Hey, What’s cooking? OH MY GOD BREW! What? Oh. AAAAAAAAAH What? Why? That is so messed up. It was a prank. Got’them. What the f— Brew. What if you couldn’t feel pain, hunger, or fatigue? It might sound like a super power or a dream come true, but that’s not necessarily the case. We feel things like pain and hunger for very good reasons, so if you were to just shut down those feelings it could cause… issues. So how would you make sure you don’t hurt yourself without realizing it? And how do people who can’t feel pain keep track of their wellbeing? When most people get hit by a car, the result is… less than pretty. But for one girl, it was no big deal, really. In 2016, then 7-year-old Olivia Farnsworth was struck by a car, then dragged for 100 feet and run over. But instead of curling up into a ball of broken and battered bones and muscles until the paramedics arrived, Olivia just got up and walked back to her mother, confused and disoriented but seemingly none the worse for wear despite the skin missing on her toe and hip and a tire mark on her chest. According to the doctors who inspected her, the reason she survived was that she felt no pain, and as such didn’t tense her body during the impact. Olivia has a rare condition known as Chromosome 6p Deletion that leaves her unable to feel pain. In the words of her mother, Niki Trepak, "Doctors have called her the bionic girl, she's made of steel. She's got no sense of danger.” And there are others with a similar lack of pain response, like Ashlyn Blocker. As a 5-year-old in 2004, Ashlyn had to have ice put in her chilli to prevent her from devouring it at burning temperatures, and had to check in with the school nurse after recess every day. Unlike Olivia though, Ashlyn’s pain-free ways come from a condition known as Congenital Insensitivity to Pain with Anhidrosis but we’re going to call it CIPA because hoo boy. There’s a difference between the two—Olivia doesn’t feel hunger or the need for sleep, whereas Ashlyn does. Why is that? Well, to answer that we have to dig in to the particulars so I hope you’re ready for some Science with Brew! Yay Science. To quote the National Library of Medicine: “In the nucleus of each cell, the DNA molecule is packaged into thread-like structures called chromosomes.” These threads weave together the tapestry of who we are with DNA providing the “genetic code” as it were, telling our cells how to function. Within a human, each cell contains 23 pairs of chromosomes. Chromosome 6p Deletion is a condition where genetic material is deleted from the short arm of the 6th chromosome. Exact effects can vary depending on how much material is deleted, more frequent effects are developmental delay, intellectual disabilities, and distinct facial features. Already a rare condition found in only around 100 people, Olivia’s specific case is even more unusual in that she is the only known individual with a chromosome 6p condition to not feel pain, hunger, or tiredness. CIPA, on the other hand, also known as hereditary sensory and autonomic neuropathy type IV, on the other hand, is a more restricted condition. CIPA is caused by mutations in the NTRK1 gene, which is responsible for making proteins that ensure the survival of sensory neurons, nerve cells that transmit information about sensations like pain, temperature, and touch. The mutation causes it to create proteins that are unable to transmit signals, which in turn causes the neurons to self-destruct, and as a result leaves those with CIPA unable to feel pain. People with CIPA also lose the nerves leading to their sweat glands, which causes anhidrosis, a fancy word which here means, “the inability to sweat normally”. Ultimately the reason Olivia feels no hunger or fatigue is down to the fact that her condition has greater impacts across her body’s functions as opposed to just affecting her nerves. Ok, sounds great, no pain, no hunger, no sleep. But come on, not being able to feel those bad things sounds like a pretty bad thing. What do you mean? Imagine how much meditating you could do if you didn’t need to sleep, or eat, or feel like your muscles were getting tired? Yeah yeah, but every part of our bodies serves a purpose, even pain. It lets us know when we draw too close to the flame, when it may reach out and burn us back. It’s beautiful, yes, but a forbidden beauty… Grill’s right. Damn right I’m right. I know a thing or two. Our body lets us feel pain, hunger, and tiredness for a reason. Not being able to feel those sensations can cause issues, big ones. Returning to our case studies, Ashlyn has to be checked over by a school nurse after recess. Because she can’t feel pain, if she were to sustain an injury while playing, or even get dirt in her eye, her body wouldn’t tell her. Like hypothetically, if she wound up rolling her ankle and kept walking on it, it could damage her joint enough to not be able to support her anymore. Or as Tara Blocker, Ashlyn’s mother said, “Pain’s there for a reason. It lets your body know something’s wrong and it needs to be fixed. I’d give anything for her to feel pain.” Whoa, that seems a little mean. Is it though? Just imagine what kind of injuries you could get without even realizing it. Well according to the New York Times, when Ashlyn was 2 she put her hand on the car’s muffler and burnt her skin so badly that it seared away. Oh no ohnoohno! I take it back! I take it back! People who can’t feel pain have issues with danger perception and exhibit fearless tendencies as a result. The BBC described that most male patients with CIPA in the UK wind up losing their lives in dangerous acts, or likely damage their joints enough to become wheelchair bound. In addition, CIPA results in the inability to feel temperature and the nasty side effect of not sweating. Sweat is used to regulate body temperature, which means maintaining a healthy temperature can also be an issue for those with the condition. Other conditions, like Olivia’s specific strain of chromosome 6p deletion, leave the person unable to feel hunger pains, or fatigue. There are even some who can’t feel when they need to go to the washroom, and without those indicators life can get… messy. Without physical indicators, those who can’t feel their body needing to go through their “waste disposal” process may have to use timers to go to the bathroom regularly, and get reminders on when to eat. Though that doesn’t stop Olivia, who is apparently a very picky eater, according to her parents. Though she has been “conditioned” as the Express put it, to eat, finding food that she’ll eat can be a problem. Plus, being unable to feel tired, she takes melatonin to help her get some rest. As annoying as it can be, our sense of pain is invaluable. It teaches us what’s bad for us, and lets us know when we need things like food and sleep - both instrumental for the upkeep of our bodies. So as much as you might wish you couldn’t feel pain, well… it would only really be helpful if you couldn’t be harmed at all. So really, you could say that the whole thing is a real pain. Nice. Good one. Yeah, real funny. Yeah, oh no that was real good. Real funny there Brew.
