#Neuropathy Spectrum

[auditorypat]

Not the ears or hearing sensitivity, but rather the brain's ability to receive and interpret sound, is the issue with APD. You may find an Auditory Processing Center in Atlanta GA to get assessed and receive APD treatment.

[pinkplasticprincess]

Being chronically ill is crazy because I’m essentially just living with multiple warning lights on my dashboard lit up but if an otherwise able bodied person suddenly had their body’s check engine light on they’d go into a coma

We built different

[helenwhiteart-blog]

Hypermobility is a spectrum disorder: its not all about subluxations!

There’s a very classic view of what hypermobility syndromes are or look like…in the case of hEDS, many joint subluxations and the like; basically, symptoms that affect joints, not taking into account a whole other range of symptoms that can often present themselves as well as, or instead of, major joint issues. Also a persistent viewpoint, maintained by GPs, that it is a rare condition (by the…

[butterfly-casket]

Lowkey can't believe I forgot to make this post but at the beginning of this week I walked out of my appointment 5 mins into speaking to my primary. (I had a pulse of 81 and BP of 112/70 going into it.) I left, immediately requested my entire medical history, canceled my insurance (specific to the hospital/clinic I went to), canceled my appointments and sent a message to my physical therapist that I appreciate her but will not be putting my health in the hands of *place* ever again. Then they asked me to fill out a short survey and I went OFF about the bs they've put me through for the past 3 years.

Under the cut is a description of my medical history from the past 3 years because I'm just trying to make some fucking sense of it all and how they still think fibromyalgia fits. I think they fucked up SO BAD for so long that they had no choice but to double down.

> At beginning of 2021, I get shooting pain down my leg & my hip keeps trying to give out

> gets so bad I go to the ER

> gets laughed out of the ER because I briefly mention that I've experienced chronic joint pain since age 10 (to give them the perspective that my pain scale is off)

> goes back to my pediatrician (I'm 18 at the time, haven't found a new primary)

> gets referral to rheumatology and bone & joint

> rheumatologist diagnosis me with joint hypermobility, says he can't do anything about it.

> meanwhile, my nerve pain is getting worse and worse.

> bone & joint doctor, I see him twice, repeatedly assures me that sometimes "people just have pain for no reason"

> pain gets so bad that the only thing I can do is sleep, being practically comatose, and only eating sandwich ingredients and dry cereal out of the box for 3 weeks.

> schedule an appointment with the first doctor I can see. My mom drives me, helps me shuffle into the clinic, and cries with me when the doctor walks in & asks what's wrong. We both become sobbing messes on accident bc I'm in so much pain.

> he tells me the only thing he thinks it can be is fibromyalgia. Prescribes me an antidepressant. The NEXT DAY. My pain is GONE seemingly out of nowhere

> I am unable to take the antidepressant consistently due to lack of primary doctor, doesn't seem to make a difference so I stop.

> 6 months later I am struggling to pee, 3 months after that I get my first uti and it was very bad (blood in my urine). I go to the ER but they quickly prove to be recurrent. I am treated by minute clinics around where I moved to.

> 8 months after the initial flare up, I start having mini flare ups while working an INCREDIBLY labor intensive job with long hours. I had already been working there for 3 months without issues

> have to back my car out of parking spaces VERY slowly because any time I turn my neck back that far to look, I start to black out and become unable to form thoughts. I was taught to neglect myself growing up, so I just thought it wasn't a big deal & that it would go away.

> 3 months after my mini flares up happened, I start to have a month long flare up that gets progressively worse before just disappearing one day.

> I think I'm better, get a new job, immediately have to take a month off of work due to extreme joint pain, muscle pain, and constant uti symptoms. (12 months later we find out I was suffering from thyroiditis.) Try to fix my sleep schedule, diet, exercise habits, and finally start to feel a little better. Go back to work but it's part-time.

> work there for 4 months in extreme pain every day, eventually have to leave because I can't take it anymore.

> apply for disability, get new insurance, & get taken care of by my partner. Also move in w roommates who I didn't realize were incredibly unsanitary. I try my best to clean up after them for 5 months before ultimately I give myself a stress fracture on both my L5 pars and send my body into yet another full body flare up that sends me to the ER. Am still experiencing hyperthyroidism without knowing it.

> ER prescribes me gabapentin and send me back to rheumatology.

> finally get a new primary who seems to really care.

> Rheumatology gives me a 9 beighton score & sends me to physical therapy which helps my joint pain a ton until I have another extreme nerve flare up 3 months later while doing my PT. Literally the worst pain I had ever experienced, could barely move. Primary ups my dose 6x and it helps at the very first but ultimately still doesn't keep up with the pain (like, at all. 1800mg a day.)

> sees a urologist who diagnoses me with Pelvic Floor Dysfunction and almost doesn't test my urine which showed crystals & a lot of bacteria (he acted like I was crazy for feeling something solid through my urethra.) He went ahead and did a CT to check for kidney stones and found an 8cm ovarian cyst (that they found 2 yrs prior & didnt tell me or my mother about even tho it 6.7cm at the time) and an L5 pars defect.

> gets reoccurring chest pain & palpations for months, one day it gets really bad and a nurse line tells me to go to the ER. ER diagnoses me with Anxiety.

> finally sees a spine doctor who diagnosis me with bilateral sciatica, spondylosis of my L5, and says there's a good chance my spine is popping in & out of alignment. Sends me to pain management.

> pain management switches me to pregabalin. It helps a little bit for a little bit. Eventually have to stop taking it due to extreme mental fog & personality changes.

> try dry needling therapy for 3 months for my lumbar back. It always relieves me for a short period but ultimately was making matters worse in the long run.

> having tons of flares ups all the time up until we had to move & 30 minutes into moving small boxes my back pops out of alignment, my legs give out and I'm in, once again, the worst pain I have ever experienced in my life for the rest of the day until the next morning I take an Epsom salt bath, feel a pop, and finally have some relief. I was sore from that flare up for a week after.

> find a new primary after moving, ask about possibly having hEDS and he sends me back to rheumatology (who found nothing) saying they have to rule out everything else first.

> go back to pain management, try a couple different things that either made matters worse or did nothing at all and decided to take a break from the disappointment.

> everyone keeps telling me I have fibromyalgia & anxiety despite the fact that it doesn't actually make sense with the pattern of my pain, doesn't match up with my symptoms &doesnt explain half my symptoms.

> symptom page is now 3 google docs pages long & after receiving my medical records I find a million inconsistencies, claims of me agreeing to things that were never discussed with me, and half of my reported symptoms are not even mentioned.

> have a dozen more symptoms that I'm scared to mention out of fear that I am going to continue to be dismissed, ignored— or worse, give them reason to think I'm seeking attention.

> completely lose hope for receiving the help I need.

> start having blurred vision and dysphagia, looks them up, reads about MS and realizes it fits nearly all of my symptoms. Make an appointment with my primary.

> goes to my primary, immediately is talked down to for "coming in the Friday before Christmas break" and "the only reason you got this appointment is because I had a cancelation."

> I burst into sobs and whip out my symptoms list just fucking begging for help, telling him I've been dismissed by almost every medical professional I've been to, most of my symptoms haven't even been recorded, & that I'm desperate. He agrees to finally help me, refers me to neurology (first time since this all started) and orders MRIs to check for MS.

> by this time I have had thyroiditis, a ton of infections, have horrible balance, tons of tingling and numbness in all my limbs, use a cane, been unable to work for a year and a half, worked with tons of physical therapists who don't know how to help my nerve pain, & have another ovarian cyst despite receiving treatment for PCOS.

> goes to the ER with my heart racing, vomiting, extreme fatigue and weakness. The doctor tries to gaslight me as they continuously tell me "You are a young healthy person. This is very psychological, you need a psychiatrist and psychologist." Until I am in literal tears because that treatment felt very uncalled for, especially because my labs hadn't even come back yet. I finally agree to see a therapist bc I recognize I am going through a very difficult thing in life and could use the extra support. I also felt very much like they were going to put me in a psych ward if I didn't agree. My lab tests come back showing I have low potassium & CO2. They treat me then send me home with 2 diagnoses: nausea WITHOUT vomiting, depression.

> neurology asks me a ton of medically irrelevant questions about school life, home life, relationship with my parents and then diagnoses me with anxiety without performing any tests.

> gets my second EMG that comes back clear

> finally gets my MRIs that shows cervical bone spurs on 3 different vertebrae.

> think I have FINALLY found the answer to almost all of my symptoms.

> goes back to my primary who says it's "just a little arthritis. Most people who have what you have don't have symptoms." & won't listen to me when I point out that I have every symptom indicative of complications with bone spurs in the neck (& I'm hypermobile)

> refuses to discuss why I have the bone spurs at age 22

> refuses to discuss the possibility of hEDS

> gets mad at me for not being treated for my fibromyalgia (even tho nothing works.) Keeps interrupting me to say it's just fibromyalgia.

> I say, "ok, we're done here" & get up to leave

> "you're leaving?!"

> "you just said nothing is wrong with me, I have the same thing everyone has been saying I've had for years, that I have the same thing I've been trying countless useless treatments for, what else can you even do for me?"

> "but I could get you a referral to a spine specialist!!"

> "you just said nothing is wrong with my neck. And I've already been to a spine specialist."

> "they could give you injections!"

> "I've already tried injections and they. Didn't. Work."

> "you don't even want a follow up appointment???!"

> "???? NO!!!"

[cripplecharacters]

Disabilities that You Should Consider Representing in Your Writing More… part 1

[large text: Disabilities that You Should Consider Representing in Your Writing More… part 1]

While all disabilities are underrepresented in basically all sorts of media, it’s hard to not notice the trend in what disabilities make up the majority of representation. It’s especially visible when having a blog like this, where we can see what disabilities writers even consider including in their writing, and which ones never come up.

One in four people are disabled. With eight billion people alive it means there’s a lot of disabled people, and a lot of reasons why they are disabled in the first place - but this diversity is rarely represented, even on this blog, and anyone who has been following for a while has probably noticed that fact.

To be blunt: there are disabilities other than “amputee” and “invisibly disabled mobility aid user”. Does that mean that it’s wrong to write either of those? No, and we don’t want to imply that it is. Does it mean that either of these have a lot of good representation? Absolutely not, half of all the amputee characters out there are written by people who don't seem to be even aware they're writing a disabled character. Does it mean that when you are deciding on what to give your character, you should think beyond (or along! people can be, and often are, multiply disabled!) just those two? Absolutely. Disability is a spectrum with thousands of things in it.

This is, simply, a list of common disabilities. This is just a few of them, as this is part one of presumably many (or, at least three as of right now). By “common” we rather arbitrarily decided on “~1% or more” - so at least 1 in 100 people has the disabilities below, which is a lot. Featuring!: links that you should click, sources of the % that are mostly just medical reports and might be hard to read, and quick, very non-exhaustive explanations to give you a basic idea of what these are. 

Intellectual disability (about 1.5%) Intellectual disability is a condition we have written about at length before. It’s a developmental disability that affects things such as conceptualization, language, problem-solving, or social and self-care skills. ID can exist on its own or be a part of another condition, like Down Syndrome, Congenital Iodine Deficiency, or Fetal Alcohol Spectrum Disorders. This post covers a lot of basic information that you might need. We have an intellectual disability tag that you can look through!

Cancer survivors (5.4% in the US, about 0.55% worldwide) A cancer survivor is a pretty self-explanatory term. There is a lot of types of cancer and some of them are very common while others are very rare, which makes this a very diverse category. Cancers also have different survival rates. While not every survivor will have disabling symptoms, they definitely happen. Most of the long-term side effects are related to chemotherapy, radiation, and other medication, especially if they happened in children. They can include all sorts of organ damage, osteoporosis, cognitive problems, sensory disabilities, infertility, and increased rate of other cancers. Other effects include removal of the affected area, such as an eye, a spleen, breasts, or the thyroid gland, each of which will have different outcomes. Cancer, and cancer treatments, can also result in PTSD.

Diabetes (about 8.5%, ~95% of that are type 2) Diabetes is a group of endocrine conditions that cause hyperglycemia (high blood sugar) for various reasons depending on the type. The vast majority of people have type 2 diabetes, which can cause fatigue, poor healing, or feeling thirsty or hungry. A diabetic person will use insulin when needed to help manage their blood sugar levels. There are many complications related to diabetes, from neuropathy, to retinopathy, and chronic kidney disease, and there's a lot of disabilities that coexist with diabetes in general! You might want to check out the #how to write type 1 diabetes tag by @type1diabetesinfandom!

Disabling vision loss (about 7.5%) Blindness and low vision are a spectrum, ranging from total blindness (around 10% of legally blind people) to mild visual impairment. Blindness can be caused by countless things, but cataracts, refractive errors, and glaucoma are the most common. While cataracts cause the person to have a clouded pupil (not the whole eye!) blind eyes usually look average, with strabismus or nystagmus being exceptions to that fairly often (but not always). Trauma isn't a common cause of blindness, and accidents are overrepresented in fiction. A blind person can use a white cane, a guide dog or horse, or both. Assistive solutions are important here, such as Braille, screenreaders, or magnifying glasses. We have a blindness tag that you can look through, and you might want to check out @blindbeta and @mimzy-writing-online.

Psoriasis (about 2-4%) Psoriasis is a chronic skin condition with multiple subtypes; it can cause intense itching, pain, and general discomfort, and often carries social stigma. It’s an autoimmune and non-contagious disability that affects the skin cells, resulting in raised patches of flaky skin covered with scales. It often (30%) leads to a related condition, psoriatic arthritis, which causes joint pain, tenderness, and fatigue, among other things.

Stroke survivors (0.5-1%) A stroke survivor is a person who has survived any kind of stroke (ischemic, hemorrhagic, etc.). While the specific symptoms often depend on the exact location on where the stroke happened, signs such as hemiplegia, slurred speech, vision problems, and cognitive changes are common in most survivors to some degree. When someone has a stroke as a baby, or before they are born, it can result in cerebral palsy, epilepsy, and other disabilities. We have a brain injury tag that you can look through!

Noonan Syndrome (about 0.1-1% - mild is 1%, severe 0.1%) Noonan Syndrome is a disability that is almost never mentioned in any context, but certainly not around the topic of writing disabled characters. It’s a congenital condition that can cause cardiomyopathy, chronic joint pain, hypermobility, short stature, facial differences such as ptosis, autism, and various lymphatic problems among other things. Some people with Noonan Syndrome might use mobility aids to help with their joint pain.

Hyperthyroidism (about 1.2%) Hyperthyroidism is a condition of the endocrine system caused by hormone overproduction that affects metabolism. It often results in irritability, weight loss, heat intolerance, tremors, mood swings, or insomnia. Undertreated hyperthyroidism has a rare, but extremely dangerous side effect associated with it called a thyroid storm, which can be fatal if untreated.

Hypothyroidism (>5%) Hypothyroidism is an endocrine condition just as hyperthyroidism is, and it causes somewhat opposite symptoms. Due to not producing enough thyroid hormones, it often causes fatigue, depression, hair loss, weight gain, and a frequent feeling of being cold. It’s often comorbid with other autoimmune disabilities, e.g. vitiligo, chronic autoimmune gastritis, and rheumatoid arthritis. Extreme hypothyroidism can also be potentially fatal because of a condition known as Myxedema coma (or “crisis”), which is also rare.

Deafblindness (about 0.2-2%) Being DeafBlind is often considered to be an extremely rare disability, but that’s not really the case. DeafBlindness on its own isn’t a diagnosis - it can be caused by a wide range of things, with CHARGE syndrome (congenital), Usher syndrome (born deaf, becomes blind later in life), congenital rubella, and age-related deafness and blindness being some of the most common reasons. DeafBlindness is a wide spectrum, the vast majority of DeafBlind people aren’t fully blind and deaf, and they can use various ways of communication. Some of these could be sign language (tactile or not), protactile, the deafblind manual, oral speech (aided by hearing aids or not), the Lorm alphabet, and more. You can learn more about assistive devices here! Despite what various media like to tell you, being DeafBlind isn’t a death sentence, and the DeafBlind community and culture are alive and thriving - especially since the start of the protactile movement. We have a DeafBlindness tag that you can look through!

It’s probably worth mentioning that we have received little to no asks in general for almost all the disabilities above, and it’s certainly not due to what mods answer for. Our best guess is that writers don’t realize how many options they have and just end up going for the same things over and over.

Only representing “cool” disabilities that are “not too much while having a particular look/aura/drama associated” isn’t what you should aim for. Disabled people just exist, and all of us deserve to be represented, including those whose disabilities aren’t your typical “cool design” or “character inspo”, and literally all of us deserve to have good, informed representation. Sometimes we are just regular people, with disabilities that are “boring” or “too much”, and don’t make for useful plot points.

mod Sasza (with huge thank you to mod Sparrow, Rot, and Virus for their contributions with research)

[haute-pockette]

The Doctor being disabled.

Every incarnation sitting somewhere on the autism spectrum. Their stims and behaviors vary between incarnations.

First doctor with alexithymia. On Gallifrey it was fine, ignored. A "superior race" that prided itself in observation without interference doesn't put too much stalk in compassion. But meeting humans up close with Barbara and Ian started him down a path of learning to put words to his own feelings as well as others.

As his body aged he also developed arthritis. The cane was for mobility as much as it was for style. He learned the hard way that aspirin is not Gallifreyan friendly (he survived the small dose, but it scared the hell out of Susan).

Two with lots of physical stims. All his gestures and wringing his hands, grabbing onto companions.

Dyspraxic Two. Chicken scratch handwriting, stumbling over his words and his feet. He really leans into tactile sensations whether it's the texture of his clothes or holding onto a companion, it was always grounding for him.

Third tended to shut down more than his first two since the constant stress and frustration of exile had him already wound pretty tight. He'll lock himself in the lab and just put himself on autopilot until he recharges enough to deal with whatever shenanigans are happening.

Three has tinnitus that of various sounds including almost like the tardis materialization sound. He often has to look up to check if the Master is showing up to bother him or not.

Four has ADHD alongside with autism. He struggles with constantly running from responsibility and wanting to have some sense of control of situations.

It's one of those snowballs of procrastination causing anxiety which causes him to procrastinate further. Unless it's urgently life threatening, his stress response is freeze.

Five masks and suppresses his emotions in an attempt to blend with neurotypicals more since he's self-conscious of his previous "eccentricity" as Four. It causes a lot of strain between him and Tegan after Earthshock.

Peripheral neuropathy causing muscle weakness in his legs cause of the difficult regeneration. Look how much he falls over and leans on the tardis console, he can't stand straight for long periods of time without aids. Usually has braces, but will use a cane around the tardis (would use the wheelchair but it's dead in the Castrovalva river).

Six gets overstimulated easier than some, especially by noises and textures. Usually that with things not going accordingly tends to set off meltdowns. Ever since he hurt Peri he turns his energy on himself instead.

Bipolar Six. He tends to handle mania better than depression, at least when he has too much energy he knows he can spend it and try to get it out. He'll usually park the tardis somewhere his companion can enjoy and shut himself away in the cloister room or zero room when at the worst of his lows.

Also type 1 diabetic six, regenerating from poison fucked with his metabolism. He is careful to take care of his blood sugar, but he's terrible at remembering to stay hydrated. That's why Mel is always shoving carrot juice at him.

Seven has ADD (yes I know it's technically "ADHD of the predominantly inattentive type" but ADD is easier). ADD as in he's always in his own head, always five points ahead of the conversation. His train of thought is incomprehensible to most, but there is a string of logic to it.

Dyspraxic Seven with an abnormal gait and stance. Bad posture makes him look shorter than he is. Only he can read his own handwriting, which he insists is not as bad as it is.

[andhumanslovedstories]

hello this is kind of heavy and no pressure at all to answer. and apologies because im sure you must have answered this before. but do you go through like a pain management flow chart for your patients and if so what are some of the steps? my dad is having some medical issues and i want to be able to help him manage his pain as much as i can. thank you and enjoy wasteland!

I work in a hospital setting so my pain management care plan is part of an interdisciplinary team in that setting. It's relatively easy for me to get, say, IV pain meds for a patient with extreme breakthrough pain. I don't know how well my approach would translate outside of that setting, I'm not palliative care trained, and I don't personally deal with chronic or acute pain (which is why I'm answering this publicly so other people can chime in), but in broad strokes:

First: Define pain. What type of pain is it? Muscle pain? Indigestion? Neuropathy? Surgical site? Stiffness from lack of movement? Is part of the pain also the fear of the pain? Sometimes when pain has been bad for a long time, or even has been bad in a short-term but very notable way, the idea of hurting that bad again is traumatizing. That fear of pain can, unfortunately, make you focus more on the pain you're feeling because now it's not just the physical sensation of pain, it's also the psychological impact of it.

Then, how does the pain affect you? Is it stopping you from sleeping? Is it stopping you from eating? Is it making you short-tempered or depressed? Does it make it difficult to focus on things? Does it make you nauseated? Anxious? Isolated? Do you feel like you need to hide it from those who care about you?

Everything pain is and affects is a place where you can intervene. Some of these interventions will be very small and would, if they were the only intervention, feel completely inadequate. Pain relief is rarely "you do one thing and you're done." You're addressing pain on multiple fronts, and sometimes that doesn't mean your focus isn't just the reduction of pain but the restoration of what pain has taken away. It's possible the worst part of pain for you isn't the pain itself but, for example, the immobility it causes. Are there different ways you can learn to move? Can you get a grabber? Can you get a shower chair? Can you find physical therapy exercises that help you regain strength or stop you from deconditioning to the degree you're able? What mobility aids might restore movement to you?

And if returning mobility is not possible at this time or ever, how can you modify your environment to support you? Can you figure out what bothers you the most about that immobility and mitigate that? If it's annoying that not being able to leave bed makes you bored, what can be within arm's reach? If it's frustrating that being too painful to move means you feel isolated from other people, can you make wherever you are more central? If pain makes having your bed on the second floor unfeasible, can you move your bed to the first floor? How can you adapt the environment around you?

I'd encourage movement too, to the degree it is possible. Being in the same position HURTS. If it feels good to stretch but you can't do it by yourself, can someone help you with range of motion? (You can look up "passive range of motion" to get an idea of how to do that.) This doesn't need to be exercising, just exploring the joy of moving your body. Related to movement is physical touch. I love lotions and medicated creams for pain patients because you can turn them into massages. Just be careful with pressure and be open about what hurts and what feels good. At the most gentle end of the spectrum is something called the M Technique which isn't even massage, it's like guided gentle touch. Give the body something else to feel.

Different medications work better with different types of pain. This part is hard to talk about in general because of the specificity of some pain med regiments. Tylenol is great, but be cautious with how much you are taking (acetaminophen overdoses are no joke) and remember that there's a point where more tylenol doesn't mean more pain relief. Opioids are great, but they can be very dangerous and aren't well-indicated for a lot of types of chronic pain. Even if opioids work best, I'd encourage you to be working on pain reduction on multiple fronts, as opioids are so controlled, it is easy to lose access to them. If opioids give you enough pain relief to do physical therapy, then make sure to do that physical therapy. Medications are amazing and I love them and I give out PRNs like crazy, but similarly to how I can't just take my depression meds and stop being depressed, pain medication works best in conjunction with other strategies. Those other strategies though can literally be something like "tramadol takes away the pain enough I can focus on something, and what I want to do with that focus is to watch a movie I've been meaning to rewatch for a while now but haven't had the spoons for." Sometimes all you will want to do when you get pain meds is sleep because you can't when you're hurting. Sleep is wonderful; how can you arrange your sleeping place and habits to make sleeping even more of a delight?

And if you find a medication that works, use it consistently. It is always easy to keep pain level than it is to address a pain spike. Don't wait until symptoms are at their worst to address them. Figure out what it feels like when your symptoms are ramping up, and intervene early.

Sometimes medications that aren't explicitly for pain can still help. If anxiety makes pain worse, consider an anxiety medication. If coughing hurts, can you get a numbing spray from your throat to make it less sensitive so you cough less?

I don't know how useful this is to you and your family. Hopefully it's at least something to think about. Think about palliative care (which is about the management of symptoms of illnesses rather than the treatment of illnesses) as not just taking away bad sensations but restoring good ones. You can't always get someone to a place with no pain. But what can you do to enhance life in the presence of that pain? There is a psychological aspect to pain, it's a parasite that drains you and makes you feel like you are nothing but a body that hurts and won't stop hurting. I want to make clear, I'm not saying pain is only in your mind. Bone mets and nerve pain exist whether you're cheerful about it or not. But pain doesn't have to mean suffering, it doesn't have to take away the things that make you you. Address pain through medication and therapies, but also remember that protecting, promoting, and prioritizing the parts of yourself that you most value and give you the most joy will help give your life so much substance that pain can't rob it all. You aren't doing one big thing. You are doing a thousand small things that make life easier, better, more suited to yourself and your abilities, and more aligned with the parts of life that you that give your life meaning.

(And a note in particular for being the family member of someone in pain--ultimately, they are going through this alone. It is their body. What can you make smoother for them? How can you protect their dignity and their privacy without making them feel abandoned or alone? How can you make it so your reaction to their pain is not part of their burden? Like for the six hundred other hypothetical questions in this endless post, the answers will be highly personal and will take time to figure out. Be patient and calm.)

[coquettemouse]

Modern au where Leo knows asl bc he got auditory neuropathy spectrum disorder (or he is deaf) and this is really annoying and exhausting. But Jason knows cause sometimes he get in long periods of being non verbal

[covid-safer-hotties]

Double trouble: Hypermobility may increase Long Covid risk - Published Aug 6, 2024

“For a middle-aged woman who hasn’t had any actual injuries, I’ve had a huge amount of physical therapy,” says Liza DiLeo Thomas, a 52-year-old emergency medicine doctor in New Orleans and mom to five kids. “My neck muscles were always weak, my knees were bad. In retrospect, I was actually hypermobile, I just didn’t realize it.”

Hypermobility is a catch-all term for a spectrum of disorders characterized by joints capable of moving beyond the normal range of motion, often due to abnormalities in connective tissue. The most common of these disorders, which range from mild to severe, is known as Hypermobile Ehlers Danlos Syndrome (HEDS).

HEDS seems to be more common in women and also may be connected to some cases of Long Covid. A recent study found that people with the condition were 30% more likely not to have recovered fully from Covid-19 infection, based on symptom surveys.

“I got my first Covid infection in March of 2020,” Thomas told The Sick Times. “After [my] second infection, I never recovered.”

Thomas has not been able to return to work in the ER. Worse still, her kids brought home more Covid-19 infections, and each reinfection over the course of the next three years triggered novel, debilitating symptoms, such as painful skin rashes and mild myelitis, an inflammation of the spinal cord. “I believe I’ve had Covid a total of five times,” she said.

In April 2021, she ended up at the office of Tulane University School of Medicine neurologist Michele Longo, who was helming a new Long Covid clinic. Longo and her colleagues have discovered that vulnerability to Long Covid may sometimes be linked to hypermobility.

Longo referred Thomas to multiple specialists, including Dr. Jacques Courseault, founder of Tulane’s specialty hypermobility clinic, launched in 2022. It is one of the few of its kind in the world. Collaboration between that clinic and Longo’s Long Covid clinic has yielded novel clues to the connection between the two conditions.

“The specialist at the clinic pushed along my iliotibial band and other parts of my leg,” recalled Thomas. “And he said, ‘Your muscle pain is not due to muscle damage. You’re hypermobile.’” Muscles will chronically contract to stabilize weak joints in hypermobile individuals, leading to chronic pain.

That insight gave clues to what might be off balance in Thomas’ body, and pointed the way for treatments that helped improve her function, including antihistamines, low-dose naltrexone, and lots of saltwater to help increase blood volume, as she was later diagnosed with dysautonomia and small fiber neuropathy. With her condition better managed, she now works part-time for the same hospital in an administrative role, mostly from home.

How a connective tissue disorder might increase risk of Long Covid Longo, the Tulane neurologist, is the kind of doctor who listens closely to her patients

“My migraine headaches brought me to neurology as a profession,” she told The Sick Times. “I’ve been living my whole life in that space of having a chronic condition that does not have a biomarker. That lends itself very well to believing my patients and empathizing with them.”

Early in the pandemic, she started seeing chronically ill individuals who were much younger than her typical patient, and who had not recovered from an acute Covid-19 case.

At her Long Covid clinic, she began to notice that some of her patients were hypermobile. She diagnosed them via the traditional Beighton scoring system — a simple in-office test which checks the flexibility of joints such as the fingers, elbows, knees, and spine. Then, she sent them over to the EDS clinic, where Courseault inevitably confirmed her suspicion. “Every patient I sent him was indeed hypermobile,” she said.

This past April, Longo and colleagues published a report on five hypermobile females with Long Covid aged 33 to 51. Once diagnosed and treated at the EDS clinic for common issues associated with hypermobility, they began to see some improvements. Longo and colleagues are now putting together a case series on fifty patients.

Read the rest at either link!

[epoxyconfetti]

State: I am old, fat and (deservedly) unloved. The diagnosed ADHD does not respond go treatment, and the highly probable position somewhere on the spectrum doesn't help. Peripheral neuropathy is worsening, taking with it my fine motor skills, balance and sense of touch. I'm avoiding opioids as long as possible for the nerve pain, so I avoid the addiction both my parents died with. Current painkiller has side effects not quite a bad. Burns and small cuts are almost daily, and if I don't stop using power tools I'm going to lose an appendage. If I don't die tripping down yet another flight of stairs. I seem to be progressing at the same rate as my dad did with memory-problems-leading-to-dementia, just at an age 20 years younger than he did. So, fifteen years tops until I'm in memory care.

Plan: Well, I'm off to school to try to train to make the world a better place, if I still can, before I die.

[expertacademicassignmenthelp]

Diabetes

Introduction to Diabetes

Diabetes, a metabolic disorder characterized by chronic hyperglycemia, arises from abnormalities in insulin secretion, insulin action, or both. The condition’s prevalence has reached epidemic proportions globally, with significant health, economic, and social implications.

Types of Diabetes

Type 1 Diabetes: This autoimmune disease results from the destruction of pancreatic beta cells, leading to absolute insulin deficiency. Genetics and environmental triggers play pivotal roles in its pathogenesis. Despite being less common than Type 2 diabetes, its onset during childhood or adolescence significantly impacts individuals’ lives.

Type 2 Diabetes: Predominantly a disorder of insulin resistance, Type 2 diabetes accounts for the majority of diabetes cases worldwide. Lifestyle factors, genetic predisposition, and obesity contribute to its development. Its insidious onset often leads to delayed diagnosis and increased risk of complications.

Gestational Diabetes: Occurring during pregnancy, gestational diabetes poses risks to both maternal and fetal health. Hormonal changes and insulin resistance characterize its pathophysiology. Effective screening and management are crucial to prevent adverse outcomes.

Other Types of Diabetes: Variants like MODY, LADA, and secondary diabetes present unique challenges in diagnosis and management, requiring tailored approaches to care.

Epidemiology and Prevalence

Diabetes prevalence varies across demographics, with disparities observed in age, gender, ethnicity, and socioeconomic status. The escalating burden of diabetes underscores the urgent need for targeted prevention and management strategies.

Symptoms and Causes

Hyperglycemia-induced symptoms like polyuria, polydipsia, and unexplained weight loss serve as clinical indicators for diabetes diagnosis. Understanding the complex interplay of genetic, environmental, and lifestyle factors elucidates the condition’s etiology.

Complications

Diabetes complications encompass a spectrum of microvascular and macrovascular disorders, significantly impacting quality of life and life expectancy. From diabetic retinopathy to cardiovascular disease, nephropathy, neuropathy, and diabetic foot complications, the ripple effects of uncontrolled diabetes are profound.

Diagnosis and Tests

Accurate diagnosis relies on comprehensive evaluation, including fasting glucose, oral glucose tolerance tests, and hemoglobin A1c measurements. Screening recommendations aim to identify at-risk individuals early, facilitating timely intervention and risk reduction.

Management and Treatment

Diabetes management strategies encompass pharmacotherapy, lifestyle modifications, patient education, and multidisciplinary care. Individualized treatment plans address glycemic control, blood pressure management, lipid optimization, and prevention of complications.

Prevention

Prevention initiatives target modifiable risk factors through health promotion, public health interventions, and community engagement. Emphasizing the role of nutrition, physical activity, and behavioral changes empowers individuals to mitigate their diabetes risk.

Outlook and Prognosis

Prognostic factors such as glycemic control, adherence to therapy, comorbidity burden, and psychosocial support influence long-term outcomes. Enhanced collaboration among healthcare providers, policymakers, and stakeholders is essential to improve diabetes prognosis globally.

Living With Diabetes

Coping with diabetes requires resilience, self-management skills, and social support networks. Empowering individuals through education, self-monitoring tools, and peer support enhances their capacity to navigate the challenges of daily diabetes management.

Impact on Individuals and Society

Diabetes exerts a profound socioeconomic burden, encompassing healthcare costs, productivity losses, and reduced quality of life. Addressing the psychosocial dimensions of diabetes care is integral to fostering holistic well-being and societal resilience.

Future Directions and Research

Advancements in diabetes research, including precision medicine, digital health technologies, and novel therapeutics, offer promising avenues for disease management and prevention. Collaborative research endeavors aim to translate scientific discoveries into tangible clinical benefits.

Conclusion

In conclusion, diabetes represents public health challenge necessitating a comprehensive, patient-centered approach. By fostering awareness, promoting early detection, and advancing evidence-based interventions, we can mitigate the impact of diabetes on individuals, families, and communities worldwide.

Medical students encounter significant academic challenges during their studies, balancing coursework, clinical rotations, research, and personal commitments. Expert Academic Assignment Help offers tailored assistance to meet their needs, providing study materials, tutoring, assignment help, and exam preparation. Beyond academics, it fosters a supportive environment for mentorship and guidance. In essence, Expert Academic Assignment Help is a valuable resource for medical students, empowering them to excel academically and develop into competent healthcare professionals. Contact at expertassignment46@gmail.com for assistance.

[holonfoil-birthday-cards]

Hi!

It looks fancy but Arc is it hard to read, sorry.

Hi! I’m Philomena!

I’m a Pokemon Therapist based in Holon! I work alongside Rangers, the local Sanctuary centre, Adoption Shelters, and trainers to care for Pokemon physically and mentally! I am constantly exhausted!

My first official Pokemon is Orich, service Espeon δ to help with my ANSD (Auditory Neuropathy Spectrum Disorder), mainly by telepathy or rubbing up against me with his metal fur to direct attention. It hurts but it works.

My second is Mab, a Quilladin I adopted from Holon’s shelter. Though originally adopted because I let him evolve under my care and that led to impulsive decisions, he’s now a service Pokemon after doing some courses — he’ll keep me upright or move me when I feel faint. Take that, hypoglycaemia!

My third and last as of now is Ambrosia, a little fidough I adopted from @/bellamew. She is a very sleepy doughball. Sophie wants me to get her trained to help hypoglycaemia too.

I work quite close with wild Pokemon around Holon and ones in the Sanctuary & Shelter, so I’ll talk about them! Likely not trainers’, that’s definitely a breach of contract. I will also swear but not excessively if I can help it.

I made this when I was new to the site, I was just kinda mimicking the types of intros & set ups I’d seen others do. It’s worked so far so I’ll keep it.

People usually use she/her for me but I’m not opposed to they!

{ooc below}

Hi! I’m less new than when I started now! This all began when a friend introduced me to this side of tumblr pretty quick and I decided why not! Do still so please just tell me if I’ve mistaken a meaning or missed something or whatever else is usual etiquette on here. I think I’ve done ok so far, the whole thing is still overwhelming but I’ve survived this long.

I’ve seen that people give warning for the topics that might arise so I’ll be adding them here as time goes on and any story develops.

Violence (likely pokemon-on-pokemon, but there’s always possibility of pokemon <--> human); tw violence , pokemon violence & pokemon injury seem to be the appropriate tags

Pokemon consumption/as food (I like food so it will probably leach onto here via pokemon); pokemon consumption

[zhaoneurology]

The Rise of Neurology Specialist Clinics

The demand for neurology specialist clinics has been on the rise globally, and Singapore is no exception. With advancements in medical science and an aging population, the need for specialized care to diagnose and treat neurological conditions has significantly increased. This trend underscores the importance of early intervention and tailored care for complex brain and nervous system disorders.

Reasons for the Increase

Aging Population Neurological disorders such as Alzheimer’s disease, Parkinson’s disease, and stroke are more prevalent in older adults. With Singapore’s rapidly aging population, the need for clinics specializing in neurological care has grown exponentially. These clinics provide targeted treatment plans and ongoing support, improving the quality of life for patients and their families.

Increased Awareness Public awareness of neurological health has improved, encouraging individuals to seek professional help for conditions like migraines, epilepsy, and neuropathy. Early diagnosis plays a critical role in managing these conditions, driving more people to neurology clinics.

Advanced Diagnostic Tools Modern neurology clinics are equipped with state-of-the-art diagnostic tools, such as MRI and CT scanners, electroencephalograms (EEGs), and advanced laboratory tests. These technologies enable precise diagnoses and effective treatment plans, attracting more patients to specialized facilities.

Focus on Mental Health The connection between mental and neurological health has gained recognition. Conditions such as depression, anxiety, and sleep disorders often have neurological roots. Specialist clinics are uniquely positioned to address these interconnected issues, providing holistic care.

Benefits of Neurology Specialist Clinics

Specialized Expertise: Neurology clinics house experts trained to manage a wide spectrum of neurological disorders.

Personalized Care: Tailored treatment plans ensure patients receive care suited to their specific needs.

Comprehensive Support: From diagnosis to rehabilitation, these clinics provide end-to-end services, ensuring continuity of care.

Future Prospects

With ongoing advancements in neurology, such as minimally invasive procedures, telemedicine, and gene therapies, specialist clinics are set to play a pivotal role in healthcare. These facilities not only address current demands but also anticipate future challenges in neurological health.

In conclusion, the rise of neurology specialist clinics reflects a positive shift toward comprehensive, accessible, and advanced care for neurological conditions. This growing trend ensures better health outcomes and an improved quality of life for patients.

[skiesbelongtoyou]

Note for my self on Alcohol:

Alcohol-mediated nutrient malabsorption involves multiple mechanisms that disrupt the normal processes of digestion, absorption, transport, metabolism, and storage of nutrients. Alcohol irritates and damages the mucosal lining of the stomach and intestines, reducing the surface area available for nutrient absorption. It also impairs the secretion of digestive enzymes from the pancreas, which are essential for breaking down macronutrients (proteins, fats, and carbohydrates) into absorbable particles. Alcohol disrupts active transport mechanisms required for the absorption of nutrients like thiamine, folate, and amino acids, which depend on specific transport proteins in the gut lining. Alcohol metabolism consumes cofactors like nicotinamide adenine dinucleotide (NAD+), reducing their availability for other metabolic pathways, such as those involved in nutrient utilization. Chronic alcohol use reduces bile production, impairing fat absorption and the absorption of fat-soluble vitamins (A, D, E, and K). Alcohol-induced liver damage (e.g., fatty liver, hepatitis, cirrhosis) impairs the synthesis of carrier proteins (like albumin) and the activation of vitamins (e.g., vitamin D and vitamin A). Alcohol alters the composition and diversity of the gut microbiome, reducing beneficial bacteria that play a role in nutrient synthesis and absorption. Alcohol-mediated nutrient malabsorption increases the risk of alcohol-related brain damage (ARBD). ARBD refers to a spectrum of cognitive, neurological, and structural brain impairments caused by chronic alcohol misuse. It encompasses a range of disorders that result from the direct neurotoxic effects of alcohol, as well as secondary consequences such as nutrient deficiencies, liver dysfunction, and trauma. ARBD is distinct from other neurodegenerative conditions but shares overlapping symptoms with disorders like dementia. The risk of alcohol-mediated nutrient malabsorption increases with the frequency and volume of consumption and the presence of other gastrointestinal health conditions such as IBS/IBD, Crohn’s, Celiac’s, diverticulosis/diverticulitis, gastroesophageal reflux disease (GERD), and a host of liver and kidney conditions, that can further impair nutrient absorbtion. The most common alcohol-mediated micronutrient deficiencies include: Vitamin A, Vitamin B1 (thiamine), Vitamin B2 (riboflavin), Vitamin B7 (biotin), Vitamin B9 (folate), Vitamin B12, Vitamin C, Vitamin D, Calcium, Iron, Magnesium, Selenium and Zinc. Those who have or are currently experiencing food insecurity and/or traumatic stress have an increased risk of alcohol addiction, and subsequently, an increased risk of alcohol-mediated nutrient malabsorption. The most common neurological conditions and symptoms associated with alcohol-mediated micronutrient deficiencies include: Wernicke-Korsakoff syndrome, Peripheral neuropathy, Myelopathy, Alcoholic polyneuropathy, Cerebellar ataxia, Anemia, Weakness and fatigue, Insomnia and sleep disturbances, Pain and Executive dysfunction.

[softhearing]

Auditory Neuropathy Spectrum Disorder: Understanding ANSD

Auditory Neuropathy Spectrum Disorder (ANSD) disrupts how sound is transmitted from the ear to the brain, leading to unique hearing challenges. Our blog, Auditory Neuropathy Spectrum Disorder: Understanding ANSD, dives into its causes, symptoms, and available treatments. Learn how early diagnosis and advancements in care can improve outcomes and offer hope for those affected.