The Entire Human Body is Plastic
It isn't just the brain
**Each entry on this blog comes with an OVER-THE-COUNTER MEDICATION TIP at the end.***
We hear a lot about neuroplasticity these days - it’s one of the sexiest anatomical topics, according to the media. Neuroplasticity is the brain's remarkable ability to adapt, regenerate and regrow itself in the face of damage. In my job as an ER doctor I see neuroplasticity in action, and it is indeed remarkable. I often order CT scans of people’s heads, perhaps for an injury or for a severe headache, and occasionally I’ll find huge cysts in the brain that have probably been there for the patient's entire life (and that have nothing at all to do with the injury or the headache).
I’ve seen some shockingly large ones too. In one patient I saw a few years ago, the cyst took up one half of the entire skull’s inner real estate. That cyst was smooshing the man’s brain into the other half of his skull, and so his brain only had half the normal space to grow and operate. And yet his brain was working just fine. Neurons, the brain’s electrified cells, are remarkably adaptable, and, even when smooshed into a much smaller skull, they can still carry on their function . He was a completely normal functioning adult with no mental or physical handicaps. That is some impressive neuroplasticity.
The truth is that every body part has the same remarkable ability to compensate and adapt in the face of injury (or smooshing). In other words, our entire bodies have the same plasticity. Two examples from my daily job:
Blood vessels which feed oxygen and other nutrients to every one of our cells are dynamic and can grow around blockages. People with chronic blockages in their coronary arteries (“coronary artery disease”) often compensate over years by sprouting new circumventing paths through which blood can flow to the heart’s cells. In this way, blood vessels are like dynamic waterways on the earth’s surface: when a rock slide newly dams up a stream, the water eventually finds a new route around it, just as the body’s cardiovascular system carves new channels for blood flow. These bypassing channels are visible during cardiac catheterization and are called “collaterals.”
One more example: removal of the gallbladder is among the most common surgeries performed in the US every year. The gallbladder functions as a reservoir for bile. Whenever we eat, the load of bile stored in it is ready to be squirted from the gallbladder, through bile ducts, and into the small intestines to help us digest food. But once the gall bladder is removed, the bile ducts adapt and take on their own reservoir function by growing in diameter. Whenever I order an ultrasound of a patient’s liver and bile ducts, I expect to see larger bile ducts if they’ve had their gallbladder removed (and the exact size of the bile ducts is very important for certain diagnoses). With the gallbladder gone, bile ducts dilate to a larger size in order to hold more bile - in other words they’ve taken on the reservoir function that the gallbladder used to provide.
The truth is that the entire body is plastic to an incredible extent, and both our bodies and our minds are more resilient than we think.
OVER THE COUNTER MEDICATION TIP (Disclaimer: this is not meant as medical advice)
While Benadryl (diphenhydramine) is the archetypal anti-histamine, it can be too sedating for use during the day. Try one of the three available non-sedating anti-histamines: loratidine (brand name Claritin), cetirizine (brand name Zyrtec, which is actually just “cetiriz…” backwards) and fexofenadine (brand name Allegra). I use the brand names here because they’re funner and easier to say, but all of them come as generics too. I’ve heard that Allegra is the strongest and Claritin is the weakest, but in my experience, different people respond differently to one or another of them. If one doesn’t work, try another one before giving up.