Friday, March 17, 2006

Proud moment for feminist Dad during NCAA basketball tournament

Being the father of a 3 1/2-year-old girl who is likely to be an only child, I have a unique opportunity in our rich academic and athletic community to provide PharmPreSchooler with superb role models who just happen to be women.

So, we got season tickets this year for one of our local university women's basketball teams. My closest research colleague and I have a had a blast taking our little daughters to the games.

I knew I was doing okay last night when we were watching the first round of the men's NCAA tournament:

PharmPreSchooler to PharmGirl, MD:

"Mommy, why are there boys playing basketball on the TV???"

I think I even scored points with my wife, too.


At Fri Mar 17, 10:10:00 PM EST, Blogger Nimitz' Lady said...

I had the same experience the first time my son saw guys playing basketball.

He was practically born at a women's game and we actually follow our team on the road.

He's six and for the last few years his single greatest disappointment in life has been that he can never be an ISU LADY Cyclone!

At Sat Mar 18, 10:07:00 PM EST, Blogger Impatient Patient said...

Hey Abel

I posted on Respectful Insolence regarding what is a good length to post. And like you, I was mindful of what has happened at Aetiology with Bialy and Barnes, and with Orac and those going to his old site and spamming. I am horrified by that, and cannot believe that crazy people can hijack threads just because.

I have been to your site often, as I will follow your link after comments on other sites. I have been blogging since December- not very coherently, but it makes me feel better. I was going to comment on this post as my youngest daughter is playing girls hockey this year, and it has been an incredibly positive experience.

So I have read your profile and I do have a million questions to ask you. You are in pharmacology and toxicology. Awesome. Maybe you can explain something to me that I in turn can explain to my doctor. Because he has no idea, and so I who am not medicaly trained, end up looking up stuff for a year before I think I have finally put it all together.

How does Botox work in pain syndromes? And describe the role of the sodium channels in regards to Botox's effects.

How is this simmilar to TTX and how does it differ?

Does shutting down the sodium channels- the nicotinic not muscarinic ones, allow the body to temporarily rest, even though it does not CURE the problem?

See- this is where i wonder if I talk too much.....

Cheers and thanks for the tongue in cheek thing. But it really did bother me that I might be bothering someone much smarter than I who might think I am an idiot for asking a million, or just one or two questions....

At Sat Mar 18, 10:10:00 PM EST, Blogger Abel PharmBoy said...

Well, you can provide him with some consolation that he can at least play for the boys team. Not a bad second, eh?

BTW, did you play for them as an undergrad?

At Mon Mar 20, 09:01:00 PM EST, Blogger Abel PharmBoy said...

impt pt: so sorry I missed your comment by a couple of minutes on Sat night.

I'm very impressed - most of my pharmacy students don't know the difference between muscarinic and nicotinic cholinergic receptors by the end of a whole semester on autonomic pharmacology! (although muscarinics are usually linked negatively to adenylate cyclase while it's the nicotinics that are Na+ channels - there are other Na+ channels not associated with acetylcholine, but the ones you care about are cholinergic nicotinic receptors that are on neuromuscular junctions).

It's been awhile since I've looked into botulinum toxin, but its use in neuropathic pain, particularly in MS, comes from its ability to inhibit acetylcholine RELEASE presynaptically by cleaving proteins (SNAP-25 comes to mind) required for vesicle fusion and release of ACh onto the postsynaptic nicotinic receptors. Sort of like turning off the faucet.

Tetrodotoxin, instead, binds to the ACh site of the postsynaptic nicotinic receptor on skeletal muscle and prevents Na+ influx, and preventing undue muscular contraction and associated pain. One might expect TTX and BTX-A to work in an additive or synergistic fashion.

The pain associated with muscle spasticity remains a problem for patients and the folks who treat them. Non-cholinergic Na channels also transmit afferent pain stimuli, but there are other mechanisms of great promise these days. Among these, and high on my list as natural products is the Sativex oral cannabinoid/vallinoid formulation being developed by GW Pharma in England. They have FDA approval to move into clinical trials in the States but I am unsure of its status with Health Canada. I am currently reviewing a book on cannabinoid pharmacology for a journal where I serve as an editor and have been incredibly impressed with the work of a British doc named Geoffrey Guy. I'd look at GW's website and inquire about the regulatory status of Sativex in Canada. The dual action of two cannabis components derived from two highly-specialized species of Cannabis sativa has yielded what will likely be an approved herbal medicine to treat pain in cancer and MS. I hope to write a post about it once I'm done my review because I am truly impressed with the approach GW has taken.

Best of luck to you and feel free to check in again if I've been too technical (I think that you are far more up to it than most of my students!)

Congrats also on your hockey-playing daughter - the lessons she learns will serve her for life regardless of whether she plays hockey into high school and university.

At Wed Mar 22, 08:40:00 PM EST, Blogger Impatient Patient said...

Hi there again!

So I have looked up Sativex, and it is sort of approved for MS pain only in Canada, if I read correctly. I don't know if that will open up any time soon. My best bud has MS so because of her I read voraciously- and then she asks her doctor. LOL!!!

I am looking at neuropathic painkillers that act on sodium channels because they seem to have the least effect on the brain, memory, mood, sleep, if they are dosed correctly and /or given transdermally or IM. If I am correct in my assumptions, being a complete nerd, but a scientific neophyte, this synergism with Botox may be a good thing, allowing less of both medications to be used with less side effects.

A family member has sciatica from scar tissue and adhesions that tether the nerve root. It is not managed well by opioids, and last year, much to my dismay, I found out that these drugs actually "piss off" microglia and astrocytes, so that their activities increase, and a cytokine cascade sort of ensues- TNF alpha, IL6 and IL1 go wild, and you need more opioids to get the same effect, which just leads to - well the fifth circle of hell comes to mind.

So- I think that three lidocaine patches and botox would be a good thing. Start with the least invasive obviously, and then add or subtract or tweak. Unfortunately, not being a doctor- well, let us just say that doctors do not like being told what to do....which means I have to keep asking until it is their idea.

The Insurance Company will foot the bill if I can get the ball rolling. Over the long run they could save money, which would be a bonus. The person in pain may get their brain back in working order, and be able to function.

You may be impressed, but I am annoyed. I read that book last summer, and apparently missed that part. I just took it out agin, and went through my copious amount of notes and questions, and accidently turned to that page- and had a AHA moment. Some Neuroscience Primer that is ancient, but had a cogent explanation of ACh and the sodium channels. I looked it up on the internet, found some medical corroboration, and went Holy Schmoley!!

The reason I was so careful about the different receptors, is that when I have talked sodium channels to docs before, their first reaction has been to caution about the heart. The difference between the two systems and what and where they worked stuck, only because of this. Sometimes I get frustrated by what others don't know. Thank you for the compliment though!!

The next question is how does minocycline given early in a pain condition stop pain, and if it does help then why are patients not given it after back surgeries almost prophylactically? Obviously resistance is one huge factor, but if there is infection and inflammation after surgery, and back surgery is not as effective as it could be, could this ameliorate any of these types of complications?

I will go away now- I told you I talk WAYYYYY too much!!

At Thu Mar 23, 11:13:00 PM EST, Blogger Congogirl said...

Just stopped by to say hello, it was nice to meet you at the meet-up and stop by my blog if you like (there is also a link through my blogspot site).


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