<div dir="auto"><div dir="auto">Some people have suggested I meditate with the goal of perceiving the pain as being separate from me. Or something like that.</div><div dir="auto"><br></div><div dir="auto">The Duloxetine (Cymbalta) has certainly changed my behavior. I am much more patient, considerate, loving, empathic, etc. Some might think I am more like the ideals of Abrahamic faith traditions which raises the question of whether you can be a better person by using meds.</div><div dir="auto"><br></div><div dir="auto">Frank </div><div dir="auto"><br><div data-smartmail="gmail_signature" dir="auto">-----------------------------------<br>Frank Wimberly<br><br>My memoir:<br><a href="https://www.amazon.com/author/frankwimberly" target="_blank" rel="noreferrer">https://www.amazon.com/author/frankwimberly</a><br><br>My scientific publications:<br><a href="https://www.researchgate.net/profile/Frank_Wimberly2" target="_blank" rel="noreferrer">https://www.researchgate.net/profile/Frank_Wimberly2</a><br><br>Phone (505) 670-9918</div></div><br><div class="gmail_quote"><div dir="ltr" class="gmail_attr">On Mon, Mar 11, 2019, 12:08 PM Frank Wimberly <<a href="mailto:wimberly3@gmail.com" target="_blank" rel="noreferrer">wimberly3@gmail.com</a>> wrote:<br></div><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex"><div dir="auto"><span style="color:rgb(60,64,67);font-family:roboto,helveticaneue,arial,sans-serif;font-size:16px;background-color:rgb(255,255,255)">Pregabalin reduces neuronal calcium currents by binding to the α</span><span style="max-height:999999px;vertical-align:baseline;color:rgb(60,64,67);font-family:roboto,helveticaneue,arial,sans-serif;background-color:rgb(255,255,255)">2</span><span style="color:rgb(60,64,67);font-family:roboto,helveticaneue,arial,sans-serif;font-size:16px;background-color:rgb(255,255,255)">δ subunit of calcium channels, and this particular mechanism may be responsible for effects in </span><b style="max-height:999999px;color:rgb(60,64,67);font-family:roboto,helveticaneue,arial,sans-serif;font-size:16px;background-color:rgb(255,255,255)">neuropathic pain</b><span style="color:rgb(60,64,67);font-family:roboto,helveticaneue,arial,sans-serif;font-size:16px;background-color:rgb(255,255,255)">, anxiety, and other </span><b style="max-height:999999px;color:rgb(60,64,67);font-family:roboto,helveticaneue,arial,sans-serif;font-size:16px;background-color:rgb(255,255,255)">pain</b><span style="color:rgb(60,64,67);font-family:roboto,helveticaneue,arial,sans-serif;font-size:16px;background-color:rgb(255,255,255)">syndromes. The exact mechanism of analgesic effect for </span><b style="max-height:999999px;color:rgb(60,64,67);font-family:roboto,helveticaneue,arial,sans-serif;font-size:16px;background-color:rgb(255,255,255)">gabapentin</b><span style="color:rgb(60,64,67);font-family:roboto,helveticaneue,arial,sans-serif;font-size:16px;background-color:rgb(255,255,255)"> has not been defined.</span><div dir="auto"><font color="#3c4043" face="roboto, helveticaneue, arial, sans-serif"><span style="font-size:16px"><br></span></font></div><div dir="auto"><span style="color:rgb(34,34,34);font-family:"helvetica neue",helvetica,"nimbus sans l",arial,"liberation sans",sans-serif;font-size:16px;background-color:rgb(255,255,255)">Duloxetine inhibits the reuptake of serotonin and norepinephrine (NE) in the central nervous system. Duloxetine increases dopamine (DA) specifically in the prefrontal cortex, where there are few DA reuptake pumps, via the inhibition of NE reuptake pumps (NET), which is believed to mediate reuptake of DA and NE.</span><sup style="margin:0px;padding:0px;border:0px;line-height:1;font-family:"helvetica neue",helvetica,"nimbus sans l",arial,"liberation sans",sans-serif;font-size:0.75em;background:none rgb(255,255,255);white-space:nowrap;color:rgb(34,34,34)"><a href="https://en.m.wikipedia.org/wiki/Duloxetine#cite_note-53" style="margin:0px;padding:0px;border:0px;font-style:inherit;font-variant:inherit;font-weight:inherit;line-height:inherit;font-family:inherit;font-size:12px;vertical-align:baseline;background:none;text-decoration-line:none;color:rgb(107,75,161)" rel="noreferrer noreferrer" target="_blank">[53]</a></sup><span style="color:rgb(34,34,34);font-family:"helvetica neue",helvetica,"nimbus sans l",arial,"liberation sans",sans-serif;font-size:16px;background-color:rgb(255,255,255)"> Duloxetine has no significant affinity for dopaminergic, cholinergic, histaminergic, opioid, glutamate, and GABA reuptake transporters, however, and can therefore be considered to be a selective reuptake inhibitor at the 5-HT and NE transporters. Duloxetine undergoes extensive </span><a href="https://en.m.wikipedia.org/wiki/Metabolism" style="margin:0px;padding:0px;border:0px;line-height:inherit;font-family:"helvetica neue",helvetica,"nimbus sans l",arial,"liberation sans",sans-serif;font-size:16px;vertical-align:baseline;background:none rgb(255,255,255);text-decoration-line:none;color:rgb(107,75,161)" rel="noreferrer noreferrer" target="_blank">metabolism</a><span style="color:rgb(34,34,34);font-family:"helvetica neue",helvetica,"nimbus sans l",arial,"liberation sans",sans-serif;font-size:16px;background-color:rgb(255,255,255)">, but the major circulating metabolites do not contribute significantly to the pharmacologic activity.</span><sup style="margin:0px;padding:0px;border:0px;line-height:1;font-family:"helvetica neue",helvetica,"nimbus sans l",arial,"liberation sans",sans-serif;font-size:0.75em;background:none rgb(255,255,255);white-space:nowrap;color:rgb(34,34,34)"><a href="https://en.m.wikipedia.org/wiki/Duloxetine#cite_note-54" style="margin:0px;padding:0px;border:0px;font-style:inherit;font-variant:inherit;font-weight:inherit;line-height:inherit;font-family:inherit;font-size:12px;vertical-align:baseline;background:none;text-decoration-line:none;color:rgb(107,75,161)" rel="noreferrer noreferrer" target="_blank">[54]</a></sup><sup style="margin:0px;padding:0px;border:0px;line-height:1;font-family:"helvetica neue",helvetica,"nimbus sans l",arial,"liberation sans",sans-serif;font-size:0.75em;background:none rgb(255,255,255);white-space:nowrap;color:rgb(34,34,34)"><a href="https://en.m.wikipedia.org/wiki/Duloxetine#cite_note-Bymaster_2005-55" style="margin:0px;padding:0px;border:0px;font-style:inherit;font-variant:inherit;font-weight:inherit;line-height:inherit;font-family:inherit;font-size:12px;vertical-align:baseline;background:none;text-decoration-line:none;color:rgb(107,75,161)" rel="noreferrer noreferrer" target="_blank">[55</a></sup><font color="#3c4043" face="roboto, helveticaneue, arial, sans-serif"><span style="font-size:16px"><br></span></font><br><div data-smartmail="gmail_signature" dir="auto">-----------------------------------<br>Frank Wimberly<br><br>My memoir:<br><a href="https://www.amazon.com/author/frankwimberly" rel="noreferrer noreferrer" target="_blank">https://www.amazon.com/author/frankwimberly</a><br><br>My scientific publications:<br><a href="https://www.researchgate.net/profile/Frank_Wimberly2" rel="noreferrer noreferrer" target="_blank">https://www.researchgate.net/profile/Frank_Wimberly2</a><br><br>Phone (505) 670-9918</div></div></div><br><div class="gmail_quote"><div dir="ltr" class="gmail_attr">On Mon, Mar 11, 2019, 11:57 AM Steven A Smith <<a href="mailto:sasmyth@swcp.com" rel="noreferrer noreferrer" target="_blank">sasmyth@swcp.com</a>> wrote:<br></div><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex">Frank -<br>
> Perhaps annoying clarification. The word closure has two important<br>
> meanings.<br>
><br>
> In a topological space a set is closed if it is the complement of an<br>
> open set.<br>
><br>
> In the more concrete case of Rn, which we're talking about, a set is<br>
> closed if it contains it's limit points (boundary).<br>
><br>
> The other use of closure is the one Glen(?) mentioned. The sum of two<br>
> elements in the set is in the set and the same for other operations.<br>
><br>
> Barry, help!<br>
<br>
Yet more good elaboration/correction. I think for Nick's benefit, the<br>
second one is *most* relevant, comes closest to your own original<br>
common-sense idea of "walking around on a surface without falling off"? <br>
Cannot 2 be derived from 3 with the right assumptions?<br>
<br>
Also, I hope your nerve pain is subsiding... I guess this bodes poorly<br>
for your tennis game? At least overhead slams and solid serves, unless<br>
it is your off-hand that is afflicted?<br>
<br>
I'm unfamiliar with the pain meds you mentioned (really all outside of<br>
the basic salisylic acid, acetomenophen, and ibuprofen. I was hoping<br>
your report of the two med's efficacy would lead to some elaboration on<br>
the question of change of behaviour without change of brain state? <br>
Where do these meds act? In the brain tissue itself? On the pinched<br>
nerve? Somewhere in between? And does that just beg the question over<br>
into whether the spinal chord and the entire nervous system are<br>
nominally "part of the brain"?<br>
<br>
- Steve<br>
<br>
<br>
<br>
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