Tag Archives: senses

Falls Awareness & Prevention Guide

Falling is the nemesis of older folks. Yes, falls can be an issue for anyone at any age, but for older folks it can mean broken bones – especially hip bones – that take a long time to heal, require physical therapy to be able to resume activity, and are all too often the harbinger of further problems.

The American Academy of Orthopaedic Surgeons and The Orthopaedic Trauma Association have put out a Falls Awareness & Prevention Guide that I recommend for anyone, regardless of age, and absolutely recommend to anyone living on their own, particularly if they are older (and you can take “older” to mean whatever age you feel like having it mean!)

My Mom lived alone for about five years, and in her last year of life she fell several times, the first on New Year’s Day 2010. We were getting ready to leave a family gathering at the home of a relative. Wearing shoes that were like slippers and did not offer much by way of support, she tripped on a towel that was near the front door and meant for wiping wet shoes. The shoes and towel were a nasty combination, causing her to lose her footing and fall to her left. As if it were happening in slow motion, several of us tried to reach out and catch her or lessen the impact of her fall. Alas, a trip to the ER showed a broken left humerus. This would be the first of two shoulder breaks, with the next one happening to her right humerus.

If you look at the Falls Awareness & Prevention Guide, you will notice inadequate footwear and all throw rugs and area rugs that are not properly secured (could just as easily apply to towels on the floor) listed as risk factors. It could have been anyone who fell on that rug, but I suspect my mother’s age also had something to do with it.

So, take a look at the guide and see if it provides some tips for you or for someone you know. Being a little proactive now can mean a lot in terms of later prevention.

And from the National Council on Aging, an info graphic to herald Falls Prevention Awareness Day, which happens to be September 23, 2014.

FPAD14-Infographic_full

Commuting.

For this school year, I am commuting 62 miles each way to where I teach. That translates to an hour’s drive in the morning, and on the days of after school meetings, anywhere from 70 to 90 minutes for the drive home.

After 14 years of teaching just four miles from my home, and several times a year walking home from school, you can perhaps begin to imagine the impact this change of time spent sitting in a car has had on me – less time available for walking, poor air quality (though I recirculate the interior air while driving on I-95 so as to minimize the trucking fumes), muscle strain from sitting in one position, and stress from intense concentration so as to keep my drive safe.

The Hidden Toll of Traffic Jams, in the November 2011 Health & Wellness section of The Wall Street Journal, discusses the impact of traffic emissions on commuters, including this tidbit:

And older men and women long exposed to higher levels of traffic-related particles and ozone had memory and reasoning problems that effectively added five years to their mental age, other university researchers in Boston reported this year. The emissions may also heighten the risk of Alzheimer’s disease and speed the effects of Parkinson’s disease.

That last sentence is fascinating to me because my Dad commuted daily from New Hyde Park, NY to Hasbrouck Heights, NJ for upwards of 20 years. While his distance was half of my current commute, the time spent in the car was about equal due to the enormous volume of traffic crossing the George Washington Bridge.

And why is this fascinating? My Dad developed Alzheimer’s and Parkinson’s in his later years. To be sure, some of that was likely hard-wired into his DNA, but “heighten the risk” and “speed the effects” make me wonder about the commute’s impact. 

Bruce McEwen, in a March 2011 Dana Foundation article Effects of Stress on the Developing Brain, talks about the effects of stress on the brain and body. “Besides major life events, abuse and neglect, it is the ordinary day-to-day experiences in family, neighborhood, commuting and work, and school that affect brain and body function and promote those health damaging behaviors.

A recent acquaintance, who crafts infographics, sent me this infographic describing The Killer Commute. The graphic is provided by CollegeAtHome.com and it speaks volumes! She asked for my feedback, and this is what I had to say: 

The graphic is a killer! Okay, what I mean is, it depicts my experience – all the “yuck” parts of commuting. I had already determined to leave my job (and gave notice in January that I did not want another contract), but if I hadn’t already done that, the graphic would have convinced me to do so.
 
The parts covering health detriments are intense, (perhaps I can use them to drum up business for a “Yoga for Commuters” class….)
 
I only have two issues with an otherwise highly effective and convincing graphic – it is demoralizing! And the sources at the bottom were difficult for me to read.

Different Strokes for Different Folks

I love when you stroke my back.

Stroke” yelled the boatswain as she set the rhythm for her oarswomen.

Draw a stroke upon the page.

Cinderella, you must leave the ball at the stroke of midnight!

Hazaah, what a stroke of luck!

My favorite stroke to swim is the crawl, also called freestyle.

Ah, stroke his ego and he’ll probably let you do what you want.

What a stroke of genius these brothers had with their Global Buckets idea!

My mother’s brain had a stroke.

So many meanings of stroke!

Different strokes for different folks.

And so it goes with my Mom, though her different stroke is not one she had on her list of all time “must haves”. Yet, in looking these over, they do share two strong similarities to the type of strokes a brain can have. Some of these strokes are long and ongoing, while the others are short and to the point.

And so it is with a stroke in the brain. My Mom had a long and ongoing stroke, called an evolutionary ischemic stroke. It began on a Saturday, as far as she could tell, and took just over a week to run its full course. Her internist told me that if you’re going to have a stroke, this is the best type to have and also the most common. The doctor described two other types of stroke: hemorrhagic, which is bleeding in the brain and often results in a coma, and embolic, which is a blood clot that breaks off from a blood vessel and travels to another location to create a blockage. [Note: the American Heart Association describes just two types of stroke.]

What appears to have happened in my Mom’s body is a hardening of the arteries, which means that the impacted artery was like a clogged off-ramp on a highway – there wasn’t room for the blood to flow. According to Mom’s doctor, this most likely happened in a larger artery impacting the left side of Mom’s brain, causing the right side of her body to shut down. She cannot move her right leg or arm, and cannot see anything that presents on the right side. However, if we stand in front or her, or to her left, she sees us just fine. Her speech and memory have also been impacted, though I am happy to say that yesterday her speech was just slow but not slurred, and she is finding alternative words to express herself. In a curious way, she is expanding her repertoire of daily words, though she always had an expansive vocabulary.

My Mom is a righty, and both a skilled and heartful piano player, and we think that physical and occupational therapy may bring back sensation and some use of her right arm and leg. What saddens me is her partial loss of vision; I need to ask about the prognosis for vision recovery.

Looks like my next stroke is to skoot ahead in Marian C. Diamond’s Human Anatomy lectures and watch her talks about the eye, sensory and motor pathways, motor pathways and the forebrain, and the forebrain.

Here are a few resources that provide further information about strokes.

Stroke of Insight

Jill Bolte Taylor’s TED Talk is the most viewed TED Talk to date, and this morning I shared it with my 81 year old Mom. I’ve suggested TED Talks to her in the past, and she’s watched them in the comfort of her own home on her own Mac, but this morning we watched together from the hospital bed where she is dealing with the fact that last week she had a stroke.

Indeed, my Mom had her own stroke of insight as she was aware of her body changing right beneath her. A week ago Saturday she asked me if she was walking okay, as she felt her feet were lagging a bit. She seemed to be walking with slightly less zest than usual, but no alarm bells went off in my mind. That was on Saturday, August 7. By the morning of Wednesday, August 11, she was positive something was not quite right. I am greeted every morning by an email from my Mom, and here is part of what she wrote that morning:

Feel a bit tired — after a good night’s sleep. Also, my legs are not holding me up similar to when I was in the hospital and sent hone with B-12, which I take every morning.

Will have to think abut this. Perhaps all I need is more walking. Well, I will give this some thought.

Later that morning my Mom fell, and then within about an hour’s time, she fell again. My Mom has a Lifeline in the form of a bracelet so all she has to do is push the button and help is on its way. With the second fall, the EMS folks insisted on taking her to the hospital (her preference was to lay down and take a nap), and she reluctantly agreed after lying down on her bed and seeing that Norma, one of the EMS folk, was going to pick her up. (My Mom may have a stubborn streak, but that’s nothing compared to the people from EMS!)

Again against her preference, we insisted she spend the night in the hospital, especially as the emergency room doctor had already admitted her for observation. The next morning, when Mom’s internist was able to come see her, Dr Lanman uttered the word “stroke” and that sent the hospital staff into action as they followed their stroke protocol. Several tests later, it was determined that my Mom had an ischemic (this simply means “lack of blood flow”) stroke and an evolutionary stroke. An evolutionary stroke means that the stroke takes place over time rather than happening all at once. In this case, it was still happening.

Dishearteningly, within two days of being admitted, we (including my Mom) watched as she gradually lost all ability to use her right arm and leg, and then a day later listened as her speech slowed down, words were lost, what she wanted to say and what came out did not match, and she began to be a little discombobulated. I noticed this morning that she didn’t initially see the scrambled egg on the breakfast plate; turns out that a stroke can cause “an inability to see one side of the visual field”, which might explain what happened. (Or else it could simply be that the lights were low…)

And my Mom knew all of this was happening as it was happening. She told me so. And she said:

Up till now, I never felt old. Now I feel old.

In the past two years she has had broken ribs, a broken right femur, a broken left femur, two hospital stays and became a widow in July, 2009. Yet she never felt old. Till now. She’s a righty and a skilled pianist. She’s also, as she has said (and I concur!), a strong cookie. She was, and remains, a stalwart fan of General Stanley McChrystal, and has often said that if she were younger, she would enlist. I told her that this same stubborn strength is what will help her to recover, and she has a goal of being able to dance at her youngest grandson’s bar mitzvah in 2012.

With that in mind, if all goes well this week, she will be transferred 15 minutes from my home to the Burke Rehabilitation Hospital, where they have a Stroke Recovery Program. And we – she, my brother and me – will begin to learn more about stroke, the brain and the body.

Journey to a Sanctuary

Last summer I wrote about our trip to Maine and the area around Muscongus Sound, which included our visit to the Todd Audubon Sanctuary. Last week we were back in Maine, Round Pond to be exact, renting a delightful cottage at the edge of the Pond. One of the delights of being so close to the water is the easy access it provides for kayaking, and what better way to get ourselves out to Hog Island, the very island we had viewed from across the water when visiting the Audubon Society the previous summer! Off we went for a five and a half hour excursion, with the friendliest company en route.

Not only did this seal join us on the way to the island, but there were two seals. And not only were there two seals, but there were also two porpoises! (They do their curvilinear swim faster than I can maneuver my camera ;-))

We paddled across Muscongus Sound, heading north to Hog Island, then through an inlet and into Muscongus Bay, mooring our kayaks on one of the few sandy beaches. (Sandy beaches are not typical in Maine!)

It was one of those gloriously sunny days, an ever so slight clean, clear breeze in the air to fill our lungs. The tide was heading out, so we knew that time was on our side. Having started out a little after 9:00 a.m., even accounting for our “awe” time with the seals and porpoises, it was still early in the morning. Off we went to explore.

The portion of the island that we explored has a number of bunks, a recreation room, a mess hall – think “summer camp” along the lines of slightly worn down wooden buildings designed to have minimal impact on the surrounding area and provide maximal interaction with the environment.

There were paths on the north, east and west sides of the point, and we took the east path, along Muscongus Bay, in search of a spot that would provide a comfortable place to settle ourselves for a view and a picnic lunch. Along the way we discovered yet more bunks, flowers, and the ever present calm, quiet sense of being in a sanctuary. After a slow and relaxing meal, I couldn’t help but pay homage to this place of green trees and nature.

Time and tide wait for no man, and so we found ourselves reluctantly readying ourselves for the return to Round Pond.

We knew we had plenty of time, and we knew the tide wouldn’t really impact our trip, other than determining how far we would wade in either water or mud and grass to get ashore at the return end. However, what we hadn’t thought about, and soon discovered, was that there’s one other force that waits for no man – Maine fog.

We did one last explore of the point, then disembarked and headed back to Round Pond, reversing the route we took to Hog Island. Within moments of reentering Muscongus Sound, we were greeted by a wall of fog coming from the south. It may be that the fog creeps in on little cat’s feet, but maybe Carl Sandburg never made it to Maine, where the fog leaps in on a cheetah and with the density of an elephant!

We were rounding the point and meandering into the Sound, when the fog appeared as if out of nowhere. Previously content to follow Fred’s lead, I was suddenly a kayak’s length ahead of him and cajoling him to “get a move on!”, spurred into action by the simple hope of arriving at the opposite shore before we were engulfed in fog so dense we would not be able to see more than a few feet in front of ourselves.

With a sigh of relief we made it to the opposite shore, beating the fog by mere inches, as we crept our kayaks along the shoreline allowing it to guide us back to Round Pond. All the while our ears were listening with heightened sensitivity, determined to avoid rocks and returning boats. The last sound we anticipated hearing was the squeals of children’s laughter – could they be water nymphs or elven sailors? Hazaah! They were the kids from the Round Pond sailing camp, three and four to a boat (you can pick them out in the photo above), sailing in and out of the fog.

Apparently, the sun often shines on Round Pond, and once within the safe haven of the harbor, the sun was still shining with abundance. The fog wouldn’t roll in for a few hours, bringing with it a magnificent thunder and lightning storm downing five inches of rain, taking out local power along with a few local roads, and producing two tornadoes about an hour south of Round Pond!

Quiet, sun-filled morning on Muscongus Sound, Todd Wildlife Sanctuary on Hog Island, moments of yoga overlooking Muscongus Bay, safe harbor in Round Pond…our day was filled with multiple sanctuaries.

Plasticity and The Senses: Paul Bach-y-Rita

This October 2012 update reflects new links for the videos, as PBS is no longer hosting Wired Science programs.
In December 2007 the PBS Wired Science show included a piece about Bach-y-Rita’s research: Mixed Feelings. Here are some additional videos covering some of the same content: BrainPort Vision Through Tongue, BrainPort Balance Device.

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The first time I heard of Paul Bach-y-Rita was on a public television broadcast of a special show about the brain. The story of Paul Bach-y-Rita fills the first chapter of Norman Doidge’s book, The Brain That Changes Itself.

The stories of Bach-y-Rita – how his father recovered from a stroke and the impact this had on Bach-y-Rita’s career, the people with severe balancing issues who were essentially cured by his discoveries and innovations, and the people who had no vision who were able to begin to see – are compelling in and of themselves. They are very human stories, derived from the work of a man who was altruistically motivated.

A major contribution of Paul Bach-y-Rita’s to neuroscience was in thinking of the brain as “polysensory”, meaning that the sensory areas of the brain, rather than only processing information from just the senses that normally report to those areas, are actually able to process information from any of the senses. The stories referenced above, relating to balance and vision, rely heavily on the polysensory ability of the brain to take input from the tongue and route it to the areas of the brain dealing with balance or vision.

Amazing? Absolutely! His work is a reminder of how adaptable our brains are, and makes me wonder how many more hidden secrets are waiting to be revealed. You can read more about the science behind Bach-y-Rita’s efforts in these articles:

On Wisconsin Magazine: Balancing Act (Spring 2007)

Discover Magazine: Can You See With Your Tongue? (June 2003)

Discover Magazine: Artifical Sight (August 2001)

College of Engineering, University of Wisconsin-Madison: Tongue seen as portal to the brain (2001)

And on an unrelated note, F, Happy Birthday tomorrow!