Thanks, Jen. You always stick up for me. Love you girl! He doesn't mean "it's all in my head" the negative way though, as in "you need a head shrink." What he means it that it is literally all in my head. When he cut the nerves, separated the branches, and relocated them into another part of my foot/feet (so they wouldn't be compressed anymore creating more stump neuromas), that messed up the way my brain saw the mapping of my nerves. Now my map has changed, and it's going to take some time to reset my brain to the new pattern. I have phantom pains, which are actually very real.
Here's what's happening according to Dr. Dellon's writings below:
Where does the Phantom Live? The location of the pain signal after amputation must be located within the amputation site, within the endings of the amputated nerves. Those nerves are within the scar, next to bone, and next to the arteries in the amputation stump. And that is where the Phantom lives.
Help for Phantom Pain is just not that complicated to understand:
1. An amputation cuts the nerve to the part that has been amputated.
2. The nerve end that has been cut, tries to grow back to that part.
3. Since the part is missing, the nerve attaches to something.
4. If that nerve attaches to the skin or the bone or a joint, then when the skin, the bone, or the joint move, the nerve is pulled, a message from the missing part is sent to the brain and the phantom appears.
5. If the nerve attaches next to an artery, and the large nerves are usually next to important arteries, then every time the heart beats, the nerve is stimulated, and this can make the phantom appear.
6. If the nerve is located next to where the artificial limb (prosthesis) fits, then, this too will make the phantom appear.
The Phantom was first described by the Neurologist, Silas Weir Mitchell, md (read more about him related to rsd in Chapter 7). In his writings after the American Civil War, in his book Injuries of Nerves and Their Consequences (published in 1872), Mitchell wrote his observations on injured soldiers after they had an amputation: “Sensory hallucination. No history of the physiology of stumps would be complete without some account of the sensorial delusions to which persons are subject in connection with their lost limbs…Nearly every man who loses a limb carries about with him a constant or inconstant phantom of the missing member, a sensory ghost of that much of himself, and sometimes a most inconvenient presence, faintly felt at time, but ready to be called up to his perception by a blow, a touch, or a change of wind.”
For anyone interested in phantom pain, check out Dr. Dellon's chapter on Phantom Pain here
http://www.dellon.com/ps/chapter.08.pdf.