Recently, I wrote a story on shoes (ladies shoes of course) in the Gurgaon supplement of our newspaper. The HT Gurgaon Glamour supplement this time, came with tremendous response on a vague story on shoes published on the lame Page 04; something not even half expected.
The moment I logged in to my office mail I encountered more than a dozen mails waiting to appreciate me for taking up this subject and for daring to be informative in my story. However, out of all the responses, one particular response got my attention the most. The mail was sent by someone who claimed to be a renowned doctor in this area, loves wearing heels, is a 47 year old and is a 'male'. Much to my surprise, this guy loves to cross dress, but obviously finds a hard time to find a comfortable and nice pair for himself in Gurgaon. I also wonder how the sales people deal with serving the 'cross dressing' crowd. With all due respect to him and his likings, pasted below is a 'piece' from his email (considering his right to anonymity although he mentioned his name and contact details for further communication):
"I am a 47 years old male. I am a doctor by profession. I have particular liking for lady's shoes and apparels and love to cross-dress. Althogh for years i have been trying to supress this feeling and rather trying to fight it out to get it jout of my mind. But i failed. Now i think of developing my this feminine side.
I find problem in finidng women's sandals of my size. My men size is 8 or 9. My feet measures 10.5 inches in lenght, So what size of women's sandal will fit me? I have tried size 10 and 11 but they are tight in front even if they are ok in lentgh. I would also like you to guide me from where i can get my size. And how much heel should I wear as such I like to wear heels. And what type of heels broad or thin? Will stilletoes suit me?
I will be highly obliged to you as i am very much distressed otherwise"
Courtesy the good old ethics of journalism in me, I replied back with whatever information I had and help I could offer. As much as I love the response from this reader, I couldn't bring myself to terms with the existing answer to a big question any writer has before he/ she writes: "Who is my audience"? I am sure that since the story received such a good response, it must be worth it. Still, I wonder, was it able to put the right feelings across? From a shoe lover (me) to a shoe lover (reader) the information was shared and evidently, much beyond its obvious audience.
I truly thank this reader for having opened my eyes to see beyond the obvious as it would certainly help me deliver better. I hence promise people of the same group to dedicate another 'hard-worked' story on 'cross dressing' very soon.
Wednesday, October 29, 2008
Tuesday, October 21, 2008
When exactly is it enough?
My US born cousin recently visited us on her office trip to India. The confident and smart four years elder to me woman that she is now, seemed so tension free. Of course, she has her problems too; but when it comes to happiness - our faces depict the obvious. She is surely more relaxed and layed out. No career problems, no diet regimes, no matchmakings - in short I envy her. They say grass on the other side is always greener and that you may always end up pittying yourself. But seriously, doesn't it get enough or rather more than enough when others too start finding you miserable?
Single life is popularly the most free life we live. There are no responsibilities and you can do what you want. Still, not many are happy being single for long. It may be fine for a change, but in the long run - you do want to be with someone. The worst of course hits only when others too think the same for you. Well...life as they say... doesn't come easy.
Single life is popularly the most free life we live. There are no responsibilities and you can do what you want. Still, not many are happy being single for long. It may be fine for a change, but in the long run - you do want to be with someone. The worst of course hits only when others too think the same for you. Well...life as they say... doesn't come easy.
Friday, October 10, 2008
The ITCH
As per a recent study written by Dr Atul Gawande and published by NY Times, the mysterious power of the ITCH may be a clue to a new theory about brains and bodies. Here is what the paper says..
"It was still shocking to M. how much a few wrong turns could change your life. She had graduated from Boston College with a degree in psychology, married at twenty-five, and had two children, a son and a daughter. She and her family settled in a town on Massachusetts’ southern shore. She worked for thirteen years in health care, becoming the director of a residence program for men who’d suffered severe head injuries. But she and her husband began fighting. There were betrayals. By the time she was thirty-two, her marriage had disintegrated. In the divorce, she lost possession of their home, and, amid her financial and psychological struggles, she saw that she was losing her children, too. Within a few years, she was drinking. She began dating someone, and they drank together. After a while, he brought some drugs home, and she tried them. The drugs got harder. Eventually, they were doing heroin, which turned out to be readily available from a street dealer a block away from her apartment.
One day, she went to see a doctor because she wasn’t feeling well, and learned that she had contracted H.I.V. from a contaminated needle. She had to leave her job. She lost visiting rights with her children. And she developed complications from the H.I.V., including shingles, which caused painful, blistering sores across her scalp and forehead. With treatment, though, her H.I.V. was brought under control. At thirty-six, she entered rehab, dropped the boyfriend, and kicked the drugs. She had two good, quiet years in which she began rebuilding her life. Then she got the itch.
It was right after a shingles episode. The blisters and the pain responded, as they usually did, to acyclovir, an antiviral medication. But this time the area of the scalp that was involved became numb, and the pain was replaced by a constant, relentless itch. She felt it mainly on the right side of her head. It crawled along her scalp, and no matter how much she scratched it would not go away. “I felt like my inner self, like my brain itself, was itching,” she says. And it took over her life just as she was starting to get it back.
Her internist didn’t know what to make of the problem. Itching is an extraordinarily common symptom. All kinds of dermatological conditions can cause it: allergic reactions, bacterial or fungal infections, skin cancer, psoriasis, dandruff, scabies, lice, poison ivy, sun damage, or just dry skin. Creams and makeup can cause itch, too. But M. used ordinary shampoo and soap, no creams. And when the doctor examined M.’s scalp she discovered nothing abnormal—no rash, no redness, no scaling, no thickening, no fungus, no parasites. All she saw was scratch marks.
The internist prescribed a medicated cream, but it didn’t help. The urge to scratch was unceasing and irresistible. “I would try to control it during the day, when I was aware of the itch, but it was really hard,” M. said. “At night, it was the worst. I guess I would scratch when I was asleep, because in the morning there would be blood on my pillowcase.” She began to lose her hair over the itchy area. She returned to her internist again and again. “I just kept haunting her and calling her,” M. said. But nothing the internist tried worked, and she began to suspect that the itch had nothing to do with M.’s skin.
Plenty of non-skin conditions can cause itching. Dr. Jeffrey Bernhard, a dermatologist with the University of Massachusetts Medical School, is among the few doctors to study itching systematically (he published the definitive textbook on the subject), and he told me of cases caused by hyperthyroidism, iron deficiency, liver disease, and cancers like Hodgkin’s lymphoma. Sometimes the syndrome is very specific. Persistent outer-arm itching that worsens in sunlight is known as brachioradial pruritus, and it’s caused by a crimped nerve in the neck. Aquagenic pruritus is recurrent, intense, diffuse itching upon getting out of a bath or shower, and although no one knows the mechanism, it’s a symptom of polycythemia vera, a rare condition in which the body produces too many red blood cells.
But M.’s itch was confined to the right side of her scalp. Her viral count showed that the H.I.V. was quiescent. Additional blood tests and X-rays were normal. So the internist concluded that M.’s problem was probably psychiatric. All sorts of psychiatric conditions can cause itching. Patients with psychosis can have cutaneous delusions—a belief that their skin is infested with, say, parasites, or crawling ants, or laced with tiny bits of fibreglass. Severe stress and other emotional experiences can also give rise to a physical symptom like itching—whether from the body’s release of endorphins (natural opioids, which, like morphine, can cause itching), increased skin temperature, nervous scratching, or increased sweating. In M.’s case, the internist suspected tricho-tillomania, an obsessive-compulsive disorder in which patients have an irresistible urge to pull out their hair.
M. was willing to consider such possibilities. Her life had been a mess, after all. But the antidepressant medications often prescribed for O.C.D. made no difference. And she didn’t actually feel a compulsion to pull out her hair. She simply felt itchy, on the area of her scalp that was left numb from the shingles. Although she could sometimes distract herself from it—by watching television or talking with a friend—the itch did not fluctuate with her mood or level of stress. The only thing that came close to offering relief was to scratch.
“Scratching is one of the sweetest gratifications of nature, and as ready at hand as any,” Montaigne wrote. “But repentance follows too annoyingly close at its heels.” For M., certainly, it did: the itching was so torturous, and the area so numb, that her scratching began to go through the skin. At a later office visit, her doctor found a silver-dollar-size patch of scalp where skin had been replaced by scab. M. tried bandaging her head, wearing caps to bed. But her fingernails would always find a way to her flesh, especially while she slept.
One morning, after she was awakened by her bedside alarm, she sat up and, she recalled, “this fluid came down my face, this greenish liquid.” She pressed a square of gauze to her head and went to see her doctor again. M. showed the doctor the fluid on the dressing. The doctor looked closely at the wound. She shined a light on it and in M.’s eyes. Then she walked out of the room and called an ambulance. Only in the Emergency Department at Massachusetts General Hospital, after the doctors started swarming, and one told her she needed surgery now, did M. learn what had happened. She had scratched through her skull during the night—and all the way into her brain.
Itching is a most peculiar and diabolical sensation. The definition offered by the German physician Samuel Hafenreffer in 1660 has yet to be improved upon: An unpleasant sensation that provokes the desire to scratch. Itch has been ranked, by scientific and artistic observers alike, among the most distressing physical sensations one can experience. In Dante’s Inferno, falsifiers were punished by “the burning rage / of fierce itching that nothing could relieve”:
Though scratching can provide momentary relief, it often makes the itching worse. Dermatologists call this the itch-scratch cycle. Scientists believe that itch, and the accompanying scratch reflex, evolved in order to protect us from insects and clinging plant toxins—from such dangers as malaria, yellow fever, and dengue, transmitted by mosquitoes; from tularemia, river blindness, and sleeping sickness, transmitted by flies; from typhus-bearing lice, plague-bearing fleas, and poisonous spiders. The theory goes a long way toward explaining why itch is so exquisitely tuned. You can spend all day without noticing the feel of your shirt collar on your neck, and yet a single stray thread poking out, or a louse’s fine legs brushing by, can set you scratching furiously.
In the operating room, a neurosurgeon washed out and debrided M.’s wound, which had become infected. Later, a plastic surgeon covered it with a graft of skin from her thigh. Though her head was wrapped in layers of gauze and she did all she could to resist the still furious itchiness, she awoke one morning to find that she had rubbed the graft away. The doctors returned her to the operating room for a second skin graft, and this time they wrapped her hands as well. She rubbed it away again anyway.
“They kept telling me I had O.C.D.,” M. said. A psychiatric team was sent in to see her each day, and the resident would ask her, “As a child, when you walked down the street did you count the lines? Did you do anything repetitive? Did you have to count everything you saw?” She kept telling him no, but he seemed skeptical. He tracked down her family and asked them, but they said no, too. Psychology tests likewise ruled out obsessive-compulsive disorder. They showed depression, though, and, of course, there was the history of addiction. So the doctors still thought her scratching was from a psychiatric disorder. They gave her drugs that made her feel logy and sleep a lot. But the itching was as bad as ever, and she still woke up scratching at that terrible wound.
One morning, she found, as she put it, “this very bright and happy-looking woman standing by my bed. She said, ‘I’m Dr. Oaklander,’ ” M. recalled. “I thought, Oh great. Here we go again. But she explained that she was a neurologist, and she said, ‘The first thing I want to say to you is that I don’t think you’re crazy. I don’t think you have O.C.D.’ At that moment, I really saw her grow wings and a halo,” M. told me. “I said, ‘Are you sure?’ And she said, ‘Yes. I have heard of this before.’ ”
Anne Louise Oaklander was about the same age as M. Her mother is a prominent neurologist at Albert Einstein College of Medicine, in New York, and she’d followed her into the field. Oaklander had specialized in disorders of peripheral nerve sensation—disorders like shingles. Although pain is the most common symptom of shingles, Oaklander had noticed during her training that some patients also had itching, occasionally severe, and seeing M. reminded her of one of her shingles patients. “I remember standing in a hallway talking to her, and what she complained about—her major concern—was that she was tormented by this terrible itch over the eye where she had had shingles,” she told me. When Oaklander looked at her, she thought that something wasn’t right. It took a moment to realize why. “The itch was so severe, she had scratched off her eyebrow.”
Oaklander tested the skin near M.’s wound. It was numb to temperature, touch, and pinprick. Nonetheless, it was itchy, and when it was scratched or rubbed M. felt the itchiness temporarily subside. Oaklander injected a few drops of local anesthetic into the skin. To M.’s surprise, the itching stopped—instantly and almost entirely. This was the first real relief she’d had in more than a year.
It was an imperfect treatment, though. The itch came back when the anesthetic wore off, and, although Oaklander tried having M. wear an anesthetic patch over the wound, the effect diminished over time. Oaklander did not have an explanation for any of this. When she took a biopsy of the itchy skin, it showed that ninety-six per cent of the nerve fibres were gone. So why was the itch so intense?
Oaklander came up with two theories. The first was that those few remaining nerve fibres were itch fibres and, with no other fibres around to offer competing signals, they had become constantly active. The second theory was the opposite. The nerves were dead, but perhaps the itch system in M.’s brain had gone haywire, running on a loop all its own.
The second theory seemed less likely. If the nerves to her scalp were dead, how would you explain the relief she got from scratching, or from the local anesthetic? Indeed, how could you explain the itch in the first place? An itch without nerve endings didn’t make sense. The neurosurgeons stuck with the first theory; they offered to cut the main sensory nerve to the front of M.’s scalp and abolish the itching permanently. Oaklander, however, thought that the second theory was the right one—that this was a brain problem, not a nerve problem—and that cutting the nerve would do more harm than good. She argued with the neurosurgeons, and she advised M. not to let them do any cutting.
“But I was desperate,” M. told me. She let them operate on her, slicing the supraorbital nerve above the right eye. When she woke up, a whole section of her forehead was numb—and the itching was gone. A few weeks later, however, it came back, in an even wider expanse than before. The doctors tried pain medications, more psychiatric medications, more local anesthetic. But the only thing that kept M. from tearing her skin and skull open again, the doctors found, was to put a foam football helmet on her head and bind her wrists to the bedrails at night.
She spent the next two years committed to a locked medical ward in a rehabilitation hospital—because, although she was not mentally ill, she was considered a danger to herself. Eventually, the staff worked out a solution that did not require binding her to the bedrails. Along with the football helmet, she had to wear white mitts that were secured around her wrists by surgical tape. “Every bedtime, it looked like they were dressing me up for Halloween—me and the guy next to me,” she told me.
“The guy next to you?” I asked. He had had shingles on his neck, she explained, and also developed a persistent itch. “Every night, they would wrap up his hands and wrap up mine.” She spoke more softly now. “But I heard he ended up dying from it, because he scratched into his carotid artery.”
I met M. seven years after she’d been discharged from the rehabilitation hospital. She is forty-eight now. She lives in a three-room apartment, with a crucifix and a bust of Jesus on the wall and the low yellow light of table lamps strung with beads over their shades. Stacked in a wicker basket next to her coffee table were Rick Warren’s “The Purpose Driven Life,” People, and the latest issue of Neurology Now, a magazine for patients. Together, they summed up her struggles, for she is still fighting the meaninglessness, the isolation, and the physiology of her predicament.
She met me at the door in a wheelchair; the injury to her brain had left her partially paralyzed on the left side of her body. She remains estranged from her children. She has not, however, relapsed into drinking or drugs. Her H.I.V. remains under control. Although the itch on her scalp and forehead persists, she has gradually learned to protect herself. She trims her nails short. She finds ways to distract herself. If she must scratch, she tries to rub gently instead. And, if that isn’t enough, she uses a soft toothbrush or a rolled-up terry cloth. “I don’t use anything sharp,” she said. The two years that she spent bound up in the hospital seemed to have broken the nighttime scratching. At home, she found that she didn’t need to wear the helmet and gloves anymore.
Still, the itching remains a daily torment. “I don’t normally tell people this,” she said, “but I have a fantasy of shaving off my eyebrow and taking a metal-wire grill brush and scratching away.”
Some of her doctors have not been willing to let go of the idea that this has been a nerve problem all along. A local neurosurgeon told her that the original operation to cut the sensory nerve to her scalp must not have gone deep enough. “He wants to go in again,” she told me.
A new scientific understanding of perception has emerged in the past few decades, and it has overturned classical, centuries-long beliefs about how our brains work—though it has apparently not penetrated the medical world yet. The old understanding of perception is what neuroscientists call “the naïve view,” and it is the view that most people, in or out of medicine, still have. We’re inclined to think that people normally perceive things in the world directly. We believe that the hardness of a rock, the coldness of an ice cube, the itchiness of a sweater are picked up by our nerve endings, transmitted through the spinal cord like a message through a wire, and decoded by the brain.
She met me at the door in a wheelchair; the injury to her brain had left her partially paralyzed on the left side of her body. She remains estranged from her children. She has not, however, relapsed into drinking or drugs. Her H.I.V. remains under control. Although the itch on her scalp and forehead persists, she has gradually learned to protect herself. She trims her nails short. She finds ways to distract herself. If she must scratch, she tries to rub gently instead. And, if that isn’t enough, she uses a soft toothbrush or a rolled-up terry cloth. “I don’t use anything sharp,” she said. The two years that she spent bound up in the hospital seemed to have broken the nighttime scratching. At home, she found that she didn’t need to wear the helmet and gloves anymore.Still, the itching remains a daily torment. “I don’t normally tell people this,” she said, but I have a fantasy of shaving off my eyebrow and taking a metal-wire grill brush and scratching away'."
These are some excerpts from the paper published by NY Times. But surely, it moves a certain nerve in us, that disturbs our age old notions and beliefs about itching and scratching. In short I should say, the paper triggers 'an itch'.
"It was still shocking to M. how much a few wrong turns could change your life. She had graduated from Boston College with a degree in psychology, married at twenty-five, and had two children, a son and a daughter. She and her family settled in a town on Massachusetts’ southern shore. She worked for thirteen years in health care, becoming the director of a residence program for men who’d suffered severe head injuries. But she and her husband began fighting. There were betrayals. By the time she was thirty-two, her marriage had disintegrated. In the divorce, she lost possession of their home, and, amid her financial and psychological struggles, she saw that she was losing her children, too. Within a few years, she was drinking. She began dating someone, and they drank together. After a while, he brought some drugs home, and she tried them. The drugs got harder. Eventually, they were doing heroin, which turned out to be readily available from a street dealer a block away from her apartment.
One day, she went to see a doctor because she wasn’t feeling well, and learned that she had contracted H.I.V. from a contaminated needle. She had to leave her job. She lost visiting rights with her children. And she developed complications from the H.I.V., including shingles, which caused painful, blistering sores across her scalp and forehead. With treatment, though, her H.I.V. was brought under control. At thirty-six, she entered rehab, dropped the boyfriend, and kicked the drugs. She had two good, quiet years in which she began rebuilding her life. Then she got the itch.
It was right after a shingles episode. The blisters and the pain responded, as they usually did, to acyclovir, an antiviral medication. But this time the area of the scalp that was involved became numb, and the pain was replaced by a constant, relentless itch. She felt it mainly on the right side of her head. It crawled along her scalp, and no matter how much she scratched it would not go away. “I felt like my inner self, like my brain itself, was itching,” she says. And it took over her life just as she was starting to get it back.
Her internist didn’t know what to make of the problem. Itching is an extraordinarily common symptom. All kinds of dermatological conditions can cause it: allergic reactions, bacterial or fungal infections, skin cancer, psoriasis, dandruff, scabies, lice, poison ivy, sun damage, or just dry skin. Creams and makeup can cause itch, too. But M. used ordinary shampoo and soap, no creams. And when the doctor examined M.’s scalp she discovered nothing abnormal—no rash, no redness, no scaling, no thickening, no fungus, no parasites. All she saw was scratch marks.
The internist prescribed a medicated cream, but it didn’t help. The urge to scratch was unceasing and irresistible. “I would try to control it during the day, when I was aware of the itch, but it was really hard,” M. said. “At night, it was the worst. I guess I would scratch when I was asleep, because in the morning there would be blood on my pillowcase.” She began to lose her hair over the itchy area. She returned to her internist again and again. “I just kept haunting her and calling her,” M. said. But nothing the internist tried worked, and she began to suspect that the itch had nothing to do with M.’s skin.
Plenty of non-skin conditions can cause itching. Dr. Jeffrey Bernhard, a dermatologist with the University of Massachusetts Medical School, is among the few doctors to study itching systematically (he published the definitive textbook on the subject), and he told me of cases caused by hyperthyroidism, iron deficiency, liver disease, and cancers like Hodgkin’s lymphoma. Sometimes the syndrome is very specific. Persistent outer-arm itching that worsens in sunlight is known as brachioradial pruritus, and it’s caused by a crimped nerve in the neck. Aquagenic pruritus is recurrent, intense, diffuse itching upon getting out of a bath or shower, and although no one knows the mechanism, it’s a symptom of polycythemia vera, a rare condition in which the body produces too many red blood cells.
But M.’s itch was confined to the right side of her scalp. Her viral count showed that the H.I.V. was quiescent. Additional blood tests and X-rays were normal. So the internist concluded that M.’s problem was probably psychiatric. All sorts of psychiatric conditions can cause itching. Patients with psychosis can have cutaneous delusions—a belief that their skin is infested with, say, parasites, or crawling ants, or laced with tiny bits of fibreglass. Severe stress and other emotional experiences can also give rise to a physical symptom like itching—whether from the body’s release of endorphins (natural opioids, which, like morphine, can cause itching), increased skin temperature, nervous scratching, or increased sweating. In M.’s case, the internist suspected tricho-tillomania, an obsessive-compulsive disorder in which patients have an irresistible urge to pull out their hair.
M. was willing to consider such possibilities. Her life had been a mess, after all. But the antidepressant medications often prescribed for O.C.D. made no difference. And she didn’t actually feel a compulsion to pull out her hair. She simply felt itchy, on the area of her scalp that was left numb from the shingles. Although she could sometimes distract herself from it—by watching television or talking with a friend—the itch did not fluctuate with her mood or level of stress. The only thing that came close to offering relief was to scratch.
“Scratching is one of the sweetest gratifications of nature, and as ready at hand as any,” Montaigne wrote. “But repentance follows too annoyingly close at its heels.” For M., certainly, it did: the itching was so torturous, and the area so numb, that her scratching began to go through the skin. At a later office visit, her doctor found a silver-dollar-size patch of scalp where skin had been replaced by scab. M. tried bandaging her head, wearing caps to bed. But her fingernails would always find a way to her flesh, especially while she slept.
One morning, after she was awakened by her bedside alarm, she sat up and, she recalled, “this fluid came down my face, this greenish liquid.” She pressed a square of gauze to her head and went to see her doctor again. M. showed the doctor the fluid on the dressing. The doctor looked closely at the wound. She shined a light on it and in M.’s eyes. Then she walked out of the room and called an ambulance. Only in the Emergency Department at Massachusetts General Hospital, after the doctors started swarming, and one told her she needed surgery now, did M. learn what had happened. She had scratched through her skull during the night—and all the way into her brain.
Itching is a most peculiar and diabolical sensation. The definition offered by the German physician Samuel Hafenreffer in 1660 has yet to be improved upon: An unpleasant sensation that provokes the desire to scratch. Itch has been ranked, by scientific and artistic observers alike, among the most distressing physical sensations one can experience. In Dante’s Inferno, falsifiers were punished by “the burning rage / of fierce itching that nothing could relieve”:
Though scratching can provide momentary relief, it often makes the itching worse. Dermatologists call this the itch-scratch cycle. Scientists believe that itch, and the accompanying scratch reflex, evolved in order to protect us from insects and clinging plant toxins—from such dangers as malaria, yellow fever, and dengue, transmitted by mosquitoes; from tularemia, river blindness, and sleeping sickness, transmitted by flies; from typhus-bearing lice, plague-bearing fleas, and poisonous spiders. The theory goes a long way toward explaining why itch is so exquisitely tuned. You can spend all day without noticing the feel of your shirt collar on your neck, and yet a single stray thread poking out, or a louse’s fine legs brushing by, can set you scratching furiously.
In the operating room, a neurosurgeon washed out and debrided M.’s wound, which had become infected. Later, a plastic surgeon covered it with a graft of skin from her thigh. Though her head was wrapped in layers of gauze and she did all she could to resist the still furious itchiness, she awoke one morning to find that she had rubbed the graft away. The doctors returned her to the operating room for a second skin graft, and this time they wrapped her hands as well. She rubbed it away again anyway.
“They kept telling me I had O.C.D.,” M. said. A psychiatric team was sent in to see her each day, and the resident would ask her, “As a child, when you walked down the street did you count the lines? Did you do anything repetitive? Did you have to count everything you saw?” She kept telling him no, but he seemed skeptical. He tracked down her family and asked them, but they said no, too. Psychology tests likewise ruled out obsessive-compulsive disorder. They showed depression, though, and, of course, there was the history of addiction. So the doctors still thought her scratching was from a psychiatric disorder. They gave her drugs that made her feel logy and sleep a lot. But the itching was as bad as ever, and she still woke up scratching at that terrible wound.
One morning, she found, as she put it, “this very bright and happy-looking woman standing by my bed. She said, ‘I’m Dr. Oaklander,’ ” M. recalled. “I thought, Oh great. Here we go again. But she explained that she was a neurologist, and she said, ‘The first thing I want to say to you is that I don’t think you’re crazy. I don’t think you have O.C.D.’ At that moment, I really saw her grow wings and a halo,” M. told me. “I said, ‘Are you sure?’ And she said, ‘Yes. I have heard of this before.’ ”
Anne Louise Oaklander was about the same age as M. Her mother is a prominent neurologist at Albert Einstein College of Medicine, in New York, and she’d followed her into the field. Oaklander had specialized in disorders of peripheral nerve sensation—disorders like shingles. Although pain is the most common symptom of shingles, Oaklander had noticed during her training that some patients also had itching, occasionally severe, and seeing M. reminded her of one of her shingles patients. “I remember standing in a hallway talking to her, and what she complained about—her major concern—was that she was tormented by this terrible itch over the eye where she had had shingles,” she told me. When Oaklander looked at her, she thought that something wasn’t right. It took a moment to realize why. “The itch was so severe, she had scratched off her eyebrow.”
Oaklander tested the skin near M.’s wound. It was numb to temperature, touch, and pinprick. Nonetheless, it was itchy, and when it was scratched or rubbed M. felt the itchiness temporarily subside. Oaklander injected a few drops of local anesthetic into the skin. To M.’s surprise, the itching stopped—instantly and almost entirely. This was the first real relief she’d had in more than a year.
It was an imperfect treatment, though. The itch came back when the anesthetic wore off, and, although Oaklander tried having M. wear an anesthetic patch over the wound, the effect diminished over time. Oaklander did not have an explanation for any of this. When she took a biopsy of the itchy skin, it showed that ninety-six per cent of the nerve fibres were gone. So why was the itch so intense?
Oaklander came up with two theories. The first was that those few remaining nerve fibres were itch fibres and, with no other fibres around to offer competing signals, they had become constantly active. The second theory was the opposite. The nerves were dead, but perhaps the itch system in M.’s brain had gone haywire, running on a loop all its own.
The second theory seemed less likely. If the nerves to her scalp were dead, how would you explain the relief she got from scratching, or from the local anesthetic? Indeed, how could you explain the itch in the first place? An itch without nerve endings didn’t make sense. The neurosurgeons stuck with the first theory; they offered to cut the main sensory nerve to the front of M.’s scalp and abolish the itching permanently. Oaklander, however, thought that the second theory was the right one—that this was a brain problem, not a nerve problem—and that cutting the nerve would do more harm than good. She argued with the neurosurgeons, and she advised M. not to let them do any cutting.
“But I was desperate,” M. told me. She let them operate on her, slicing the supraorbital nerve above the right eye. When she woke up, a whole section of her forehead was numb—and the itching was gone. A few weeks later, however, it came back, in an even wider expanse than before. The doctors tried pain medications, more psychiatric medications, more local anesthetic. But the only thing that kept M. from tearing her skin and skull open again, the doctors found, was to put a foam football helmet on her head and bind her wrists to the bedrails at night.
She spent the next two years committed to a locked medical ward in a rehabilitation hospital—because, although she was not mentally ill, she was considered a danger to herself. Eventually, the staff worked out a solution that did not require binding her to the bedrails. Along with the football helmet, she had to wear white mitts that were secured around her wrists by surgical tape. “Every bedtime, it looked like they were dressing me up for Halloween—me and the guy next to me,” she told me.
“The guy next to you?” I asked. He had had shingles on his neck, she explained, and also developed a persistent itch. “Every night, they would wrap up his hands and wrap up mine.” She spoke more softly now. “But I heard he ended up dying from it, because he scratched into his carotid artery.”
I met M. seven years after she’d been discharged from the rehabilitation hospital. She is forty-eight now. She lives in a three-room apartment, with a crucifix and a bust of Jesus on the wall and the low yellow light of table lamps strung with beads over their shades. Stacked in a wicker basket next to her coffee table were Rick Warren’s “The Purpose Driven Life,” People, and the latest issue of Neurology Now, a magazine for patients. Together, they summed up her struggles, for she is still fighting the meaninglessness, the isolation, and the physiology of her predicament.
She met me at the door in a wheelchair; the injury to her brain had left her partially paralyzed on the left side of her body. She remains estranged from her children. She has not, however, relapsed into drinking or drugs. Her H.I.V. remains under control. Although the itch on her scalp and forehead persists, she has gradually learned to protect herself. She trims her nails short. She finds ways to distract herself. If she must scratch, she tries to rub gently instead. And, if that isn’t enough, she uses a soft toothbrush or a rolled-up terry cloth. “I don’t use anything sharp,” she said. The two years that she spent bound up in the hospital seemed to have broken the nighttime scratching. At home, she found that she didn’t need to wear the helmet and gloves anymore.
Still, the itching remains a daily torment. “I don’t normally tell people this,” she said, “but I have a fantasy of shaving off my eyebrow and taking a metal-wire grill brush and scratching away.”
Some of her doctors have not been willing to let go of the idea that this has been a nerve problem all along. A local neurosurgeon told her that the original operation to cut the sensory nerve to her scalp must not have gone deep enough. “He wants to go in again,” she told me.
A new scientific understanding of perception has emerged in the past few decades, and it has overturned classical, centuries-long beliefs about how our brains work—though it has apparently not penetrated the medical world yet. The old understanding of perception is what neuroscientists call “the naïve view,” and it is the view that most people, in or out of medicine, still have. We’re inclined to think that people normally perceive things in the world directly. We believe that the hardness of a rock, the coldness of an ice cube, the itchiness of a sweater are picked up by our nerve endings, transmitted through the spinal cord like a message through a wire, and decoded by the brain.
She met me at the door in a wheelchair; the injury to her brain had left her partially paralyzed on the left side of her body. She remains estranged from her children. She has not, however, relapsed into drinking or drugs. Her H.I.V. remains under control. Although the itch on her scalp and forehead persists, she has gradually learned to protect herself. She trims her nails short. She finds ways to distract herself. If she must scratch, she tries to rub gently instead. And, if that isn’t enough, she uses a soft toothbrush or a rolled-up terry cloth. “I don’t use anything sharp,” she said. The two years that she spent bound up in the hospital seemed to have broken the nighttime scratching. At home, she found that she didn’t need to wear the helmet and gloves anymore.Still, the itching remains a daily torment. “I don’t normally tell people this,” she said, but I have a fantasy of shaving off my eyebrow and taking a metal-wire grill brush and scratching away'."
These are some excerpts from the paper published by NY Times. But surely, it moves a certain nerve in us, that disturbs our age old notions and beliefs about itching and scratching. In short I should say, the paper triggers 'an itch'.
A woman’s right to shoes
As much as we love our shoes, there is something strange about the way some girls deal with it. With the rich variety of designs, brands, colours and heels available in the market, who can stop herself from indulging? But shoes or heels to say more appropriately need you to do your own research and know what you are getting into. As much as thrilling an experience it is, not all of us are Carrie Bradshaw of Sex and the City. After all, in real life even Sarah Jessica Parker had hurt her ankles. So to make matters easier, here is a gist of how well you should know your shoes.
It is true that heels bring a curve to your body and that you can walk more confidently in them rather than when you put on your sneakers. However, a bitter fact is also that these heels have ruined many lives to its credit. The foremost and most prominent reason behind this is the lack of knowledge and carelessness while dealing with these amazing objects. There is still no reason to quit your heels just yet. All you need is a little bit of info. Lets start with the lengths of heels available.
Low heels--start your quest here!
If you want to taste the life of a high heeler, and yet want to avoid the pains, just go low-heels! Girls wear low heels to train themselves for a bigger task (stiletto, for many) or they just prioritize health over style. Doesn't matter to which category you fall in, whats important for you to know is that you are not alone. These heels help you pep-up your confidence and are very much acceptable in a professional atmosphere as well.
Medium heels--for the undergraduates!
Medium heels are for those who crave to wear high heels but still lack that most wanted terrible balance. Practicing on medium heels will surely pay you and it is one of the top tips that high heel experts give. But if you are naturally tall, don't ever compete with the Everest; instead opt medium heels and get satisfied with them.
High heels—necessity sometimes!
Wearing a pair of high-heeled shoes makes a more sexy curve in the body. The body above your hip bends naturally to balance itself, thereby creating an almost seductive curve. So don't ever think that high heels are just for your feet, you never know what all those stares are for.
Warnings for high-heel lovers
As a common fact known to many, if you constantly wear heels, the intense stress on your muscles, tendons and joints can cause permanent damage to your feet. As much as we high-heel lovers want to deny this fact, it is in our own interest to accept it.
Too much pain is a bad sign. If your feet are giving you a hard time, take off your shoes and figure out why. If they don't fit, no matter how much you like them, get rid of them. After all, shoes can be replaced, but you have one pair of feet.
You need to be much more careful while walking in high-heels. Be careful about terrain, grass, ice, metal grates and other things that can trip you up very easily, damaging or breaking your heel, or worse. Long walks in heels aren't recommended either; the shorter the step, you will have to make many more steps to cover any given distance. Don’t do that; you’d be forced to spend the rest of your life in comfort shoes, and that's a harsh fate. Bunions, hammertoes and achilles tendon problems are common in high heel wearers. Take a break, change shoes regularly and exercise to stay in shape.
High heels, especially stiletto heels, never go out of style with true fashionistas. But being fashionable isn't always confortable. If you are a slave to high heels you might also suffer from corns, bunions, and fallen arches. Luckily, there are ways to make them less harmful to your feet (and not just by spending $400+ on an elite designer pair). TYPES
A kitten heel is a short, slender heel, usually from 3.5 centimeters (1.5 inches) to 5 centimeters (2 inches) high with a slight curve setting the heel in from the edge of the shoe. The style was popularized by Audrey Hepburn. They are particularly common on sandals.
A kitten heel is a stiletto heel of 5 centimeters or less in height; some are as low as 3 cm. They are classified as stiletto heels and despite their lack of height are generally classified as ‘high heels’ because of their sex appeal; particularly when teamed with a sharp pointed toe or long ‘winklepicker’ toe. This is an anomaly because a shoe or pump with regular wide heels of 3.5 centimeters high would normally be considered a flat shoe; it is the addition of a stiletto heel, however short, that turns it into a sexual accessory.
A stiletto heel (also known as a spike heel) is a long, thin heel found on some boots and shoes, usually for women. It is named after the stiletto dagger, the phrase being first recorded in the early 1930s. Stiletto heels may vary in length from 2.5 cm (1 inch) to 20 cm (8 inches) or more if a platform sole is used, and are sometimes defined as having a diameter at the ground of less than 1 cm (slightly less than half an inch). Not all high slim heels merit the description stiletto. The extremely slender original Italian-style stiletto heels of the very early 1960s were no more than 5mm in diameter for much of their length, although the heel sometimes flared out a little at the tip. After their demise in the mid-late 1960s, such slender heels were difficult to find until recently due to changes in the way heels were mass-produced. However, no moulded plastic heel with internal metal tube can hope to achieve the slender line or strength of a metal-stemmed stiletto, so it was only a matter of time before popular opinion and the demands of shoe designers brought back the manufacture of genuine stiletto heels.
A spool heel is a heel that is wide at the top and bottom and narrower in the middle. Spool heels were first popular in Europe during the Early Georgian era (1715-1750).
How to choose heels??
High heels can make your legs look long, lean and luscious. Unfortunately, they can also be quite uncomfortable if not chosen wisely. To avoid foot problems, you need to strike a balance between looks and comfort. Here's how to choose high heels that'll feel as good as they look: The right fit is critical High heels aren't the most comfortable shoes to begin with so getting the right fit is critical. By getting the right fit, you can reduce your risk of developing blisters and corns. When you try heels on in the store, walk around for at least five minutes before making a decision to purchase. Rise up on your toes and see if the shoes still feel comfortable. Before purchasing, make sure they're returnable in the event you get them home and they don't fit properly. Always try on shoes at the end of the day when your foot is it's largest due to fluid retention. Be wary of purchasing high heels online where you can't try them to see if they're comfortable. Consider your buildIf you have chunky or muscular legs and calves, choose a thicker, more substantial heel to balance out your leg. A good choice is a platform heel or an espadrille style. Not only do these tend to be more comfortable, they can make a chunky leg look smaller. Thin heeled shoes such as stilettos look best on people with thinner legs. Invest in neutral colorsAlthough you may want to branch into colored shoes occasionally for variety, blacks, browns, and neutrals are much more versatile and can be worn more places. Get out of the mindset that you need to match shoe color with your outfit. This is often overkill. Buy a few pairs of high quality heels in neutral tones that look good with almost everything. Buy one or two pairs of colored heels for special events. Consider your heightIf you're six feet tall, you may want to avoid wearing five inch stilettos unless you want to look down on everyone. If you're short and petite, tall stilettos may add height, but can be overpowering. Choose a more modest two and a half to three inch height for daytime wear. You can wear a slightly taller heel for evening. If you want to add height when wearing pants, a platform or wedge heel can work well. These shoe styles also provide better foot support than narrow heels. Give yourself a breakIf you plan on wearing high heels to work, take along a pair of flat shoes to wear during your lunch break if you'll be doing a lot of walking. To avoid foot problems, it's always a good idea to give you feet a break from the stress of high heels. For additional comfort, consider adding a pair of gel soles to your shoes. High heels can be stylish to wear and they don't have to be uncomfortable if chosen wisely. Spend some time trying on a variety of high heels before purchasing. Don't make the mistake of sacrificing comfort for style.
It is true that heels bring a curve to your body and that you can walk more confidently in them rather than when you put on your sneakers. However, a bitter fact is also that these heels have ruined many lives to its credit. The foremost and most prominent reason behind this is the lack of knowledge and carelessness while dealing with these amazing objects. There is still no reason to quit your heels just yet. All you need is a little bit of info. Lets start with the lengths of heels available.
Low heels--start your quest here!
If you want to taste the life of a high heeler, and yet want to avoid the pains, just go low-heels! Girls wear low heels to train themselves for a bigger task (stiletto, for many) or they just prioritize health over style. Doesn't matter to which category you fall in, whats important for you to know is that you are not alone. These heels help you pep-up your confidence and are very much acceptable in a professional atmosphere as well.
Medium heels--for the undergraduates!
Medium heels are for those who crave to wear high heels but still lack that most wanted terrible balance. Practicing on medium heels will surely pay you and it is one of the top tips that high heel experts give. But if you are naturally tall, don't ever compete with the Everest; instead opt medium heels and get satisfied with them.
High heels—necessity sometimes!
Wearing a pair of high-heeled shoes makes a more sexy curve in the body. The body above your hip bends naturally to balance itself, thereby creating an almost seductive curve. So don't ever think that high heels are just for your feet, you never know what all those stares are for.
Warnings for high-heel lovers
As a common fact known to many, if you constantly wear heels, the intense stress on your muscles, tendons and joints can cause permanent damage to your feet. As much as we high-heel lovers want to deny this fact, it is in our own interest to accept it.
Too much pain is a bad sign. If your feet are giving you a hard time, take off your shoes and figure out why. If they don't fit, no matter how much you like them, get rid of them. After all, shoes can be replaced, but you have one pair of feet.
You need to be much more careful while walking in high-heels. Be careful about terrain, grass, ice, metal grates and other things that can trip you up very easily, damaging or breaking your heel, or worse. Long walks in heels aren't recommended either; the shorter the step, you will have to make many more steps to cover any given distance. Don’t do that; you’d be forced to spend the rest of your life in comfort shoes, and that's a harsh fate. Bunions, hammertoes and achilles tendon problems are common in high heel wearers. Take a break, change shoes regularly and exercise to stay in shape.
High heels, especially stiletto heels, never go out of style with true fashionistas. But being fashionable isn't always confortable. If you are a slave to high heels you might also suffer from corns, bunions, and fallen arches. Luckily, there are ways to make them less harmful to your feet (and not just by spending $400+ on an elite designer pair). TYPES
A kitten heel is a short, slender heel, usually from 3.5 centimeters (1.5 inches) to 5 centimeters (2 inches) high with a slight curve setting the heel in from the edge of the shoe. The style was popularized by Audrey Hepburn. They are particularly common on sandals.
A kitten heel is a stiletto heel of 5 centimeters or less in height; some are as low as 3 cm. They are classified as stiletto heels and despite their lack of height are generally classified as ‘high heels’ because of their sex appeal; particularly when teamed with a sharp pointed toe or long ‘winklepicker’ toe. This is an anomaly because a shoe or pump with regular wide heels of 3.5 centimeters high would normally be considered a flat shoe; it is the addition of a stiletto heel, however short, that turns it into a sexual accessory.
A stiletto heel (also known as a spike heel) is a long, thin heel found on some boots and shoes, usually for women. It is named after the stiletto dagger, the phrase being first recorded in the early 1930s. Stiletto heels may vary in length from 2.5 cm (1 inch) to 20 cm (8 inches) or more if a platform sole is used, and are sometimes defined as having a diameter at the ground of less than 1 cm (slightly less than half an inch). Not all high slim heels merit the description stiletto. The extremely slender original Italian-style stiletto heels of the very early 1960s were no more than 5mm in diameter for much of their length, although the heel sometimes flared out a little at the tip. After their demise in the mid-late 1960s, such slender heels were difficult to find until recently due to changes in the way heels were mass-produced. However, no moulded plastic heel with internal metal tube can hope to achieve the slender line or strength of a metal-stemmed stiletto, so it was only a matter of time before popular opinion and the demands of shoe designers brought back the manufacture of genuine stiletto heels.
A spool heel is a heel that is wide at the top and bottom and narrower in the middle. Spool heels were first popular in Europe during the Early Georgian era (1715-1750).
How to choose heels??
High heels can make your legs look long, lean and luscious. Unfortunately, they can also be quite uncomfortable if not chosen wisely. To avoid foot problems, you need to strike a balance between looks and comfort. Here's how to choose high heels that'll feel as good as they look: The right fit is critical High heels aren't the most comfortable shoes to begin with so getting the right fit is critical. By getting the right fit, you can reduce your risk of developing blisters and corns. When you try heels on in the store, walk around for at least five minutes before making a decision to purchase. Rise up on your toes and see if the shoes still feel comfortable. Before purchasing, make sure they're returnable in the event you get them home and they don't fit properly. Always try on shoes at the end of the day when your foot is it's largest due to fluid retention. Be wary of purchasing high heels online where you can't try them to see if they're comfortable. Consider your buildIf you have chunky or muscular legs and calves, choose a thicker, more substantial heel to balance out your leg. A good choice is a platform heel or an espadrille style. Not only do these tend to be more comfortable, they can make a chunky leg look smaller. Thin heeled shoes such as stilettos look best on people with thinner legs. Invest in neutral colorsAlthough you may want to branch into colored shoes occasionally for variety, blacks, browns, and neutrals are much more versatile and can be worn more places. Get out of the mindset that you need to match shoe color with your outfit. This is often overkill. Buy a few pairs of high quality heels in neutral tones that look good with almost everything. Buy one or two pairs of colored heels for special events. Consider your heightIf you're six feet tall, you may want to avoid wearing five inch stilettos unless you want to look down on everyone. If you're short and petite, tall stilettos may add height, but can be overpowering. Choose a more modest two and a half to three inch height for daytime wear. You can wear a slightly taller heel for evening. If you want to add height when wearing pants, a platform or wedge heel can work well. These shoe styles also provide better foot support than narrow heels. Give yourself a breakIf you plan on wearing high heels to work, take along a pair of flat shoes to wear during your lunch break if you'll be doing a lot of walking. To avoid foot problems, it's always a good idea to give you feet a break from the stress of high heels. For additional comfort, consider adding a pair of gel soles to your shoes. High heels can be stylish to wear and they don't have to be uncomfortable if chosen wisely. Spend some time trying on a variety of high heels before purchasing. Don't make the mistake of sacrificing comfort for style.
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