Red sky at night,
sailors' delight. Red sky at morning, sailors take warning.
— Sailors' proverb
As the husband of an amputee, when my wife says, “My foot hurts,” I can usually be sure she doesn't mean the foot I can see. The Phantom has come to call once again, and the pain she feels is as frustrating for me as it is real and excruciating for her – and there's usually nothing I can do to make it better.
Theories of what causes phantom pain can be complex and arcane, much of them in the realm of specialists theorizing about the interaction among the nerves that are left after surgery, the rewiring of the spinal cord and the synaptic activity of the cortex and thalamus, and even deep-seated psychological needs. A particularly spiritualminded friend told us he regards phantom limb sensations as proof of the existence of a soul, which takes up the original form of the body but with a limb that was not amputated and that can be felt because it still exists. But none of these deep wells of knowledge, or anything in between, is helpful when the problem is, simply stated, “It hurts.” From the practical and immediate point of view, it would be more helpful to know the reality of why it starts up, rather than theories. In my wife's case, the Phantom arrives in the rush of a storm, borne by an “ill wind” that blows her no good.
The association of phantom limb pain with the weather has been noted as far back as the Civil War, according to information found on The Weather Channel Web site. The information includes an interesting article on the weather aspect of the phenomenon, as well as an “Aches and Pains Index” based on changes in the weather. You can set up a Web page for your city that will include this and other information. Start by inputting your city name or ZIP code, and select “See weather related to:” Aches & Pains, Golf, Skiing, Boats & Beaches – whatever you want to monitor. You can bookmark this “My City” page, and it will update and display the information you've selected each time you return to it.
According to another article on The Weather Channel Web site, “Aches and Pains 101,” the well-known phenomenon of people with arthritis feeling changes in the weather “in their bones,” migraine headaches, and phantom limb pain is related to a combination of weather factors that are measurable and predictable. Any of these conditions can cause stress, which can be part of a chain of events leading to the Phantom calling out your name.
- Barometric pressure, a measure of the weight of the air on us, has an effect especially when it drops rapidly. Low pressure is associated with stormy weather. Although the scientific community doesn't fully understand this phenomenon, the relationships between pain and barometric pressure has been well-documented in medical literature, as well as reported by the amputee community.
- Humidity affects most people adversely when it's higher than we're used to. Some pain conditions are triggered by low humidity, especially with low temperatures.
- Precipitation, whether rain, snow, sleet, etc., may not stop the mailman but can be a predictor since it correlates to barometric pressure changes and, of course, humidity.
- Temperatures changing rapidly signal the onset of storms with their associated barometric pressure and humidity changes. Extremes in temperatures, independent of the rate of change, may cause discomfort that will set up phantom limb pain in an amputee with other conditions; for example, cold weather is particularly hard on people with asthma, arthritis or a tendency for migraine headaches.
- Wind can also cause discomfort, bringing pollution and allergens to people with respiratory problems.
Weather is only one of many external factors known to precipitate phantom limb pain. Physical activity (or lack of it), fatigue, chronic problems with a prosthesis, stump irritation and edema, stress (both physical and emotional), intestinal problems, other bodily functions, changes in diet, and periodic illnesses have all been reported by amputees in association with phantom pain.
Not all amputees are bothered by the same factors; in fact, many have no idea at all about the possible cause of their pain. However, says Dr. Christina Skoski, having an understanding of what our personal triggers are can be used to our advantage. Rather than simply reaching for a pain pill, other noninvasive or medical interventions can be tried first in an attempt to counteract or at least diminish the initial trigger.
As Mark Twain once quipped, everyone talks about the weather, but no one does anything about it. Granted, we may not be able to change the weather, but it helps to know and understand that, just as all storms shall pass, so too will the occasional bouts of phantom pain for those who are sensitive to this phenomenon.
Related Resources
American Academy of Pain Medicine
847/375-4731
www.painmed.org
American Chronic Pain Association
800/533 -3231
www.theacpa.org
American Pain Foundation
888/615-PAIN
www.painfoundation.org
American Pain Society
847/375-4715
www.ampainsoc.org
National Foundation for the Treatment of Pain
713/862-933 2
www.paincare.org
National Pain Foundation
300 E Hampden Avenue, Suite 100
Englewood, CO 80113
www.painconnection.org
The Weather Channel
www.weather.com
