October Newsletter – 2018

Happy Halloween!

I’d planned to send out a full newsletter on Wednesday night. On Wednesday night I was drinking chocolate milk at my computer desk. Just as I was typing in e-mail addresses for my members to send out my newsletter I knocked over the chocolate milk. Somehow I hit delete on my keyboard and lost all of my newsletter. I was so pissed off! I’d just finished the newsletter but hadn’t made a copy yet. The following is what I managed to remember. Mr. Short Term memory (me) was challenged to do this much. What a doofus, I apologize.

I’m going to discuss a couple of things in this newsletter. I had my teeth taken out on August 20th. I’ve felt just crappy since the operation. For the last 40 days I’ve done absolutely nothing. First, my mouth and face hurt for two weeks. The numbness in my chin ended just last week. I’ve also been feeling just exhausted. My fatigue has seemed more worse than in recent memory. I’ve always been an early riser. However, after my tooth extractions I just laid on my bed watching TV and dozing on and off all day. I was just a load! lol

When I wasn’t resting one good thing I found on my computer was a Solitaire game. To date I’ve played about 1,400 games. I spoke with my neurologist and my oral surgeon and both said extracting 26 teeth could possibly lead to more fatigue. I like both of my doctors but neither seemed to want to commit to anything. Couldn’t they just say yes, you feel more fatigue because of the surgery! I suppose they are worried about law suits. My guess is that my immune system went to fight the healing in my mouth and everything else in my body went haywire. Today is October 4th and my fatigue is slowly coming back to it’s usual crappy level. lol

One thing I never ever thought I’d have to deal with from Multiple Sclerosis is bed sores or pressure sores. However, for the past six months I’ve had bed sores as a result of sitting on my scooter or toilet seat for roughly 12 hours per day. Those things can hurt when you accidentally sit on them wrong. lol

** The following is from the National MS Society website: Pressure sores, also called bed sores occur when the skin breaks down from constant pressure especially from sitting or lying in one position for any extended period of time. The pressure cuts off the blood supply to the underlying skin, fat, and muscle. These sores usually occur over bony parts of the body — tailbone, buttock, heel, shoulder blade, elbow, and occasionally the back of the head. However, pressure sores are not limited to these areas and can occur other places as well. Sores may also develop from friction to the skin. This is called shear and may result from sliding across a bed or wheelchair seat. Because the skin is much more likely to break down if it is moist or infected incontinence of bowel or bladder can add to the problem.

Several interacting risk factors have been identified in the development of pressure sores:
– Immobility or inactivity
– Decreased sensation
– Bowel or bladder incontinence
– Poor nutrition
– Older age
– Obesity — the extra weight can contribute to the formation of sores
– underweight — bony body parts can contribute to the formation of sores skin and or dehydration
– Moist skin
– Smoking
– Diabetes, anemia, or cardiovascular disorders
– Cognitive confusion
– Pressure sores begin as relatively benign problem, but can quickly progress to a more serious problem if left untreated.

Stage 1 — A small area of warm, reddened or purpled skin that does not return to its natural color when pressed.

Stage 2 — The outer layer of skin breaks down. Blistering and swelling as well as warmth and redness may be seen.

Stage 3 — Live tissue dies. The sore extends down into the deep skin layers and to the fat and muscle immediately beneath the skin. This hole or crater has a foul smell.

Stage 4 — The sore extends down to the deep muscle, possibly down to the bone. Infection may occur and may tunnel under the skin, increasing the size of the sore.

The best way to treat a pressure sore is to avoid developing one in the first place.

Pressure sores can be prevented in the following ways:

– If you can, keep mobile.
– Unless advised differently by your physician, drink a lot of fluids and eat a well-rounded diet.
– If you are not mobile your position must be changed at least every two hours.
– Your bed should be fitted with a mattress or a mattress pad that is capable of alternating and distributing the pressure applied by the body on the mattress. – Foam “egg-crate” mattresses are not recommended for prevention.
– You should use padding or boots for pressure points (e.g., elbows, heels). – – Nurses, physical therapists, and/or physiatrists (physicians specializing in rehabilitation medicine) are the best sources of guidance about prevention of pressure sores.
– If you use a wheelchair it is important that you sit on a cushion that distributes your weight. A gel-filed cushion is often recommended. Ask your physician or physical therapist about an evaluation by a seating specialist. Sitting on pillows, towels, or foam pads may add to your risk of developing pressure sores.
– The treatment of pressure sores becomes more difficult as the sore advances in severity. A Stage 1 sore is usually well managed by eliminating the source of the pressure. This should result in a rapid resolution of the early pressure sore. Stage 2 sores can be treated by medication and protective coverings, under the advice of a physician or wound specialist who may be a nurse of physician. The treatment for a Stage 3 or 4 sore often involves long-term dressings, a special bed, medications, (including antibiotics if there is insufficient healing), and perhaps even surgical intervention.

** It is thus imperative to see your physician if you suspect that a pressure sore has begun.

My MS has also given me something called disinhibition. I define it like this. I say what’s on my mind and

it’s usually accompanied with colorful words. Fortunately or unfortunately, my wife Doris hears about 95% of

my disinhibition and colorful words when talking about something. Another thing that happens is I can fly off

the handle quickly. Simple things that in the old days didn’t bother me can now really piss me off! I’ve also

had some faux pas in the past 20 years when I said something in public that I shouldn’t have. The brakes in

my brain to not say something are worn and need to be replaced. lol

** The following information comes from Wikipedia. In psychology, disinhibition is a lack of restraint

shown in disregard for social conventions, impulsivity and poor risk assessment. Disinhibition affects motor,

instinctual, emotional, cognitive and perceptual aspects with signs and symptoms similar to the diagnostic

criteria for mania. Hypersexuality, hyperphagia, and aggressive outbursts are indicative of disinhibited

instinctual drives.

Disinhibited behaviour occurs when people do not follow the social rules about what or where to say or do

something. People who are disinhibited may come across as rude, tactless or even offensive. For example, a

person with a brain injury may make a comment about how ugly another person is or a person with dementia

may have lost their social manners and look as though they are deliberately harassing another person.

The reasons why these behaviors may occur include:

Damage to the brain such as in brain injury, usually the frontal cortex areas (part behind the forehead)
Difficulty thinking about the consequences of their behavior
Misinterpreting social cues; poor social judgement
Being unable to communicate in an appropriate way
Feeling lonely
Discomfort such as being too hot or cold may lead to undressing or a urinary tract infection may lead to touching one’s own genitals

As much as I like to piss and moan Doris and I learned some upsetting news last week which make my problems seem tiny. Doris is from Lima, Peru. Last week we found out Doris’ sister Edith has cancer. She had a tumor in her lung which had traveled to her brain and kidney. Then three days ago she suffered a stroke which has paralyzed her right side. Edith is only 45 years old and literally has done nothing in her life but work. At this time her prognosis is not good. I worry because healthcare in Peru is not the best. It’s enough to make me want to cry but I have to be strong for Doris. Just goes to show me there is always someone worse off than you.

That’s all I can remember right now from the original newsletter. Everybody take care and be good.