What’s All That Noise?

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There are very rare instances when the slightest noise will set me off. Even if it is something as benign as one of my roommates opening the refrigerator door, it can sound like a thousand spoons clattering to the floor to me if I am in this state. For whatever reason, I didn’t think much of it until about three weeks ago when EVERY little noise I heard was painful for me, and I was in complete agony the entire night. Lucky me…I have been experiencing misphonia, and have had this condition since childhood.

What freaks me out the most is that my dislike of sounds when I am caught up in this nightmare can send me into so much anxiety that I must hide away until things return to normal. It was a tremendous problem for me during medical school, when I found that I had to wear earplugs while studying in public places or when taking exams. The mere sound of someone coughing would send me into such distress that it would take a massive effort for me to concentrate on my studies or an exam.

Misphonia, also called selective sound sensitivity syndrome, is usually set off by a small repetitive noise, causing the sufferer to become agitated, disgusted, panicky, and angry. Those who suffer from misphonia may seem to react excessively to soft sounds, such as the sounds of a person eating, or a dog barking in the background. This is considered a lifelong condition which is more common in females than males, and usually appears between the ages of 9 and 13. It is aggravated by emotional exhaustion, so those of you ladies who might have noticed that noises which would be considered normal can suddenly become jarring when you are in the middle of an emotional and stressful situation.

This is a very real condition, so if you think you might have it, talk to your doctor about getting tested to see if you have it. If you don’t want to go that route, you might want to read this very amusing article by Wendy Aron on how she handled her own case of misphonia:

https://www.psychologytoday.com/blog/sounds-awful/201405/how-my-shrink-cured-my-misophonia-free

MAW Nutrition Update!

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MAW Nutrition Inc. now has meals available! You can select 3, 4, 6, 8, or 10 ounce portions of cooked chicken, then customize the rest of the meal by choosing any one of the carb sources, and any one of the vegetable sources.

Check it out here: http://www.mawnutritioninc.com/category-s/1866.htm

As always, you can order a la carte selections as well. Be sure to use my discount code, NAITO10, for 10% off your order!

Cake Heaven!

If you click on the link below and scroll through it, you will definitely crave dessert! These 17 tasty sweet treats are incredibly decadent! I have added images of a few of the desserts featured on this link. Somebody had better hurry up and have a birthday, and not when anyone is in the middle of show prep!

http://www.buzzfeed.com/sarahdigregorio/17-reasons-not-to-despair?utm_term=.cvXoqP4rB#.uv1JaeA7Q

S’mores Cake (YUM):

S'mores Cake

Chocolate Cake with Chocolate-Chip Buttercream and Chocolate Ganache:

Chocolate cake with buttercream and chocolate ganache

I am including the donut cake because it is so ridiculous. Thankfully, I don’t like donuts, so this one isn’t torture for me at all:

Donut Cake

How Hoarders Process Information

I found the following article to be incredibly fascinating, and concur with study author Jennifer M. Sumner’s statement that hoarders have difficulties with establishing bulk categories for their possessions. This results in a complete inability to organize items, so they accumulate. I have included a link to the original post for reference.

mind of a hoarder

https://www.braindecoder.com/inside-the-mind-of-a-hoarder-1378787672.html

Inside the Mind of a Hoarder
A new study hints at the real reason behind the mess.
By Agata Blaszczak Boxe

When Paul Hammond, a resident of Mobile, Alabama, started collecting used cars and appliances to sell for scrap metal, he probably did not suspect that his habit would one day turn into a serious hoarding issue and land him in jail.

But, over the years, random items kept piling up in his yard, and Hammond just was not getting rid of them. After numerous complaints from the neighbors, who accused him of turning his property into a junkyard, county authorities got involved and cited him for criminal littering. They also threatened to put him in jail if he did not clean up.

When Hammond’s brother came to visit him for the Fourth of July several years ago, he saw about 90 cars, about 50 refrigerators and 100 lawn mowers in the yard. The brother quit his job for four months to help Hammond get rid of the stuff. But the county officials were not happy with the job the men did and they put Hammond in jail for five days.

“I thought I was a law-abiding citizen,” Hammond told A&E’s show Hoarders. Although he was released after the five days, he was still facing up to 90 more days in jail if he did not clean up around the time the TV crew came to film an episode about him.

Hammond is one of the many people with hoarding disorder who end up being overwhelmed with possessions they can’t organize or get rid of. Hoarding is a disorder that may be present on its own or as a symptom of another disorder, for example, obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD) and depression. To try to understand what mechanisms in the brain may be responsible for hoarding behavior, researchers have recently begun to look at the neurocognitive aspects of the disorder, but studies have yielded mixed results.

For example, one study looked at people with obsessive-compulsive disorder and found that those who had high levels of hoarding behavior performed significantly worse on tests of decision making, planning and properly shifting attention, compared with people with OCD with lower levels of hoarding. However, it’s difficult to conclude that these cognitive traits are responsible for hoarding because another study found people with hoarding disorder actually performed better on the same type of test than participants with non-hoarding OCD.

In a new study, published in Neuropsychology, researchers looked at neurocognitive functioning in 26 people with hoarding disorder and 23 people without the disorder. The researchers thought the discrepancies between the results of previous studies could have been caused by the effects of medications used by some of the participants, so in the new study, they decided to only include people who were not taking any medication that could affect their brain functioning in any way.

The new study found no significant differences in how people in both groups performed on tests examining their verbal memory, attention, or executive functions such as planning, organization and decision-making.

But the researchers did find a difference between the groups: when they asked the participants to categorize different stimuli in a separate test, the people with the hoarding disorder appeared to use different learning strategies during the categorizing task, compared with the controls. Namely, they tended to use explicit learning, which is about developing and verbalizing rules to remember something, explained study author Jennifer M. Sumner, of the University of California San Diego School of Medicine. In contrast, most people without the disorder used implicit learning, which is an unconscious, non-linear and non-verbal way to learn new information.

The researchers don’t know for sure how these results should be interpreted. But the findings do make them wonder whether, in people with hoarding disorder, the inability to organize and sort through their possessions might have something to do with how they process information, Sumner said.

It could be, for example, that people with the disorder try to come up with rules as to where different objects should go, but because they may end up creating too many rules, “it ends up being chaotic and cluttered,” Sumner said. Conversely, people without the disorder “might look at objects in their home and have this implicit, intrinsic subconscious ability to know where objects go, to know what is not important and what they can get rid of,” she told Braindecoder. “So they don’t have that clutter.”

In fact, previous research has suggested that people with the disorder tend to be under-inclusive in how they categorize the things they have, Sumner said.

“If you give them 10 objects to sort, they may put them in 10 different categories because they are all unique and complex in their own way,” Sumner said. But if a person without the disorder is given the same 10 objects, they may be able to put them in just two different groups, so they are easily organized and there is no clutter, she said.

“So we have this ability implicitly to decide where things should go,” which many people with hoarding disorder may not have, Sumner said.

Who’s Going To Nationals? Ravish Sands Suit For Sale!

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I have an absolutely GORGEOUS gold/yellow Ravish Sands competition bikini up for sale. The reason why I am selling this suit is because I just don’t need three suits. I will never get rid of the tangerine suit in which I won my Pro Card, and I have one other suit I am hanging onto, but which I may sell as well, since I think my competing days may be over. This suit is in excellent condition, and has only been worn at two Pro contests.

The top can fit a small D cup, but I think a B or C cup would be better for this suit. The bottoms fit a 34 inch hip measurement. For reference, I am 5’5″, 119 pounds. The top and the front of the suit bottoms feature dense crystallization with Swarovski bubble crystals in gold, which looks amazing onstage! Originally paid $500 for this beauty.

PRICE: $275
(Does not include shipping)

Please message me if you are interested. This would look STUNNING on the National stage!

Sarah lil’Mini Phoenix Dancing

This little girl is AMAZING! She’s got some mad dancing skills for sure! Check out her moves here:

There’s another incredible video of her doing freestyle to Truffle Butter, which has a great beat but is a nasty song. I can’t post the actual video here, but you can look it up on YouTube under: Sarah lil’Mini Phoenix | Truffle Butter | #immaBEAST

30 Actual Sentences Found In Patients Hospital Charts

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I recently saw this post on a friend’s Facebook timeline, and was compelled to write a response to it. The thing is, most of these chart notes ARE funny, but some are taken out of context. In addition, the language used in several of the notes are completely appropriate when spoken within the medical world, so I clarified those notes in a comment which I posted. Here is the original list of chart comments, followed by my clarifying remarks.

http://www.tickld.com/x/jaw/30-actual-sentences-found-in-patients-hospital-charts

1. She has no rigors or shaking chills, but her husband states she was very hot in bed last night.
2. Examination of genitalia reveals that he is circus sized.
3. Since she can’t get pregnant with her husband, I thought you might like to work her up.
4. The patient is tearful and crying constantly. She also appears to be depressed.
5. The patient has been depressed since she began seeing me in 1993.
6. Discharge status: Alive but without my permission.
7. Healthy appearing decrepit 69 year-old male, mentally alert but forgetful.
8. The patient refused autopsy.
9. The patient has no previous history of suicides.
10. Patient has left white blood cells at another hospital.
11. Patient’s medical history has been remarkably insignificant with only a 40 pound weight gain in the past three days.
12. Patient had waffles for breakfast and anorexia for lunch.
13. Between you and me, we ought to be able to get this lady pregnant.
14. On the second day the knee was better, and on the third day it disappeared.
15. She is numb from her toes down.
16. While in ER, she was examined, X-rated and sent home.
17. The skin was moist and dry.
18. Occasional, constant, infrequent headaches.
19. Patient was alert and unresponsive.
20. Rectal examination revealed a normal size thyroid.
21. She stated that she had been constipated for most of her life, until she got a divorce.
22. I saw your patient today, who is still under our car for physical therapy.
23. Both breasts are equal and reactive to light and accommodation.
24. Patient has chest pain if she lies on her left side for over a year.
25. The lab test indicated abnormal lover function.
26. The patient was to have a bowel resection. However, he took a job as a stock broker instead.
27. Skin: somewhat pale but present.
28. The pelvic exam will be done later on the floor.
29. Patient was seen in consultation by DR. Blank, who felt we should sit on the abdomen and I agree.
30. Patient has two teenage children, but no other abnormalities.

As a physician, I know that some of these chart notes actually make perfect sense to those who work in the medical field and who are on the hospital wards.

For example, “Since she can’t get pregnant with her husband, I thought you might like to work her up.” refers to a physician referring a patient to a fertility specialist who would be able to “work up” a patients to see what the issue might be with respect to difficulty getting pregnant.

Here’s another one: “The patient is tearful and crying constantly. She also appears to be depressed.” Crying “constantly” does not automatically infer that someone is depressed. Ostensibly the patient is distressed over something, but the clinical diagnosis of depression has a set of criteria which must be met on evaluation of the patient.

“The patient has been depressed since she began seeing me in 1993.” Really, just stupid. This patient had depression beginning at the very latest in 1993, and this clinician had begun seeing the patient at that time. So snicker all you want, but the clinician’s presence in the patient’s life is NOT the causative factor in her depression.

“The patient was to have a bowel resection. However, he took a job as a stock broker instead.” If I could count the number of times a patient was advised to have a surgical procedure, only to evade medical advice, I’d be a millionaire by now.

“The pelvic exam will be done later on the floor.” The “floor” refers to a hospital ward. This patient was most likely evaluated in the emergency room, so the plan was to do a full work-up, including a pelvic exam, once the patient was transferred to a regular bed in the appropriate ward or section of the hospital.

“Patient was seen in consultation by DR. Blank, who felt we should sit on the abdomen and I agree.” The phrase, “sit on the abdomen” means that the clinicians who were evaluating the patient had decided to hold off on any interventions with respect to the abdomen, most likely because they were confident that there was no imminent danger, and no need for surgical intervention.

The remaining chart notes ARE funny, and I could see why lay people find them amusing.
Hope this clears up some of the confusion regarding some of the notes which were perfectly sound within the medical world.

Stress And Your Skin

stressed out woman

Did you know that stress can do a number on your skin? You are probably familiar with the stress-induced breakout, but prolonged, chronic stress can also prematurely age the skin. Stressful situations trigger the release of cortisol, adrenaline, pro-inflammatory cytokines, and angiotensin, all of which rob your skin of collagen and weaken its cellular repairing capabilities. Circulation is diverted away from the skin during stressful situations, which explains the dull, pale appearance of the skin in people who deal with constant stress.

Cortisol in particular inhibits the growth of fibroblasts which are responsible for making collagen, so they can’t keep up with the constant breakdown of old tissue. The result is skin which is collagen deficient, resulting in thinner, more wrinkled skin. Free radicals are formed in response to stress, which then damages skin cells and adversely affects the condition of the skin.

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So how can you fight the effects of stress on the skin? There are three keys:

1. Exercise:

Every cell in the body benefits from exercise, including skin cells The pores of the skin dilate during exercise, and when you work up a sweat, trapped dirt particles are released. In addition, the increased circulation which results from exercise delivers more oxygen and other nutrients to skin cells, as well as carries away waste products and free radicals.

2. Relax:

We all know how frustrating it can be to have a big event looming, only to have an acne breakout right before the big day. The fact is that the stress associated with preparing for the event can trigger excess oil production in the skin, which clogs pores and sets up the perfect environment for an acne flareup. Even other skin issues, like psoriasis, are linked to stress. However, by practicing relaxation techniques, you can increase blood flow to the skin and offset any triggering factors (such as buildup of oil or free radicals) which contribute to skin maladies.

3. Use topicals:

Some of the best friends for your skin are topical agents such as antioxidants and retinoids. I am a big fan of vitamin C, not only because of its general antioxidant benefits, but also because it has a tendency to lighten up brown spots and impart a brighter appearance to the complexion. Retinoids are great for increasing cell turnover, and are potent anti-aging compounds.

When Words Elude You

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I have always been a decent writer, and have prided myself on having a substantial vocabulary. So when my mind completely draws a blank and can’t find a simple word which I am trying to remember, I become rather frustrated. I will stand there with a vacant expression on my face, sifting through the memory banks, hoping for some kind of trigger. I have become accustomed to the random brain fog moment, which is followed up about an hour later with the word innocently floating into my conscious mind, as if to say, “Here I am…looking for me?” For example, I couldn’t remember the word “cryptic” the other day, but it suddenly appeared after the situation in which I needed to the remember the word had passed. I was heating up a meal, and there it was, POP, in my head. What the hell? Where were you when I needed you?

Instead of struggling endlessly to find a word, I usually give up after less than a minute. It turns out that stubbornly trying to remember a word makes it more difficult to recall that word in the future, so I guess I am giving my brain a break. Perhaps I am also mellowing with age, sinking into a resigned state, and knowing that my noggin will have its misfirings every now and then.

cryptic
I have made the delayed word recall which occurs into a bit of a game now so that the word sticks. When “cryptic” came back to me, I immediately thought of Tales From The Crypt so that the word would stick, sort of like a memory glue so that the synapses might fire correctly next time and give me the word on demand. It seems to work pretty well, so I will continue to do it.

Another thing which I do is to play a word game on the Lumosity website, in which I have to enter words based on a given word root. I figure this is a good exercise for any writer, and will keep me actively thinking about vocabulary. I will say, however, that I have stepped away somewhat from the scientific mode of writing which has been required of me when I write clinical papers. I love complex vocabulary, especially multi-syllabic words which have a way of twisting the tongues of most people. Yes, I am weird that way, a bit of a science nerd. These days, though, I am not writing for an audience of physicians or scientists, so the vocabulary I turn to is a bit more basic. After all, I am not trying to talk over people or blind them with science. I am trying to inform, educate, and communicate, so I want my work to be completely accessible and easy to understand.

Even with all this word training, I still feel like a complete idiot when my mind is desperately fishing for a word or name. It can be downright frustrating to give up on trying to find a word, and settling for a synonym instead. What’s even worse is when I can’t think of a word, and can only think of a phrase which describes what I am trying to say with that one, elusive word. In that situation, I redirect my writing so that I avoid the roadblock. However, if it happens when I am speaking with someone, I am sort of screwed!