Chapter 34

My memory is pretty good, but my back is driving me crazy…

Helping your brain help your body.

  1. Annotation largely in earlier chapter.
  2. H Flor driving antinociception
  3. In its early history, enduring pain was a relatively infrequently occuring negative outcome following surgical mastectomy. That picture has changed over the past 3-4 decades; now, estimates of enduring pain justifying treatment range from about 25 to 60% of post-surgical cases, with that pain persisting over a period of many months to years in the majority of treated women. See, for example, Jung BF et al (2003) Neuropathic pain following breast cancer surgery: proposed classification and research update. Pain 104:1; Meyerowitz BE (1980) Psychosocial correlates of breast cancer and its treatments. Psychological Bulll 87:108. Gartner R et al. (2009) Changes in pain perception in mastectomy. JAMA (doi:10.1001/jama.1568)
  4. Knee replacement surgery is a relatively modern invention. Over a 30-or-so year history, the number of replacement procedures has risen to about a million/year in the US; by 2030, epidemiologists predict that more than 3 million procedures will be conducted in medicare patients alone (e.g., Cram P et al, 2012, Total knee arthroplasticy volume, utilization, and outcomes among Medicare beneficiaries, 1991-2010. JAMA 308:1227; Slover J, Zuckerman JD, 2012, Increasing use of total knee replacement and revision surgery. JAMA 308:1266). There is nearly as great a rate of growth of spinal surgical procedures targeting back pain. For example, see Brox JL et al, 2010, Four-year follow-up of surgical versus non-surgical therapy for chronic low back pain. Ann Rheum Dis 69:1643; Devo RA, 2013,.
  5. For a review analyzing how all that sitting is bad for your health, you might begin with Chau JY et al, 2013, Daily sitting time and all-cause mortality: a meta-analysis. PLoS One 8(11): e80000. Doi: 10.1371/journal.pone.0080000If that does not get you up out of your chair, read Veerman JL et al, 2012, Television viewing time and reduced life expectancy: a life table analysis. Br. J Sports Med 46:927. They note that once you get up to 6 hours of TV viewing/ day, every hour you spend watching the tube subtracts more than 20 minutes from your lifespan!
  6. Jerri Edwards and colleagues from the University of South Florida (who have conducted many important studies related to healthy aging) conducted a highly controlled study evaluating the impacts of losing your ability to move around town in your car. See Edwards JD et al, 2009, Driving status and three-year mortality among community-dwelling older adults. J Gerontol A Biol Sci Med Sci 64:300. Note that these scientists very closely considered every other factor in matching people who had given up driving except for that single distinction. Alas, those folks had a >4-fold chance of dying, over the following year. A large number of studies document almost equally discouraging statistics for those individuals who lose their physical mobility.My takeaway message from this class of research: 1) Keep your brain and body in shape in ways that continue to support your safe driving and physical mobility. 2) If you DO give up driving, and/or DO lose the ability to run or walk through your world, get thee to the brain gym and the physical gym and work harder at driving around THERE!