Mortimer Adler, one of my learning heroes, says that one should annotate a book – have a conversation with the author, write summaries in the margins or at the head or foot of the page. Adler should know, he is one of the most well-read people of the 20th century, having written a two volume syntopicon of some 100+ topics gleaned from a 50+ volume encyclopedia. He even wrote books on how to read a book, and how to learn.

# Better patient care starts with improved communication

In medicine and health related fields, a common language and set of criteria to assess and describe diseases, syndromes, spectra, and symptoms is imperative for relating patient data between providers and parties with an interest in a patient’s care. This facilitates accurate communication for monitoring and documenting progress or decline, relaying instructions to health care personnel, and for determining health care benefits.

The term spasticity, while widely used to describe symptoms associated with stroke [cerebrovascular accident (CVA) or cerebrovascular insult (CVI)], spinal cord injury (SCI), multiple sclerosis (MS) and other diseases, is not clearly defined and is often used as a shorthand for a host of symptoms including hyperreflexia, hypertonia, clonus, or others. This lack of clear definitions and vocabulary can lead to the inability to precisely communicate a patient’s symptoms between those with an interest in the patient’s health.

While we had hoped to define a vocabulary and submit it for publication, in researching the issue we found several groups had already tackled this issue and published their results. Like many professions, healthcare and rehabilitation are large ships with small rudders and change comes about slowly. Hopefully, the work  done by these groups will eventually be incorporated into daily practice by clinicians and therapists.

# Allergies or Allergens?

A recent blog post related one mother’s frustrations with her and her son’s allergies, and lamented the apparent rise in the number of people with allergies and with the number of allergies each person is burdened with.

Perhaps what we are observing is not an increase in allergies, but is instead an increase in availability of allergens. With the advent of fast worldwide shipping, foods that once were seasonal are now available year-round. This can result in the near-constant exposure to allergens that previously would have been available intermittently throughout the year. Not to mention the availability of a greater variety of allergens from distant countries.

The examples related in the article are good evidence of this. The mother and her son were exposed to multiple allergens simultaneously which resulted in anaphylaxis. In days past, these exposures would have been limited by the growing season and scarcity of preserved foods. For example, strawberry jelly would be served for a week, perhaps coinciding with serving frozen corn. While both may have been allergens for a person, the result may have been a mild rash that went unnoticed. Today, those two allergens could easily be encountered on a daily basis, along with a handful of other allergens which might eventually result in anaphylaxis.

If this hypothesis holds true, perhaps one day people will learn they can have strawberries if particular plants aren’t blooming, or they can have a cat if they avoid certain foods. Perhaps there will be an assessment available to check ones allergen burden and learn that one should avoid allergens at all cost because anaphylaxis is imminent, or that it is okay to have a PBJ.

Let’s hope.

# Acceptance

Thursday, March 13, 2014 was an exceptional day. When I returned home, a letter was waiting for me, and my girlfriend was quite excited. The letter was from The Georgia Institute of Technology. I made a point of sitting down first, then opened the letter. The first three words were, I am pleased. This was one of the happiest days of my life. I have been accepted to earn a PhD in Applied Physiology with a focus in Prosthetics and Orthotics. With those three words, I knew that the past five years of hard work had paid off, and the next step is now before me.

I will work to create an implantable interface to allow two-way communication from the wearer’s nervous system to a prosthetic limb. This will allow control of the limb, but more importantly will give the wearer a sense of touch. This sense of touch will result in the prosthetic becoming incorporated into the wearer’s body scheme – they will come to think of the limb as their limb, not just a machine attached to their body. This will improve satisfaction with and the utility of prosthetic limbs, thus improving the amputee’s quality of life.

I can’t wait to get started.

As one would suspect, graduation was a triumphant occasion, but tinged with a bit of sadness as I leave GGC, my home for the last four years. I learned so much at GGC – not just course work – but about people and leading fellow students in group projects, and being led by professors or fellow students; giving presentations; planning projects; culturing neurons; creating documents in $\LaTeX$; the list goes on. I met so many inspiring students and professors whom I really connected with. Their guidance and friendship have been, and continue to be, invaluable.