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IMAGES IN CLINICAL MEDICINE: Squamous-Cell Carcinoma with Pericardial Metastases

A 78-year-old woman presented with dyspnea, cough, and a pleural effusion on the left side. She had fractured a hip 3 years earlier, and a chronic decubitus ulcer developed while ... (Source: New England Journal of Medicine)

A Different Kind of dream

Nope, not new to dreaming, according to my
mom, I seem to go through most of the day doing just that; but I digress. I’m referring to my dream last night and
while it was not my first kind of this nature it all seemed so real.

Last night I dreamed that I was back to my
old self so to speak. What was really
weird about it was that at no time did I have any compunction of my current
situation – A C3 Quadriplegic paralyzed from the neck down and dependent on a
ventilator for my breathing! I suspect
that most people with a spinal cord injury have had similar experiences, but
this was perhaps my first that I can recollect with such vivid detail. Needless to say, it would be superfluous
indeed to say that I was a disappointed man when I was awoken at 6:00am by my
attendant telling me good morning while deftly following up with the question
of “shall I start your stretching exercise now?” while the melodic sound of my
ventilator began to fade into my conscious hearing.

It did not take me long to be sure it was
just another dream, which was reinforced rather quickly as I found myself
dangling from my hoyer lift as I was transferred from the bed to my
wheelchair. I could hear a voice
practically taunting in my head, saying over and over, “your back in the real
world now mate!” If I’m being really truthful here I would have to confess I
was not in the best of moods at this point and perhaps this is why I feel
almost compelled to submit this experience to paper as some weird sort of therapy,
gosh I have gone all “Oprah” here!

As I sit here now writing this entry, I’m
wondering if I am truly at the stage of acceptance and awareness of my current
situation? I mean the thing is; I don’t
consider myself to be under any illusion and I would seriously like to think
I’m fully cognisant of the situation and all it consequences that from here on
in, I just another quadriplegic who must come to terms with the fact that life
will no longer be what it used to be.
Don’t get me wrong, I don’t mean that in a bad way but for clarity – All
that stuff I used to enjoy such as snowboarding, mountain biking or more
succinctly, activities such as breathing, eating on my own or the simply task
of getting out of bed and “wiping the sleep out of my eyes” are task I now
depend on other to perform for me.

I wonder, bear with me I’m typing this “in
the raw” – as I’m thinking it, I writing it, trouble is my thinking capacity is
slightly quicker that than this speech software can cope with. I used to go to a support group, and one of
the things I quite never understood, was this girl who was a paraplegic and
apart from being very attractive, she often gave me the impression that she was
quite happy and accepting of her accident and that in fact, she thinks it has made
her a better person! Hmmmm…… ??? I’m sorry on this one, perhaps this too will
come, but I am nowhere in the vicinity, of reaching that juncture! I would like to know the secret to that one,
and I know she was not alone as I often read and see on television people with
spinal cord injuries whom claim similar experiences. I’m just curious as to what was their life
prior to injury? I am wrong here, or
just don’t get it?

Gosh, who would have though something as
trivial as a dream could evoke such though!
Well I guess it’s all part of life’s experience in a wired way, but hey
that just my experience! Tell me what you think?

Definition and Classification of Negative Motor Signs in Childhood

In this report we describe the outcome of a consensus meeting that occurred at the National Institutes of Health in Bethesda, Maryland, March 12 through 14, 2005. The meeting brought together 39 specialists from multiple clinical and research disciplines including developmental pediatrics, neurology, neurosurgery, orthopedic surgery, physical therapy, occupational therapy, physical medicine and rehabilitation, neurophysiology, muscle physiology, motor control, and biomechanics. The purpose of the meeting was to establish terminology and definitions for 4 aspects of motor disorders that occur in children: weakness, reduced selective motor control, ataxia, and deficits of praxis. The purpose of the definitions is to assist communication between clinicians, select homogeneous groups of childr...

Optical assessment of skin blood content and oxygenation.

Authors: Barbanel JC, Gibson F, Turnbull F The alteration of blood flow in the skin and subcutaneous tissue due to mechanical loading is of great importance in the prevention of decubitus ulcers. A technique is described for assessing changes in blood content optically. The results indicate that such changes occur after loading even though the deformation is maintained constant. PMID: 17153118 [PubMed] (Source: Journal of Tissue Viability)