The Mother of Dragons Had a Brain Aneurysm After Season 1?!

Clarke, E. (2019, March 21.) A battle for my life. The New Yorker.

I honestly picked this story because I was a huge fan of "Game of Thrones" (up until the last few season/ I named my car after Arya Stark's direwolf Nymeria but we aren't talking about that). I do a pretty alright job of keeping up with what is going on in the pop culture world, but I had never heard about any of this happening. So I was pretty surprised and captivated simply by the title, I had to know more.
The Mother of Dragons had two brain aneurysms. Wild. She obviously has made a complete full recovery from them. For the first one in 2011, she just had an endovascular coiling which just means that they took a wire through her femoral artery all the way up her body and to her brain to stop the bleeding. (How wild a wire can go from your groin all the way to your brain! Medicine is cool.) Her second procedure in 2013 did not go as planned. It was supposed to be another simple operation but she has a massive brain bleed so the surgeons had to cut her skull open and fix the problem "the old fashion way". She dealt with aphasia for a while but after a few weeks she was back to normal learning her lines for upcoming "Game of Thrones" season 4.
A personal take away from Emilia's story is just that you never know what it going on internally, so always be on your toes for any changes within yourself and those around you. No matter how healthy you are, something could easily go wrong within you and bam that could be it. She spoke about possible warning signs she and her family might have ignored like migraines and fainting as a child. Maybe if she would have gone to the doctor sooner and spoke about these things she wouldn't had to have two operations or they could have done something sooner before her first aneurysm. I feel like people need to know the signs and symptoms of when someone else is having a brain injury whether it's traumatic or non-traumatic.

https://www.newyorker.com/culture/personal-history/emilia-clarke-a-battle-for-my-life-brain-aneurysm-surgery-game-of-thrones?source=EDT_NYR_EDIT_NEWSLETTER_0_imagenewsletter_Daily_ZZ&utm_campaign=aud-dev&utm_source=nl&utm_brand=tny&utm_mailing=TNY_Daily_123119_TopTen&utm_medium=email&bxid=5c323320639ec86e604a6ea6&cndid=48059106&esrc=&mbid=&utm_term=TNY_Daily

Social Determinants of Health

So how do you define social determinants of health? To me it is when your "social status" affects your health in a way that might not be completely in your control. Yes we can all go outside and walk for 15 minutes everyday. But that becomes challenging when your town doesn't have safe sidewalks or even a small park. Or what if you simply live in an area with a bunch of factories and there air filter system isn't very efficient or what if you don't have proper plumbing on a trip to a third world country? I took a trip to London when I was in high school with my mom and the air is so polluted there that our mucus turned black. Social determinant of health automatically put your health at a disadvantage without you even doing anything. 

This related to your nervous system in a few ways. When I blew my nose in London and saw black snot... It kind of freaked me out. I remember thinking pretty often that this is what was going into my lungs and inside my body, but I couldn't do anything about it. The TED Talk we listened to started off with a doctor talking about one his patients in the past. She suffered from migraines. None of her previous doctors could come up with a solution to her problem but he figured out that her home had mold, a water leak and rats. Her poor living conditions were causing her health problem. She took action and had her landlord fix her home and bam, recovered. 

The UTHSC OT program requires us to have a certain amount of service/ professional development hours during our time as student's here. I think this is an excellent way to go ahead and get upcoming 

OT's in a mindset of helping the community in different/creative ways. To go ahead and form good habits of observing our community and finding ways to improve it as we grow within ourselves and as a whole.

Locomotion and Adaptive Devices

As life progresses or after a traumatic event, you or someone you know will need an assistive device. It is very important to make sure that you are properly fitted for your assistive device. Say you were playing basketball with some friends and you sprained your ankle. You go to the nurse, the ankle gets wrapped up and you leave with axillary crutches. This is just your standard crutch that goes under the armpit and has one surface toughing the floor. You want to make sure that it is not too close under your armpit because this will increase the amount of pressure there and possibly damage your brachial plexus. Then you really will have a much bigger problem than a sprained ankle. So preventing other possible injuries is one reason. Another reason would be to prevent fatigue, this device is supposed to assist, not make the client's life a little harder. Say for example grandpa is having leg pain. His therapist orders him a cane but doesn't measure everything correctly and the cane comes in a little too short. The therapist blows this off and says eh you'll be fine. Well as grandpa is using the cane he is hunched over to one side and not standing up tall with good posture. Over time grandpa's back is going to start to hurt and he is probably not going to want to walk much since it causes him pain. A few inches off could really make or break an assistive device. You want to carefully measure everything because again, these devices are to "assist" and make life a little easier/ mobile not cause other problems and make you become more sedentary. Life is too short to watch it blow by from sitting on the couch.

In the following sentences I will explain how to measure and fit a client for a cane, axillary crutches, Lofstrand crutches, platform walker and a rolling walker.

• A cane you want the hand grip to be at the level of the ulnar styloid process, wrist crease, or greater trochanter so that the elbow is flexed at a 20-30°. Also decide which type of cane the client wants. There is a standard cane and also a wide based quad cane (WBQC) with 4 prongs touching the floor. The 4 prongs increases the stability for clients with a decrease in balance. There is also a narrow based quad cane that is the same as the WBQC but the 4 prongs are just closer together.

• Axillary crutches are the normal standard crutch that goes under your armpit. You want the axillary rest (the top) to be about 5 centimeters (or about 4 finger widths) below the floor of the axilla (armpit) with shoulders relaxed, so that there is no increased pressure on the axilla.

• Lofstrand crutches are the type of crutches you would see used by someone with Cerebral Palsy (think of the son from Breaking Bad). There is an arm cuff that wraps around the proximal arm (about 2/3 up the forearm) and hand grips for the client to hold onto. You want the hand grips close for a resting neutral position.

• Platform walker is a standard walker with a platform to support a forearm. You want the walker hand grips to be level with the ulnar styloid process, wrist crease, or greater trochanter and the elbows flexed at 20-30° like for a cane.

• Rolling walker is a walker with 4 wheels and the hand grips have brake pulls to help with stopping. These are for clients that can't lift a walker so you can just push them. Normally they come with a basket and also a place to sit in case client becomes fatigued while walking. Keep in mind that this is the least stable assistive device. 

Hierarchy of Mobility Skills

After a traumatic event and a client is stuck in bed there is a certain hierarchy of mobility skills that much be met for them to successfully and safely walk on their on once again. The hierarchy is as follows: bed mobility, mat transfer, wheelchair transfer, bed transfer, functional ambulation for ADL, toilet and tub transfer, car transfer, functional ambulation for community mobility, and community mobility and driving. In my mind this process makes perfect sense like the saying you gotta walk before you can run. Well you must be able to move around in your own bed before you can be expected to get up in a wheelchair. I think it was planned out this way because if you were to make an assumption that your client can complete a task, you might want them to fall back on pillows instead of possibly the floor. It just seems like the logical and safest way for movements to progress. I can't really say that I have seen this in my past to my knowledge. When I worked at an assisted living faculty our residents there were relatively mobile when they wanted to be (that was the key). I feel like I would see more of this in an ICU unit or maybe even a nursing home. I completely agree with this process you start small (like sitting up in bed) and work your way up (like to transfer into the tub). I also think accomplishing multiple "small goals" builds confidence for much larger goals and makes things feel easier when taking everything slow and steady.

Proper Posture and Body Mechanics

There are many important reasons for clients to have proper posture. Number 1 would be for preventative measures. Standing up correctly will help to prevent disc herniation and general back pain. I have a hunch to my upper back and notice that my lower back hurts a lot. I noticed when I started working out at the gym and focused on my back muscles that the pain went away for the most part. Having a standing desk would also help strengthen a back because the client would not be leaning over it throughout most of the day. Number 2 would be to have good body awareness, with poor body posture you're more likely to lose sensation in places and not knowing where exactly they are in space. Number 3 is to prevent spinal contractures. Improper posture adds extra stress and strain on ligaments and tendons which can also lead to back pain. Lastly appearance, good standing posture has a positive affect to those around you. It makes you appear taller while also demands a certain amount of respect in the workforce.

An example that we were shown during this week was to hold a stick to your back while you squat to make sure you're bending your knees and not hunching your back is a good one because it has minimum equipment and you can do it at home. I also liked the slouch-overcorrect technique we learned about, sitting hunched over and then sitting extremely upright relaxing about 10% effort. This is a good exercise to do every once in a while especially when sitting at a desk for a long period of time. Another thing you could do for improvement is simply record the client squatting or standing and show them on camera where the problems lie and also record yourself for them to see proper form. 

How Do You Feel About M&Ms?

This M&M Christmas commercial weirdly gets me in my feelings. I think it is because they play the same one every year so it's been a consist thing since my childhood. I'm not really a big fan of normal M&Ms but I love the peanut butter, peanut, brownie fudge, minis, basically all of them except a normal chocolate one like I said. They just tap into my longterm childhood memories which is part of the hippocampus in the brain; makes me imagine Christmas and what happened years ago. Recently M&Ms are doing yearly voting where the company releases three new flavors and you can buy them, try them, and vote for it to be permanent. These really stick with me because I make it a mission to try them all just to say I did it and was a part of the process. It really taps into my declarative memory sometimes, the company released a jalapeño M&M and I remember being at the Hilton Head beach trying that with my cousins. I made a co-worker try these and she almost threw up right in front of me so that memory is probably stored in her amygdala. Family members now send me the weird ones they come across and it's a fun conversation starter sometimes. It is kind of cool to think that a little piece of chocolate can take me back to very specific times and places in my life.

I Got Chills Reading Man From the South

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