A Vivid and Unique Explaination of A Stroke

Yes, Yes the slimfast challenge is going well. I had to hide under the stairs to drink it at school today so no one would see me. So embarrassing.

This video is a talk given by neuroanatomist Jill Bolt Taylor. She describes, in amazing detail and with great insight, her experience going through a stroke. Pretty cool if you take them time to listen. (A little long but I think the end gets real interesting). I like that, even as a neuroanatomist, she still ties her experience into a greater context of energy, spirituality, transition, and the world today.

http://www.ted.com/talks/view/id/229

"One morning, a blood vessel in Jill Bolte Taylor's brain exploded. As a brain scientist, she realized she had a ringside seat to her own stroke. She watched as her brain functions shut down one by one: motion, speech, memory, self-awareness ...
Amazed to find herself alive, Taylor spent eight years recovering her ability to think, walk and talk. She has become a spokesperson for stroke recovery and for the possibility of coming back from brain injury stronger than before. In her case, although the stroke damaged the left side of her brain, her recovery unleashed a torrent of creative energy from her right. From her home base in Indiana, she now travels the country on behalf of the Harvard Brain Bank as the "Singin' Scientist."

Confesssion of a fat boy and the slimfast challenge.

So, I knew I was getting a little hefty. It has been a long winter with mostly sitting in class from 8am-4pm for excercise and then studying into the night. I get a fair amount of yoga in during the week but that has not been cutting it. Plus, I am down to about 3 days of skiing this winter from the norm of around 80-100.

So, I finally sacked up and got on the scale three days ago. 198! AHHH. I was down to 176 in Colorado, my all time low, just a winter ago. (My high was 210 in college when I was weight lifting and training for my collegiate sport a lot). What happened to me? Medical school happened. Apparently, this is a concern for my medical school colleauges as well.
http://lonecoyote11.blogspot.com/2008/03/you-are-what-you-eat.html

The funny thing is that I am not really that fat. Being big already (6'2" and medium build muscle-wise), an extra 20 pounds sort of disperses on you. I can still run 6 min miles, ski skin all day, and do 1.5 hrs of hot yoga with no trouble but I just got this extra layer! The other thing is that I actually eat well. I cook with my girlfriend and I avoid processed foods 99% of the time. I think what is really getting to me are the stress hormones, lack of sleep, and decreased excercise, not an excess of food.

So the plan. I will be 175 for summer so I feel lean and mean for getting right back on the mtn. bike and enjoying shirtless days. How? Well, coming from someone who was a veghead for 14 years, straightedge for 6, and an competitive athelete for 20, this is going to sound lamo, but I started slimfast. Mostly as an experiment. Yah, an experiment for my future obese clients, thats it. One shake for breakfast, one for lunch, and then a small dinner. The plan here is to simply reduce the number of calories I take in during one day. When I decided to try this after the 198 weigh in, I went to the grocery store so I would not let the lameness of the plan deter me. I asked the grocery store lady where they were as I could not find them for the life of me.

"Ummm. Excuse me mam? But, do you know where the slimfast shakes are? My mom wanted me to pick up a few cases for her. She is a little big."

So, off I went with 36 slim fast shakes (18 days worth) to start the medical school slimfast challenge. Amazingly, they sustain me for quite a while. I have one for breakfast and I am not hungry till lunch. I have one at lunch and I am hungry just before dinner! What do they put in these things? Crack? Nicotine? Meth? I dont care at this point. Lose the lb's and then I will be back to good food, just smaller portions.

The main thing I am missing is my glass of wine or 1-2 beers/night. BOOO! I know these are a classic useless calorie intake for me while I study but I love a little ETOH after sitting in class all day long.Ohh, well. Good to give that habit a break as well.

Weight in:
3-26 198
3-27 am:195, pm: 193
3-28 am:192, pm?

Yeah, loss of water weight and lower amount of food going through my bowels is what is going on here but hell, I will be into th 180s in no time.

Stay updated on the slimfast fat boy challege!

This Can Happen? Horrible. Who Knew? Glad I never had a pool.

http://www.ketv.com/news/15664664/detail.html

On a happier note. Spring break starts today. More like super fast catch up study session starts today. Breaks hold new value these days.

Might write something interesting soon. Hang in there.

BTW, WTF?
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2008/03/13/wtoilet113.xml

Perspective

Ahhh. I am back from a 4 day backcountry ski trip into the mountains. Time in the mountains is always a spiritual and emotional journey for me. It gives me perspective on life. On this trip, it put my medical education back were it belongs: as part of my path rather than a life consuming monster that defines me. Sometimes you got to shove the beast back under the bed.

opps...Time to catch up on work, got to go ;)

Violence

Tonight I am sitting in a cafe reading about Type 2 Diabetes. Or trying to....there are 3 teenagers next to me yelling and pointing to their computer screens. Each one has their own separate war game going on.

"ahhh! Joe, he just blew up!" "I shot him with a rocket."
"That was sweet."
on and on....

This love of violence is becoming absurd. I will admit that some video games (limited) penetrated my adolescent years as well, but come on....they are getting worse. This level of violence, in my opinion, all stems from shitty, violent world leaders. Like Bush. Leaders should outright reject violence, not pursue it. I wonder what the world would be like if each country committed to electing a peace activist as leader? There would still be problems, inequality, conflict, and elements of violence but we would not resort to war and violence so quickly and with such pleasure.

I was looking through a Rolling Stones magazine on my lunch break in the library today just trying to read up on good 'ol Jack Johnson: king of chillness and cool. Instead, I wandered upon a picture of two American soldiers proudly and laughingly displaying the decapitated head of an ALLY. Yes, someone who had collaborated with them.
(I had a hard time finding the picture on the web but if you want to see it, the picture is on this blog entry:
http://oldhickorysweblog.blogspot.com/2008/02/nir-rosen-on-iraq-war.html
and no, it is not photoshopped as accused by the conservative comments)

I felt sick. The physical image of a body less head made me feel sick. My doctor persona became defensive. How can this make you feel ill? Are you not trying to become a EM doc or maybe even a surgeon?

Later after class, I entered the cadaver lab to start working on some spines. I recently started a new job dissecting on my spare time, partly for a little cash but mostly to secure a job working over the summer in the anatomy lab. Next to me, my classmate was working on a decapitated man. I took the time to look at the corpse, the person. I could look right into his jugular veins descending into his unopened thoracic cavity, the severed nerves, and the sliced vertebra and muscles...

and then it hit me. It was not the decapitated head that had stirred my guts earlier in the day, it was just the shear level of violence, evil, and terror insinuated. This was an obvious betrayal, a disgust, a representation of why we are hated all over the world. The man in the picture died in one of the worse possible ways. And we laugh in amusement. On the other hand, the man without a head in front of me had donated his body out of love and for the sake of science and helping others.

It was not the bodies or the gore after all. It was simply the intentions associated with each decapitated human.

I can still be Juvenile!

I am really loving my Osteopathic medicine education. Not only do we learn what the Allopathic folks (M.D.s) get to but we also learn some great hands-on techniques that only add to our bags of tricks when treating patients. For those of you who still don't know what an Osteopathic Physician is in the United States I refer you to the wonderful wikipedia!
http://en.wikipedia.org/wiki/Osteopathic_medicine

Osteopathic medicine is not for all doctors, but it works well with my personality, philosophies, and goals. Besides, why not add in a little holistic, hands-on care when the drugs seem to be filled with issues of late.

See:
http://www.sciam.com/article.cfm?id=expensive-sugar-pills-wor
I mean 80% pain relief with sugar pills? Only the expensive ones? Does America even know what pain is anymore?! Shows how people seem to think that today's pills have all the answers.

See:
http://news.bbc.co.uk/2/hi/health/7263494.stm
yummy...pills! They make me feel better! Or do they?

See:
http://www.usatoday.com/news/health/2004-10-12-vioxx-cover_x.htm
Ummm. Sometimes the pills just kill you!


Don't get me wrong. I understand the value of drugs in Medicine and will likely spend more time prescribing them than doing manipulations, but there is something to be said for actually touching your patient and maintaining a sense of simplicity in practice when warrented.

Anyhow...enough seriousness. The actual objective of this post was to point out some of the hilarious manipulations and treatments I have come across in my first year of school. They bring out the immature teenager in all of us during lab time.

"Hey man! You better be quiet or I am going to give you the obturator!"
"Hey Mike, I have not gotten to practice the ischial tube spread in a while, do you mind bending over?"


While we learn several modalities in our first year, including HVLA (high velocity low amplitude/ "cracking"), muscle energy, soft tissue, and balance ligamentous tension, the common culprit is a treatment called "Counterstrain".

In all fairness, this treatment is a pretty amazing accumulation of knowledge and works quite well. Counterstain works to address somatic dysfunctions that result in "tenderpoints", most commonly found in muscle bellies or muscle attachments. The physician first identifies the point and then positions the patient to maximally relieve the discomfort. The physician holds the patient in the maximally relaxed position and then slowly returns the passive patient to a neutral body position. The physiological basis for this is quite interesting, however I will not address that here. (See Figure 1. below)





















This maneuvering puts both the patient and physician into some pretty awkward and funny positions. Hands also end up in interesting places. You get to know your classmates well.


SOME OF THE BEST...

Figure 2. My favorite. The obturator. The obturator internus is a small muscle under your gluteal muscles that helps you laterally rotate your hip. Sometimes it gets sore. Treatment: Well, look for yourself.





Figure 3. The Anterior Upper Thoracic Tenderpoints. Aka, the Boob grab.

Figure 4. The Adductor Treatment. Aka: the testicular flick.

Figure 5. The infraorbital tenderpoint. AKA: the smother.

Figure 6. Not counterstain but a great Tx regardless. The ischial spread.

So rest easy. Know that for every ache, sore, and dysfunction you have, we Osteopathic physicians have a treatment.

By the way, anyone want to volunteer to be a practice patient...?

Still trying to figure out how I would not get sued when working in a ER using these particular techniques.