For a problem as pervasive as traumatic brain injury one would think that the different forms it can take would be widely known and understood. However, in my practice of community-based neurology I find this is not the case. Patients and their families are seldom familiar with the concepts of cerebral (brain) contusion and concussion, and a common error is to believe that they are basically the same, except that a contusion is a more severe form of a concussion.Before exploring the differences between these two terms, let's first acknowledge how they are alike:* Both are due to head trauma.* Both are common.* Both are serious.But that's where the similarities end. The differences between cerebral contusions and concussions can be boiled down to two basic concepts:* Contusions are localized, while concussions are widespread.* Contusions are macroscopic, while concussions are microscopic.To flesh out these concepts more fully we'll need to discuss brain anatomy, brain physiology and brain-imaging technologies. A contusion is a bruise. At one time or another everyone has bruised himself or herself, as, for example, when they banged a forearm against a hard object. This caused bleeding within or beneath the skin. In the days following the injury it turned purple and perhaps a variety of other colors as the body's repair mechanisms degraded and absorbed the red blood cells that had escaped from the injured blood vessels.The same thing can happen to the brain, except that the bruises are not located in a place the eye can see. However, with the help of imaging technology the bruises (contusions) can be made visible. To a close approximation, computed tomographic (CT) scans and magnetic resonance (MR) scans can "see" a level of detail corresponding to what the naked eye can see, except that the information is presented like slices of a loaf of bread, shown one slice at a time. "Macroscopic" means that the naked eye can see the contusions (with the help of a scanner). If a similar process occurs at a "microscopic" level, it is too small for the eye (and scanner) to see.CT scans are more useful than MR scans in evaluating patients with acute brain trauma because seriously ill patients can be better monitored while receiving CT scans and because fresh hemorrhages are more apparent. In images created by CT scanners fresh blood appears intensely white, while normal brain tissue appears gray.Although contusions can be multiple, they occur in single locations. That's what "localized" implies. So a brain contusion is both macroscopic and localized. One common pattern of contusions is "coup-contrecoup." When a moving head is abruptly stopped (as occurs during a fall when it strikes the ground) the brain nearest the point of impact bashes against the inner surface of the hard skull, producing a contusion. That is the "coup" injury. But then there is either a bounce-back of the brain within the skull or a suddenly created vacuum that produces a second "contrecoup" contusion on the opposite pole of the brain.Contusions can occur in large enough numbers to produce a "salt-and-pepper" appearance on CT scans. Adjacent contusions can also coalesce via further oozing of blood to produce larger blood-deposits. If a collection of blood becomes large enough to compress and distort the rest of the brain, it might require surgical removal. It is important to realize that injury to brain tissue is not limited to that produced by bleeding. The same physical blow that disrupts blood vessels is also capable of damaging the brain cells directly.Now let's contrast these findings with what occurs in a cerebral concussion. In a pure concussion there is no macroscopic, localized collection of blood. Any bleeding that occurs is at a scale that escapes detection by the eye (helped by the scanner). In a concussion there is diffuse, widespread, homogeneous impairment of brain tissue, but nothing that shows as a macroscopic, localized abnormality on a scan.In fact, it may not be fair to imply that even a microscope could see the changes that occur in a concussion. Although in severe concussions there can be a physical snapping-in-two of axons (the long extensions that brain cells use to communicate with each other) a concussion disrupts the physiology (functioning) of brain cells more than their anatomy (structure). That is, the trauma makes large numbers of brain cells sick without actually killing them. While sick, the brain cells under-perform. As a result, the victim of a concussion might lose consciousness or become confused. Because emotions are also produced by interactions among brain cells, the concussed patient might show tearfulness, irritability or other changes in behavior as a result of the injury.While a person with "traumatic brain injury" might experience contusion without concussion, or concussion without contusion, having one does not preclude having the other, and it is common for both to occur together. So while cerebral contusions and concussions are different from each other, a victim of head trauma might be unlucky enough to have both.(C) 2005 by Gary Cordingley
Copyright 2006 Howard McGarityEveryone can recall a time when their best intention to stick with a particular task weakened and failed. Ill bet its happened to you more than once, especially if you have been a player in the diet and exercise gameBeing heavy and failing to stay on your diet feels like a personal defeat. It is demoralizing to imagine people thinking, "He just has no willpower"..."she lacks character"..."he can't control himself".The worst thing is that you may believe these things yourself. But you are wrong. Wrong! And here is why:Depending on willpower to sustain you through a diet and fitness program is like jumping out of an airplane with a handkerchief for a parachute.Evolution is Against You.The problem is that when you set out to get in shape and lose a significant amount of weight, you are actually forcing your body to do something that it has been designed to resist.At the most basic level, evolution is against you. Since the dawn of mankind, our physiology has developed mechanisms to conserve precious energy. In earlier times, loss of bodyweight was always a potential threat to survival and as a result, our bodys immediate response to a reduced caloric intake (a diet) is to slow its metabolic rate and store fat.To compound the problem, physical deprivation quickly results in a deep, systemic urge to eat that is impossible to deny.Next, social and emotional factors come into play to further test your already weakened resolve. In time, be it three days, three weeks or three months, your diet plan will eventually crash and burn.It is clear that willpower is no match for nature. There are, however, strategies you can easily learn that are far more effective and reliable.Create Systems and Habits.It is not enough to simply decide to eat less or cut out junk food or to just pick a new diet de jour from the long list available.What you must understand is. exactly why you are doing this in the first place. exactly what the rewards of success will be. precisely how you will handle every detail of exercise and nutrition. who will be your supporters. and finally, how you will manage the internal and external saboteurs that lie in wait to defeat you.If you are able to use systems that later develop into habits, you command powerful tools that replace and eventually eliminate any dependence on willpower.Here are some important examples. You can easily use your imagination to customize these and also design new ones to meet your needs.1. Use a structured eating plan. If you are not completely confident that you understand what constitutes a healthy, balanced diet and that you can design a plan to consume enough calories so that you lose no more than one or two pounds a week, buy a session with a registered dietitian. This knowledge will last you a lifetime and puts you way ahead of all the other dieters out there2. Avoid Hunger. Plan what you are going to eat for the entire day in advance, three small meals and two or three decent snacks. Dont get caught short, starving with nothing to eat. Buy a small, insulated cool-pack, stock it with snacks and always have it with you. Eat a meal or a snack every two-and-a-half to three hours. Allow yourself one anything I want meal each week; enjoy two when you are on track and losing steadily. Schedule them and write it down.3. Always include some exercise. Walking is best; jog if you are able. Easy and simple is best; save the tough stuff for when you are in shape and exercise is a habit. Schedule your exercise in advance and log exactly what you do. Track your TV viewing for a week. It is easy to find shows you watch that you can live without. This is where you will find your exercise time. If a crisis occurs commit to doing five or ten minutes. Something is a thousand percent better than nothing.4. Get a partner to join you; at the very least, show and explain your plan to someone and ask for their support. Set daily, weekly and monthly goals in writing and have your supporter hold you accountable. If you make your goal, they take you out to dinner. If you fail, you buy them dinner. twice.5. Create a vision. Sitting in a quiet place, relax and visualize exactly how you will look and feel and enjoy life more when you have reached your goal. Make a movie in your head; make it in color with sounds, smells and actions. Look at yourself in the movie and then write a list of ten or twelve adjectives that describe how you look and behave. Describe yourself physically, mentally, socially and spiritually. Envision and repeat: I am (your description). Do this at least three times a day and whenever you are feeling stressed, overworked, tired, angry, nervous or afraid.Strategies like this do three things for you.They help you avoid circumstances that lead to bad lifestyle choices in the first place.They help create an environment that is conducive to making healthy lifestyle choices a habit, simply a natural part of your routine.They build motivation and a correct mental attitude that is the essential first step to achieving weight loss, health and well-being.When you have systems and habits working for you in place of unreliable willpower, success is much easier. A fitness plan that does not include this kind of an approach is usually doomed to failure before it begins.Be Strong. Be Lean Howard McGarity Coach Mac
For individuals with disability, walking aids can help change their lives. These simple mobility walking aids can give them back the independence and mobility that they lost. In times when you want to get out of your wheelchair for a little exercise, walking aids can be used. Walking aids are likewise ideal when visiting a place that is not accessible by wheelchair. Any disabled person who wishes to remain active and independent can gain a great deal by using walking aids. By having a walking support, many are able to continue with many or more activities that they enjoy doing. Walking aids are also important to enhance safety when pain, balance and fatigue are factors. There are several types of walking aids such as canes, crutches, walkers and rollators. These walking aids are fairly portable and lightweight. Canes come in various styles. Single point canes offer some stability while quad canes give a more sturdy footing. If you intend to use the cane for long term, it is better to purchase quad canes. Crutches are also available in several varieties. It is important though to pay attention to the height restrictions when purchasing a crutch. Walkers are suitable for persons who are easily fatigued or have poor balance. If the walker is not properly sized, you may have trouble moving it around. That is why it is important to carefully choose the walking aid that you will use.Basically, the type of walking aid that you choose will depend largely on your disability and stamina. You maybe able to use a walker but not a cane or crutch. You need to consider several factors before using your cane, walker or crutches such as your body strength, fit, comfort, and body balance and travel needs. It is important to learn how to safely use the walking aid when buying it or you might end up hurting yourself. Make sure that you have to right reasons for buying the walking aid. Dont just go out and buy one and start using it. Perhaps it is a good idea to consult your doctor before deciding which walking aid to use. Permanently disabled individuals are not the only persons who can use walking aids. Temporarily injured individuals often use walking aids during the rehabilitation process and physiotherapy. Most walking aids are adjustable to suit your height. They are also built to handle a certain weight capacity. When it comes to staying in style there are a lot of choices when in comes to size, shape, design, colors and materials. So dont buy anything you are not satisfied with. When it comes to walking and mobility, comfort is the most important.
He played the raging green monster The Incredible Hulk in the '70s TV series of the same title. Thanks to his glossy credentials as a bodybuilder, he got the part. Lou Ferrigno was named Mr. Universe in 1973 and again in 1974. Ferrigno appeared as himself alongside Arnold Schwarzenegger in the 1977 bodybuilding documentary Pumping Iron. The next year, he began his five-season run as The Hulk (1978-82), paired with Bill Bixby as The Hulk's mild-mannered alter ego, David Banner. After The Incredible Hulk ended, Ferrigno went on to other musclebound roles, including Hercules in Hercules (1983) and Sinbad in Sinbad of the Seven Seas (1989).But during his younger years, The Incredible Hulk had another alias --- Deaf Louie. He got the nickname from his hearing peers who teased him for being hard of hearing (HOH). Ferrigno lost much of his hearing after suffering from an ear infection as an infant. The constant ridicule from his hearing friends proved so hard for Ferrigno that at some point, he was sulked in depression and anxiety. HOH is a term generally used to describe individuals who use their residual hearing and speech to communicate. Many hard of hearing people can understand some speech sounds with or without a hearing aid. Generally, these individuals supplement their residual hearing with speechreading, hearing aids and technical devices. A hard of hearing person, in audiological terms, may have a mild to moderate hearing loss. People lose their hearing in various ways. The most common causes of hearing loss are:Childhood illnesses (spinal meningitis and rubella/German measles are the most common examples);Pregnancy-related illnesses (such as rubella/German measles or dependence on drugs/alcohol);Injury (a severe blow to the head can damage the hearing);Excessive or prolonged exposure to noise;Heredity (scientists involved with the mapping of the Human Genome Project have identified approximately fifty (50) deaf genes to date, and they are working on identifying the remaining 350 deaf' genes)Aging (progressive deterioration of hearing in older people, which is a natural part of aging process)Another diagnosis that can result hearing loss among children is Otitis Media. It is the most common diagnosis in sick children in the U.S. Young children, infants, and preschoolers are particularly prone. Almost every child has at least one bout of acute otitis media before the age of 6. Three tiny bones in the middle ear carry sound vibrations from the eardrum to the inner ear. When fluid is present, the vibrations are not transmitted efficiently and sound energy is lost. The result may be mild or even moderate hearing loss. Therefore, speech sounds are muffled or inaudible. Generally, this type of hearing loss is conductive and is temporary. However when otitis media occurs over and over again, damage to the eardrum, the bones of the ear, or even the hearing nerve can occur and cause a permanent, sensorineural hearing loss.Hearing loss can be very difficult especially among children. Children learn speech and language from listening to other people talk. The first few years of their lives are especially critical for this development. If a hearing loss exists, a child does not get the full benefit of language learning experiences. This can affect the relationship of the child to his or her peers. This was proven true enough with the experience of Lou Ferrigno, during his childhood years while he was mocked because he was HOH. However, with Lou Ferrigno's determination and to overcome the trauma of being a HOH, he was motivated to become a bodybuilder as a teenager by an experience very common to hearing impaired youth of the '70s. Today, Lou Ferrigno focuses on bodybuilding education. He has a website which offers booklets on bodybuilding. He has his own book on bodybuilding too: Lou Ferrigno's Guide to Personal Power, Bodybuilding and Fitness for Everyone. In addition, both he and his wife Carla offer personal fitness training services to residents of the Los Angeles, California region. To this date, Lou Ferrigno, proves to be an inspiration, the incredible hero both to the non-hearing and hearing alike.
Cancer is serious business. It is a deadly illness that has claimed many lives, and will continue to take lives despite the variety of treatment options available for it. Cancer is considered in some circles as the best place to exercise the supposed power of positive thinking. In theory, a person in stable emotional health and positive mindset is more likely to survive a brutal illness, such as cancer, than someone who simply accepts defeat and gives in to fate. However, recent studies have found that there is really no truth to that previously accepted notion, with scientific data showing that people who were optimistic about their chances were just as likely to bite the dust as those who held more realistic, or even pessimistic, views of their chances of survival.Emotional health and status, according to the study recently concluded under the supervision of Dr. James Coyne, held no bearing on the chances of survival. According to the data gathered over a period of several years, which include detailed analysis of two different studies on cancer, there was no correlation between feelings and cancer. The study went to great pains to eliminate other possible factors affecting the survival of a cancer patient, including gender, psychological factors, the location of the tumor, and the stage of the disease. The results universally showed that positivity had no effect whatsoever on the chances of survival, but the researchers do concede that psychological and emotional support does still provide help for cancer patients. It just doesn't really do anything to extend one's life or help treatment methods in making the cancer recede.The study covered several types of cancer, with the test subjects being in different stages of the disease. The researchers also took consideration of a pool of patients in different methods of cancer treatment, to obtain the best possible data and results for the study. Of the 1,093 patients who were included in the study, over 646 of them had died during the timespan of the study. The researchers took careful note of everything they could, including outlook, attitude, psychological state, and "emotional health" . Their data effectively discards the long-held notion that positive thinking and emotions can help prolong a person's life, which has been among the most prevalent pieces of advice that doctors provide their patients.The research team also determined that those with more realistic expectations, or were outright pessimistic about their chances, did not have a higher mortality rate than their happier counterparts. This, too, contradicts previously held notions that negative thinking can aid in the spread of a tumor. The only real discrepancy the study could note was that pessimistic patients tended to be less eager to work their way through the difficult methods of fighting cancer, which did have an effect on their chances. However, removing negative perceptions and emotions altogether did not have any feasible effect on its own.The researchers aren't saying that people should forbid cancer patients from engaging or joining in support groups or psychiatric counseling sessions. There are still benefits to allowing a patient to go to those groups if they want to. The effects, however, are likely going to be purely psychological.