The More You Know…

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I’ve started substitute teaching. You probably remember crusty, old geezers teaching your class when one of your teachers was gone. These fossils were fond of telling students that they don’t know what hard work is, that they had to recite the pledge of allegiance in Greek and had to learn math with an abacus.

 

Whatever the case, there was always the assumption that, like teaching vampires who only came out during the school day, subs didn’t have an everyday normal life; when the school day was over they’d retreat to the school basement to read the textbooks for enjoyment before using them as a bed to sleep on until they were called to action again.

 

My point is that, with a single day substitute, there isn’t really a chance to get to know the sub.

 

I typically sub at the school where I once taught and assisted librarily, so I know most of the teachers and they know of my condition. Given enough notice, I’ll offer to give a presentation to the kiddos about me. This way the teacher doesn’t have to prepare as much and the students get first-hand knowledge of why I am the way I am. I’ve posted a version of this presentation before (LINK), but it was a raggedy old PowerPoint.

 

AND THEN…last summer – I went to a writer’s conference to pitch my memoir. I wanted to stand out, so I put together a presentation. I had just given the students a crash course in PowerPoint presentations and Prezi, so I thought I’d give that a try. I didn’t get a book deal >:(, but my presentation was pretty sweet. Find it HERE

 

AND THEN…a new school year started and the sub jobs came pouring in. So far, I’ve presented to about 250 seventh graders, most of the eighth graders saw it last year.

 

AND THEN…my younger sister, a Latin teacher (She teaches Latin, she’s not a teacher who is Latin, no one is or really has been since the Roman empire), asked me to come talk to one of her classes. I thought that this nexus of presentation opportunities called for a revamped presentation.

 

AND THEN…I combined the raggedy PowerPoint with the fresh, shiny Prezi to create a PreziPoint (PowerPrezi?). The svelte can be viewed in all its smoothly transitioning glory HERE. Or, for your convenience, I’ve reproduced the presentation here in slideshow form.

 

AND THEN…actually, ‘AND THEN…’ doesn’t work here, but I’m nothing if not consistent, the frames with a 🌟 in the lower right corner were adapted from the original PowerPoint. This means that the ones without a star make up the original Prezi.

 

AND THEN… If you don’t notice, apart from the book excerpts, it rhymes! Isn’t that delicious?

 

AND THEN…FIN

 

AND THEN…@JarrettLWilson

 

A Picture is Worth a Thousand…Pictures…

All Done

All Done…or 93 pictures if you’re the GIF above. By that count, if a picture is truly worth 1,000 words, that GIF is a tidy package of 93,000 words. Add to that the words you’re reading, and you have the world’s longest blog post. Honestly, I almost could’ve written 93,000 words in the time it took to make this GIF.

While I explain what it is, I’ll explain how it was made. I have the MRI images for most of my scans, in total I found/used eight sets of scans. Then, I made some pictures with my webcam of my profile and the top of my freakishly large head. If my math is correct, that makes 8+1 = 9 sets of images. Each set has roughly 10 pictures – including multiples of the original and duplicates of the fading shots. The sequence of the scans is chronological (For instance, a scan from 2010 would come after a scan from 2009, a scan done in May of some year will come before a scan…scanned in September of that same year…And so on).

The images are labeled with the reason for and date of the scan. I’d only point out the first scan from May, 2009 showing a big blob of white stuff just below the very center of my brain profile and slightly off center looking at the top. It’s almost as if someone tried to white it out. Really, it’s blood, the doctor injects you with the air from inside a blacklight, then your blood glows white.

The magnetic manipulation of the various cells and particles that form a mass called “Jarrett” (Magnetic), and the clicking and knocking noises (Resonance) labored to produce the this Image a few days after the hemorrhage.

The magnets and sounds continued their unlikely coupling through my skull on August 15, 2016, one day before my appointment with my neurosurgeon (I verbally sparred with both the doctor’s office and the insurance company for a month and had to reschedule twice, but that’s a different story altogether).

On the last MRI image, notice all the white out has been removed. When looking down from the top of my head, the “cavern” that the cavernous malformation called home is still a dark hole. I can only speculate that this is why I forget stuff almost as quickly as it pops into my head, it gets sucked into this vortex of blackest black, of darkest dark, of ebon opacity, of obsidian obscurity, etc.

Anyway, this GIF sums up seven years of the physiological side of brain injury recovery. I’ll stop writing now as this post has now reached a staggering 93,443 words.

This is all to say that my latest scans show no activity, and my recovery continues.

FIN (93,460 words if counting the number)

@JarrettLWilson (93,468)

Aztec Gods, Needles in a Foot and Hand Torture, Oh My!

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I’ve been pretty lazy about the look of my blog. Previous banners have been hastily cropped images of my MRI scans or some such thing. So, I set about to remedy the situation by creating a banner representing my “injourney”. Though it may look precariously thrown together, I assure you that each object represents something very meaningful. I’ll start with perhaps the most powerful being on the banner. The colorful fella in the right corner is Huitzilopochtli,the Aztec god of war and the sun. I’ve a tattoo of Huitzilopochtli on my right shoulder blade –

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What struck me was, if you say “war” and “sun” back to back very quickly, it almost sounds like “Wilson” – and as you know, Wilson makes top quality sporting good products, and is my last name.
I jest, although not one of his defining divine powers, he’s also associated as being the guide for journeys, having led the Mexica  (Aztecs, though don’t let Huitzi hear you say that, he was against that nomenclature – thought it sounded too much like “ass-tech” and didn’t want people thinking they made fancy toilets or other such things) from Aztlan to the site that would become Tenochtitlan, the Azte…err, Mexica capital city. It is this quality that convinced me that his likeness should appear on my right should blade for the rest of my days. He would always be near to guide me.
The colorful dude on the other side is Xipe Totec, which means “He of the colorful commode”. As you can see, he’s sitting, almost squatting, on a very colorful chair. This is actually a toilet. He was fine with name “Aztec”, thought it’d be a good opportunity to spread the word his sacrificial, butt guillotine commode. While pooping, a blade slices off the bottom and flushes it straight to Templo Mayor in Tenochtitlan to be offered up to the gods.
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Again, I jest.

Xipe Totec or “Our Lord the Flayed One”, is the god of, among many other things, the cycle of life-death-rebirth. You see, I’ve come to consider May 22nd, 2009 (the approximate date of my hemorrhage), as the date my old self died. I was reborn when I had surgery to remove the cause of the hemorrhage.

Getting back to the mortal realm, the little girl in the yellow shirt and headlamp is my darling daughter, Quinn. I go to the gym, and therapize myself that I might get to be more active with that little fireball. The headlamp is for what I call “technology spelunking”. I wear it when I need to fiddle around inside my computer case or complete some other task without adequate lighting.

The hand in the vice is a not so subtle reference to occupational therapy and its toils. Not much more to be said about this – if you’ve ever wanted break off your aching hand and use it to give someone (esp. an occupational therapist) a bloody slap across the face, then flip the bird with it, then you understand that image.

Rounding (more like ovaling) out the left side is a MRI scan of the top of my head. The white dot in the middle is a marshmallow I shoved up my nose when I was seven. Since that time, every time someone asks, “What’s that smell?” I invariably answer “marshmallows”.

Come to find out, the marshmallow passed through my digestive tract the same as if I’d eaten it – as such, it has long since done the thing that biological things do, whose name esca…DECOMPOSED (!) in the bowels of some sewage treatment facility.

The white dot in this scan, and the scan of the stick man in the middle, is actually blood – these scans were taken very soon after the big bleed.

The relatively huge foot (MY foot with a NEEDLE in it) is a direct result of that white dot – the blood scrambled some wiring up there, causing a perpetual spasm running through my left arm and left leg/foot. To combat this unpleasant symptom, I get injections of botox every three months, two of which go in my foot (let me reiterate: TWO INJECTIONS! FOOT!)

All these things make up my injourney, and so, are strewn about my path like so many playthings carelessly scattered across the front yard by a whimsical child.

The stick man furthest down the path has a question mark for a head. This is for two raisins –
1. In the future, my head will probably look about the same on the outside. I can’t make any assumptions about what it’ll look like on the inside. Of course, there will still be neurons and dendrites and hormones of varying flavor, but I have to accept the possibility that there might be more white stuff (there also might be a “Johnny Mnemonic” style hard drive or an antenna ala Vonnegut’s Sirens of Titan.
2. I couldn’t think of anything to put there.

And what banner would be complete without the auspices of LepreSean? He popped in and asked, “Whersh me potta gold?” Xipe replied, “I’m sitting on it!”

FIN

@JARRETTLWILSON

Trunk Rotations can be Hazardous

…ln other news,  Jarrett Wilson managed to snap,  krinkle and/or pop the catheter of his baclofen pump at an intense workout on Monday.  He began to experience increased spasticity that night and ever more as the week went on. The initial suspicion was nuvigil withdrawal but after going bac…lofen  through the symptoms,  baclofen withdrawal seemed a more prudent diagnosis.  The first and most obvious sign of baclofen withdrawal is enhanced tremors and spasticity – the patient will shake as if his insides were some diabolical popcorn machine. Next,  the patient might start hallucinating. Our sources report that this symptom had been seen in Jarrett,. Let’s go to Chuck in the amusement park cafeteria for more details. Chuck: Thanks, Flo. The great and powerful writer of this blog wants me to tell the readers that he’s abandoning the news room bit – it started off pretty cute, but now is kinda like a turtle, slow with no discernible direction. I figure I’ll just be straight up, here are the facts –

As Flo mentioned, while doing some trunk rotations at the gym. I figured I’d add more weight that day, because that’s what you’re supposed to do at the gym and what’s the worst that can happen? As if the universe was listening, it replied by creating an unexpected pop in my abdomen and sending me into baclofen withdrawal. At work the next day, it was becoming harder and harder to control the tremors from my left leg. I started becoming concerned when having sudden temperatures changes in some isolated part of my body. I entertained the idea that the temperature and body part might symbolize someone’s attitude toward me. For instance, if my butt got really warm it’d mean somebody thought I was a hot piece of ass. If my shoulder went cold it was because someone thought I was unjustly ignoring him or her (i.e. getting the cold shoulder). I needed more period that something was amiss so I took my blood pressure. I’m glad I did, it was freakin high. I called my all things disability doctor, and she told me to go to the ER.

Within 20 minutes I’m in my principals hot rod headed to the ER. They got me in for a CT scan of my noodle and found nada – the ER doc prescribed something for anxiety and I was on my way.

The next day, PM/R doc and I puzzled over it – baclofen pump? Medication reaction? Another hemorrhage? Global warming? Not enough donuts in my diet? There were signs everywhere, but the answer was oh so elusive. Think of it like The DaVinci Code meets neurological disorders. In essence, we were looking for Da – Neuro Code. After that first meeting, there weren’t any dead bodies with clues written on them or ambiguous paintings to draw direction from, so we improvised, discussing symptoms and recent med changes. We decided that it was a complication caused by my skipping my nuvigil doses the weekend before. I would continue on nuvigil as usual and my hot ass wouldn’t be giving anymore cold shoulders.
After another day of tremors, temperature anomalies and high BP and a trip to the ER, it was back to the PM/R doc to reassess. The more we spoke on it, the more it pointed toward baclofen withdrawal, so she scheduled surgery the next day.

Turns out, we were right, the catheter leading from the pump to my spine had snapped. After replacing the catheter, my body decided to bleed a lot, there was concern that the blood would put too much pressure on my spine. Luckily, that fixed itself, however, I still had a leak – much the same as the great CSF flood of 2011 after the pump was first put in.

Listen, the brain and spinal cord are very particular about the amount of fluid they will sit in. If they sense that the amount of CSF is not just so, they demand that my head fill with an abundance of discomfort juice and that the discomfort juice should spread to my stomach and take the form of bile and partially digested food and exit out of my face portal with much heaving and dramatic bellowing.

To assuage all of these various fluids, a new fluid must be introduced as mediator, to “patch” things up if you will. Put simply, my blood is injected at the site of the leak and clots, sealing the leak.

A few hours after having this done, the discomfort juice was gone and the contents of my stomach would continue their course to exit out the correct portal. In fact, the improvement was so great that the Dr. decided to send me home that day.

That was two days ago, I’ve been holed up at my parents house resting since then. I hope to return to work later this week or early next week.

I’ll check back after I know more. FIN

@JarrettLWilson

How Standardized testing contributes to Global Warming and Other Curiosities

INSPIRATION! I found you! It was hiding in the vast tangled forest of the rules and regulations that is standardized testing.

You see, I work in a middle school and state testing days are quite an ordeal. The only comparison I can think to make is what a building would have to go through to prepare to receive the president (a lame comparison, I know. I’m still shaking the rust of my inspiration gland).

EVERYTHING is considered a threat (to test security), every corner is monitored by highly trained personnel (i.e. the next name on the alphabetized staff roster as duties are assigned), and the event is catered (insofar as you can say that school lunch is a catered affair).My duty was predetermined at conception.

Listen, I’m a dude. Society dictates that I potty in a room where only dudes are allowed. Rumor has it that there are similar rooms for chicks, but I’ve never been in one. During state testing, the restrooms have to be monitored. The students like have think tanks after going potty. Such a clandestine rendezvous might cause a student to score a little higher and help him or her land a job that he/she is not qualified for (before discussing it in the bathroom, he/she thought the square root of 64 was 116, or that George Washington discovered America, or something).

Such a forbidden meeting might go like this (it’s funnier if you imagine them speaking in British accents): “The answer to #4 is unequivocally option ‘C.'” Says George. Carl scoffs at this, replies “I’d put ‘C’ if I wanted to get it wrong!” Jim busts in and says, “Will one of you please hurry? I really need to go potty.” He then starts doing the potty hop on one leg. George and Carl, having agreed that the answer is actually ‘D’, have moved on to discussing the merits of multiple choice testing and are too engrossed in the subject to hear Jim’s urgent request to pee (peequest?). Just as they decide that short answer questions would be the best assessment tool, but too difficult to grade, Jim soils himself. Now Jim rushes to finish the test so he can go home to change his pants. He ends up failing the test, and repeats the grade. His self esteem is shot, he stops trying in school, and is forced to take a low paying job at an aerosol can factory. As we all know, aerosol cans deplete the ozone layer – contributing to global warming.

In effect, not monitoring the bathrooms during standardized testing contributes to global warming.

This brings us back to my conception. In order to prevent cheating, rousing discussions on testing methods, and global warming, the people who create and enforce standardized testing (Satan, Barbra Streisand, Rush Limbaugh, etc.) have decreed that all potties be monitored during standardized testing. As a male, it is altogether fitting and proper that I should do this.  Getting back to being I.N.S.P.I.R.E.D (part one HERE), ‘P’ will now stand for “potty monitor”.

In keeping with the topic of standardized testing, ‘I’ stands for “Irregularity”. This is a very common, yet much maligned term used for any aberration from testing procedures, which is pretty much everything.

For instance, I told a student to “knock it dead”, ‘it’ being the science test. Moments later an owl flew by and dropped a letter at my feet. It was addressed to “Test Defiler Wilson”. I opened it and it started screaming at me (sounded like Tom Cruise). It said, ” It was reported at 8:03:56am that you bade a student to ” knock it dead” in reference to a test. This is in direct violation of subsection ee of decree 17 of chapter 119 of section four of the third edition of the educator code, copied here for your convenience: Thou shalt not wish luck to any student the student to figuratively use violence between 8:02 and 8:07am. Examples: “knock it dead,” “kick it’s butt,” and “slay that puppy”. For this irregularity, we’re taking away your stapler. May God have mercy on your soul.”

I can’t give you a example of a real irregularity – that, in and of itself, would be an irregularity. However, I can tell you that ‘R’ stands for refill.

When I write the word ” refill”, you probably think of an icy cold beverage at your favorite local eatery. That is quite far from I’m talking about. I refer, of course, to going to the doctor to refill the pump in your abdomen with that sweet, sweet muscle relaxer called Baclofen – which is 1,000 times stronger than the oral stuff. If you’re unfamiliar with this process, I’ve provided some pictures for you. These shots capture the wide variety of emotions that surface during a refill (read the captions for more info).

Primary emotion - euphoria. I never learn, every time I go in for a refill, I think they're going fill it with Pepsi or something, so I'm very excited. But...
Reading the Pump. Primary emotion – euphoria. I never learn, every time I go in for a refill, I think they’re going fill it with Pepsi or something, so I’m very excited. But…
...then comes the dread of knowing that, even if they do fill it with Pepsi, I'm going to get poked. Primary emotion - dread
Dawning the Pump               …then comes the dread of knowing that, even if they do fill it with Pepsi, I’m going to get poked. Primary emotion – dread

 

Primary emotion - boredom. I've been stuck with A LOT of needles. I'm not bragging when I say that getting stuck with a needle is as routine as going potty.
Prepping for the Poke. Primary emotion – boredom. I’ve been stuck with A LOT of needles. I’m not bragging when I say that getting stuck with a needle is as routine as going potty.
The Stick. Primary emotion - rage. Like I said in the previous pic, getting poked doesn't bother me. If I recall, I was so upset on this particular occasion because they didn't have any "Where's Waldo" books in this exam room.
The Stick. Primary emotion – rage. Like I said in the previous pic, getting poked doesn’t bother me. If I recall, I was so upset on this particular occasion because they didn’t have any “Where’s Waldo” books in this exam room.
Sucking out the old stuff. Primary emotion - stunned sadness. The old Baclofen had been a part of me for a few months, now it's gone.
Sucking out the old stuff. Primary emotion – stunned sadness. The old Baclofen had been a part of me for a few months, now it’s gone.
Pumping in the new stuff. Primary emotion - contentment. I'm just about done and the medical assistant has gone to get the "Where's Waldo" books
Pumping in the new stuff. Primary emotion – contentment. I’m just about done and the medical assistant has gone to get the “Where’s Waldo” books

FIN

@JarrettLWilson

 

 

Medical Vernacular Spectacular!

Part of having a condition like mine is learning a lot of big words. I like big words and I like to write silly poems – seems reasonable to assume that I would double like a poem about big words. I haven’t written the poem yet, but I’m sure I’ll like like it. To that end, I’ll quit introducing and start writing the poem you’re about to read. One last note – I’m going to stick to a simple AABBCC rhyme scheme – Shakespeare I amn’t. I’m going to italicize the terms to set them apart.

The medical field uses words that are big and complex,

For instance, raising you for at the able is called dorsiflex(ion) :).

The above word is one of the many that end with I-O-N,

Proprioception is a word that I use often;

It’s a big word for knowing where your limbs are in space.

Circumduction is another I-O-N, it affects walking pace.

When the knee doesn’t want to bend, the leg swings;

If I’m not careful, I’ll start to kick things.

Yet another I-O-N is ambulation;

Or you could say “walking”, if you value concision

Walking is made more difficult by the symptoms of spasticity.

Incontinence is when you have trouble going pee-pee,

“Pee-pee” is a silly word for releasing fluid that is pent.

The fancy term for pooping is “bowel movement”.

There is also a tube for moving pee-pee and other fluids hither and thither,

The fancy word for this tube is catheter.

There’s an intrathecal catheter delivering medicine to my spine ,

The catheter carries medicine from a baclofen pump to help me feel fine.

At first, the needle caused my spine to leak,

But thanks to a blood patch twas fixed in about a week.

To get the blood for the blood patch, the nurses set a Mid line,

The needle went so deep into my arm, I felt like dying.

Medtronic is the company that makes my pump.

Ataxia, or loss of balance, makes it difficult to jump.

Seeing two of something is called double vision or diplopia.

Seeing two of something is called double vision or diplopia.

Dysphagia is one of the fanciest medical terms I know,

It’s easier just to say “it’s hard to swallow”.

Let’s not forget the word for constant muscle contraction,

Hypertonicity is the word given to this action

I owe this list of words to the Pons region of the brainstem,

Without having a major hemorrhage there. I wouldn’t have learned them

This concludes the list

Did you get the gist?

I know I left some off, but I’m happy with this list, short as it may be. I think I explained the meaning of the words pretty well, but here’s a list with definitions just in case –

Dorsiflexion: This is when a door opens – I jest. Quite simply, it’s bending your ankle so that your foot/toes goes up

Proprioception: Obviously this describes a professional at “priocepting”, and as we all know (right?), prioception is the ability to perceive of a Toyota Prius. Actually, it’s your perception of the relative position of some body part.

Circumduction: The Romans came up with this one. Circ is Latin for “Pringles” (they’ve been around for a while). Um is Latin (and every other language ever for “WTF?”). Duction translates to “talking with one’s mouth full”. In essence, when in Rome, it’s not cool to talk with a mouth full of Pringles. Truthfully, it’s when the leg swings outward because the knee won’t bend enough to clear the ground.

Ambulation: Walking

Spasticity: Tremors caused by constant muscle activity

Incontinence: When you’re not on a continent. Examples – swimming in the ocean, flying on a plane or exploring outer space. A less awesome and more truer answer is when you can’t pee

Bowel movement: Pooping (heh, poop)

Catheter: This one was adequately covered above – it’s just a tube

Baclofen pump: A hockey puck shaped machine that delivers sweet, sweet baclofen (muscle relaxer) to the spine

Blood patch: The use of blood to patch a leak in the spine. I asked them if they could just use tape. They laughed derisively and said we could, but then we won’t get to set a…

…Mid line; thereby IMPALING my right bicep to harvest blood from a deep vein

Medtronic: A science fictiony name for a company that makes baclofen pumps

Ataxia: The IRS’s answer to whether or not there’s a tax for some object. E.g. “Is there a tax for asking stupid questions?” IRS reply: “A tax, yeah.” That, or loss of balance.

Diplopia: This one means double vision, I don’t get it. When I think of the word “plop” I think of poop splashing into the toilet.

Dysphagia: Saying disparaging remarks to some named “Phagia” – she(?) will punch you in the throat and make it difficult to swallow.

Hypertonicity: Similar to “spasticity” – constant muscle contractions.

Pons: Latin for bridge due to its position between the cerebellum and the cerebrum on the brainstem (that sounded pretty scientifical, eh?)

Hemorrhage: Internal bleeding, which, when paired with the term above, can create everything above that. Basically, it’s at the bottom of everything (symbolic, no?)

FIN

@JarrettLWilson

Presenting – My…Presentation

I work at a middle school.

I’ve been employed there in some fashion for a number of years.

My first two years I taught 8th grade US history and coached boys’ athletics. The next year I taught 8th grade English and coached girls’ athletics.

At the end of that school year some blood vessels in my brain leaked like so much kiddie pool left to rot in the sun.

I taught 8th grade English for half of the next two school years. I came back the next school year as the assistant librarian and have filled that role for going on three years now.

Assuming my math is correct (2+1+.5+.5+3), I’ve been working there for 21,553 years – this raises a few questions.

Firstly, I’m only 32 years old. Secondly, the school has only been there for 40ish years. Let’s round that figure down to eight school years.

I do so enjoy working there and continuing to work with students. Thing is, I’m not like any of the other teachers/professionals in the school.

When I returned to teaching after the hemorrhage, I created a PowerPoint presentation about my condition to show to my class to prepare them for my uniqueness.

Recently, I had the opportunity to speak to the new seventh graders. I modified the presentation to fit my condition today. I thought I’d share it with you, the internet –

1

This is the title slide – note that it has the title written (in English, no less!) on it.

2

This slide is for a handout. The students were given the same graphic, but with blanks. In essence, they started with an empty brain and ended with a full one (symbolic, no?)

3

In the same fashion as the previous slide, the students filled in the blanks on the same graphic.

4

This slide is a pictorial representation (pictoriational?) of the functions of each lobe. For instance, the temporal lobe (orange) controls the instinct to swat things away from your ear (actually, that represents hearing), and the frontal lobe controls the confusion that comes from staring at gibberish on a sign post (actually, that represents planning).

5

Now we get to my contribution – you see, the seventh grade reading classes at the school where I work are covering non-fiction. They are reading Gifted Hands by Dr. Ben Carson – the brain surgeon that removed half of a girl’s brain. One of the teachers is a friend of mine and asked me to present my experience as a primer. The image in the slide is my brain (isn’t it beautiful?). The white dot in the middle is my cavernoma isn’t it (or rather, wasn’t it) ugly?

6

Not much to say about this slide that isn’t in the slide. I’ll just add that the symptoms listed are enough to get you a 20 minute helicopter ride.

7

Much like the image in the “My Brain Issues” slide – the head pictured is my head. My head is perfectly round and my brain has many different colors. I know what you’re thinking, “But Jarrett, there weren’t no color in the other image and your head ain’t perfectly round.”

I’ve a twofold reply to this comment. First of all, I was joking – that’s not my head. Secondly, you need to work on your grammar. Moving on, this one has info about the surgery. That fact weighed heavily in my decision to title the slide “The Surgery 9/2009.”

8

A few summers ago I went on a tour of a Nair factory – this happened to be the day that Gillette planned to sabotage the Nair factory. They set explosives…I’m tired of this explanation. It started off with promise, but now I hate it!

Truthfully, a few summers ago I wanted to see the scar, so I shaved my head.

9

This slide is linked to a file with moving pictures and sound! This “video” is about *drumroll* neuro-plasticity! A fancy term denoting the brain’s ability to form new connections.

10

This is a visual representation of how your brain thinks. For instance, you see a donut with your occipital lobe. That info shoots to your frontal lobe and activates your happy gland. Your happy gland shoots a message to your parietal lobe “GO GET THAT F’N DONUT!” Someone gets it before you can, so your temporal lobe tells you to break out your megaphone and shout obscenities at this person and threaten to call the police. This guy dressed a nearby napkin dispenser and wangs you in the Temple…

11

…That blow to the Temple gives you a TBI. Your brain rewires itself and finds an alternate route to your happy gland.

12

I included this slide to give the students an explanation as to why I sometimes shake when I speak and why I walk with a limp and hike up my left arm like so much Bob Dole. It also helps explain the little girl in the moving picture mentioned earlier. It also gave me a chance to…

14

…mention the painful treatments. One thing I’ve learned from working in a middle school is that, as much as the kids want to be treated as adults, they still love to hear about people getting poked with needles and meeting a real life cyborg.

13

I like to pepper in some humor here and there to make sure the kids are awake. When this slide appears, it’s accompanied by a very loud, obnoxious laugh.

15

I don’t really do any of these anymore, but I mention it because I did it for so long, and it drives home the point that I’ve had a long road.

16

In my mind, all of these will someday be replaced with “Painfully normal”. For purposes of this presentation, it gives the students an idea of what to expect when they see me.

17

It can be difficult to work around young people with my disabilities. Instead of hiding or pretending that I’m no different, I encourage the students to come talk to me if they have a question. I want to think that I’m an ambassador for the disabled. Hopefully, these students will apply what I’ve tried to teach them to others with disabilities.

I included the last bullet because I’ve had some students speak very loudly and very slowly to me. You see, they have to tell me their student ID number to check out a book. In previous years, a student or two would speak to me as if I was unable to type and listen at the same time.

18

I’m a pretty smart dude and I can be pretty creative, but I didn’t discover any of this and I didn’t make this sh*t up.

If there’s one thing I learned in college, it’s that Keystone Light is super cheap and tastes like weedkiller. If there’s a second thing I learned in college, it’s that plagiarism is bad (I remember a syllabus that said there’s a special place in hell for those that plagiarize).

We try to instill that fear into the students, so I model the proper citing of sources.

FIN

@JarrettLWilson

“The Wilds of a Brain Injurah-d Routine” Episode One

I’m not sure what I was thinking on the last three posts. I guess I wanted to spread my writing wings.

Fact is, this blog started as a means to inform those close to me on my condition. I’ve since used it to share my experiences of life after brain surgery.

Recently, I’ve gotten comments about how insightful and informative some of my posts are.

That being the case, I need to get back to my roots – I like the idea that someone can benefit from my experiences.

With this post, I’m getting back to basics. I’ve mentioned before that you (yes, you there with the pants) should be your own advocate. That is, if you are facing adversity, do your homework to make your life easier. Therefore, I’m

going to lay out the adaptations of the Jarrett in the form of a nature show.

Thing is, the nature shows that I remember (the good ones, anyway) were narrated by Australians, so this blog will be written with an Australian inflection. If you’d like me to clarify anything from this, leave a comment. Here goes. Before I start, I would like to announce that I’m cutting back to a post every two weeks. I plan on focusing more effort on writing a book and illustrating my “Terds”. No, I’m not going to draw pictures of my poop; I’m talking about this silly words that I come up with and tweet; I’ve put a few examples at the bottom of this post. I reserve the right to throw a post out there when the urge hits me; but as far as regular posts, I’m cutting back to one every two weeks. Moving on –

Let’s watch as the majeestic Jarretto Awesomicus goes through hees morning reechal (ritual) –

Noteece that eet’s extremely urly. The Jarretto will wake up up to three hours before werk to make all the necesseery preparations. The Jarretto does thees for all commeetments – thees ees most lih-kely due to hees slow pace.

CRIKY! We’re getting a reh (rare) gleempse at one of the Jarretto’s morning exyersyah-zes (exercises) – the postyah (posture) and stability vogue. Een thees exyersyah-ze, the Jarretto flails his ahms about Een front of a mirrah to monitah and correct hees postyah.

What’s thees? He appeahs to be streetching hees amstrings. He does thees to loosen up the muscles een hees legs a beet (bit). You see, the spasteecity (spasticity) een hees legs makes hees muscles veery tih-ght. He ees done streetching and has moved on to his balance and weight beering (baring) exyersyah-ze. During thees exersyah-ze, the Jarretto balances on his left leg for at least 30 seconds and weel often try for up to a meenit (minute)

Now we see the Jarretto putting a Swedeesh knee cage (knee brace) on hees left leg. You see, the Jarretto’s brain doesn’t tell his left amstring to fie-ah (fire) when he straightens hees leg, causing heem to hyperexteend hees knee. Eef he deedn’t have thees brace, hees knee wood sirtinly break Een ‘af.

Ee’s of now to feeneesh getting ready for woork. But that wraps it up for us. We hope you’ve enjoyed thees edeetion of “The Wilds of a Brain Injurah-d Routine”. G’day, mates!

When purchasing laundry products, do not make the mistake of writing down "laundry detergent" on your list. Be very very specific about the brand name, etc.
When purchasing laundry products, do not make the mistake of writing down “laundry detergent” on your list. Be very very specific about the brand name, etc.
This would go well on the Wii's opening screen about the risk of seizures.
This would go well on the Wii’s opening screen about the risk of seizures.

FIN

@JarrettLWilson

On a More Seriouser Note

The following is an article I wrote to submit to magazines – unfortunately, People turned me down.

My previous entry about botox generated a buzz on the Bookface and it weren’t even scholarly. This one is more informativer and could prove to be more helpfuler.

Be warned, this article is long and boring.

 

To Botox or not to Botox?

 Wouldn’t it be nice if there was a catch-all medication for the symptoms that occur after a brain injury or stroke? Alas, the symptoms and deficits left in the wake of such an event are so varied that such a medication would have to address thousands of symptoms. One such symptom that I continue to experience, resulting from a hemorrhage and surgery back in 2009, is spasticity, or “motor dysfunction arising from upper motor neuron lesions… significantly interfer(ing) with body image, balance and gait.”*

A common treatment for spasticity is botulinum toxin. This treatment involves vials of this toxic substance and several needles. I won’t sugarcoat it, you become a human pin cushion; I’ve had to endure as many as 15 injections in my left leg (yes, that includes my foot) and left arm.

I continue to endure this treatment because, for me, it works. However, there are some shortcomings to this treatment – that is to say, there are areas where botulinum toxin falls short; this has been my experience and the research backs me up. Before I discuss the strengths and weaknesses of botulinum toxin, I’ll tell you more about the general applications of botulinum toxin.

General Information

The consensus according to the medical literature is that botulinum toxin does work, the degree to which it helps varies depending on: 1. Where it’s injected, 2. The dose, and 3. Active vs. Passive outcomes (more on this later). Concerning the injection location, studies are divided into upper limb outcomes and lower limb outcomes. Much of the current research looks at the effect of botulinum toxin in the upper limbs (elbow, wrist, finger flexors, etc.). What little research there is for lower limb outcomes shows an improvement in gait, speed, stride length and standing posture.* Dosing is pretty straightforward – a bigger dose produces better results. With a higher dose comes the question of side effects. I’ve not experienced any of these, but it’s possible for 1. The botulinum toxin to seep onto surrounding muscle – causing them to become weaker, 2. A muscle to receive too much botulinum toxin, making it difficult to use; thereby stifling any therapeutic advantage, and 3. Building an immunity to botulinum toxin.** Moreover, a higher dose does not increase the duration of the results; there doesn’t appear to be any correlation between the amount of medicine and the length of time that spasticity symptoms subside.***

Passive vs. Active Outcomes

Improvement is not easy to define. Outcomes are often classified as “active” or “passive”. Active improvements refer to a measurable change in some activity (a timed walk, putting on a shirt, etc.). Passive improvements report changes in spasticity symptoms at rest. The former are measured by a therapist or doctor using one of various tests of function; the latter can be observed and reported by a therapist or doctor, but are more often expressed by the patients,*** or caregivers.**

As previously noted, treatment is divided into two zones: 1. Upper limb, and 2. Lower limb. This being the case, the results of botulinum toxin treatment fall into four categories: 1. Upper limb active outcomes (functional improvements, such as getting dressed faster or completing household chores more quickly), 2. Upper limb passive outcomes (relief from the spasticity symptoms, etc.), 3. Lower limb active outcomes (stride length, speed, standing posture, etc.), and 4. Lower limb passive outcomes (relief from spasticity in the lower limbs).

Upper Limb Outcomes

There is no shortage of data available that focuses on upper limb responses to botulinum toxin treatment. Although they all have different results, there are a few constants –

1. More botulinum toxin = better results

2. More botulinum toxin ≠ Longer duration of results

3. Despite the outcome of any functional measurement, patients report being more comfortable

4. Combining therapies (electronic stimulation, physical therapy, wrapping, etc.) will produce better outcomes, both in terms of active and passive.

Active outcomes are a mixed bag. A report analyzing data from several studies of botulinum toxin treatments for both upper and lower limbs found “no significant functional improvement” in five out of ten studies. Eight out of the ten reported “significant reduction” in symptoms related to spasticity; four of those eight specifically mention an increased range of movement in the fingers, wrist and/or elbow.*

A first-hand study found similar results; including, “significant reduction in spasticity at the wrist and fingers with a greater range of passive movement at the wrist and less finger curl at rest.”***

These findings suggest that botulinum toxin may not help much in terms of functional activities (i.e. getting dressed), but there’s a pretty good chance that these injections will relieve some of the passive symptoms of spasticity.

Interestingly, some patients reported and were observed to have a better walking pattern due to upper limb injections. It is believed that this unintended effect was the result of “better walking symmetry.”***

My Upper Limb Experience

When I started getting botulinum toxin injections, a small part of me hoped that the injections would completely restore my dexterity and coordination, or at least make my left arm more useful. I did get a little more use out of it, but at the time, the improvement was not enough to justify continued treatment.

I have since continued with upper limb treatment with the understanding that my arm won’t be lot more useful, but I will get some relief from spasticity. My experience with lower limb injections has been more successful from a functional standpoint.

Most of my injections go to my left leg. My doctor will often inject what is needed in my leg first, then whatever is left goes to my arm. Therefore, most of the experience I will relate will be with the leg.

Lower Limb Outcomes

Published research for lower limb botulinum toxin injections are generally positive. In an article from Neurology, researchers pooled data from multiple studies and found that injections in the hamstring and calf were effective in improving gait.**

With lower limb results, passive outcomes often lead to active outcomes. For instance,

“While correlation has been observed between muscle tone reduction and gait parameters, significant improvements have also been reported for walking speed, stride length and premature activity of soleus muscle after injection.”*

Studies that report the effects of lower limb outcomes tend to focus on issues associated with spasticity below the knee.

In the case of the thigh, studies have found some improvement in functional outcomes with hamstring injections and adductor injections.**

Most of the research regarding botulinum toxin in the lower limbs focuses on injections in the gastrocnemius (calf). One study in particular reported “Improved gait over 1 to 3 months.”** Other studies document similar results. Specifically, a study of 12 patients with spastic calf muscles showed improvement in “Velocity, stride length and stance symmetry.”***

My Lower Limb Experience

Spasticity in my left leg makes it difficult for me to walk. Without the injections, it’s difficult for me to raise my foot (ankle dorsiflexion), causing my foot to drag. In terms of function, the injections help smooth my gait by making it easier to lift my foot. Spasticity also causes the toes on my left foot to constantly curl, making them sore. I get relief from this discomfort, (note: to relieve spasticity in the toe flexors, I have to get shots in the bottom of my foot – painful, yes. Worth it? Absolutely.)

I can’t offer much information regarding injections into the hamstring. Although I have gotten them in very small doses, my doctor typically advises me to inject more into the calf muscle. The problem with the hamstring is that, if injected with too much botulinum toxin, the hamstring will be too weak for standing and walking.

I like benchmarks to measure improvement. At the end of last year I decided to time myself as I walked the perimeter of my apartment complex (roughly 1/4 mile) – my time shows an improvement when within the window of botulinum toxin’s greatest effect (10 days to two months after injection). As of this writing, my last botulinum toxin treatment was Thursday 1/03. My average time on the walks before then is 8:10. The average time for walks from the two months after the injections is 7:56. Not only do I move a bit quicker, but I feel like I’m walking much more smoothly. Both of these are due to increased dorsiflexion in my ankle – I don’t drag my foot as much.

Closing Thoughts

Like with any treatment, it’s always better to be informed and aware of what to expect. That is especially the case with a treatment like this one. Most people don’t enjoy getting one shot, let alone a dozen or more.

It is debatable how much more function you might gain, but both research and I agree that you will get some relief – worth a try while we wait for a treatment that covers every symptom of stroke/ brain injury.

*Ozcakir, S., & Koncuy, S. (2007). Botulinum Toxin in Poststroke Spasticity. Clinical Medicine & Research, 5(2), 132-138.

**Simpson, D. M., Gracies, J., & Graham, H. K. (2008). Assessment: Botulinum Neurotoxin for the treatment of spasticity (an evidence-based review): Report of the therapeutics and technology assessment subcommittee of the american academy of neurology. Neurology, 70(19), 1691-1698. Retrieved from http://www.neurology.org/content/70/19/1691.full.html

***Smith, S. J., Ellis, E., White, S., & Moore, A. P. (2000). A double-blind placebo study of botulinum toxin in upper limb spasticity after stroke or head injury. Clinical Rehabilitation, 14(5), 6-13. Retrieved from http://cre.sagepub.com/

TBI is…Truly Stunning Botox Images

I know that there ain’t no ‘S’ in TBI, we can make believe that TBI should really be TSBI for Traumatic Suckass Brain Injury.

Anyway, this is just a quickie. I thought I’d share these pictures with you.

This first image is regular ol’ Jarrett, enjoying life with no needles in my foot. The next picture shows that, indeed, life can be enjoyed because, indeed, my foot is, indeed, needle free.

Notice that I'm not wincing
Notice that I’m not wincing
Notice that the bottom of my foot ain't got no needle in it
Notice that the bottom of my foot ain’t got no needle in it

Indeed, this needle free bliss would be short lived, indeed. Should I stop with the indeeds? I should, indeed!

Moving on (indeed? Err…nevermind), these are images of a needle in my foot. Take note – the foot is my foot and there’s a needle in it. The nurse took three pictures because she’s an overachiever.

Notice that the bottom of my foot has a needle in it
Notice that the bottom of my foot has a needle in it
On a more seriouser note, notice the curl of my toes. They do this all the time, it gets pretty painful. Botox injections help make it a lot more manageable.
On a more seriouser note, notice the curl of my toes. They do this all the time, it gets pretty painful. Botox injections help make it a lot more manageable.
Notice that the bottom of my foot STILL has a needle in it
Notice that the bottom of my foot STILL has a needle in it

My mood has been altered verily as can be seen in this next pic. The sudden change of mood might be confusing for you, I’ll explain. You see (actually you can’t) the bottom of my f*cking foot has a f*cking needle in it.

The True Face of Pain

The True Face of Pain

FIN

@JarrettLWilson