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Showing posts from October, 2018

3.11. Sign = objective evidence of disease

According to Saussure, a "sign" is a combination of signifier (what we perceive) and signified (the meaning we make of what's perceived).
In medicine, a "sign" is objective evidence of a disease (blood pressure 150/100 mmHg) as opposed to a "symptom," (headache) only perceivable by the patient. The signs & symptoms indicate a disease process or differential diagnosis.
Here are some signs that may or may not come in handy one day.

Auspitz sign: if you pick off a patch of your own scaly skin (why?) and see pin point bleeding underneath, it's psoriasis.
Brudzinski's sign: when my mother was dying from meningitis and someone pushed on her neck to bend it upwards, her knees would bend too, helping confirm the diagnosis.

Blumbergs sign: tender pain after a doctor presses on the abdomen then lets go. Possible peritonitis.
Cardinal signs of choking: inability to speak, cyanosis, & collapse. (If you ask, "Are you choking?" and there's…

3.10. Crisis = time-limited, disruptive, challenge

Are you in a crisis? According to Erik Erikson, we all are. Erikson divides psychosocial development into eight stages. Each period comes with its own "crisis," which once resolved, yields an appropriate "virtue."

0-1.5 years: Baby learns to trust, or mistrust the world. The former yields hope; the latter does not. Seems like many of us are still working on this one.
1.5-3 years: Toddler's crisis (or rather, Toddler's parents' crisis) involves a battle between autonomy v. shame & doubt. Making it through this stage confirms the child's (free) will. No, _____, this does not mean you always get your way.
3-5 years: The Preschooler may struggle with initiative v. guilt, but "purpose" emerges as a way to make sense of it all (hence the Why? why? Whyyyyyyy? WHHHYYY?s). A little bit of guilt here and there is fine for the developing ego and superego.
5-12 years: The School-age Child feels anxious about industry v. inferiority, ideally striv…

3.9. Pain = pieces of hurt

The Pieces of Hurt Pain Tool asks subjects 5 years old and up to, "stack pieces of hurt," to indicate their level of pain.
The logic behind using gambling paraphernalia with pediatric patients is beyond the scope of this discussion, but the the idea of turning pain into something as concrete and mundane as plastic chips, and stacking them to show the additive nature of "hurt," is nothing short of poetry. It also serves as a reminder that while pain cannot be seen, whatever the patient feels is real, and the causes of pain may not always be visible or physical.

Somatic pain arises from deep body structures such as muscles and bone. Visceral pain involves sensations that arise from internal organs. There's also neuropathic pain involving damage to nerves. Most interesting, however, is psychosomatic pain.

Contrary to popular misconception, psychosomatic does not mean something is not real. It means the cause of an issue or pain arises from psychological factors su…

3.8. CHD = congenital heart disease

Some hearts come with mistakes.

Some are missing parts or have extra holes in them. Some are boot-shaped. Some have arteries connected to the wrong side, so that each side of the heart/circulation keeps its own blood, and once the connections that shunt blood between them close there is no more oxygenated blood available to the body.

Hearts may not literally break, but they can fail, or stop.

Inside Mom's body, Baby receives free oxygenated blood that moves through extra, functional holes and blood vessels, but once born, the umbilical cord (with its artery and two veins) is clamped and it's up to Baby's new lungs to breathe in oxygen and Baby's heart to deliver that oxygen (in blood) to every part of a tiny new body.

After birth, the hole between atria should close within hours, while the duct between major arteries turns into a ligament in a few weeks. Ideally, all the walls are walls (no Pyramus and Thisbe action) and valves are not sealed shut or prolapsed. Otherwi…