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Effects Of Drug Abuse; Family And Friends

Dealing with Drug Abuse in the Family
What exactly is drug abuse?
The use of a drug for a nontherapeutic effect. Some of the most commonly abused drugs are alcohol; nicotine; marijuana; amphetamines; barbiturates; cocaine; methaqualone; opium alkaloids; synthetic opioids; benzodiazepines, including flunitrazepam (Rohypnol); gamma-hydroxybutyrate; 3,4-methylenedioxymethamphetamine (MDMA, ecstasy); phencyclidine; ketamine; and anabolic steroids. Drug abuse may lead to organ damage, addiction, and disturbed patterns of behaviour. Some illicit drugs, such as heroin, lysergic acid diethylamide, and phencyclidine hydrochloride, have no recognized therapeutic effect in humans. Use of these drugs often incurs criminal penalty in addition to the potential for physical, social, and psychological harm.

Ecstasy – Class A – Article

Drug abuse does not just effect those abusing the drug – it also effects those around the user, including (but not limited to); family, friends and co-workers. In this article I’ll explain two things to you; what these effects are, and how you can get help to tackle them.

Effects:

Children, young children especially, are easily affected by drug abusing parents. When a child’s parents are abusing drugs openly it can push the child into viewing themselves as different. It might seem like a small thing, but feeling different from everybody else is one of the most common roads to depression, and depression kills more than drugs – indirectly. He or she may feel outward from their peers or even strangers in their own home – if you had a drug abusing parent, would you take your friends home to play the play station?
It also puts a heavy implication on them to develop an OCD or even worse, wind up involved in crime.

The friends of a drug addict will often feel rejected as the drug abuser starts to stay at home taking drugs rather than going out with friends, this can lead to the friends feeling not only rejected, but it also puts them in a tricky situation. Friends are important and if a person is going to quit drugs – then they will need all of the support they can get!

Drug abuse has a very negative effect on a person’s financial status. Drugs are not cheap at the best of times – but it doesn’t help that drug dealers tend to offer them at a low price first, and then raise the price when the user is addicted so that they are prepared to pay absurd amounts of money for a ‘fix’. If money isn’t legally available then an addict might eventually be pressured into crime or ‘service’ – which means they’ll be either stealing money to pay for drugs, or they’ll be ‘working’ illegally for drugs.

Help:

Help can come from many places, below is a list I compiled of websites and organisations which I feel can help you!

Websites and Organizations;
http://www.lifeline.org.uk
www.drugsline.org
‘Unhooked’

Medicine in the Victorian Age

The beginning of the Victorian age was characterized by steady population growth with a new look on medicine and a fresh approach to science.

During the Victorian age, physicians used the new science of optics in the form of microscopes to confirm the existence of bacteria, the main cause of many deadly illnesses.

Numerous educated people began to believe the presence of bacteria and germs and started taking preventive measures. Various paradigms, ideas, concepts, theories and philosophies were systematically tested for the first time by the large number of inquisitive and qualified physicians educated in the new schools of this time period.

The Victorian medicine enhanced the not only the level of comfort and quality of life during this period, but also blazed a new path for the upcoming generations.

During this era, the surgeons and doctors frequently received high rank and prestige in any society.

Elizabeth Blackwell, the first college educated female physician in Western history graduated in this time, and Florence Nightingale revolutionized the field of nursing.

Even with all this new medical knowledge being discovered at high speed, most of the people in the Victorian age still relied on home remedies, herbal treatments and homemade prescriptions.

Health suggestions were given either by a household manual or by word of mouth. Matrons, heads of households and frequently servants had adequate medical knowledge and remedies for minor ailments.

Even in affluent neighborhoods where the residents could afford doctors at will at least one member of any household would be well versed in herbal medicine.

People would frequently lance boils, sooth coughs and make poultices for wounds at home.

This home-grown confidence and knowledge served both as an alternative to and ongoing support for professional aid.

Common treatments given to people during the Victorian age included bleeding, purging, plastering, sweating, amputation and blistering.

These techniques are not often found in use today, but at the time helped many people alleviate symptoms of a variety of painful disorders.

Plastering was a treatment that used a paste made from a range of ingredients including mud or plaster and then applying such substances in the affected area of the patient to relieve internal pain or cold.

Bleeding was done in an attempt to relieve high blood pressure, sweating was thought to expel poisons from the body, and amputation was possible for the first time as a viable alternative to gangrene.

Poultices were also used for bites, boils and wounds. Poultice ingredients could be as commonplaces as milk and bread to exotic herbs and cow manure.

Purging involved providing a patient with heavy dose of emetics or laxatives to expel “poisons” from an individual’s body.

Surgery in the Victorian age became more sophisticated and safer through the usage of antiseptic medicines and the beginnings of aseptic technique.

However, during this time while these developments were welcomed, many remained dependent on household manuals for everyday medical treatment.

These historical home remedies occasionally even offer symptom relief from various chronic ailments even today.

What Is A Vitamin? Fat Soluble Versus Water Soluble Vitamins

A vitamin is an extremely complex organic substance needed in very small amounts in the diet, but is essential for human life and metabolic processes. Metabolic processes would include growth, maintenance, and health. The body is not capable of producing sufficient quantities of vitamins to supply its needs under normal circumstances.

There are some substances that we would call vitamin-like substances that are not considered essential since the body’s tissues are usually able to produce them in sufficient amounts. Sometimes, they are supplied as composite parts of vitamin complexes of other nutrients.

Each vitamin has its own unique function in the human body and cannot be replaced by any other substance. Vitamins, for example, as coenzymes, perform principally as regulators of metabolic activity at a physical and chemical level at a cellular level. These processes play important roles in energy production.

Vitamins are obtained typically from foods and are an integral part of a nutritive mix or compound which is exquisitely interlaced and fused with the whole food itself. Some vitamins are just provitamins or they are precursor to a whole food vitamin preparation. In other words, these precursors are converted into the required active substances within the body.

Although vitamins often times are considered to be a single substance, each vitamin is actually a group of chemically related compounds. Separating or fractioning the group or the compounds into a single incomplete vitamin portion converts it from a physiological, biochemical, active micronutrient into a disabled, debilitated chemical of little or no value to living cells.

Traditionally, the most convenient way to classify vitamins is by their solubility. Basically, what that means is, are they capable of being dissolved in water or fat.

Fat-soluble vitamins are soluble in fat solvents. In other words, they are held in fats and absorbed with dietary fats and offer integrated fats into the diet. Fat-soluble vitamins are insoluble in water. The fat-soluble vitamins would include the following: Vitamin A, D, E, K, and the essential fatty acids. Fat soluble vitamins typically are not excreted in the urine, but tend to be stored in moderate amounts in our bodies.

Water soluble vitamins of course are soluble in water and are thus suspended in water molecules and food. These will include all the vitamins of the B complex and C complex groups.

The traditional view of vitamins for many, many decades had been that they were compounds essential for preventing deficiency diseases and as coenzymes or activators in key physical and chemical reactions in the body. Now, as we understand more what vitamins do in our bodies, we are identifying new functions and roles that are being found by these vital nutrients. Vitamin needs by our human body vary from individual to individual.

Nutritional requirements by individuals also vary from individual to individual, and although each person needs all the same nutrients, the quantities of each nutrient needed daily are distinctively different for every individual. Each individual human has patterns and needs all of his own, which in itself may vary due to environmental, circumstantial, and genetic conditions.

Most of our vitamins can be found in food and are either directly or indirectly produced by plants. The exceptions are vitamin D which can be produced in adequate amounts by the body utilizing the ultraviolet light from the sun and vitamin B12 which can be produced by fungus, soil microorganisms, and some bacteria. The intestinal bacteria normally also produce at least a portion of the needed vitamin K, as well as smaller quantities of some other B complex factors.

Nevertheless, vitamin-rich whole foods are still the only source or the most important source of virtually all vitamins. Some of the best sources of vitamins include seeds of all kinds including nuts, whole grains, and eggs, particularly the germ, which would eventually develop into a new plant or animal, yeast, yeast extracts, liver and some other organ meats, since the vitamins tend to concentrate in organ tissues in animals, and finally fruits and vegetables. How do we know if we are deficient to certain vitamins or minerals?

A subclinical deficiency means the body’s vitamin or mineral or trace mineral stores are gradually drained resulting in loss of optimal health and impaired body process that depend on that particular nutrient.

In future articles, I will be discussing the various different vitamins, what foods they can be found in, and their importance in overall human health. Until then, I would recommend you consult with your family physician or healthcare provider for more information on vitamin, nutritional needs.

Catchy Slogans For Hospitals: How To Get The Best Hospital Campaign Slogans & Taglines

Hospital branding is more competitive than ever. That’s because hospitals are more competitive than ever. That’s why healthcare organizations are trying to utilize every advantage possible to attract more patients and more profitable patients. Among of the most powerful ways hospitals can stand out is through catchy campaign slogans. Hospital ad slogans and taglines can be tricky though. It’s tough to represent an incredibly complex healthcare organization in just a few words. To make things worse, in trying to come up with a slogan most organizations have a hard time finding consensus on which of their potential campaign slogans is right for them. That often results in bland, generic, never effective hospital marketing slogans and advertising taglines like “Experience You Can Trust” or “Serving Our Community Since 1989.”

Someone get me a pillow. I’m about to fall asleep!

Catchy slogans, whether they’re hospital advertising slogans for billboards or hospital taglines to compliment your logo, should always offer a point of differentiation and have that point of differentiation delivered in a memorable way. There’s a great slogan being used right now by an academic medical center in Florida. Their slogan is “The Science of Hope.” Talking about the scientific aspect or their organization differentiates them from the for profit hospitals and adding hope into the equation makes it a catchy slogan with a truly feel good tone.

So how do you get great hospital ad slogans, hospital campaign slogans or hospital taglines that demonstrate your differentiation in a clever way? Don’t try and do it yourself! You wouldn’t want a professional slogan writer performing surgery on you so why would you attempt to do their job?

Among the most popular options at present is initiating a confidential hospital advertising slogan contest using a slogan generator website. Using these professional slogan generator sites, simply require you to put up a cash prize of anywhere from $200 – $999. Then professional slogan writers begin submitting ad agency quality marketing slogans, usually starting within 24 hours. Once the contest has ended, usually after a week to two, depending on the site, you select your favorite entry. The best slogan or advertising tagline writer wins the cash and the rights to the slogan/tagline are passed along to you. Slogan writers are found everywhere from the United States to Australia and England.

Your other option is to hire an ad firm with experience in hospital advertising slogans. Yes, that means far fewer choices than a contest slogan site and the price is sure to be more expensive, however that might be the best route if you prefer the traditional way of getting a slogan.

An effective hospital advertising tagline can be among the best investments you can make in your brand. So just like your ask of a great hospital doctor, make the diagnosis, take action and enjoy the fruits of your label – a healthy marketing foundation.

Medicine in Elizabethan England

During the reign of Henry VIII (1485-1509) in England, the royal confiscation of monastic land s and church properties put a huge crutch on the entire charitable system. Between 1536 and 1544, one would have to search far and wide for medical help, and there was absolutely no help for indigent people in the city of London. In 1569, royal hospitals were finally restored, including Christ’s Hospital for Children, St. Mary’s of Bethlem for mental cases, and general hospitals such as St. Bartholomew’s and St. Thomas’. However, hospitals were not the only options for a sick individual. Queen Elizabeth I’s reign (1558-1603) brought the restoration of general charity, and there were many types of professionals and individuals to turn to for seeking medicals attention. As a result of this broad spectrum of medical choices, a mixture of the theory of Humors, the Doctrine of Signatures, astrology, tradition, chemical science, and magic became the basis for popular medicine in Elizabethan England.

One of the most socially acceptable and encouraged forms of charity was medical charity. It was believed that sick people obviously needed help to have a positive recovery. Another motive for giving medical help was to help the poor make a safe return from sickness back to work, and thus removing the need to further provide monetary help. The city of Norwich often paid large amounts for physicians to treat the poor. It was also often that the city would hire one poor person to nurse and keep another poor, sick person, to kill two birds with one stone. An interesting fact is that it was common for a small sum to be paid initially to a bonesetter, but the bulk of the fee would only be paid when the patient was able to walk again. Thus, it is apparent that the practitioner took full responsibility for the patient during the recovery period. The city of Norwich also paid for shelter during the recovery period for patient. Norwich is the prime example of the great involvement and motivation for treating the poor and the sick in Elizabethan England.

When a merchant in Elizabethan London gets a fever, he first will ask the physician to diagnose him. Then, he will ask his wife if she knows of a certain herb that will lower his fever. If she has nothing in her stillroom, then she contacts an apothecary. The apothecary will then prepare the medicine prescribed by the physician. If finding little relief, the merchant will then go to the local “cunning” woman down the street, who will give him a charm sprinkled with bergamot oil, advise him to eat cool and dry foods, and maybe advise him to consider attaching a leach or two to his skin to relieve his blood Humor, This is an example of the common diagnosis and treatment of a patient.

It is apparent that medicine was distributed by an array of different people. The doctor a patient could see depended on the patient’s class and whether he or she had the money to pay the fee. These professional physicians, who would have received an education at one of the Universities or Colleges for Physicians, were usually only afforded by the very wealthy. Surgeons had a similar reputation to the barbers, whom they associated with and belonged to in the Company of Barber-Surgeons. Barbers were only allowed to pull teeth or let blood by cutting or use of leaches. Usually, patients first visited the apothecary, who was the Elizabethan equivalent for today’s pharmacist. They carried herbs, oils, chemicals, cosmetics, perfumes, and drugs. The Church could be considered a participating medical practitioner for providing attention and comfort to the sick and poor. Poor patients, however, usually first contacted the local “wise woman” or “cunning woman.” Usually, this woman had a good reputation for traditional remedies and treatments. Bonesetters set bones for broken limbs and ribs. Midwives took care of the childbirth department of medicine. There were also herb-gatherers-and-compounders, hernia specialists, cataract couchers, dentists, and many other types other types of specialist. Lastly, there were ordinary Elizabethan housewives, who were expected to have some knowledge of simple herbal and traditional remedies to produce homemade medicines and potions. En masse, a patient who had many options, and picked and chose from different services from many individuals and types of providers.

Medicine in Elizabethan England was ridiculously basic for an era with terrible illnesses, such as the Bubonic plague and typhoid, and an enormous lack of sanitation in large cities with open sewers filled with garbage, infestation of rats, lice, and fleas, and no running water. The cause of illness was almost entirely unknown, and the beliefs were mostly based on teachings by ancient Greeks and astrology. The ignorance is also apparent in the common clothing of physicians, which were often seen as very strange. The clothing consisted of a large, full, dark cloak, boots, gloves, a hat, and a mask shaped like a bird’s beak, which held bergamot oil. They also wore amulets of dried blood and ground-up toads at the waist for preventative purposes. It was also a custom to douse oneself with vinegar and to chew angelica before approaching the patient. These precautionary steps may seem very ridiculous and random. However, the popular belief about medicine formed from six different theories, which happened to make sense at the time.

The ancient Greek, Galen, formed the first theory. He believed that the body consists of our bodily fluids called “Humors”: blood, phlegm, yellow bile, and black bile. Each humor possessed certain characteristics. Blood is hot and wet, Phlegm is cold and wet, Yellow Bile is hot and dry, and Black Bile is cold and dry. A natural balance of these fluids will keep the body in a healthy state. Any imbalance will result in illness. For example, a cold is the result of too much hot and dry phlegm in the body. This can be counteracted by drying and heating, or staying in bed and eating hot soup. For another example, a fever is the result of an excess of blood in the body. A treatment for the fever would be to remove excess blood with leaches, or eat cool and dry foods, like crackers. The characteristics of the four Humors were also considered for treating mental illnesses, as blood is sanguine, phlegm is phlegmatic, yellow bile is choleric, and black bile is melancholic.

The second theory is the Doctrine of Signatures. This theory comes from the Bible, stating that God gave Man lower creatures for Man to use for his benefit. Man uses many creatures for sustenance, and many creatures for labor. Other non-edible creatures on Earth should be used as ingredients in medicines. For example, Lungwort is good for the lungs, and Eyebright will clear the eyesight.

The third theory, astrology, has been signs and planet orbits of a patient’s birthday to determine the severity and duration of an illness. The fourth theory is the traditional approach to medicine. This theory states that illness is a foreign presence in the body; the expropriation of the forging presence is the key to treatment. For example, an exorcism is necessary for mental illness, a King’s touch is a cure for scrofula, tuberculosis in the neck, and toads are a cure for warts.

The fifth theory uses chemical science, in which newly discovered pure substances and non-organic materials were pressed into medical service, such as tobacco and mercury. The sixth theory deals with magic. In days, the dividing line between magic and legitimate medical practice was extremely blurred. Magic seemed perfectly logical and even scientific to an Elizabethan.

The most common cleansing agent used was vinegar, which was applied to most wounds to prevent from infection. The only cure for toothache was having the tooth pulled, which did not include the use of any anesthetics. Bubonic Plague was treated by applying warm butter, onion, and garlic to the bubo. Other various remedies for the plague were tried, including tobacco, arsenic, lily root, and dried toad. Head pains were treated with sweet-smelling herbs such as sage, bay leaf, rose, and lavender. Stomach pains were treated with wormwood, mint, and balm. Lung problems were treated with licorice and comfrey. These are all specific examples of treatments for common complication in the Elizabethan era.

An important benefit of all Elizabethan medicine is the confirmation of the placebo effect. The belief in one’s treatment excites the patient’s optimism and hopes, which is often the most important part of the recovery process. This is probably the most prevalent, underlying secret to Elizabethan medicine, whether the medical practitioners and patients knew it or not. The great variety of specialists, learned physicians, and magicians and all their ideas and beliefs, including the bodily Humors, the Doctrine of Signatures, astrology, tradition, chemical science, and magic, is important reason why everybody did not die in unsanitary, Bubonic Plagued, rat-infested, and garbage-filled Elizabethan England.

Work Citied

Bynum, W F., and Roy Porter. Companion Encyclopedia of the History of Medicine. London: Routledge,1993.

Holmes, Martin, Elizabethan London. London: Praeger, 1969.

Kiple, Kenneth F. The Cambridge World History of Human Disease. New York City: Cambridge UP, 1993

McGrew, Robert E., comp. Encyclopedia of Medical History. McGraw-Hill Book Company, 1985.

Pritchard, R E. Shakespeare’s England: Life in Elizabethan & Jacobean Times.

What is Bhrigu Bindu

Dr. Shanker Adawal

Bhrigu Bindu is an imaginary, but very sensitive mid-point of Rahu-Moon axis. When any planet, benefic or malefic including Rahu & Ketu, during transit aspects or conjuncts this point, some momentous favourable or unfavourable events takes place. This Bindu (point) is arrived at by adding the longituders of the Moon and Rahu (counted from zero degree of Aries) and then dividing the total by 2. For example if in a natal chart, the Moon is in Taurus at 19 degree, 47′ and Rahu is in Leo at 29 degree 27′. Then the Bhrigu point will be (1-19-47 + 4-29-27)/ 2 = 3- 9- 44′ or 9 degrees 44′ in sign Cancer. The lord of the sign occupied by Bhrigu Bindu, always give good results provided it is not weak.

The Moon, Sun, Mercury & Venus, during their cycle will form two such results, one of aspect (7th) and the other of conjunction. The outer planets, Mars, Jupiter & Saturn will form four such results per cycle, three for aspects (4th, 7th & 8th by Mars, 5th, 7th & 9th by Jupiter and 3rd & 7th, & 10th by Saturn) and one for conjunction in each of their average cycle of 18 months, 12 years & 30 years respectively. It should always be remembered that the effects of transit by conjunction are more potent than those by aspect. There is some doubt about Rahu & Ketu, but normally it is considered similar to those of Jupiter in each of their cycle.

A benefic Jupiter during transit, as referred above, will give favourable results such as progress in studies, birth of children, getting employment/ marriage, promotion in service/ business, increase in wealth or fulfillment of long cherished desires. Fast moving benefic planets like Venus, Mercury or Moon, will indicate small gain of wealth/ happiness, meeting of friends/ relations, pilgrimage, rejoicings & festivities etc. Some times when two or more benefics simultaneously aspect/ conjunct this mid-point, give increasing magnitude of favourable results. Benefic planets & Bhrigu Bindu, if posited in Kendra/ Trikone to each other in natal chart, produce good & auspicious results.

Saturn, a slow moving planet, during transit over the Bindu produces unfavourable results such as chronic sickness, domestic unhappiness, sickness/ separation from family, sudden loss of wealth or even death etc. Mars has a peculiar liking for blood, accidents, quarrels and Sun acts a separatist or unhappy situations. Transit of Rahu/ Ketu causes events all of a sudden, on a big scale and from unexpected quarters, mental sufferings/ worries due to state actions, or poisonous infection etc. A weak planet when transiting Bhrigu Bindu, always gives bad results relating to the house it owns. But lords of malefics houses, having minimum strength and having 6th or 8th position in relation to the Bindu, fail to produce bad results to the house they own.

Conclusion

There are many sensitive points in a horoscope, transits of planets over which cause/  indicate important events/ trends in a native’s life. The nature of these events/ trends depends on and is modified by various factors. In the previous chapters we have seen how nature & strength of planets and their relative position from a reference point lagna or the Moon sign denotes the results/ trends. However these are modified by concept of Vedha/ Vipreet Vedha, Nakshtra considerations, Saptsalakha Chakra and Moorthy Nirnay methods of use of Bhrigu Bindu. These modifications have been explained with the help of 11 tables and appropriate examples. However transit of slow moving planets or retrograde planets are more apparent than of other planets.

Cure for Skin Rashes and Itching

Common rashes are often called dermatitis, meaning inflammation of the skin; they involve changes in the color or texture of the skin including skin redness or inflammation. Common rashes are also known as skin lesions, Rubor and Erythema.

Skin reactions are more common today due to many new fabrics in use. Some of the body rashes affect the whole body (termed as a generalized), where as others appear on discrete areas of the skin. Skin rashes can be self limiting or require medications. Babies often develop skin rashes because of irritation from the coloring materials in these fabrics. Skin or the body rash is a common term that describes a group of special spots, an area of inflammation or altered color or texture of the skin. Skin rashes might be associated with various other symptoms such as itching, tingling, burning, pain, inflammation and sometimes, surprisingly with no discomfort at all. Belladonna remedy is useful for conditions with sudden onset that are hot, bright red, and throbbing. Rash may be accompanied by fever.

Oatmeal bath is preferred

Applying olive oil to the rash could provide some relief.

Aloe Vera gel, cod liver oil and Vitamin E oil are also helpful in combating body rash.

Using baking powder on the affected area is another suggestion to deal with body and back rash.

Aloe Vera: Widely known for treating burns and sunburns, aloe vera also helps in healing wounds and minor skin irritations such as itchiness and rashes. This plant produces anti inflammatory, anti bacterial, and anti fungal properties. It also contains folic acid, zinc, and vitamins C and E.
Chamomile Essential Oil: Has anti inflammatory (anti-microbial) properties that soothes and eliminates an itchy skin rash and irritations. Chamomile is also used in treating eczema, psoriasis, and sunburn. Please be aware, people who are normally allergic to grass and ragweed may acquire an allergic reaction to chamomile.

Witch hazel: Acts as an astringent that relieves itching and minor skin inflammation. Also used for treating sunburns. For maximum benefit, use fresh witch hazel bark. Simmer one ounce of the bark with one pint of water and leave for ten minutes. Strain and cool. Apply with a clean cloth and leave it on for about thirty minutes.

There are natural alternatives to cortisone cream treatment for rashes. For example Eczema is often treated with cortisone cream to combat the itching. There is, unfortunately, no known cure for Eczema, but natural medicines can help reduce the symptoms of Eczema without the harmful side effects associated with cortisones and other pharmaceutical medications.

There are many treatment of skin Rashes. Cortisone is often used to decrease local inflammation, swelling, burning and itching often associated with common rashes. Many natural remedy creams that provide instant and long-term relief rashes. The best home remedy for body rashes is to apply olive oil on the rash affected area. Belladonna remedy is useful for conditions with sudden onset that are hot, bright red, and throbbing. Rash may be accompanied by fever. Ledum palustre remedy is indicated for a puffy and swollen rash. Both the swelling and the itching are relieved by cold applications.

Itch relief is important, because scratching can itself irritate the skin and lead to more itching, creating an itching-scratching-itching cycle. Fingernails should be kept short to minimize abrasions from scratching. Applying eucalyptus oil on the skin can be helpful or take a cotton ball or Q-Tip and apply Tea Tree Oil full strength to area that is itching.

The Science Of Phobias

Here’s how phobias work.

There are two parts to your mind – one that thinks, and one that feels.

The thinking part is the conscious, rational mind that you are using now as you read this.

The feeling part is the unconscious, emotional mind. It takes care of automatic tasks like regulating the heart, controlling pain and managing our instincts.

It’s the unconscious mind that is programmed to act instinctively in times of danger. It reacts very fast – making you run or fight – rather than allowing your thinking mind to philosophize while you are attacked by a tiger. This has great survival value.

The unconscious mind is also a very fast learner. The same emergency route that can bypass the rational mind in times of danger can also stamp strong emotional experiences (traumatic ones) in the unconscious mind. This makes evolutionary sense – it ensures that we have vivid imprints of the things that threaten us.

And just as we have two minds, so we have two memory systems: one for the facts and one for the emotions that may or may not go with those facts.

Sometimes, when a person experiences a very traumatic event, the highly emotional memory of the event becomes trapped – locked in the emotional brain – in an area called the amygdala which is the emotional storehouse. There is no chance for the rational mind to process it and save it as an ordinary, non-threatening memory in factual storage (in the hippocampus). Like the memory of what you did last weekend.

Instead, the emotional brain holds onto this unprocessed reaction pattern because it thinks it needs it for survival. And it will trigger it whenever you encounter a situation or object that is anything like the original trauma. It doesn’t have to be a precise match.

This is pure survival again. You only need to see part of a tiger through the bushes for the fear reaction to kick in again – for the “fight or flight” response to trigger – you don’t have to wait until you see the whole tiger or identify it exactly as the tiger that attacked you before. In fact, it probably only has to be something orange and black moving through the bushes. This is why the pattern matching process is necessarily approximate, or sloppy. You err on the side of safety. You don’t have to have all the details to know if something is dangerous.

This is the basis of a phobia: a fear response attached to something that was present in the original trauma. The response is terror, shaking, sweating, heart pounding etc. And because of the sloppy pattern-matching it can get stuck to literally anything – animal, mineral or vegetable. It may not even be glued to the thing that caused the trauma. So a child attacked in a pram by a dog may develop a phobia of prams rather than of dogs.

It is because phobias are created in this way, by our natural psycho-neurology, that they are so common. It’s the way we are wired. Approximately 10% of people have a phobia. It’s a very human thing. And it’s precisely because they are created by the unconscious mind that they seem so irrational. Of course they are – the rational thinking brain hasn’t had a chance to go to work on them.

Many traditional phobia treatments, including drugs, attempt to deal with the phobia by calming things down after this response pattern has triggered. They treat the symptoms, not the cause.

To treat the cause, this trapped traumatic memory has to be turned into, and saved as, an ordinary unemotional memory of a past event. The emotional tag, the terror response, needs to be unstuck from that object or situation.

This is exactly what a remarkable therapy called the Fast Phobia Cure does. It allows the phobia sufferer to review the traumatic event or memory from a calm and dissociated, or disconnected, state. The rational mind can then do its work in turning the memory into an ordinary, neutral, non-threatening one. And store it in factual memory where it should have been to start with. This happens very quickly because the mind learns fast. It learns the fear response quickly and it learns (or relearns) the neutral response just as quickly. And when that happens the phobia is gone.

Stroke, its Risk and how to deal with it

STROKE

th_Stroke_Illustration_Final.jpg?t=13293Blood Suppply to the Brain

The major portion of the blood supply to the brain flows through main arteries arising from the arch of the aorta (see chapter one on anatomy of the heart). On the right side, one large artery arises from the aortic arch called the brachiocephalic trunk. After a short distance, it divides into the right subclavian artery (which supplies the right arm and other structures) and the right common carotid artery. On the left side, the subclavian and left common carotid arteries arise independently from the aortic arch (Figure 1). Therefore, except for the origins of these arteries, the arterial supply is generally symmetrical and identical on both sides.

                                                    th_Blood_to_Brain.jpg?t=1329318888

Figure 1 Schematic diagram of the blood supply to the brain, Ao = aortic arch, LSA
left subclavian artery, LCC = left common carotid, BCT = brachiocephalic trunk, RSA right subclavian artery, RCC right common carotid, 1 = right common carotid, 2 = left common carotid, 3 = left external carotid, 4 = left internal carotid, 5 = basilar artery, 6 = vertebral artery, 7 = ophthalmic artery

The right and left subclavian arteries supply blood to the right and left arms, while the right and left carotid arteries supply blood to the head and neck.

Each common carotid artery, passes somewhat lateral to the midline of the neck. About midpoint between the root of the neck and the base of the skull, the carotid artery divides into two branches: the external carotid artery and the internal carotid artery.

The internal carotid artery continues straight up to the base of the skull without giving off any branches. It enters the skull, and its first branch is an artery called ophthalmic artery that supplies blood to the eye. It further gives numerous branches to supply the remainder of the brain. The external carotid artery, on the other hand, provides blood to the structures of the head and neck except for the eyes and the brain. The entire system of internal and external carotid arteries is actually intercommunicating by small arteries, which play a very important
role. In case of narrowing in one of the major arteries, they become thecomponents of the collateral circulation to the brain (Figure 2).

                                      th_Internal_Carotid.jpg?t=1329318889

Figure 2 Internal carotid artery and its first branch, the ophthalmic artery. Intercommunicating branches play an important role in collateral circulation, 1 = common carotid artery, 2 = external carotid artery, 3 = internal carotid artery, 4 = ophthalmic artery

Although the subclavian artery supplies primarily the upper limbs, it also supplies the head and neck. One such artery is the vertebral artery. This artery travels in the neck and eventually enters the skull to join with the vertebral artery of the opposite side to become the basilar artery. This artery supplies blood to the posterior portion of the cranial cavity. Furthermore, the internal carotid arteries from the opposite side also meet to form an important structure called the circle of Willis, which also supplies the posterior of the brain
(Figure 3).

As  demonstrated, the carotid artery is the only link to the brain. If an area of this artery narrows because of atherosclerosis, and if the narrowing is severe, brain tissues will be damaged, resulting in a stroke. The most frequently affected location by atherosclerosis is the carotid bifurcation—in particular, the origin of the internal carotid. A large number of patients with cerebral ischemia have narrowing or stenosis at the bifurcation area. Other sites are also affected, but it is not the purpose of this book to elaborate on detailed information on the anatomy of the blood supply to the brain and the most frequent affected sites.

                                          th_Vertebral_Artery.jpg?t=1329318891

Figure 3, Vertebral arteries of opposite sides meet to form the basilar artery. Also, internal carotid arteries meet with the basilar artery to form the Circle of Willis, 1 = left and right vertebral arteries, 2 = basilar artery, 3 = left and right internal carotid arteries, 4 =ophthalmic artery, 5 = Circle of Willis.

Mechanism of Brain Damage

A stroke disrupts the flow of blood to the brain damaging its tissue. There are
two major types of brain damage in stroke patients:

  1. Stroke caused by ischemia is the most common
  2. Stroke caused by hemorrhage is the result of bleeding due to a rupture blood vessel

Stroke Caused by Ischemia

About 90 percent of strokes are ischemic in nature,
they occur when the formation of a clot within an artery obstructs blood flow
to one or more blood vessels. Usually, the lumen (the space in the interior of
an artery or vein) of the vessel is narrowed because of changes occurring in
the wall of that vessel due to atherosclerosis and the formation of plaques.

Ischemia (deficiency of blood flow) to brain tissue
could also be the result of diminished blood perfusion due to poor cardiac
activity because of coronary artery disease and/or heart attack.

The severity of brain ischemia depends on the location
and duration of poor perfusion and the ability of collateral circulation to
provide an adequate supply of oxygen and nutrients to the affected region. The
most common ischemic strokes are;

  • Thrombotic stroke. This type of stroke is the result of blood clots
    (thrombus) formed in one of the arteries that supply blood to the brain. A
    blood clot usually forms in areas already damaged by atherosclerosis. The
    location greatly varies but the carotid artery is mostly affected.
  • Embolic stroke. Embolic stroke occurs when a blood clot or other
    debris from a blood vessel away from the brain ‑ most likely from the heart is
    swept by the bloodstream to lodge itself in the smaller blood vessels of the brain.
    This type of clot is called an embolus. One such cause of clots is due to an
    irregular heart rhythm causing the pooling of the blood in the heart that
    prompts the formation of clots. This rhythm is called atrial fibrillation.

Stroke Caused by Hemorrhage

Hemorrhage is the medical term for bleeding. It could
be the direct result and most often originates from rupture of aneurysms
(ballooning in the wall of an artery because of a weak spot), flooding the
surrounding brain tissue with blood. The accumulated blood can cause an
excessive increase in pressure, whereas bleeding from other sources is usually
slower and at a much lesser pressure.

When hemorrhage starts directly into the brain
substance, the cause is most often hypertension, blood leaks from small
arterioles damaged by high blood pressure. The severity of the damage will
depend largely on the location of the bleeding, rapidity of the bleeding,
volume, and pressure of bleeding (Figure 4). There are two types of hemorrhagic stroke;

  • Intracerebral hemorrhage. This type of stroke is the result of a blood vessel
    that bursts in the brain and spills into the surrounding brain tissue, damaging
    brain cells. In addition, brain cells beyond the point of leakage are deprived
    of blood are damaged. Hypertension is the most common cause of this type of
    hemorrhagic stroke. Over time, high blood pressure can cause damage to the
    small vessels that eventually becoming brittle and rupture easily.
  • Subarachnoid hemorrhage. This type of stroke is when the bleeding starts on, or near the surface of the brain. Blood spills in the space between the brain and the skull. This bleeding prompts the sudden onset of pain, severe headache, and causes damage to the surrounding brain tissue.

                                              th_Thrombus_Artery.jpg?t=1329318890

Figure 4, A = Thrombus causes total occlusion of the artery, B = Embolism: small fragments dislodge to totally obstruct smaller arteries distally, C = Hemorrhage, D = Aneurysm

Warning Signals

It is quite often that certain warning signals do manifest themselves prior to the
onset of a stroke for example:

  • Sudden, temporary weakness or numbness of the face, arm, and/or leg on one side of the body
  • Sudden confusion and temporary loss of speech, difficulty speaking, or difficulty understanding speech
  • Dizziness, loss of balance, and falling down
  • Problems with vision, including double vision, blurriness, or total loss of sight
  • Sensation changes such as to heat, affinity to distinguish or feel pain or lose the feeling of touch
  • Hearing changes
  • Sudden, severe headache with no known cause
  • Change of personality moods and/or emotional changes
  • Loss of memory
  • Changes in taste
  • Problems reading or writing
  • Difficulty walking and becoming very clumsy

Usually, miniature strokes precede a major stroke; these are known as transient ischemic attacks or TIA.

These TIAs can occur days, weeks, or even months prior
to a major stroke. Blood clots are usually responsible for occluding the artery
temporarily. TIAs can also occur when an artery of the brain goes into spasm,
causing temporary occlusion of the artery and, therefore, interrupting blood
flow. The resulting symptoms usually occur very rapidly and last for a
relatively short period. Some of these symptoms are similar to the ones
mentioned in the above section.

Whenever you, or an acquaintance  you know experiences any of the above
symptoms, it is very important that you seek medical help immediately so that a
major stroke can be prevented. Explain to your doctor the exact symptoms since
he has to determine whether you suffered from a TIA or another ailment that has
similar symptoms such as a seizure, fainting, or symptoms from a cardiac
condition. In any event, prompt medical attention is important since it might
prevent a fatal or disabling stroke from happening.

If you experience any of the above, or you are a
witness to someone you know that started to experience the symptoms,
immediately and without any hesitation call 9-1-1 or the Emergency Medical
Services (EMS) number so an
ambulance equipped with advance life support be sent
to your location. One very important fact, check the time when the symptoms
first appeared.

A clot busting drug called plasminogen activator (tPA)
if given within the first three hours of the start of the symptoms can greatly
reduce long-term disabling effects of a stroke.

Prevention and Risk Factors

Preventing a stroke is very important. It can result
in a much healthier life for both the patient and their families.

It is very unfortunate to find that most of the
population is unaware of stroke. Even though a stroke is the third-leading
cause of death in the United States, it has received much less attention than
many other more publicized diseases.

A survey of a large number of the population showed
that nearly half could not name any early warning signs of stroke. The survey results also included the following:

  1. Most were aware
    that stroke is among the three major causes of death in the United States.
  2. In answering to
    the question, “A stroke occurs when the blood supply is cut off to what part of the body? Twenty-nine percent failed to select the “brain” as the correct answer from the choices of “heart,” “brain,” or  “others.”
  3. About 7 percent thought that arthritis was a major cause of stroke.
  4. Only 44 percent identified weakness or loss of feeling in one arm or leg as a symptom of stroke.

Despite the lack of knowledge about stroke, there has
been a constant decline in stroke incidences. The public has become more health
conscious. Eating habits have changed, and there has been a reduction of
smoking and alcohol. Physicians are treating hypertension more aggressively,
and the availability of better diagnostic methods has led to better assessing
vascular disease in general.

Therefore, the best way to prevent stroke is to reduce
the risk factors involved. There
are two types of risk factors:

  1. Uncontrollable risk factors for stroke
  2. Controllable riskfactors for stroke

Uncontrollable Risk Factors For Stroke

Age

The incidence of stroke is greatly related to aging
and increases tremendously in each successive decade for people over fifty-five
years of age. The incidence of hemorrhage rises steadily with age. Stroke in
individuals less than forty-five years of age is frequently related to cardiac
in origin. This does not mean that only the elderly suffer from stroke because
a number of younger people are equally affected.

Sex

Men have 30 percent more risks of stroke than women
have; however, for people under the age of sixty-five, the difference is
slightly greater yet. In most age groups, more men than women will have a
stroke in a given year. However, more than half of total stroke deaths occur in
women. Use of birth control pills and pregnancy pose special stroke risks for
women.

Race

African-Americans
have a much greater risk of death and disability than whites do, and the reason
is black people have a higher incidence of high blood pressure, diabetes and
obesity  than white people.

Prior Strokes

The risk of having another stroke in an individual who already has a history of
prior ones, is greatly increased compared to an individual who never had a
history of strokes. TIAs (transient ischemic attacks) are a very strong
predictor of stroke and should be considered as a medical emergency.
Recognizing the signs and symptoms of TIAs will reduce the risk of a major
stroke.

Heredity

Your stroke risk is greater if a parent, grandparent, sister or brother has had a
stroke. Some strokes may be symptoms of genetic disorders like CADASIL
(Cerebral Autosomal Dominant Arteriopathy that causes  a gene mutation that leads to damage of blood vessel walls in the brain, blocking blood flow).

Diagnosis

Once an individual has shown some signs or symptoms of
transient ischemic attack (TIA), or stroke, a physician must follow that
patient closely and gather all necessary medical history and physical
information to determine whether

Controllable Risk Factors For Stroke

High Blood Pressure

Hypertension, is a condition that affects a large number of the population and can start as early as age nine. However, high blood pressure weighs more heavily than any other risk factor for stroke; in fact, the risk of stroke varies directly with a person’s blood pressure. High blood pressure affects both sexes almost equally and is not very well tolerated. As described earlier, hypertension is a silent disease; it does not cause any pain or symptoms, and that is why in so many people it goes undetected without treatment. This is also, why so many people die from sudden death due to a stroke.

High blood pressure is easily controllable and thus has a direct relationship in the death rate reduction from strokes. Blood pressure must be checked regularly. If it remains high, consult your physician immediately.

Diabetes

Diabetes is a controllable disease. It affects a person and adds a tremendous stress on the metabolism,  and it becomes a risk factor for stroke. This is even truer for women than men. Diabetes also strongly correlates with high blood pressure, making the risk for stroke greater.

Cardiovascular Disease

Cardiovascular disease increases the risk of stroke, mainly because of two reasons the first since the heart fails as a pump, and the consistency of a failing pump will cause deficiencies in the circulation, which leads to poor oxygen supply to the brain. Secondly, a diseased heart is a source of emboli (blood clots), which are carried by the bloodstream, causing obstruction to certain arteries responsible for supplying blood to the brain; thus, a stroke occurs. Diseased blood vessels of the arms, legs, and carotid arteries are a pathway of debris
towards the brain. Atrial fibrillation or quivering of the heart is anothercause of clot formation.

High Red Blood Cell Count

An increase in the red blood cell count may cause a stroke because the red blood cells tend to stick to each other, causing the formation of clots. The administration of blood thinners may solve the problem, preventing stroke. Sickle cell disease is a genetic disorder that
affects mostly African-Americans and Hispanic children. Sickled red blood cells
are not able to carry the normal amount of oxygen to the tissues and organs.

Besides the above two groups of risk factors, there are a number of other factors that play a role in promoting stroke who should be mentioned. Although these factors play a smaller role, they could become major risks if they are in association with others.

These risks are:

  1. High cholesterol intake of fat in your food
  2. Elevatedcholesterol and triglyceride levels
  3. Cigarette smoking
  4. Excessive consumption of alcohol
  5. Lack of exercise
  6. Obesity
  7. Oral contraceptives
  8. Poor diet
  9. Suffice to mention that other factors such as; Geographic location,
    Socio-economic factors, alcohol abuse and drug abuse play a role in the onset of stroke.

Although these are minor risk factors for strokes, they are major factors for heart disease; and heart disease is a major risk factor for stroke.

Stroke can cause death. Certain people have described that death is better than the disabling condition  patient experiences after a stroke. Furthermore, it is a traumatic experience for the direct family members of patients; therefore, it is important to understand the causes of stroke, and the risk factors involved. Unfortunately, no one can prevent a stroke, from happening, but one should be able to control the risk factors. Following a good diet and participating in an exercise program will definitely reduce the chances of suffering a stroke. Regular visits to your doctor and controlling high blood pressure is a healthy way to prevent a stroke.

Diagnosis

Once an individual has shown some signs or symptoms of transient ischemic attack (TIA), or stroke, a physician must follow that patient closely and gather all necessary medical history and physical information to determine whether these symptoms are, in fact, those of a stroke, since they could be of a different non-related disease.

A careful review of the events that happen are very important. Once all the physical data, facts, and laboratory test results are completed, the physician will be able to determine and pinpoint the presence of any abnormality(s) causing the symptoms.

Since the carotid arteries are the only link of blood supply to the brain, a careful examination of these arteries is appropriate and should be conducted, particularly if a bruit (unusual noise) is heard in the carotid artery region. An ultrasound examination is completely safe,
non-invasive, and painless, and it will show if any plaques are present in the artery that could possibly cause a significant reduction of blood flow to the brain.

If this test is positive, an arteriogram should be conducted in which a dye is injected into the blood at the site of the plaque, and digital images are recorded. These pictures will show the exact location and percentage of narrowing, if any is present. Upon the final interpretation
of the arteriogram, your physician will be able to make the decision regarding a method of treatment. If the narrowing is not important , the patient will be put on medication and watched very carefully. On the other hand, if the narrowing is significant, surgical intervention might be necessary. This is known, as carotid endarterectomy.
Your physician will determine the course of treatment. Similar to coronary  arteries stenting described in the Cardiac catheterization chapter, carotid artery stenting is feasible if the location and type of obstruction are favorable, thus preventing a surgical intervention.

The carotid arteries are not the only vessels responsible for causing a stroke; vessels present within the brain could also cause a stroke. An arteriogram of the brain is conducted to determine the presence of any disease. An arteriogram will also reveal the presence of a
brain tumor, that produces symptoms similar to those of a stroke. Cat Scan or computerized axial tomography scanner is another technique to diagnose the presence of tumors, and injury to the brain. If a lesion is found in the arteries of the brain, intervention can be performed to correct the problem. These aggressive techniques are not within the scope of this book. If a lesion is found in the arteries of the brain, intervention can be performed
to correct the problem.

Treatment of Stroke

Emergency treatment for stroke depends on whether you are having an ischemic stroke blocking an artery — the most common kind — or ahemorrhagic stroke involving bleeding into the brain.

            Ischemic stroke. To treat an ischemic stroke, doctors must quickly restore blood flow to your brain.

            Emergency treatment with medications. Therapy with clot-busting drugs must start within three hours — and the sooner, the better. Quick treatment not only improves
your chances of survival, but may also reduce the complications from your
stroke. You may be given: blood-thinning drugs such as Coumadin, heparin or others.
Aspirin is the best-proven immediate treatment after an ischemic stroke to
reduce the likelihood of having another stroke.

Several methods and techniques are available for the treatment of stroke:

  1. The surgical removal of plaques in arteries and tumors surgically, this    requires hospital admission and fullanesthesia.
  2. Drug therapy is administered aggressively through an intravenous (IV) of the most promising treatment by injecting the FDA-approved tPA (tissue plasminogen activator) that can significantly reduce the effects of stroke and reduce permanent
    disability. Generally, 3-5 percent of those who suffer a stroke reach the hospital in time to even be   considered for the treatment.
  3. Acute hospital care
  4. Rehabilitation
  5. Stenting could also be utilized to open an obstructive lesion similar to   the method described for coronary stenting (see: cardiac catheterization).

In many occasions, treatment of the heart can mean treatment of the stroke since
many forms of valvular diseases (diseases of the heart valves) may cause the
formation of clots that dislodge, travel in the blood stream, and end up in the
brain, causing a stroke.

We have outlined very briefly the method of treatments. Since treatment of stroke
is a very personalized matter, your physician should be able to give you
additional information regarding this matter. You can contact the stroke
division of your local American Heart Association for more information. The
Internet has a vast library dealing with stroke, stroke patients, recovery, and
much more.

Coping with Stroke Patients

In the next few pages, we will describe briefly and give you general guidelines as to why stroke patients behave the way they do and some helpful hints in their rehabilitation . The following quotes are often heard from family members of stroke patients.

I understand why my wife has difficulty using her arm and leg following her stroke, but why does she cry so much?

My father has learned to walk since he had his stroke, but why does he keep bumping into things?

Mom used to be such a good housekeeper before her stroke, and now she is sloppy.

My husband had a stroke, and now nothing I do seem to please him.

th_Brain_Opposite_Side.jpg?t=1329318888Figure 5 Brain damage affects opposite side of the body.

It is important to understand that stroke affects the brain. Some areas of the brain are damaged, and this damage is probably permanent; the behavior of these patients has completely changed their personality. Stroke will not affect all areas of the brain, nor is intelligence affected equally; as a result, all stroke patients are not affected alike. Each stroke patient will behave and act differently depending on the type and severity of the affected area.

The brain is made of two halves: the right and left side. If an injury occurs on the left side of the brain, the right side of the body is affected. On the other hand, if the right side of the brain is injured, the left side of the body is affected (Figure 5).

Right-Sided Paralysis

A right-side paralysis, or right hemiplegia, means the left side of the brain is damaged or
injured. A stroke patient with right hemiplegia is likely to have speech and
language problems. This is called aphasia. Aphasia (apha’sia) is defined as “A weakening or loss of the faculty of transmission of ideas by language in any of its forms, reading, writing,
speaking or failure in the appreciation of the written, printed or spoken word”
(Stedman’s Medical Dictionary) (Figure 6).

th_Left_Sided_Stroke.jpg?t=1329318889Figure 6 Left side of Brain damaged causing right-sided paralysis

Language and Memory Problems

Aphasia is a condition, that follows brain injury, but not everyone who suffers from a stroke becomes aphasic. That person begins to
experience a life of scrambled communication. For every word, he attempts to say, another one comes out, no matter how hard he tries. When he speaks, it sounds like complete nonsense.

In our society, a great deal of emphasis is placed upon speech and communication. When a person cannot speak or cannot be understood, we have the tendency to regard him as a disabled person. Because an
aphasic person cannot speak properly with others, it does not mean that he is unable to communicate. Along with speech difficulty, there is also a difficulty in reading, writing, or using numbers.

It is an error to isolate the aphasic patient in a world of no communication simply because his language is gone. Many other activities can be carried out daily without the use of speech.

At times, an aphasic patient may describe an item or object with a word that we do not understand. For example, he might use the word BAK to describe a table or chair; therefore, we can use his word if that term is being consistently used. Insisting on using the correct terminology can generate a great deal of frustration and anger. Many aphasic patients will quickly develop a way of communication without the use of speech. They develop an effective language by supplementing gestures, sounds, or nonsense words. If you treat the patient, as if he cannot communicate and do not respond to his “language,” he may stop
completely from trying to communicate with you.

The aphasic patient needs to recover the use of language that he possessed before his stroke. It is believed that he has not lost his language but rather the ability to recall it, and how to use it. So recovery does not mean he has to learn the language like a child, but rather
recalling what has already been learned.

One of the most common errors made when dealing with an aphasic patient is to overestimate his understanding of speech. At first, you may be dismayed at his inability to speak or understand speech. You may think that he cannot communicate or use language in any form, but then you discover signs that look as if he understands. Therefore, it is easy to jump to the conclusion that he understands much more than he actually does.

It is a good idea to check he level of understanding of an aphasic patient. This can be done easily by saying one thing and pointing to another. For example, if it was summer, you smile, look out the window, and say, “It is snowing today, isn’t it?” If the patient smiles or indicates yes, then you have evidence that he is responding to the sound of your voice rather
than the spoken words.

It is important to use small and simple sentences rather than long and complicated ones. You might find yourself speaking louder to a person who seems not to understand. Remember that there is nothing wrong with the patient’s hearing. Always maintain the same tone of voice and speak normally with small and simple phrases.

The most frequent physical problem accompanying aphasia is weakness or paralysis of the right side of the body. Usually, only the leg, one arm, a hand, and a portion of the face are affected.

In time, the use of both the arm and leg are regained, but weakness lingers in the arm more than the leg and in the hand longer than the arm.

Aphasic patients may have severe headaches, and at times, convulsions. They also may experience visual disturbances such as seeingobjects off to the right or left.

Behavior Problems

In addition to language problems, right hemiplegic patients have a tendency to be slow and cautious in their actions. This behavior will surprise friends and family members that knew the patient to be quite different before his stroke.

Because of brain injury, the individual has less control over his emotions than before his illness. The aphasic patient tends to become very frustrated by not being able to make himself understood. These patients become easily irritable and cry, laugh, and act impulsively at times.

The right hemiplegic patient is likely to need frequent, and plenty of feedback that his performance is correct. It is better to give more feedback than too little. If he performed correctly, give him some positive reinforcement immediately. It has to be the correct feedback; otherwise, you will be insulting his intelligence. If he commits an error, wait
for him to correct it; if he continues in error, show him it is incorrect, give him a hint, and indicate success thereafter.

The right hemiplegic patient needs more indications of success than failures; therefore, always keep your comments positive rather than negative or critical. Just remember that if he acts the way, he does it, is not because he wants to, but because his handicap makes him do so.

Recovery from Aphasia

Recovery from aphasia is a continuous process, and it is difficult to predict with any accuracy how a patient will improve over a specific period. Most of the progress will be made before the end of the first year, but progress will continue forever even over a lifetime. Some make great recoveries in short period of times; others recover in varying degrees. It is important that family members work steadily with the patient. The family should not count on the patient recovering without assistance. Help is necessary and should be given in every possible way. Speech control usually returns gradually.

Besides his loss of communication and his limitation in movement, (paralyzed arm or leg), the aphasic patient will feel as if he is enclosed behind a fence with very limited means to get out. His main goal is to move from behind that fence and overcome his speech problem and physical disability (if he has one). The family by his side has a unique opportunity to help him meet these needs.

Summary

Right paralysis or right hemiplegia means left brain damage.

Right hemiplegics will often have difficulty with speech and language. They are cautious, anxious, and disorganized when performing new tasks.

  1. Do not underestimate the ability of an aphasic patient to communicate, even if he has lost his speech.
  2. If he cannot speak, use a different form of communication such as hand language.
  3. Do not shout or use special voices. Keep a normal tone of voice and use  simple and short sentences.
  4. Any tasks given to aphasic patients should be given in simple steps.
  5. Always give feedback and encouragement when he performs correctly.

Left-Sided Paralysis

A left-sided paralysis, or left hemiplegia, means the right side of the brain has been damaged
(Figure 8-7). The stroke patient with right brain damage will often show difficulty with spatial-perceptual tasks. The patient will have difficulty judging distance, size, place, rate of movement, form, and the relation of certain parts of an object to the whole object. A stroke patient with right brain damage has more difficulty learning to care for himself than the patient with equally severe aphasia.

th_Right_Sided_Stroke.jpg?t=1329318889Figure 7 Right side of the Brain is damaged causing left side paralysis

Almost all normal people have experienced at one point
or another minor deficit of spatial-perceptual ability; for example, when you expect to have another step when there is none, you will be “jarred” when you find it is not there, or when you place an object on the table to find that you missed the table completely.

The left hemiplegic patient has exactly the same problems but extremely
magnified, consistent, and severe. A patient might put all his concentrations into achieving a certain act, and yet he would still miss. He may also confuse the inside and outside of his clothes and the left from the right.

He might have some difficulty differentiating, whether he is sitting or standing and difficulty estimating the distance of objects. He might have difficulty reading the newspaper or even adding a simple column of numbers because he keeps losing his place in the paper. He will miss buttons when buttoning his shirt, making it uneven. A female patient may put her
lipstick on crooked.

Behavior Problems

A left hemiplegic patient behaves in ways, which promote overestimation of his ability. He tends to be impulsive and fast; he behaves as if he is unaware of his problem and will comment that he can do anything. He will always try to do things that are beyond his
ability and are unsafe. He will try to walk without his walker just to fall within the first few steps. Do not take the word of left hemiplegic patients (since they will tell you that
they are capable of performing anything) unless they can demonstrate toyou that they really can.

If you have some difficulty teaching a task to a left hemiplegic patient, try to talk him through the task rather than using signs and gestures to teach him that particular task. It is not a bad sign if the left hemiplegic starts to talk to himself about how to accomplish certain tasks. He needs a great deal of feedback when attempting to complete a task, and he also needs to be encouraged, and every completed step needs to be checked.

Feedback should be in the form of encouragement rather than criticism. Do not nag; it tends to make them extremely angry and upset, and most definitely, their performance will drop. Left hemiplegic patients have difficulty understanding with visual cues since they misjudge distance. A cluttered room is very disturbing because it becomes distracting. Sudden and
fast-moving people or objects will just add to their confusion. Provide them with clearly marked reference points, such as doorframes or a standing full mirror. A well-lit room and simpleobjects are very important.

Summary

A left hemiplegic patient has right brain damage. He will be unable to judge size and distance. He will always talk better than he actually can perform. He is impulsive and careless. However:

  1. Do not overestimate his abilities
  2. Use language if he has difficulty with demonstration
  3. His tasks should be given in small steps; give plenty of feedback
  4. Check his action rather than taking his word for it
  5. Keep his effects neat and avoid clutter
  6. Minimize any sudden and fast movements
  7. Pinpoint visual reference points

Stroke in General

Stroke in general is damage to the brain. Some patients will show no evidence of paralysis, and yet they will give intellectual deficits. Others will show paralysis but not intellectual
problems. However, usually stroke patients will demonstrate some kind of behavioral deficits—an indication of brain damage.

It is important that a stroke patient should be able to guide and check his own behavior. This means doing the “right” thing at the “right” time. This could also be called social judgment. This kind of control is best identified by those closest to the patient, since they can see and
identify the changes that might be completely missed by friends and relatives who are not with the patient at all times.

The quality of life and the changes that occur to stroke patients are enormous and obvious. The meticulous person might become very sloppy and care little about his appearance. He may say the wrong thing at the wrong time. The quiet person may become noisy. The shy person may become immodest and very aggressive. The previously talented conversationalist may become boring and repetitive, and the prudent and cautious person with his money may start spending on impulse.

These enormous changes in the quality of life are very obvious and annoying to others because these changes are quite often not well-understood. They are mistaken for psychological problems, and patients with visible deficits are called sloppy or lazy. Patients with minor speech deficits are called depressed or disinterested because they do not talk. Patients with a memory deficit are sometimes called dirty old men because they forget to zip
their pants.

Conclusion

While stroke patients have significant emotional problems and might need professional help, it is very important to recognize these deficits and not make things more severe by ignoring these problems. These patients lack control of the quality of life they lead, and they will
undoubtedly need all the help they can get from the environment. They will need more encouragement and feedback than just psychotherapy alone. The stroke patient who fails to bathe or change his shirt may well have the ability to dress himself independently and groom adequately. Unfortunately, because of his intellectual deficit, he forgets or cannot see his errors.

Remember that the purpose of feedback is to help him recognize his bad behavior and to let him practice a better way. Do not nag at stroke patients, since they will become very angry and things might become worse. Your feedback should be prompt; otherwise, its effect is lost. Most importantly, you will need plenty of patience.

As previously mentioned stroke is a very large subject. A complete book can be devoted to it; however, we have outlined the general information about stroke patients and briefly described how to recognize some of their actions and behavior. If the reader requires more
detailed information, contact your physician or your local chapter of the American Heart Association (AHA), or the American Stroke Association (ASA), and they will supply you with more information regarding the subject.

Stroke is a disease of the cardiovascular system, it affects a large number of the population and its mai causes and risk factors are similar to those of Heart Disease. A new book is now available for everyone to learn and describes many topics about the prevention of both heart attack as well as stroke.

You can obtain a copy of the book at the following link;

http://www.tatepublishing.com/bookstore/book.php?w=9781613468449
 

How to Help People With Psychosis or Psychotic Disorders

Psychosis or Psychotic Disorders represent a group of serious, chronic and persistent brain disease. The group includes schizophrenia, schizophreniform disorder, schizoaffective disorder, delusional disorder, brief psychotic disorder, and shared psychotic disorder. Schizophrenia is the most serious of them all. Psychotic disorders are characterized by five major problems, i.e. disorder of thought, disorder of perception, emotional difficulty, disorganized behavior, and impaired ability for relationships.

1. Disorder of Thought: Patients with psychosis may suffer from a disorder of thought. This problem is classified into disorder of thought content and disorder of thought content. Problems of thought content include various delusions such as paranoid, grandiose, religious, somatic, nihilistic, persecutory, thought broadcasting, thought insertion, thought control, hypochondriacal, erotomanic, and jealous delusions. Delusions are fixed false beliefs held by the patient. Paranoid patients believe there is someone out there persecuting or trying to do some harm to them. Grandiosity means the patient believes he has some special powers or possessions. In religious delusions, the patients may claim to be God. Delusion of thought broadcasting means the patient believes someone, or some media is broadcasting what is in his mind. The second aspect of thought disorder is disorder of thought process. This includes memory difficulty, attention difficulty, poor concentration, poor insight, poor judgment incoherence, circumstantiality (in a conversation, patient responds with various digressions before making his point), tangentiality (patient veers off completely with various digressions and never comes back to the original topic), and clanging (patient responds, using meaningless combination of words that rhyme together).

2. Disorder of Perception: This includes various hallucinations such as auditory hallucination (hearing sound or voice that does not exist), visual hallucination, olfactory hallucination (smelling odor that does not exist), gustatory hallucination (unreal taste), tactile hallucination (unreal touch such as a bug crawling on his skin), cenesthetic hallucination (feeling internal body functions such as urine forming in his kidneys), kinesthetic hallucination (feeling that his body or part of his body is moving while it is not), and command hallucination (hearing a voice commanding him to do something such as to kill himself or hit somebody).

3. Emotional Difficulty: The patient may experience a mood or affect disorder. Mood is the patient’s tone of feeling as expressed by the patient. Affect is the patient’s tone of feeling as observed by someone else, such as the nurse or therapist. Patient’s mood may be sad, depressed, alexithymic (inability to describe the mood), apathetic (lack of feeling or interest), anhedonic (inability to experience pleasure), anxious, or angry. The affect may be described as bizarre (e.g. grimacing, giggling, mumbling), blunted (i.e. minimal emotional response), flat (completely blank look), incongruent (inappropriate with reality, e.g. laughing while saying something sad), or labile (rapidly changing).

4. Disorganized Behavior. The patient may exhibit the following behavior: motor agitation e.g. running around, apraxia (difficulty with motor activity), echopraxia (imitation of the movements of someone else), echolalia (imitating what someone else says), waxy flexibility (prolonged maintenance of a posture), agitation and aggressive behavior, and stereotyped behavior (repeating  the same action over and over).

5. Impaired Ability for Relationships: The patient may exhibit withdrawal to himself or isolation. This may be due to delusions, hallucinations, apathy, anhedonia, deteriorating social skills, lowered self esteem, anxiety, stigma and sense of helplessness. 

Classification of Symptoms: All the symptoms classified into the 5 categories above may actually be classified into 2 categories, i.e. positive and negative symptoms of psychosis. Positive symptoms include delusions, hallucinations, thought disorders, disorganized speech, bizarre behavior, and inappropriate affect. Negative symptoms include flat affect, anhedonia, apathy, attention deficit, social withdrawal, and poverty of speech.

Causes: There are various theories put forward to explain schizophrenia and other forms of psychosis. The genetic theory explains that 15-35% of schizophrenia is genetic. The neural theory says problems with the frontal, temporal and limbic regions of the brain are the cause. Some have implicated poor blood flow and metabolism in the frontal lobe. The must popular theory is that there is high Dopamine level in the synapses of the brain. Some say a low serotonin level causes the negative symptoms. Other theories are intrauterine neural damage, viral infection, psychosocial stressors, and multifactorial causes.   

Schizophrenia: There are 5 types of schizophrenia: Paranoid, Disorganized, Catatonic, Undifferentiated, and Residual.

1. Paranoid Schizophrenia: Patients suffering from paranoid schizophrenia are usually suspicious and untrusting of everyone. They are on guard, hyperalert and hypervigilant. They use projection (blaming others) frequently. They can be argumentative, hostile and exhibit poor interpersonal relationships. They may experience delusions of persecution, grandeur, thought insertion, thought control, and thought broadcasting. Because of the delusions, suspicion and lack of trust, they may refuse food and medication. They may also suffer hallucinations. Therefore, there is a need for the care provider to first establish and maintain trust with the patient. Assess potential for violence, command hallucinations, suicidal and homicidal ideations. Encourage patient to discuss his feelings. Do not argue delusions because they, after all, false fixed beliefs. Be very cautious in using touch since this aggravates the anxiety of an already untrusting patient. Be nonjudgmental and respectful. Be honest and consistent. Use presence and silence in caring if patient is mute. Use brief, clear and concise statements in communicating with the patient. Always keep your promises to sustain trust. Explain planned care before you do it. Beware of your actions that may trigger or worsen the patient’s suspicion. Maintain a low level of stimuli. Avoid threatening environments. Avoid competitive and group activities. Assess for signs of anxiety and hostility. Provide verbal and physical limits when necessary. Let the patient know that you will not allow you him to hurt himself or others and if he becomes unable to control himself, you and others around will help him. You may initially have to offer foods in cans, containers, or skins if patient continuously refuses other foods because of mistrust. You may also have to initiate suicidal and homicidal precautions.    

2. Disorganized Schizophrenia: This type of schizophrenia is characterized by the following disorganized speech and behavior. Disorganized speech includes: word salad, e.g. “Birds and fishes framewoes mud and stars and thump-bump going”; neologisms, e.g. “I want all the vetchkisses to leave the room and leave me alone”; echolalia; clanging, i.e. “Lack on the track in big Mac or get the sack”; and loose associations, e.g. “The world became embryonic and no talking in wet places”. Disorganized behavior includes: grimacing, incongruent affect, and bizarre behaviors. Delusions and hallucinations are minimal in disorganized schizophrenia.

3. Catatonic Schizophrenia: This is characterized by stupor, waxy flexibility (staying fixed and motionless in one position for a long time), agitation, negativism, mutism, posturing, stereotyped movements, grimaces, echolalia (repeating what someone says) and echopraxia (repeating what someone does).

4. Undifferentiated Schizophrenia: This has the combined features of catatonic, paranoid and disorganized schizophrenia. Delusions, hallucinations and bizarre behavior are present. No one clinical presentation dominates.

5. Residual Schizophrenia: The patient no longer has the active phase of any type of schizophrenia. However, some residual symptoms still persist. There may be some residual isolation, withdrawal, impairment in role function, eccentric behaviors, neglect of personal hygiene, apathy, and blunted affect.

6. Other Psychotic Disorders: The patient with Schizophreniform Disorder has fewer psychotic symptoms than schizophrenia. The patient with Schizoaffective Disorder has schizophrenia alternating with depression and manic behavior. The patient with Delusional Disorder experiences delusions that are relatively plausible and non-bizarre. A patient with Brief Psychotic disorder has psychotic symptoms lasting 1-30 days and returns to ‘normal’. A patient with Shared Psychotic Disorder shares a delusion with another delusional person.

Clinical Hints for Helping Patients with Psychosis: Listen actively to understand the patient. Teach patient to focus on the important. Teach patient to avoid noise and excessive stimulations. Give patient time to process information. Be clear and simple in your communication. Help patient with vocabulary as needed. Use literal meaning of words – no sarcasms, no metaphors, and no proverbs. Have patient repeat back your teaching, so you are sure there is no miscommunication. Help patient understand his or her illness. Help patients understand their medications. Help and teach patients to identify and prioritize their needs daily. Teach patient to rise and lie slowly in case spychotropic medications are causing hypotension that may trigger dizziness. Motivate the patient for medication adherence.

Treatment Modalities: Treatment modalities for psychoses include psychopharmacology, individual psychotherapy, group therapy, family therapy, milieu therapy, psychoeducation, psychiatric rehabilitation, and self help groups.

Antipsychotics: Typical (older) antipsychotics include haldol, thorazine, prolixin, trilafon, mellaril, navane, moban and stelazine. They block dopamine at mesolimbic pathways in the temporal lobes. Atypical (newer) antipsychotics include zyprexa, risperdol, abilify, and clozaril. In addition to blocking excess dopamine, they also block serotinin at mesocortical pathways in the frontal lobe. This makes atypical antipsychotic good with controlling both positive and negative symptoms. Patients taking Clozaril need frequent and regular blood checks because the medication can cause fatal agranulocytosis. Haldol and prolixin decanoate (given by injection every two weeks) are good for patients who are non-adherent with their medications. Encourage patients not to stop taking their medications simply because symptoms have subsided. Watch out for side effects of antipsychotics, e.g. extrapyramidal symptoms (EPS) such as dystonia, akathysia, tardive dyskenesia, neuroleptic malignant syndrome, and pseudoparkinsonism. Dystonias are spasms, stiffness and contractions of muscles especially of the face and neck. They can be painful and frightening to patient especially if airways are compromised.  Benadryl or cogentin are usually given to treat dystonias. Reassure the patient. Provide a quiet non-stimulating environment. Akathisia is restlessness, restless leg syndrome, and inability to sit still. It may make patient very anxious. Benadryl, cogentin, clonidine, propanolol, diazepam or lorazepam can be given. Dose of the antipsychotic might be reduced. Tardive Dyskinesia is a late occurring irreversible side-effect of antipsychotics. It manifests by abnormal involuntary movement e.g. tongue-thrusting, writhing of wrists, lip pursing, lip smacking, facial grimacing, and grunting. Teach patient to recognize and report early warning signs. Administer the Abnormal Involuntary Movement Scale (AIMS) every 6 months for early detection. Reduce antipsychotics or change from typical to atypical. Neuroleptic Malignant Syndrome (NMS) is a clinical emergency resulting from antipsychotics. It involves altered consciousness; unstable blood pressure, breathing and pulse rates; fever; lead pipe rigidity; diaphoresis; tremors; and drooling. Withhold the antipsychotic immediately and notify the prescriber. Care for the patient’s breathing, fever, anxiety, and hydration. Dantrolene or Bromocryptine may be prescribed. NMS is fatal in 15-20% cases. Pseudoparkinsonism involves muscle rigidity, slow movement, shuffling gate, tremors, masklike face, hypersalivation and drooling. Notify the prescriber of the antipsychotic. The dose may be reduced. Artane or cogenting may be ordered. Other side effects of antipsychotics are sedation, drowsiness, orthostatic hypotension, increased appetite, agranulocytosis (from clozaril), hyperglycemia, allergy, rash, and photosensitivity.

References:

Copstead, L. C., & Banasik, J. L. (2005). Pathophysiology (3rd ed.). St. Louis, MO: Elsevier   Saunders.

Stuart, G. W. & Laraia, M. T. (2005). Principles and practice of psychiatric nursing (8th ed.). St. Louis, MO: Elsevier Mosby.

http://allpsych.com/disorders/psychotic/index.html

http://www.athealth.com/Consumer/Disorders/Psychotic.html

Alopecia Areata

Alopecia Areata is a disease that causes hair loss. It usually affects the scalp, but can also affect other areas of the body that have hair. The hair loss is quite rapid, and occurs in patches. Alopecia Areata (AA) is common form of hair loss, unpredictable and not painful disease. Usually people who suffer this disease are losing their hair in small, round patches from areas of the body, usually the scalp.

Alopecia Areata usually affects younger women and children.  This condition has unknown causes, although in some cases, it happens because of the body’s auto-immune response to form white cells and the hair follicles on the areas where the hair is commonly produced are attacked.  A distinguishable polished area of the scalp that feels silky smooth commonly becomes noticeable.  And the hairs that surround the bald areas are thin and break off easily.  These may be extremely fine and the entire shaft of hair would resemble an exclamation mark.

Causes of Alopecia

The specific cause of alopecia areata is unknown. A family history of alopecia is present in about a fifth of all cases. Alopecia areata is occasionally associated with autoimmune diseases . –Normally the immune system protects the body against infection and disease. In an autoimmune disease, the body’s immune system mistakenly attacks some part of your own body. In alopecia areata, the immune system attacks the hair follicles. For people whose genes put them at risk for the disease, some type of trigger starts the attack on the hair follicles. The triggers may be a virus or something in the person’s environment.

Symptoms of Alopecia

Alopecia areata is actually a disease of the immune system and is commonly referred to as an autoimmune syndrome. This puts this disease into a class that also includes Crohn’s disease as well as IBD and so on. The most common symptoms of alopecia areata is the hair loss on the head as well as the other parts of the body. The reason this occurs is the fact that the immune system starts to attack the hair follicles and stops them from growing hair or maintaining the root structure. When this happens the hair is no longer healthy and will fall out. With this particular form of alopecia you will normally have quarter sized patches of hair loss on the scalp and men can suffer from the same on the chest and so on.

Treatment of Alopecia

1. Certain medications to promote hair growth (such as minoxidil and finasteride).

2. Treating any underlying condition or disease.

3. Corticosteroid injections (when treating alopecia areata).

4. Scalp reduction.

5. A doctor can prescribe several drugs, including creams and steroid injections. Many people also respond well to drugs that promote hair growth.

Sufferers of alopecia areata should not give up hope of a cure as there are many ongoing research projects are currently being undertaken. Some of the most promising involve gene therapy, stem cells research and hair follicle development and new alopecia areata treatments will continue to be made available.

Read About Home Remedies also Read about Hair loss in Women and Alopecia Areata

A Quick History of Sign Language

The history of sign language is littered with shocking events. At several points in history, some not long ago, deaf people were strongly oppressed. At one point, they were even denied their basic rights. How their language, sign language, was treated during these oppressive times is directly related to why the deaf place such a high value on sign language today.

The first person to make a claim about deaf people was Aristotle. He theorized that people are only able to learn by hearing spoken words. Deaf people, then, were seen as unable to be educated.

Deaf people were denied their basic rights because of this claim. They weren’t allowed to marry or own property. The law actually labeled them as “non-persons.”

During the Renaissance in Europe, the claim was finally challenged. After 2,000 years of believing that deaf people couldn’t be educated, scholars made their first attempts to educate deaf people. This point in the Deaf history was the beginning of signed language development.

<b>The Beginning of Deaf Education</b>

An Italian Physician named Geronimo Cardano recognized that to learn, you do not have to hear. He found that by using the written word, deaf people could be educated.

In Spain, Pedro Ponce de Leon around the same time was educating deaf children. He was a Benedictine monk and was successful with his methods of teaching.

Juan Pablo de Bonet was inspired by Pedro Ponce de Leon’s success and used his own methods to teach the deaf. He was a Spanish monk and used earlier methods of teaching the deaf that included writing, reading, speechreading, and his own manual alphabet. Juan Pablo de Bonet’s manual alphabet represented the different speech sounds and was the first known manual alphabet system in the history of sign language.

Until the 1750’s, organized education of deaf people did not exist. Established in Paris by Abbé Charles Michel de L’Epée, a French priest, was the first social and religious association for the deaf.

There is a popular story that has been retold throughout Deaf history about Abbé de L’Epée. The story claims that while L’Epée was visiting a poor part of Paris, he met two deaf sisters. The mother had wanted them educated in religion, and she wanted L’Epée to teach them. L’Epée was inspired to educate them after he discovered their deafness. Soon after this encounter, he devoted his life completely to the education of the deaf.

In 1771, Abbé de L’Epée founded the first public school for the deaf. The name of the school was the Institut National des Jeune Sourds-Muets (National Institute for Deaf-Mutes). Children travelled from all over the country to attend this school. The children who attended the institute had been signing at home and creating a sort of “home sign language” with their families. Abbé de L’Epée learned these home signs and used them to teach the children French.

The signs L’Epée learned from his students formed the standard sign language that L’Epée taught. More schools for the deaf were established and the children were bringing this standard language home to their communities. This standard language became the first standard signed language in Deaf history and is now known as Old French Sign Language. More and more deaf students were becoming educated so this standard language spread widely throughout Europe.

Abbé de L’Epée established twenty-one schools for the deaf and is known today as the “Father of Sign Language and Deaf Education.”

Abbé de L’Epée is also often credited with being the inventor of sign language. This is inaccurate. Sign language was invented by deaf people. Even before they were formally educated, deaf children were signing with their families using home made signs. However, Abbé de L’Epée was the first to bring together these signs and create a standard sign language to educate the deaf.

Abbé de L’Epée claimed that sign language was the natural language of the deaf. However, a German educator named Samuel Heinicke thought different. He supported the oral method of educating deaf children. Oralism is the term used for educating the deaf using a system of speech and speechreading instead of sign language and fingerspelling. Samuel Heinicke taught his students how to speak, not sign. While he spoke, he had his students feel the vibrations of his throat.

Oralism was the first major roadblock after all of the positive advancements with the history of sign language. Abbé de L’Epée is known as the “Father of Sign Language” and Samuel Heinicke is known as the “Father of Oralism.”

<b>American Sign Language</b>

American Sign Language is traced back to 1814. Dr. Thomas Hopkins Gallaudet, a minister from Hartford, Connecticut, had a neighbor named Mason Fitch Cogswell. Cogswell had a nine-year-old daughter named Alice who was deaf. Gallaudet met Alice and Gallaudet wanted to teach her how to communicate.

Gallaudet did not really know anything about educating a deaf child. So, he raised enough money to travel to Europe to learn their methods of deaf education.

Gallaudet met Abbé Roche Ambroise Sicard who was Abbé de L’Epée’s successor and the head of the National Institute for Deaf-Mutes in Paris. Gallaudet also met Jean Massieu and Laurent Clerc, two accomplished teachers of the deaf from the same institution.

Gallaudet attended classes with Sicard, Massieu, and Clerc at the Institute. He studied their methods of teaching and took private lessons from Clerc.

Preparing to return to America, Gallaudet asked Clerc to join him. He knew that Clerc would be instrumental in starting a school for the deaf in the United States. Clerc agreed to travel with him back to America.

The American Asylum for Deaf-Mutes (now known as the American School for the Deaf) was established in 1817 in Hartford, Connecticut. This was the first public school for the deaf in America.

Deaf people from all over the U.S. travelled to attend the school. Just like at Abbé de L’Epée’s school in Paris, children brought signs they learned at home with them. From these signs and the signs from French Sign Language that Gallaudet learned, American Sign Language was created.

<b>A Deaf College</b>

In 1851, Thomas Hopkins Gallaudet died. However, his two sons, Thomas Gallaudet and Edward Miner Gallaudet succeeded him and continued work in deaf education.

Edward wanted to establish a college for the deaf, but the funding always stopped him. In 1857, though, Amos Kendall donated acres of land to establish a residential school in Washington, D.C. called the Columbia Institution for the Deaf and Dumb and the Blind and wanted Edward to be the superintendent of the school.

Edward accepted the offer, but still wanted to start a college for the deaf. So, he presented his idea for a deaf college to Congress and Congress passed legislation in 1864 allowing the Columbia Institute to grant college degrees.

The Columbia Institute’s college division (the National Deaf-Mute College) opened in 1864. In all of Deaf history, this was the first college for the deaf.

The National Deaf-Mute College was renamed in 1893 and again in 1986 to the name it still has today-Gallaudet University. Gallaudet University was the first and is still the only liberal arts university for the deaf in the world.

<b>Oralism versus Sign Language</b>

Sign language was spreading widely and was used by both deaf and hearing people. However, supporters of oralism believe that deaf people need to learn how to speak to be able to function in society.

The Institution for the Improved Instruction of Deaf-Mutes was founded in New York in 1867 and the Clarke Institution for Deaf-Mutes was founded in Northampton, Massachusetts. These schools began educating deaf children using oralism only. If that wasn’t bad enough, these schools encouraged all deaf schools to use only the oralism approach as well. The oralist methods of teaching speech, listening, and speechreading spread quickly to schools across the nation.

Alexander Graham Bell was one of the strongest supporters of oralism. In 1872, he established a school in Boston. This school trained teachers to use oralism to teach deaf children.

Bell established the American Association to Promote the Teaching of Speech to the Deaf, Inc. in 1890. This association is now called the Alexander Graham Bell Association for the Deaf.

From 1880 to 1990, the sign language versus oralism debate intensified. Meeting in Milan, Italy in 1880, the International Congress on the Education of the Deaf met to address this issue. Many leaders in education attended this conference that is now known as the Milan Conference.

Oralism won the debate at this conference and Congress then passed a declaration stating “the incontestable superiority of speech over sign for integrating the deaf-mute into society and for giving him better command of the language.”

Because of this conference, the use of sign language in deaf education declined drastically over the next decade. Some oralism activists wanted to eradicate sign language completely.

By 1920, 80% of deaf children were taught using the oral method. Teachers of deaf children were once 40% deaf and 60% hearing. By the 1860’s, only 15% of teachers of the deaf were deaf.

Outside of the classroom, however, sign language was still widely used. The National Association of the Deaf (NAD) was established in the U.S. and supported the sign language method of deaf education. The NAD argued against oralism saying that it is not the right choice for the education of many deaf people. They gained support and kept the use of sign language alive during this time.

Amid this great debate, William Stokoe, a hearing Gallaudet College professor, published his claim that proved American Sign Language is a real language. He proved that ASL is a language separate from English and that it has its own grammar and syntax.

American Sign Language was then finally seen as an important national language.

Congress issued the Babbidge Report in 1964 on oral deaf education that stated oral education was a “dismal failure.” This quote dismissed the decision that was made in Milan.

In 1970, a movement began that did not choose between signed or oral education. The movement was called Total Communication and attempted to mix several methods of deaf education. Total Communication gave deaf people the right to information through all possible ways. This method of teaching can include speech, sign language, fingerspelling, lipreading, pantomime, computers, pictures, facial expressions, gestures, writing, hearing aid devices, and reading.

The changes that have occurred throughout the history of sign language makes sign language and the lives of deaf people what they are today. Deaf people have experienced great hardships as well as great achievements to bring sign language, the language of the Deaf, the respect that it deserves.

Stammer Cure – Effective Techniques To Help

Do you’ve got a speech impediment? Do you have a stammer? Do you yearn to be in a position to speak fluently? Well if you have answered any of these questions in the positive then this article could be interesting to you. I am a person who had to endure living with a stammer for eighteen years of my life, the stammer appeared to control those eighteen years and affected nearly each decision I ever made. I was anxious to find a stammer cure as the idea of having the speech snag for the remainder of my life was a idea that I was not ready have.

During my teen years it was like I was living in fear, in fear of stuttering. Looking backwards I remember having a major detestation for faculty. It was not because I found the college work too troublesome or because I was bullied or because I was loathed. Despite the fact that I had a stammer I had quite a few buddies and good mates at that. I was actually not bullied in the physical sense however there was the inescapable “mickey taking” with people laughing at me when I wasn’t able to communicate fluently in the class. As for the faculty work I really found it rather easy, that’s not gloating, but i did.

So why, folk may wonder, did you leave faculty and education at the age of sixteen if you were so bright? Quite easy truly, as I have previously stated I did not like faculty. Why? I was always one minute away from stammering. I entered each class praying that the teacher wouldn’t ask me a query, and they wouldn’t ask me to read out a loud from a book as an example. It was no way to live and this is why I craved to be ready to talk fluently.

What I needed was a group of techniques to enable me to beat the stammer and at the age of twenty-two i managed to find them. My dream of fluency became fact and life all of a sudden became a whole lot less complicated.

For more related artilces about stammer cure, click on links below!

Stammer Therapy – What’s The Most Effective Technique?
Self Help For Stuttering – How I Managed To Deal With It

Tantra, With Your Clothes On

Tantra is like the black sheep of the family, she’s a really misunderstood being. Especially here in the west where we have bastardized the word to mean anything we want, but generally related to sex workers, or a type of erotic massage, or endless physical orgasm.

Tantra is a life philosophy, a school of thought, an intimate experience of your own body, soul and the universe. It is a solo practice especially at the start, and it is not a casual undertaking.

My definition of the concept of Tantra is: “Tantra is the ultimate love affair with yourself and all of your existence. In the process of igniting your internal flame, you come to experience all ordinary moments as extraordinary experiences. Immersed in that experience, you realize that you are the divine, there is nothing else to need or want, but that moment.”

Only 3 percent of Tantra is even related to sex. Yes, you say, but sex is the part you want to learn about.

Well here’s the thing. You can not have a truly spiritual sexual relationship with another until you have a truly spiritual life with yourself and others with your clothes on.

Most people are just plain getting it backwards.

Trying to be a master lover with technique alone is like being a mute singer. You may be able to form the muscles to make the sound, but no sound will be heard.

Most of Tantra is practiced with your clothes on. Even the extremely deep love making to another’s soul can be accomplished without being naked. That’s the beauty of learning Tantra, once you learn to utilize its principles you can do magick.

The endless orgasm and living in arousal that Tantra is famous for is really misinterpreted to be a physical response in the genitals when in actuality it is a full body, soul and divine ( God) experience.

Living In full arousal is experiencing living in the fullest expression you have as a human. It would be a sad thing for such an enormous expression to be so limited to only your crotch. That would be like the ocean only having one color, or a song with only one note.

Living in a state of full expression as a human is done by being dynamic, in all aspects of your range of emotional feelings and physical sensations. It has little to do with your head (simply a state of logic) or just pleasure in your lower body. Full body integration is a tough thing to understand in a world where we are so compartmentalized.

Our bodies, feelings, and souls are out of balance, and most people are leading with only one major expression at a time.

For example, every one knows that person with the soft touch. They tend to “fall in love” easily and never say no to anyone who needs help. They usually end up acting like a martyr because they are so out of balance. Then there is the cerebral person, who seems to posses no feelings, and makes all their decisions from logic. Usually this person seems cold and not very romantic (no heart), frequently they will have anger lurking beneath the surface from repressed emotions, once again out of balance.

The art of Tantra is way to rebalance the body, mind and soul. It is an exploration of self, and an opening to all the wonders that are in and outside of us, a way to connect fully with the universe.

Starting with the self you will learn to tune into your feelings, and physical sensations, learning to expand your capacity for both of these. Most of you are living a 2 on a scale to infinity in the amount of pleasure you can feel, both emotionally and physically.

Once you learn to expand in self you can start to look around with new wonder at all the things you have not noticed before. It is as if you are awakening to a new life, and new way of being, and you are.

Then once open to this path you will find you will not want to go back. You will want more and more of the full expression you are capable of.

From here you can start to experience the potential of loving in an entirely new way, physically and emotionally. Now all the techniques you know for love making are merely extension of your soul instead of physical manipulation. Just gazing at your lover with your clothes on will be more magnificent than any physical act you created before, ever was.

And that’s just the tip of the ice berg of the art form of Tantra.