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A, Amygdala

A, Amygdala

I woke up this morning thinking: Amygdala.A2Z-BADGE-0002015-LifeisGood-230_zps660c38a0

This is explainable by two facts – 1. the A to Z Challenge starts today, and 2. my dad is facing a decision on prophylactic brain irradiation following chemo for lung cancer, and this decision includes the possibility of cranial sparing of the hippocampus at a treatment center far from home.

Amygdala? Hippocampus? Prophylactic what?

These are the things you shouldn’t need to think about. Like the names of chemotherapy drugs and survival statistics.

Why ‘amygdala’? Some part of my medical training must have floated to the surface during the night, reminding me of the anatomy of the brain. The amygdaloid bodies (there are two, you see), sit adjacent to the hippocampus (the latter needed for short-term memory, executive brain function), and are part of the limbic system, the feeling/remembering/adrenalin/smelling center of the brain.

Prophylactic Cranial Irradiation - this is 'a thing'. 
It even has its own acronym: PCI

Apparently the brain is brainy enough to have a layer of protection against the chemotherapy drugs, making it a safe haven for cancer cells after the rest of the body has evicted them, thus the radiation works to to make the brain a hostile environment, to create a travel alert for cancer cells, so to speak. The kink in that plan is the cognitive deficits caused by the radiation, and they can be long-lasting, affect memory and processing and personality. Of all the information thrown at my parents, this was the hardest to digest. in a few short months, they will need to decide whether to radiate Dad’s brain, or let the cancer get at it. There are some treatment centers (Sydney, Australia, and note the current trial at John Hopkins) that will ‘spare’ the hippocampus (storer of long-term, ‘declarative’ memory) during radiation, making these deficits less likely. Great.

But how, I need to know, does it make sense to spare the hippocampus without sparing the amygdala?

“The amygdala is shown in research to perform a primary role in the processing of memory, decision-making, and emotional reactions.” (Wikipedia).

A well-oiled amygdala means social connections, 
assertive behavior, clear decision-making. 
This much I knew, the rest I had to google.

What I’ve come to understand is that the amygdala is part of what makes us who we are – part of our uniqueness, integrating emotional memories and responding in a unique way. My husband’s mother had Alzheimer’s and I ‘get’ that this loss can be the worst of all the cognitive losses. Sharp edges of personality slipping into a soupy well.

So right, all very depressing, but this explains why I awoke thinking ‘amygdala’. Or does it? Letting go of any control of somebody else’s cancer journey is so much harder than it sounds. And this kind of nitpicking research and questions for the belabored oncologist is not helpful, I’ve learnt. Then why?

Could this obscure noun be visiting to spray 
a potpourri scent on my own state of mind?

Truth is, concussion and sick-dad aside, I’m afraid I’m mid brain-fart. Yes, some stinky brain butt has expelled stinky gas into my amygdala, putting me into a state of brain-takes-flight-atitis where inflammation of said flight creates a nowhere trajectory. In other words, I’ve lost my mojo. Baby.

At this moment, I don’t know what to do with my life, I don’t know how I feel, including how I feel about not knowing what to do with my life. If I were to break it down in Web MD decision-tree manner, this delirium includes:

– apathy

– distractibility

– poor/no decision-making

– lost in the world

– lack of direction

Perhaps you can relate? An overloaded amygdala? Too bloated with emotional memories to work with the rest of the limbic engine. Sharp edges of personality slipping into a soupy well. Well that’s today anyway.

Which brings me to tomorrow, ‘B’-day. Because B, obviously and declaratively, is for brain-fart.

Unless I wake up thinking something else entirely.

 

Footnote:

A number of studies regarding a patient with little to no amygdala function, cited in this article, outlined findings suggesting: “.. the amygdala plays a role in memory and in the modulation of social and emotional behavior,” “the amygdala plays a pivotal role in triggering a state of fear,” “the amygdala is necessary for linking external stimuli to the elicitation of appropriate social behavior and to the appropriate experience of emotion, particularly negative emotions.” The patient exhibited “impaired recognition of social and emotional information.” On Healthline: “The abnormal working of the amygdaloid body can lead to developmental problems, depression, anxiety, and autism.” This study discusses hippocampal-sparing.

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© Robyn T. Murphy

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