Dr. Richard McIlmoyle BSc, DC, PgCPain
Dinosaurs, sunburns and CS???
Who gets excited by a sunburn???
The same guy who's first thought after having an unexpected seizure is "Cool!!! I'm going to get to see imaging of my brain!!!"
Being that I have the complexion handed down through my Scottish heritage, that can only be described as "fish belly white", I am generally judicious with my use of sunscreen and am aware of my minutes of sun exposure.
This past weekend however, I dropped the ball.
I was with my kids and being that I am responsible for their wellbeing AND they have inherited (at least one of them has) my lily-white skin, I was diligent with their sunscreen application. Yet, with the excitement of the gargantuan inflatable dinosaur we had purchased to float around the lake beckoning and the light breeze that had kicked up (this thing catches the wind like a spinnaker on a racing boat), alas, my own application was shoddy at best.
Now typically this would not be much of a problem as my aforementioned diligence with timing of sun exposure would kick in and I would slather on another appropriate volume of said sunscreen.
Here is where the story takes an expected turn for the pale protagonist. We had paddled the
behemoth out and around the point, approximately a mere 400-500 meters from the main beach to a wonderful spot to jump off the rocks into the refreshing embrace of the sun warmed lake. We were having the kind of fun that can only be had on one of those lazy summer days, when there are no hard timelines and there are no cares to be had, time seems to stand still. Time ticks away while Fathers and sons, Moms and daughters all jump into the lake until... Let's head back... Remember that breeze??
It was now a steady headwind.
Remember the gargantuan dinosaur that acts as a spinnaker???
I can't truly say how long that paddle back took me...splayed out on my belly performing a version of the breast stroke with my arms rhythmically pushing the water, head bowed, not willing to look up or to the side to witness how snail-like our progress was. Suffice it to say that the previously mentioned Mom and daughter who had the good sense to walk back to the main beach, were nearly asleep in the sun by the time we had run aground again. This little tale serves to explain how I ended up with my first sunburn...real sunburn... in probably a decade.
And, this is where the pain science geek in me emerges.
I know exactly what is happening...I have some peripheral sensitization due to the sun damage, but it is leading to some effects of central sensitization. So cool how the experience is when there is an overlay of understanding, and of course, this is my unique experience.
1. There was an intensity to the experience that was on the painful spectrum, but it was more like curiously intense stimulus than I remember with previous sunburns. I believe my understanding helped make the whole experience less distressing and therefore a less "painful" experience
2. DYNAMIC MECHANICAL ALLODYNIA!!!(1) I could have pressure applied to my back with absolutely no discomfort, zero, zilch!!! But if my shirt brushed across the skin, it was wildly intense, AND there was AFTER EFFECT... (pain lingered)(1). These are hallmarks of central sensitization which are so fascinating to experience when you know what is happening. (Again remember, I was the guy excited to get brain imaging because of a seizure)
3. I also had THERMAL ALLODYNIA which is a peripheral sensitization effect, not due to the spinal cord based phenomenon (CS). Step into that shower that feels almost cool on my hand and it feels like I am scalding my back with boiling water. I have been playing around with all of these interesting effects over the days while my sunburn heals and I am grateful for having had the experience. It is a reminder however, to maintain my diligence on sunscreen application, wind direction and "actual size of product" on packaging.
1. Woolf, C. J. (2007). Central Sensitization. Anesthesiology, 106(4), 864–867. https://doi.org/10.1097/01.anes.0000264769.87038.55