Nope, it's stopped. It was really only a thing for the ~4 months where I tried to treat a sleep disorder at home by intentionally establishing a 48-hour sleep cycle. Said sleep disorder is being treated properly now—with appropriate drugs, under medical supervision—and accordingly, I neither sleep for 12-18 hours nor stay awake for 30-36 hours on anything like a regular basis.
Whoa! It never occurred to me that the answer would be "your entire skin" but that makes so much sense. Weird but super cool, thank you!
would people be interested in a long but semi-thorough walkthrough of 'how to make up your own disease without succumbing to A Wizard Did It'? which mind, 'a wizard did it' isn't bad, but for some setting, something more realistic might be needed, and the topic's cropped up a few times in this forum so like, maybe a masterpost would be a good idea if people would enjoy that?
Alright, let's start with the basics: What Is Your Infection Even? Infectious agents can be (broadly) classed into five groups, and which you pick makes a major difference in how treatable your disease is. The rough split is: bacteria viruses parasites (the broadest group, ranging from fully formed nematodes to single cell protozoa, but in this case specifically endoparasites, not things like fleas or lice.) fungi prions most people will be most familiar with bacterial and viral infections, on account that most of us have experienced them before. Which one you pick influences what symptoms your infectee will exhibit. Some symptoms are relatively common and unspecific. For example, fever, inflammation, coughs and sneezes, as well as a general feeling of malaise is something your OWN body does to you, in reacting to an infection. Anything mucuous related: your body is trying to 'flush out' the infection, especially if it's something that's entering through your mucuous membranes Fever: many infectious things like to live at very specific temperatures. Cranking up the heat might kill them. It might also kill you, if your core temp rises too high. This is the hunger games. Inflammation: your immune system sends white blood cells (further: WBC) to the entry site of the infection, trying to take it out at the root. As the infection progresses, the inflammation might too. This is also were pus comes in. Pus is bascially mostly dead WBC and 'melted down' cells. Pus color can changed based on what's in it. Feelings of malaise: fighting an infection is HARD work for your body, so being fatigued is fairly normal Then of course, symptoms might get more specific, based on the location of the infection (lungs vs intestine) and the infectious agents. Bacteria have their own metabolism. Their metabolic products can hurt you beyond the immune response. For example, the cramps associated with tetanus are from the toxin the bacterium in question produces. The same is true for botullism, but instead of cramps the muscle goes slack. If you got for a bacterial infection, be aware that the bacterium needs to eat, which is why for example bacterial infections in the spinal fluid result in reduced glucose levels in there: the bacteria eat the glucose. Parasites ALSO have their own metabolism. But they're generally closer to human metabolism, making specifically targeting them potentially risk if you don't wanna hurt the host. A 'good' parasites wants its host to live as long as possible so that it can reproduce and infect new people. That means that a parasitic infection can be very, very lowkey. It's possible to carry intestinal parasites around for a longass time and never notice. They do this, in part, by tricking your immune system into not noticing them. However, when it does notice, you're likely to see a spike in eosinophiles, a specific group of WBC. Since parasites are such a broad group, they can cause a VERY broad range of symptoms, depending on where they live, what their life cycle is like, and if humans are the target host. Parasites are often VERY host specific, and getting a parasite into the wrong host can result in 'basically nothing happens as the parasite just shrivels up and dies' to 'the parasite find the wrong organ and proceeds to cause devastating damage'. For example: brain amoeba: BAD. Myxobolos cerebralis (a cnidaria that lives on fish): won't even infect you. Parasites often don't travel directly from human to human but go over an additional species that they need to complete their life cycle, like invertebrate (snails are popular, as are insects). Depeding on what tissue they live in symptoms can vary wildly. Malaria ones live in your blood cells and thus will involve hematological symptoms like anemia. Parasites confined to your intestinal tract will most likely cause intestinal symptoms like diarrhea or constipation. They might only cause symptoms during specific parts of their live cycle, so symptoms may come in 'waves'. Fungi also have their own metabolism. Infections can range from relatively benign like athlete's foot, to potentially devastating ones like aspergillosis. Fungi like a very specific environment, so you're unlikely to find one species that infects a large array of host species. Transfer from human to human is possible and even likely. They are, effectively, something growing on/in your tissue. Generally, in an otherwise health human, you won't see systemic mykosis (fungal infection), but something that's on the surface (skin, nails, hair) or mucous membranes (yeast infections ahoy). Topical treatment is usually sufficient. In immunocompromised people, having the fungus enter the body, often through inhaled spores in the lungs, can be a serious problem. Even if you have a fungus enter the body of an immunocompetent person, it's likely to not do anything at all, or not do anything worse than above mentioned feelings of general 'sickness' that passes on its own. Treatment here is antimykotica, Viruses DON'T have their own metabolism, they rely on your cells' to multiply. That means that they have to enter your cells, and to leave they destroy them. This means that whatever tissue the virus lives in gets damaged. As such, a virus that lives in your skin will produce different damages that one that lives in your nerve cells. Viruses tend to be rather host specific and something that's usually only found in birds will have to work hard to infect a human. That's of course not true for all of them ('sup Rabies) but the larger the species barrier, the less likely a virus will be able to work across them. A virus that infects a plant is virtually impossible to infect a human, one that targets fish is unlikely to hit dogs etc. Last but certainly not least: PRIONS. If you wanna give an epidemiologist palpitations, ask them to imagine air-borne prion infections and watch them pale. Like a virus, a prion has no metabolism on its own. That's because a prion isn't even alive. It's just a protein that's folded wrong, and it has a devious, DEVIOUS ability: if it comes into contact with proteins that are folded right, it can 'covert' them into the wrong folding. All currently known prion diseases are neurodegenerative. They tend to have fairly long incubation times, as they basically gotta convert enough proteins to start showing effect. They are really, seriously, terrible hard to destroy. The things that work to disinfect stuff otherwise, like bleach or autoclaving straight up don't work on these fucks. As mentioned, all known ones are neurodegenerative, meaning they impact mental function and the ability to move. Alzheimer, scrapie, kuru and familiar lethal insomnia are all examples of them. They can be inherited but they can also be infectious. They basically kill your nerve cells by accumulating in them until they die. Speaking of infectious, let's speak of venues of infections: Depending on where your infectious agent lives, different bits might be infectious. An intestinal parasite won't show in your coughs, etc. This also influences how easy it is to catch an infection. Generally, the less direct contact you need, the easier it will spread, so things that can be smeared on surfaces and then stay infectious on there for a while, or those that are straight up airborne tend to have the easiest time. That's part of why ebola is not as scary as it looks at the first glance: yes it's a terrible disease, but it requires direct fluid contact to get to you, so proper hygiene can do a lot to limit spread. Meanwhile even with hygiene at its best, flu can run through a population seriously quick because you can catch it by inhaling infected droplets from someone's sneeze. If you want something that's VERY infectious, you virtually always want either airborne, or depending on hygienic standards, water borne. Water borne ones like to be fecal-oral, meaning they live in the intestine, get pooped out, enter the drinking water supply and are consumed by a new host. Parasites generally don't do human to human and like intermediate hosts, though since 'parasite' covers such a massive field. What else you need to do is determine how much it needs to infect someone. Is a single exposure enough? prolonged exposure? Do ten infectious particles entering the host do the trick or does it need a lot of them at once. A disease that needs a looooot of exposure to get to a new host is less dangerous than one that just need you to take one wrong breathe, or drink one tainted glass of water. Another factor is incubation time. This means the period from 'patient becomes infected' to 'patient starts showing symptoms'. This can vary WILDLY. Flu tends to hit you within days of sufficient exposure, whereas even untreated HIV can take years to become clinical. There is a caveat here: some things already are infectious before the patient starts showing symptoms, and it's possible for an animal or person to show no symptoms at all, EVER, while still shedding infectious particles left right and center. Generally, the longer a patient is infectious but not symptomatic yet, the better they will be at spreading their disease. Nobody wants to play tonsil hockey with someone who's already bleeding from their eyeballs or snot running out of their nose. now let's move onto treatments. Bacteria: Antibiotics Parasites: depends on the parasite! treatment options can range from 'physically remove parasite' to 'give med, wait' Fungi: Antimykotica Viruses: Virostatica (stop the reproduction). Virozides (kill the virus) are not currently available as meds Prions: Nothing. You Are Fucked. All the first dour can have issues with forming resistances, which is part of why virostatica are not used broadly. People made that mistake with antibiotics, we're trying to learn from this. It's possible to test for this beforehand, either genetically, in case of known stuff like MRSA, or via sensitivity tests on an agar plate. This is particularly relevant to things to you CAN culture on a plate, so mostly bacteria, followed by fungi. Viruses, having no metabolism of their own are hard to culture in a regular lab. As a result, cultures are common to ID bacterial infections, but for viruses PCRs are your friends. It's potentially possible to treat viral infections by injection existing antibodies into the patient to help the patient's immune system get the job done but this is still kinda in the testing phase (interesting article go here) As mentioned, prions take no fucking prisoners and are not just untreatable, they're as far as we're aware, invariably fatal. Right, got the basics down? i know it's a lot of epidemiology is tricky. Let's apply it to an example: ZOMBIE OUTBREAK!! For the purpose of this, let's assume that the 'zombies' in question aren't actually dead, but just in an altered mental state, maybe comparable to rabies. Now, how would a classic zombie outbreak fare? Let's lay down some basic parameters: neurological symptoms (aggression, attempt to bite, reduced pain reception, problems with fine motor control), spread by bite, human to human Bacterial: this could possibly be a variant of a meningokokken infection. This one can already be passed on airborne, via droplets, since the bacerium likes to sit in your nasopharyngal cavity (further: NPC). It often causes pussy infections of the menings aka the membranes around your brain. That means neurological symptoms are likely, such as extreme fatigue, photophobia, apthy etc. A limiting factor here is the speed of the infection. The bacteria need time to grow so you can't go bite -> infection in a matter of hours. Remember these things have their own metabolism and need to grow and divide. They need time for that. In the case of a bite, I think we'd be more likely to see a septic case than a meningal one, meaning that your patient might well die long before showing zombie symptoms. Treatment comes by 'the earlier the better' and in the shape of antibiotics. As a result, treatment may happen before you truly have a secure diagnosis. Delayed treatment can both kill your patient, or if it doesn't, result in permanent consequences such as deafness or epilepsy. The spread through airborne particles makes this a good candidate for a quick spread across populations, but the potentially very quick death can limit it again. also there's several vaccines available, making it easier to potentially adapt a new one, even if the current one provides absolutely no protection, plus good hygiene can seriously limit this one. Viral: Why rabies of course. It already comes with the biting behaviour and aggression, great. It's even invariably fatal. The problem is of course that we have a vaccine, and post exposure treatment, as well as rabies apparently slow going mutation (unlike flu. fuck flu). Treatment is... well, 'pray, do milwaukee protocoll if possible, pray more'. of course here we have the problem that a patient who starts biting people will not manage to bite very many people before someone notices. Again, the virus needs to spread to do anything, in this case, it needs to reach the brain, and then start multiplying in there before it does anything. Human to human transmission has been seen, but only in organ transplants. As such, the infection is likely self-limiting because biting is a fairly shitty way of transmitting diseases, as mentioned above. You want distance. You can want spread. Biting accomplishes neither. The other issue is that even if you with 'spreads by bite', rabies doesn't have great survival times. Viruses that kill quickly tend to self-limit, because quick death also means quickly losing your transmission vector. So worst case? You can wait it the hell out, and you prolly won't need as long as 28 Days Later would have you wait, considering that death can occur as fast as 2 days after first symptoms, though the incubation time can be longer (of course then the issue is 'is the patient even infectious before showing symptoms). Parasitic: HM. Now the issue here is that the parasite would have to do two things: number one, penetrate the blood-brain barrier and set up camp in there to cause the neurological symptoms. This is possible, but somewhat rare. Amoeba do it by traveling along the nasal nerves, but this is sort of an accident. Amoeba don't really need a human to live on. They don't particularly want to, either. We're an accident to them. Toxoplasmosis might be worth a look, but the main issue here is that humans are just a intermediate hots and neurological symptoms in healthy people are unlikely, which makes sense because again, humans aren't the goal here. The goal is cats. Biting other humans is super not useful, and good luck trying to bite a cat. Having motor problems is not gonna be helping you there. The normal cycle is for the intermediate host to become catfood, not the other way around. The issue here is again that the incubation period would be as long as it takes for the parasite to reach the brain and start multiplying enough to actually DO something. Toxoplasma specifically needs 6h to fill up a single cell ad burst out. That's the absolute minimum you're looking at to see anything, and even then just providing you got hit by a HUGE load of pathogens to begin with. Fungal: ahh, the sweet sweet call of cordyceps. Upside: known to influence host behaviour to a massive extend! downside: basically married to parasitizing arthopodes. making the jump to using humans is unlikely. Even if that happened, zombie behaviour of bitey-rage is unlikely. After all, the established pattern is to pilot the host onto an exposed point, and sprout forth the fruiting bodies from there, catching a lot of wind to spread spores. Also, as mentioned, fungal infections tend to run fairly mild in healthy people because your immune system keeps them in check. Again, this is limited by how quickly the fungus can grown inside the host, and get to the brain. An issue here is that arthropodes don't have a segregated brain, they have ganglia that just sort of lie in their bodies, and a very different immune system, compared to humans (or mammals in general). In a mammal, the fungus would have to overcome the blood brain barrier to even reach the brain. In general, unlikely to cause biting madness because there are better ways to spread if you're a fungus and prefer to be airborne anyways. Prions: The. Worst. Again, invariable fatal, invariable neurological as far as we know, no treatment. All of that makes them GREAT for a zombie diseases. You don't really have to explain the symptoms like with rabies - where biting ups the chance of spread - because prions are just proteins. Accidents of nature. There are also no common infection signs like fever or inflammation. The issue here is time. Prions don't work quick, in part because you need to be exposed to a fairly hefty dose to start with and in part because they rely on contacting a healthy protein and folding it over. Most of the relevant proteins are in the nerves and particularly the brain. The protein doesn't influence where it's occuring and in fact works by clogging up your nerve cells until they die (far as we can tell), so secretion through saliva is exceedingly unlikely. Infection through consumption of tainted food is possible, and in case of BSE and Scrapie even very very likely, but that would need a healthy person to bite the zombie, not the other way around. The incubation period is seriously long and again, since the infection takes quit a bit of work, it's not a great pick for a zombie disease. UNLESS.... well. Unless you make it much easier to spread. If the prion for some reason sheds into body tissue like the mucous membranes...then you have a potential pandemic of terrifying extend at hand. Think of HIV. Then think of HIV that has absolutely not treatment option and might not be limited to being transferred by direct fluid contact. An airborne prion disease would be a nightmare to deal with, in no small part because it might take years, even decades, before you even realize that you HAVE a pandemic, at which point the spread through the population might be staggering. So for a quick working zombie disease? bad choice. But if you manage to make it easier to spread...then it has a great potential for apocalyptic scenarios. For a quick working one, you should go for one of the others. A rabies relative if a popular choice for good reasons, since it comes frontloaded with most of the symptoms. The speed shown in many a ZomieOutbreak movie is still unattainable, but it fits the description well enough otherwise, and if you manage to knock out available treatment options, this can turn into a short term crisis.
I've wondered this my whole life, and I have a question related to this as well, if that's okay: why does the flu shot seem to hurt more some years than others? Obviously they're inoculating against different strains every year, but is that why some years it hurts really bad and some years it's okay?
Because it triggers tge immune response, which includes inflamnatiobs! Those tend to include a tenderness and ache, thus injection ow. This is also why shots can lead to a slight fever and feeling a bit under the weather: these symptoms are caused by your own body becoming active against a suspected infection.
In addition to what Owlet said, a really ridiculous factor that can influence how much an injection hurts is... the positioning of the needle and where in the skin and muscle it hits. I call it proper poking technique. needles have an angled point that should be positioned in different directions. for drawing blood, the 'slope' should be up, to help break the skin - but for intramuscular injections it should be to the side to follow the lines of the muscle fibers and 'slide' between them without breaking them. Some people don't really check which way the needle is going, and while it's not a lot of difference it can make it more painful because the needle isn't gliding as easily. Also, the skin and muscle is full of all kinds of receptors - nerves specialized in detecting stimuli. they're more concentrated in your hands and less concentrated in your arms and forearms, and it can happen that a particular injection goes in an area that has less pain receptors - and so it hurts less. as for variations between medications, oily formulas hurt more than watery formulas because, roughly speaking, they are thicker and take longer to absorb - so they stay in place letting the local pain receptors know that there is something strange going on there for longer.
oh interesting! when i was taking my T via needle, i never thought to check which way the point was angled, i just thought the wide variation in how much it hurts had to do with the fact that my outer thighs don't have a lot of nerves so maybe i was sometimes hitting a less-sensitive bit of skin. T is oil based and it definitely hurt a lot more than water based injections i've had. i have a bio question for you. Inflammation: What The Fuck. <- basically a novel my body is writing. my body likes to be inflamed basically all the time. it varies from day to day how bad it is, and doesn't seem to respond to any environmental inputs at all. sometimes i'll be exposed to a ton of allergens, for instance, and have a huge allergy attack, but the inflammation confines itself sedately to my lower back, keeping the damaged region of my spine company in case it gets lonely. other times, i'll be having a nice respite from allergens -- house kept vacuumed, neighbors not burning anything for once, clean sheets, no rummaging in the basement -- but i get Sausage Fingers for days and my face puffs up so i don't recognize myself. it's not just my face and hands, of course, my entire body feels overinflated and hard to bend, but the face and hands are where it's most noticeable. i'm on a diuretic for it, which i call the Pee Pill, and it makes me process a LOT of liquid. this does help a bit -- the sausage fingers don't get bad enough that i can't type, though still sometimes bad enough that i don't want to. i'm also on 800 mg of ibuprofen 3 times a day for my back. i eat/drink things that i'm told counter inflammation, such as cranberry juice. but it's still doing its thing. what i want to know is, what the hell is my body thinking. like, why would 'overinflate the entire body' even be an option? and why does nothing fix it? doctors tell me it's because of my spine barnacles, which makes sense as an origin story, but how does 'these vertebrae are grody' translate into 'sta-puf marshmallow man cosplay forever'?
“Immune response that doesn’t have to do with anything obvious” was a friend’s sitch and they turned out to have an autoimmune disorder. Idk if that’s plausible in this case though
Yeah honestly this pings me like something into the autoimmune corner. Your body most certainly shouldn't be dancing the Inflammenco all over your everything. It's entirely possible for an autoimmune disorder to be triggered by a singular event like your spine thing, but I'd poke them about checking autoimmune things, especially if it occurs basically independently of external stressors.
I don't want to derail from the actual subject, but can I just briefly note that this is an amazing turn of phrase?
The side of the tigh does have less tactile receptors than the rest of it - like for the upper limbs, most of them are concentrated on the feet! - but all of those are factors for why T hurts. As for the inflammation question, I nth the recommendation to ask your doctor about it first of all! second, Immunology is a second year subject so I haven't studied it in-depth yet, but I can try to sum up from what i already learned. So, your body produces a variety of hurt juices - interleukins and other cytokines - and cells react to these juices in different ways depending on the combination, that is, they are signals to cells. These are produced by leukocytes, your defense cells, and they come in a variety of types depending on their function. Two important types of defense cells are mastocytes and basophils. They are sibs from different cribs - they have different origins but are very similar, in which they carry grains in them that are full of histamine, heparin, and a bunch of other hurt juices that are released when the antibodies stuck to their membranes connect to their antigens, which can be basically anything that isn't how or what it is supposed to be where it is supposed to be or anything not from your body. These chemicals signal to the other cells of the immune system - the ones that actually do the job of getting rid of antigens - that there is something wrong afoot in this place of the body. Alas! the other cells in your immune system are in your blood, and most of the antigens aren't - they're in the connective tissue that makes up most of everything else. So they have to get out of the circulation to do their jobs. To get out of the circulation, the capillary blood vessels have to become less tight-knit so that these cells can slip out of the blood stream. Circulation to this place must also increase, because more immune cells are needed there. Histamine and heparin do all that. This all means vasodilation, and an increase in blood flow, blood pressure, and vascular permeability. With all that, some of the water that makes up your blood escapes to the nearby tissue and can't go back - hence, the diuretics working to reduce swelling, but not solving the issue completely. Osmosis also has a bit to do with it, because you're changing the concentrations of solutes and water flows to where there is more stuff and less water. (edema can also happen if your liver is not doing a good enough job at making blood proteins, particularly albumins, or if your kidneys are having issues filtering your blood and some of these proteins are ending up in your urine. pain medication is either liver or kidney-toxic, but as you have medical supervision i assume your chronic pain doctor is checking those and this is more of a curiosity thing. just... give them a shout out if your swelling lasts a long time and you turn yellow or start having foam in your pee) The other cytokines to the rest of the inflammation job, like induce fever and make you feel like generalized crap, as well as some other chemical environment balances that are needed to get rid of the issue. Mastocytes are specially bitchy about allergens, and tend to freak out very easily. An allergic reaction happens when you have so many antibodies for a real dumb antigen, that your mastocytes are hypersensible and release way too much histamin. There's a lot more complexity to the whole thing than that, and that's the reason why immune disorders are such a pain in the ass. Allergies and inflammation can be triggered by pretty much anything your body feels like fighting today, and they can play together in confusing ways, and if you still have this doubt by december 2020 i would be able to give a much better answer :p
How do painkillers actually work? How do they just affect the sensation of pain and not other sensations?
