? sadly, this girl will have very difficult life ahead of her. hopefully, it'll be a happy one too.
posted by ruwan at 1:47 AM on February 29, 2004

Wow, crazy.

I'd heard about things like that in my brain chemistry class, but I had no idea of all the complications. I guess if one grew up with pain, and knew how far things should be pushed it wouldn't be to bad, but this girl has no clue about what's 'bad' and what's 'okay' for her body.

I wonder why, if she can't feel pain she was scratching anything. In theory itchyness and pain are both sensed by the same systems, but people with this condition (or those on opiates, as I know from experiance :P) can still itch.
posted by delmoi at 2:39 AM on February 29, 2004

She would make the ultimate soldier.

We must pick her up and start her training now, while she is still young.
posted by Civil_Disobedient at 4:54 AM on February 29, 2004

That was the most horrifying human interest copy I've ever read. I am going to have nightmares about chewing off my arm and scratching my eyes out.
posted by damehex at 5:09 AM on February 29, 2004

That condition is also called "congenital analgesia." I remember that one of my professors -- Ron Melzack, who specializes in studying pain -- has done some research on it. People who have it generally die fairly young. There is some information on it in this article, if you're interested (the info about congenital analgesia starts on the bottom of the second column).
posted by Badmichelle at 5:38 AM on February 29, 2004

That's probably one of the saddest things I've ever heard.
posted by ColdChef at 5:56 AM on February 29, 2004

I wonder how long she'll actually live.

A pleasant thought. Maybe we could get a dead pool going.
posted by the fire you left me at 6:35 AM on February 29, 2004

Crazy quote from Badmichelle's PDF link above:

"And because there was no discomfort to let her know when she should shift her weight or posture, she ventually developed an inflammation in her joints and died at the age of 29."

There's just so much about the body that I take for granted.
posted by Civil_Disobedient at 6:45 AM on February 29, 2004

A pleasant thought. Maybe we could get a dead pool going.

I didn't mean it in that regard, but in the sense that wow, a three year old that can't feel pain is so dangerous to herself, and has inflicted enough damage on herself that she might accidentally endanger her own life very soon. I didn't even think it was possible for a toddler to hurt themselves like this, and wonder honestly, and without any callousness, how long she could possibly go on like this, considering all the bad effects it has had so far.

It's a shocking and very sad story and I really feel for her parents. I don't know if I could handle something this serious.
posted by mathowie at 7:09 AM on February 29, 2004

What an upsetting story. From the news clip, she seems like such a bright, charming little girl with so much potential and such an amazing attitude. I hope her parents & doctors find ways to manage this so that she gets to live out as normal a life as possible for as long as possible.
posted by catfood at 7:59 AM on February 29, 2004

" The teeth she didn't break off while biting toys were removed by an oral surgeon after Gabby chewed up her mouth and tongue so badly she had to be hospitalized."

Do you think they used anaesthetic? They wouldn't have to, but I'll be the surgeon would be mighty uncomfortable performing the operation without it.
posted by five fresh fish at 10:43 AM on February 29, 2004

Do you think they used anaesthetic? They wouldn't have to, but I'll be the surgeon would be mighty uncomfortable performing the operation without it.

Most dentists are willing to do work without anaesthetic. Some would actually prefer it that way, I hear. After having a temporarialy novocaine-poisoned lingual nerve (they say it's rare, it isn't actually, there's thousands of others out there who have had the same thing happen), I might consider not having any next time also.

Note that after having that nerve damaged, I managed to masticate my own tongue pretty badly (enough I noticed teeth marks in the mirror and decided to be way more careful). Therefore I can empathize and understand what's going on with this girl. Very, very sad.
posted by shepd at 12:12 PM on February 29, 2004

The ideal soldier (or person in general) would probably be alert of pain, but it would be a mere sensation (like, say, cold) so they wouldn't be compromised by it. Of course, in the real world, pain is wonderful because the majority of people are too stupid or reckless to act on the mere fact that they're injured, they need a visceral incentive.
posted by abcde at 1:46 PM on February 29, 2004

She would, on the other hand, make one helluva boxer.

I think I suffered some lingual nerve damage during my molar extraction. Didn't bite off my tongue, but I hated the dead feeling along one side of my mouth.
posted by five fresh fish at 1:54 PM on February 29, 2004

But does this mean she can't feel anything? Not even nice sensations? I know they said she could feel touch, but I don't understand how a hug is different from a punch, to the nerves themselves I mean.

I suppose that's not a concern right now because she's a toddler and they're just trying to keep her from leaving her hand on the burner. But could she feel the wind on her face when she was sledding? What about when she's a teenager and older, and starts wanting to physically intimate with boyfriends/girlfriends whoever?

I'm just curious, how do they know she can feel being hugged or kissed? She seeks out being held of course, but how much of that is based on physical sensation, and not learned behaviors from watching others? I'm baring my ignorance here!
posted by nelleish at 2:17 PM on February 29, 2004

" ...but I don't understand how a hug is different from a punch."

Who are you, Tony Soprano?

I keed, I keed!
posted by Fofer at 4:30 PM on February 29, 2004

I don't understand how a hug is different from a punch.

Touch and pain (as well as heat, cold and pressure) are sensed by different receptors, and transmitted differently.
posted by biscotti at 5:10 PM on February 29, 2004

I have a date with a dental chair in the morning and a pair of root canals... so forgive me if I must INSIST on believing that lingual nerve damage is so rare as to be virtually unheard of. In fact, I suspect you made it up to scare me.

Well, I'm not biting. (That, or much of anything else, at the moment.)

Refutations involving silly things like scientific citations and medical facts will not be welcomed until the time tomorrow afternoon that my left lower lip ceases dangling below my jaw.

Joking aside, I've been *intellectually* aware of the impotance of pain in alerting us to problems - but reading this poor girl's story makes the dry facts sink in on an emotional level as well.
posted by John Smallberries at 5:35 PM on February 29, 2004

Being a parent of a toddler is a lot of work under the best of conditions. This girl's parents have an infinitely harder job: they'll have to watch her all the time, and as noted, the odds are not in her favor. I wish them all the best of luck.
posted by tommasz at 6:02 PM on February 29, 2004

So often we think of pain in a negative way. But it is pain that protects us.

*brushes away a tear*
Yes, master.
posted by squirrel at 6:11 PM on February 29, 2004

Fascinating story that makes a lot of good points about the need for suffering in the world. For a brief, but pretty good overview of how pain works, this is pretty good. Of some interest is the gate-control theory of pain control mentioned in it. This is an important leap forward in our understanding of pain, and it was proposed in by Dr. Ronald Melzack as cited by Badmichelle above; she was fortunate to study with someone of his caliber.
posted by TedW at 6:29 PM on February 29, 2004

I don't understand how a hug is different from a punch.

As biscotti said, noxious and non-noxious stimuli are transduced and transmitted differently. Non-noxious stimuli are transduced by specialized receptor organs that correspond to different stimuli (e.g. pressure, heat, cold, vibration), which are associated with a specific type of afferent nerve fibre. Noxious stimuli, on the other hand are almost exclusively transduced by the free nerve endings of another class of afferent neurones.

I'm currently in the same department as Ron Melzack at McGill, and I've heard him talk about his experiences with individuals who have congenital analgesia on several occasions, and as Civil_Disobedient said, we really take for granted how important pain is as a basic protective mechanism.
posted by trident at 12:13 AM on March 1, 2004

Some would actually prefer it that way, I hear.

I had my wisdom teeth removed using only Novicane as anaesthetic. While there was no pain per se, there was a maddening terror that hit me when my 350 lb. dentist (the guy has the arms of a linebacker) used what looked like nothing more than simple pliers to pull, turn, twist and pry the teeth out of my skull.

The guy had to push against my head for leverage at one point. I was shocked at the primitiveness of the whole operation -- there are a lot of operations that differ only slightly from the ones Neandertals are preprorted to have used.

As for my "ultimate soldier" idea:

No, she'd get shot, not notice it, and bleed to death from some eminently treatable wound.

That's a very good point.
posted by Civil_Disobedient at 5:50 AM on March 1, 2004

"Pain?" Lieutenant Scheisskopf's wife pounced upon the word victoriously. "Pain is a useful symptom. Pain is a warning to us of bodily dangers."
"And who created the dangers?" Yossarian demanded. He laughed caustically. "Oh, He was really being charitable to us when He gave us pain! Why couldn't He have used a doorbell instead to notify us, or one of his celestial choirs? Or a system of blue-and-red neon tubes right in the middle of each person's forehead. Any jukebox manufacturer worth his salt could have done that. Why couldn't He?"
"People would certainly look silly walking around with red neon tubes in the middle of their foreheads."
"They certainly look beautiful now writhing in agony or stupefied with morphine, don't they?"

- Joseph Heller, Catch-22
posted by Mapes at 7:41 AM on March 1, 2004

From the article:

"Gabby didn't have pain to save her eyes either. She scratched them so severely, that at one point doctors sewed them shut to keep her fingers out. But, the damage was already done."

That is absolutely horrifying. Poor, poor baby.
posted by jennyb at 7:44 AM on March 1, 2004

Sorry about the "Super Soldier" side-bar, but along similar lines it was long thought that American Indians had some biological, genetic explanation for their lack of acrophobia (fear of heights). I did a little reading, and found this alternative explanation:

"For example, some Mohawk Indians were referred to as "skywalkers" because of their supposed innate fearlessness of heights. In their book, Oswalt and Neely examine why Mohawk men were such successful high - beam steel workers, constructing bridges and skyscrapers under extremely dangerous working conditions. It was suggested that at least some Mohawk men did not fear heights and that because the work was dangerous, it became an attractive type of employment for them. In this same book, Morris Freilich confers that Mohawk skywalkers repressed their real fear in order to "behave as warriors and prove their courage" (1958)."
posted by Civil_Disobedient at 8:38 AM on March 1, 2004

I had my wisdom teeth removed using only Novicane as anaesthetic.

There's another way? I asked my dentist to dope me to oblivion, but he didn't...
posted by five fresh fish at 8:51 AM on March 1, 2004

"Gabby didn't have pain to save her eyes either. She scratched them so severely, that at one point doctors sewed them shut to keep her fingers out. But, the damage was already done."

Its unbelievable how much seemingly needless damage this girl did to herself before parents and doctors responded. I mean the rather dire situation of not being able to feel pain requires some muscular forward planning, and yet you get the impression they were always reacting too late: first she eats her mouth then they pull the teeth; first she digs out her eyes, then they sew them shut. I mean before this girl was born I was shown some slides in high-school of this condition, and it was the same things - the kid in the picture had eaten his tongue and big holes through both cheeks. This consequence is a documented and seemingly predictable result of the condition, so why not do something first? How about sewing the jaws shut, and feeding the kid a liquid diet {like what my uncle had after jaw surgery} until she's old enough to reason about such a challenge? Or how about keeping the kid heavily restrained until the same age? I would think these would be common sense reactions to a disability such as this - one which a person might live a semi-normal life with if they can be preserved to the age of reason and maturity.
posted by dgaicun at 9:15 AM on March 1, 2004

You can never underestimate a parent's ability to deny there's a problem. I've seen that time and again with FAS and autistic kids.
posted by five fresh fish at 9:23 AM on March 1, 2004

Thanks everyone for the information and links on nerves! I didn't take human anatomy in high school when I had the chance to, and it's stories and conditions like these that make me wish I had (now in university I'm too overloaded with studying hydrogeology and oil spills to have the time).

In any event, I'm very happy to know this little girl has the more pleasant tactile sensations. I just imagined what it would be like to not feel anything, and it seemed awful (not that what she will go through in her life isn't, but at least it's mediated by being able to feel being held).
posted by nelleish at 9:27 AM on March 1, 2004

I asked my dentist to dope me to oblivion

All the more reason to see an oral surgeon. I had a short-acting general anaesthetic for my wisdom tooth removal and everything was smooth sailing: minimal pain and swelling afterward. It's easier for you AND for the surgeon if you have a general.
posted by biscotti at 9:33 AM on March 1, 2004

Yep. General here too. I woke up to the sound of someone shouting. It was me. I stopped when I realized I didn't actually hurt, I was merely startled that I'd been moved.
posted by kindall at 10:36 AM on March 1, 2004

This is getting a bit off topic, but if you do choose general anesthesia for oral surgeries or other minor procedures, be sure that it will be adminstered by a qualified person (anesthesiologist, nurse anesthetist, or PA anesthetist) and not someone with minimal training. Here in Georgia we have a few reports each year of children dying during dental procedures from an overdose of anesthetic. At my hospital when children (or adults, for that matter) are anesthetized for dental work, they are cared for by the same people and with the same precautions as for major surgery. Anesthesia as performed today is incredibly safe, but only when adminstered by those with proper training. For what its worth, I had my wisdom teeth removed by an oral surgeon using light sedation and local anesthesia, and it was a breeze.
posted by TedW at 3:06 PM on March 2, 2004

Well, for what it's worth, my leftside molars were removed using only local, no sedation. The top one fell out with a twist; the other was deeply grown and took considerable cutting, breaking, yanking, and reaming. And despite all that, I didn't need painkillers when the local wore off.

Maybe I'm made of sterner stuff than most. Or maybe surgery really isn't that big and painful after all.
posted by five fresh fish at 3:13 PM on March 2, 2004

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