PTSD: POST TRAUMATIC STRESS DISORDER

PTSD (Post-Traumatic Stress Disorder) is defined by NIMH (National Institute for Mental Health) as: An anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat.

Medline writes: "Posttraumatic stress disorder (PTSD) is a highly disabling condition that is associated with intrusive recollections of a traumatic event, hyperarousal, avoidance of clues associated with the trauma, and psychological numbing. The field of neuroimaging has made tremendous advances in the past decade and has contributed greatly to our understanding of the physiology of fear and the pathophysiology of PTSD. Neuroimaging studies have demonstrated significant neurobiologic changes in PTSD. There appear to be 3 areas of the brain that are different in patients with PTSD compared with those in control subjects: the hippocampus, the amygdala, and the medial frontal cortex. The amygdala appears to be hyperreactive to trauma-related stimuli. The hallmark symptoms of PTSD, including exaggerated startle response and flashbacks, may be related to a failure of higher brain regions (i.e., the hippocampus and the medial frontal cortex) to dampen the exaggerated symptoms of arousal and distress that are mediated through the amygdala in response to reminders of the traumatic event. The findings of structural and functional neuroimaging studies of PTSD are reviewed as they relate to our current understanding of the pathophysiology of this disorder."

Having seen PTSD patients clinically, it has struck me that people are being treated much as a 'one size fits all'. Admittedly, I may not current with all the therapies being used but I have not heard that all patients are given brain imaging to find the extent of their brain changes through time. Nor am I aware that treatment programs are different as relates to the extent of those brain changes. It makes me question whether a Korean War or Viet Nam War veteran will have more brain change than a more recent veteran of Iraq, for example. Obviously there are physical and chemical brain changes that stress imposes on one's body. Stress hormones wreak their own havoc. The length of time they work on a brain and body must influence the degree of damage which is evidenced both physically and psychologically. Working with someone who has suffered the trauma many years ago is impressive in that logic plays little importance in the thought content of their view of the world and relationships around them. Assuming the singular, trauma, is even accurate. What about those individuals who suffered repeated traumas, many of different kinds of assaults, for years?

Much effort is being put into researching PTSD, especially since it is now being recognized in troops returning from the Middle East. We must not forget that years of incest or domestic physical or emotional abuse can produce all the same symptoms. It is a concern of mine that research is not focusing (at least that I am aware of) on the difference in treatment responses in those who are fairly new to PTSD versus those for whom it has been part of most their lives and resulted brain change. In treating patients, I have often seen that they cannot retain images or explanations that are different than those they have held for years. Their seriously damaged self-images, wounded egos and sense of worth, their feeling responsible for all that befell them, their total acceptance that nothing can change how feel, is all encompassing. Medication, psychotherapy, cognitive behavior therapy, patience, and new and positive life experiences are only part of the some of the treatments.

If I were given a single wish, it might be to see that PTSD research address the differences in PTSD patients...the length of suffering post-trauma, the nature of the trauma and its being taken as a reflection of some fault of the patient, the brain and hormonal changes, levels of neurotransmitters, memory loss (as well as repression and denial), coping mechanisms, and so much more. I would want to know if there are differences reflected by gender difference since chemistry is such a variable between them.

In a perfect world, some of these questions would be answered. But, alas, the world is not yet perfect.

SOMETIMES OTHERS SAY IT BETTER

Miss California was asked what she thought of gay marriage and honestly commented (while I disagree with her view) that she was taught and believes that a marriage is between a man and a woman.

Following the N.Y.Times article there were pieces by some bloggers. Among them, I was particularly impressed by the position stated so fairly by the founder of Log Cabin Representatives.

Avoid the Bully Trap Rich Tafel

Rich Tafel is president of RLT Strategies, which provides personal and organizational strategy. An ordained minister and founder of Log Cabin Republicans, he was an early proponent of gay marriage.

"In the recent dust-up between Perez Hilton, the gay blogger, and Miss California at the Miss USA pageant, a number of questions have arisen about her answer to his question on whether she supports gay marriage.

I think it was a perfectly acceptable question. And though I completely disagree with her, I think her response was perfectly fine too. It mirrors President Obama’s belief and practically every other politician’s views for that matter.

All of us have a belief system, whether it is informed by our faith or a secular world view. The freedom to share those even unpopular positions is what makes this nation great.

As the tide turns in favor of gay equality, it will be a sad victory if we become the new bullies.

In my hundreds of debates for gay rights with Christian conservatives, I was often subject to mean and personal attacks and at times was concerned for my safety.

As the tide turns in favor of gay equality, what a sad victory it will be if we become the new bullies. We lose the moral high ground that propelled our cause. Calling this woman an unprintable name, as Perez Hilton did, is indefensible.

The crime here is not that people have opinions we disagree with. The crime is treating those who disagree with us with the same incivility that they treated us to."

Sometimes someone writes things as you would have stated them. This makes me feel less alone. I never mind debating with people who do not sink to calling me names and insulting me because I differ from that person's beliefs.

THE SHAME OF AMERICANS TORTURING

When someone moves, surprises are often left behind in the closet. So, it seems, it happened when the G. W. Bush administration moved, after hiding all their dirty laundry under the rug of attempts to claim Executive Privilege. The pundits certainly have very mixed reviews if you listen to Rove, Hannitty, et al over at Fox News or other news channels where there is a more objective concern over what our world standing is currently as a result.

One can empathize with all children whose parents violate the entire family by committing crimes of shame, leaving children to suffer the concerns from everyone around them as to whether they will grow up to be like the offending parent.

Now that the truth is coming out, how will honest people feel about the way that the Administration leaders who set it up and gave their approval it, underwrote it all, and allowed so many of the underlings to spend years incarcerated for following orders? When the military takes in marginally bright bodies, it should not be surprising that they do not know that they can stand up to their superiors when they were never taught a sense of law, morality, and what constitutes torture. When they saw what was done to prisoners who didn't go along with them and heard their President saying, "You are either with me or against me." it might have been very difficult to refuse, unless they were hand picked for their cruel and sadistic tendencies.

We can only hope that most of the world will not forget the kindness of this country to so many in world, though much of the Middle Eastern world would scarcely remember very much before 9/11 and the ensuing wars in Iraq and Afghanistan.

I, for one, appreciate that President Obama hasn't gone after the past Administration officials to prosecute but is letting the truth of what happened come out naturally, through efforts of others, so that he need do nothing other than refrain from stopping any legal process started.

TECHNOLOGY ADVANCES FIGURITIVELY REACHING THE SPEED OF LIGHT

Technology is moving too fast for the average person, even for me whom I consider well above average. In the world of mobile phones that deliver email to your hand-held device, a huge photo album, an entire music collection, access to the Internet, the resources of Google and other search engines which give you the world at your finger tips, twitter...I could go on and on. I have reached that which a few years ago I could never conceive. I have stopped buying new stuff and finally realize there will be stuff friends have that I can't possibly justify paying for or taking the time to slog through the learning curve involved.

It is frightening to think of how much is stored on the Internet when countries are playing around with nuclear bomb plans. It reminds me of the spoof The Onion has on YouTube.

Never before have I experienced such a disparity of skills among well-educated people with high intelligence. I cringe as I realize there are many who are still resisting learning to use a computer (and I'm not talking about the Amish, or others whose religious beliefs prevent them from coming into the 21st C.) It surprises me that, for the first time, I own so many electronic devices about which I struggle to make more than basic use. It seems like having the whole world at my disposal and choosing to live only on one small island. As more and more computer chips are in more and more appliances which are not made to last, it makes me wonder why designers can't make some things universally compatible. I have finally stopped buying cell phone chargers for my car because the phone won't last long enough to make the purchase cost effective. Why don't things last like the Sony TV I have had for nearly 25 years? It was in color, had an excellent picture, but just wasn't cable ready. I worked around that by hooking it up to a VHS recorder...in fact it outlasted three of them until finally all VHS format was put in the tech graveyard as I retired the poor things, still clinging to life, and moved another TV into the space.

Finally I have resorted to attaching a name tag to every cord and cable that enters the house. I label each AC converter to tie it in with the appliance that it services. Most of you might imagine the boxes of those things I had before I started to label them and what finally drove me to that bit of obsessiveness.

It baffles me that I could have bought an Amana Radarange at least 20 years ago that still works great though I have never used it to roast a turkey (which is why this one is as big as it is). While it does many things, my limited use of it is to cook vegetables and heat liquids. Wrong, I also cook regular oatmeal in it. I used to cook bacon in it but got tired of needing half a roll of Bounty to drain the fat into. Now I just bake bacon and it tastes better to me and I don't have to watch it constantly.

I own two DVD recorders on which I used to record TV shows I wanted to see but couldn't sit in front of the TV at the time to do. Then Verizon got proprietary and made them both obsolete for that purpose. I hate that companies can be so heartless as to wipe out functions in your life with no conscience about the pain they cause.

If the economic downturn has any positive effect, it may stop the plethora of new and better models of everything that make all of what I own no longer work.

BABY ON BOARD

A few years ago I used to see stickers on windows of cars, often in the rear window, that said Baby on Board. I could never figure out why people wanted to advertise that fact. Can you imagine the road conversations?

Trucker to Hitchhiker beside him: "Ga-awsh! Lookie there, they have a baby on board. I guess I'll have to careful not to hit them...wouldn't be so careful if it was only Parents on Board".

Hitchhiker: "Dunno, Bobby Joe, iffn t'was parents got hit, them babies left ta home'd be orphans! That'd be just durned bad for them little orphans."

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Dowager to driver: "Good Heavens, Heathford! This young generation shouldn't be allowed to have babies. They've got the poor thing on a board! Someone should report them immediately for cruelty to the child!"

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Poor man to his wife in car: "Look, Flossie, a baby on Board but it don't mention Room. D'ya think they're homeless?"

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Teen to his buddies in car: "Hey, Bro's, what part of the car do I aim for?"

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The concept of that sticker must be that some entrepreneur got smart, knowing there were lots of proud parents who really thought that no one would dare hit them if they had a sign on the car. Or, figured that, with the sign, people would slow down to get a look at the best looking baby in the world, produced by the drivers, of course.

I always wanted to put one of those Baby on Board stickers on one of those farm trucks that block the road, carrying a load of manure to the farm part down the road a bit. That should give the driver behind something to think about, especially if he had a couple of plastic diapers stuck on. NASCAR racers have so many stickers on their cars, I'll bet no one would notice Baby on Board among the rest.

I've always thought that any kind of sticker was a bit foolish except the one that says If You Can Read This, You're Too Damned Close. We Support the Troops should make everyone who doesn't, feel guilty. Just plain Support the Troops seems a bit pushy. But the one I think I like the most is the One Day at a Time sticker. You might as well just say it simply...Drive Cautiously; I'm an Alcoholic.

ROBOTS

Robots are being evolved as though their goal is to reach the speed of light. Some of them are even designing themselves. At this point there can be little question of their usefulness in warfare. However, when I heard that they are being used to escort patients to their destination in a hospital ...(now putting volunteer candy stripers out of a job for a cost of millions of dollars, at least), I have to wonder if this is not just big boys playing with toys. However, just as 50 years ago people thought that auto racing was a waste of time and money, it turned out that it produced many life saving devices and equipment for non-racing drivers.

Robots have replaced many workers who were in danger of getting injured on the job. While they have replaced many humans on jobs, new jobs keep opening up for humans, as well. Somehow I don't think that mankind is destined to become the overweight, immobile hunks of humanity that were depicted in the movie Wall-E. Whenever there is a discussion of this kind, the slippery slope arguments get pulled out. They are as amusing as the tea-bag occurrence this past week. One man held up a placard as he demonstrated saying, "I just want things to go back as they were." Perhaps someone should tell him he will be able to do that once a time machine is invented and he can go back in time and stay there.

Ginger, a new family of Robots is used in hospitals and many health care facilities. There are courier and escort services which use the same base. In military use, they are often going into dangerous situations, thus saving soldier's lives. They will become more mobile and autonomous and will have an even higher profile in our daily lives than we currently have.

The Maker fair in Newcastle is an example of what people are trying to do for fun and education. For example, a relatively new field is that of the 3-D artist.

It is highly unlikely that man will be replaced by machine in the future, but there is a far bigger place for Robots to settle in than one might have dared imagine a decade ago.

TRADITIONS: Happy Greek Easter today

There is something to be said about everything. The celebration of Easter in the Greek home is one something can be said about. Work always fell on the Greek mother in the past. She died eggs dark red (to symbolize Christ's blood) and baked bread, trimming the top with dough in the shape of a cross with some red eggs buried in it. When cut, the bread always looks odd with red lining the holes in which the hard boiled eggs rested. By the time the bread was baked, they were REALLY hard boiled.

Women dyed and hard boiled many extra eggs because throughout the day anyone in a village could drop by to visit (life didn't have much to offer by way of self-entertainment in the villages a few years agfo) and the expectation would be that they would be served a red hard boiled egg and a cookie (koulouraki), tediously rolled into pencil thin rods, twisted, egg washed, sesame sprinkled on, then baked.
Since I made a batch tonight, I can say that 1 batch (3# flour worth) made 132 cookies and took 110 minutes to roll, egg wash, add sesame, then bake.

There are lots of hors d'ouevres, drinks, and one might think the meal was over, judging from the satiated tummies in the room rather than that the meal being about to start. People have struck the nose of their eggs against another until your egg's nose is broken. The winner will remain full of luck for the year. The final person lucky enough to have an egg with nose intact is declared the finalist.

Before the meal, since it is also a religious observance, as part of grace and thanking God for the meal, a special song is sung which acknowledges that Christ has risen. People can be heard saying to one another, "Christos Anesti", meaning Christ has risen. The answer follows: "Alithos Anesti", meaning indeed he has! The hymn sung with the same theme is lovely though a younger generation, at least in our house, has never been able to keep quiet long enough to hear the words or the translation. As I suspect with many ethnic groups, the first and second generation American-born, can try to hold on to some of the traditions but, inter-faith marriages and questioning the beliefs of the elders make the spirit of the day feel different than organized religion would wish.

Lamb or goat, barbecued or roasted with vegetables and potatoes, was typical. The USA does not provide mountain grown oregano sufficient to cut it while tender leaves and stalks are still growing, it can be cooked as a vegetable and the first boil water is drawn off, reboiled; it is delicately scented and an exquisite companion to the meat. The meat has been marinated in garlic and lemon, with dried oregano sprinkled on when nearly done. There are usually several entrees and no one leaves the table who can do more than waddle away.

Greeks are noted for their desserts and would make a dieter pale with the numerous offerings...all decadently caloric. In the past, stay-at-home mothers had many days to prepare for the feast. Life being what it is, many families no longer try to get everyone under one roof for a sit-down dinner. However, many still value family enough to go all out with their Holiday hospitality. It is not uncommon to hear we will be having 5 dinner guests and a stray. For Passover observants, the guest goes with the script.

Since the best of food is trotted out for these events, if you don't have your relatives to treat you, find someone in need of a guest, or just feeling charitable enough to share with you, and life can, usually, really be beautiful gastronomically.