Assignment: First Person Anecdotal Evidence

** Please note:  This blog post was written in whole or in part as an assignment for a class that I was taking.  If you decide to use some of my work in your own assignments, please give credit where credit is due and cite your source!  Thanks :) **

New unit in school, so new types of assignments!  Here is one for this week…

Have you ever made decisions using causal arguments based on anecdotal evidence? Give examples. Explain why you used anecdotal evidence. What was the result? Did the decisions prove correct?

I think that everyone makes decisions based on anecdotal evidence, and quite frequently.  I don’t think that it is necessarily a bad idea to make a decision this way, as long as you are aware that you are making a decision based on opinions rather than facts.  It would help to add some research to your anecdotal evidence, but that would not be the point of the assignment!

I have personally made decisions this way in regards to certain aspects of my health care. When I was first diagnosed as a diabetic my doctor really didn’t give me any information about what was going on or what I should be doing.  He impressed upon me the seriousness of the matter, but provided me with little more than the basics in how to deal with this disease.  Almost immediately I came across a variety of situations where I didn’t know what to do.  I did a lot of research on my own and gained a lot more information, but since it was all new to me I wanted to find out what had worked for other people.  I started looking online for other people and reading their questions, other people’s answers, and a variety of opinions.  I eventually found a wonderful community of people who were happy to talk about a variety of different subjects relating to diabetes, and loved to share stories of events and how things worked for them.  In particular I learned more about how to adjust my doses and learned why certain types of insulin seem to work better than others in certain types of people or certain types of situations.  Based on other people’s opinions and stories I was able to manage my own disease.

Disclaimer: My decisions and actions were mine and my doctor WAS consulted, so don’t just take your medical care into your own hands!!  :)

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more about the old eyeballs

So its been almost 2 weeks since I had the Lasek surgery on my eyes… and let me say, its been a trial!!  After I got the contact lenses removed I was so thrilled to not be in pain (from them) and to also be able to see.. but the whole next week was torturous because i developed EXTREME light sensitivity.

Anyone who has had eye surgery I’m sure can say that yes, bright lights are very very bright.  My sister complained about it when she got her eyes done, although she probably will say she doesn’t remember because it was so long ago.  But this was really really really bad!!!  I had a really hard time driving to and from work because I literally couldn’t keep my eyes open long enough to focus.  It was a horrific drive, trying to blink constantly, get my focus, and shield my eyes (some days with 2 pairs of sunglasses on).

I still have a hard time in the mornings, but by the afternoon I’m usually doing pretty good and can see things without squinting.. usually.  I have to constantly apologize to patients in my office for squinting at them or looking at them with my eyes half closed.  I don’t want them to think I’m half asleep!!

The weirdest thing is that if I hold my hands over the top of my eyes, forming a little shelf with blinders on the sides, its almost like giving my eyes a solid line to focus out of and that seems to help.  I don’t know why though… its very odd.

I think that part of this comes from a side effect of the Ciprofloxacin drops that I had to put in my eyes… its listed as one of the side effects but maybe it just affected me more?  I don’t know.  I’m glad those drops are done (as of today), so I can see if that was part of the reason.

Fun fun fun!

my eyeballs….

So I had Lasek surgery on my eyes last Thursday!   The difference between Lasik and Lasek is basically that my corneas were too thin to cut that flap out before burning through my corneas with a laser, so instead they just burned right through and I spent the whole weekend with bandaid contact lenses in (not vision correcting at all, just like a bandaid for my poor, laser burned corneas).  This pretty much gave the impression of wearing a filthy grimy pair of old contacts for three days straight, with all the accompanying burning and pain, and none of the relief of knowing that I could take them out at any time!

I got the contacts out today and while I’m happy to report that my eyeballs aren’t killing me anymore, I can’t see any better than when I had them in :(  I intended to go to work today but its about all I can do to increase my screen fonts by about 600% and type this one message!  Although it does seem better now than it did a few hours ago, so that gives me hope that tomorrow I’ll be able to work without getting yelled at for something…. well at least not something related to not being able to see… … … …

But so far, I’m totally thrilled!  I can see myself in the mirror when I get ready in the morning, and I can … see!!  Even if my vision doesn’t turn out to be perfect (which is a risk I had to take!) I’m quite happy with what I expect the results to be!

I had to skip out of the last half of d-blog week, so I’ll be finishing up those posts sometime and posting them anyway, just because I enjoy having a topic to post about.. in case anyone found themselves here based on previous posts…

I’ll update more when I can see a little better!

 

D-Blog Week 2012! – Fantasy Diabetes Device

Today’s topic for Diabetes Blog Week is Fantasy Diabetes Device!

Today let’s tackle an idea inspired by Bennet of Your Diabetes May Vary.  Tell us what your Fantasy Diabetes Device would be?  Think of your dream blood glucose checker, delivery system for insulin or other meds, magic carb counter, etc etc etc.  The sky is the limit – what would you love to see?

I guess that to be stuck with diabetes is to be stuck with diabetes… so what could make that easier?

I think that the device that I would most like to see would be a glucometer that is actually accurate!  Its so scary to see those super highs or super lows and then have a second (or third) test tell you something completely different!  Its especially scary when I see a high number and know that if I had corrected for it I would be crashing.

Another device that would be wonderful would be something that can accurately calculate the amount of carbs in the serving of food on your plate.  I have no clue how that would be done, but gosh that would be nice.  Maybe something that takes a picture of what you’re eating and can somehow figure it out?  Yeah, I don’t see that happening, but it would be pretty cool!

 

Assignment 5.2: Case Studies

** Please note:  This blog post was written in whole or in part as an assignment for a class that I was taking.  If you decide to use some of my work in your own assignments, please give credit where credit is due and cite your source!  Thanks :) **

This one ended up being a little bit long, so feel free to skip it if you like!  And let me know if you disagree with my diagnoses or treatment plans!  I’m only taking this class for a brief time, and it probably won’t be where my career path ends, but I’ve always been interested in Psychology, so I’d love to hear others opinions!

The assignment is to write an analysis of each case. For each case, include the following:

  • An analysis of the situation and possible causes for the subject’s behavior
  • A preliminary diagnosis of the subject’s disorder using the symptoms he or she displays
  • The set of therapies you suggest for helping the subject deal with his or her symptoms

 Karen

Karen is a 30-year-old single woman. She was referred to a psychiatrist after six visits to her primary care physician complaining of headaches, body aches, sharp pains above her left ear, and a ringing in both ears. She was convinced she had a brain tumor, but a CAT scan revealed no physiological cause.

During the interview, Karen mentions that she doesn’t like being in a hospital “because being in a hospital puts you at risk for so many other diseases.” When pressed, she mentions swine flu, avian flu, and AIDS. Karen does not use illegal substances or alcohol. She carries hand sanitizer and discreetly spritzes it on her hands about every ten minutes or so. Part way through the interview, Karen put on sunglasses “to block the fluorescent rays” from the overhead lamps.

Family History: Father died three years ago of cancer. Mother is still alive. Grandmother committed suicide at 31 when mother was eight. Grandfather is still alive, with history of alcoholism.

ANALYSIS

Karen frequently feels symptoms of problems that do not exist physiologically.  She takes great pains to prevent diseases and viruses.  Minor aches and pains are interpreted as severe and do not go away, despite visiting her doctor multiple times and having tests and scans done.  Frequent use of hand sanitizer shows an obsessive desire to be free of germs and keep her “safe.”  She seems to be trying to get a handle on things that are out of her control.

 CAUSES

These problems could stem from her father’s death from cancer.  She may be using the symptoms as a way of coping with her father’s death, her grandfather’s alcoholism, or even to distract from being single at age 30.

 PRELIMINARY DIAGNOSIS

Karen seems to be suffering from the somatoform disorder of hypochondriasis.  She feels that she is suffering from serious physical illness (the brain tumor) where there is none.  Her life is disrupted by being overly concerned with a variety of different diseases that could be caught while in the hospital, and takes great pains to keep her hands clean and prevent the rays from the fluorescent lamps.

Karen also exhibits signs of obsessive-compulsive disorder, with her obsessive hand sanitizer use.  This may be a way to attempt to keep control on things that she can’t control.  This could stem from her father’s cancer or her grandmother’s suicide, things that were out of her control.

TREATMENT/THERAPY

I think that many different types of therapy could be beneficial for Karen’s condition.  Cognitive-Behavioral Therapy (CBT) would probably be the best type of therapy, as it would help her recognize the behaviors that are detrimental, look at them realistically, and change them.  Incorporating behavior therapy using fear-reduction methods such as systemic desensitization or virtual therapy could be helpful when she is ready to face her fears and learn to cope with them.   This type of therapy would help with both the obsessive-compulsive tendencies and the hypochondriasis.

Drugs such as antidepressants could also be helpful for some of her symptoms.


Perla

Perla is a 50-year-old woman in a same sex partnership. She arrived with a stack of pages from the Internet that “proved” that she has adult-onset ADHD. She mentions that she has long periods of activity, including not sleeping for days. She says she “self-medicates” with marijuana, energy drinks like Red Bull, and sleeping pills.

During the interview, it is hard to keep up with Perla. She bounces around the room and from topic to topic. When the interviewer asks her to fill out a questionnaire, she asks for a stapler. She then proceeds to simply staple her ADHD pages to the form. The interviewer asks Perla to complete the survey on the form, Perla becomes irate: “I already did your damn work for you. I told you I have ADHD!”

Family History: Unknown. Perla was adopted from Venezuela as a baby.

ANALYSIS

Perla seems to have a lot of energy and has become fixated on the idea that she has ADHD.  She clearly put a lot of effort into completely researching the condition and feels that she has proven beyond a shadow of a doubt that she has it.  She uses different mind altering chemicals depending on what her mood.  She becomes agitated easily when someone disagrees with her.

 CAUSES

Possible causes for these symptoms could be the use of marijuana, energy drinks and sleeping pills  that she takes, or could even be related to hormonal changes based on her age.  She may be feeling stress from her relationship, depending on the acceptance of her same-sex partnership by others.  Since we know nothing of her family history, it is possible that genetic factors are involved as well.

 PRELIMINARY DIAGNOSIS

Perla would most likely be classified as having bipolar disorder, particularly displaying manic characteristics.   She is restless with long periods of activity including insomnia, which she attempts to correct cyclically with uppers and downers like energy drinks, marijuana, and sleeping pills.  During the conversation she showed rapid flight of ideas jumping from topic to topic, typical of manic behavior.  It is uncertain from this situation if she also suffers from depression.  She exhibits irritability, and seems desperate to find a final answer to her mood, implying mood swings.

 TREATMENT/THERAPY

Bipolar disorder is another type of disorder that can be treated with a variety of different types of therapies.  Cognitive therapy can be helpful here, as it helps the patient locate their own problems and ways of thinking and make changes to them, and helps patients cope with stress.  Group therapy could also be helpful because often hearing other people having the same types of issues can lead the patient to better understand their own ways of thinking.

Although our book only touched on Interpersonal Psychotherapy (IPT), a little more research on this topic shows that many therapists are using this type of treatment for patients with bipolar disorder.  The National Institute of Mental Health also talks about Interpersonal and Social Rhythm Therapy (IPSRT) which combines IPT with behavioral therapy to help patients develop a regular routine to help stabilize their life.  Since IPT focuses on social relationships, this type of therapy is particularly helpful because it helps patients develop routines that include others involved in their life as well as just themselves.

<http://www.nimh.nih.gov/health/topics/psychotherapies/index.shtml>

Typically patients with bipolar disorder will require medication such as mood stabilizers so that they are able to accept other types of therapy, which are used in conjunction with the medication.


Jordan

Jordan is a 22-year-old man who received medical discharge from the army after a 2-year tour in Iraq. The initial discharge was for depression, but Jordan’s family has begun to believe that it may be more complicated. Jordan has been discovered wandering at night “following the way the flags are showing me to go” or following a possibly imaginary woman with a scarred neck.

During the interview, Jordan seems lucid, but lethargic. He drums his fingers slowly on each thigh, as if playing a slow piano scale. His answers are all one or two words, such as “fine” or “I guess.” When asked about the woman with the scarred neck, he becomes slightly more animated.

Jordan: She’s a beautiful woman, isn’t she?

Interviewer: I don’t know, Jordan. I’ve never seen her.

Jordan: Right, because you don’t have the ring.

Interviewer: What ring?

Jordan: [mumbles]

Interviewer: Can you tell me about the ring?

Jordan: I said the ring is the fuse.

Interviewer: The fuse to what, Jordan?

Jordan: Without the fuse… well, you know what happens. It’s a fuse.

Interviewer: I don’t, Jordan. What happens?

Jordan: Fuses light up you know. And then, they blow up. That’s all.  

Family History:Mother and father are still alive, but divorced. Mother is remarried. Mother has history of diabetes. Father’s leg was amputated during first Gulf War. History of emotional abuse by father.

ANALYSIS

Jordan shows many different symptoms that can fit different psychological disorders.  He was obviously showing signs of depression or that could be taken as depression, since that was the reason for his discharge from the army.  His wanderings and statements about flags and the woman with the scarred neck seem the be delusional or hallucinatory.  Jordan’s mood in the interview is lucid but lethargic and he might be listening to piano music inside his head.  When answering questions about the woman with the scarred neck, his thoughts are disjointed and disorganized, and odd.

 CAUSES

There are many different factors to consider as a cause for many different diagnoses.  He could be affected by hidden fear since his father had his leg amputated after serving in the Gulf War.  Emotional abuse by his father could play a role in causing any number of different psychological disorders.  If his mother had complications during her pregnancy because of her diabetes, this too could be the root cause of some disorders.

 PRELIMINARY DIAGNOSIS

My initial preliminary diagnosis is schizophrenia, with an emphasis on disorganized schizophrenia.  I am hesitant to use this as a diagnosis since it affects such a small percentage of the worldwide population and neither of his parents appear to have the disorder, however Jordan is only 22 and early onset is typical in those affected.  His thinking and communication skills are disjointed and disorganized, and he jumps from topic to topic.  During the interview he had trouble with paying attention and communicating.  He shows signs of social withdrawal and his thought seem preoccupied.  He is apparently seeing things that are not there, such as the woman with the scarred neck, and there are indications of auditory hallucinations as well, if he was in fact playing a slow piano tune with his fingers.  His motor activity is slower and responses to questions seem emotionless most of the time.  If his mother had complications during pregnancy, this could be another indicator towards a diagnosis of schizophrenia, since this can also be a risk factor.

Another possible diagnosis could be Major Depressive Disorder (MDD) due to his initial diagnosis of depression at the time of his discharge.  Psychomotor retardation could explain some of his behaviors during the interview.  Some symptoms of MDD include delusions and hallucinations as well.

TREATMENT/THERAPY

Whether the diagnosis is schizophrenia (of any type) or major depressive disorder, a combination of medication and psychotherapy would be required, and it would be required long-term.  Antidepressants and cognitive-behavior type of therapy would most likely be best for major depressive disorder.  A diagnosis of schizophrenia would require a combination of antidepressants, antipsychotics, and anti-anxiety medications as well as therapy.  Therapy could be cognitive therapy, group therapy, and family therapy.  Group and family therapy would help Jordan because having a support system is important for those with this diagnosis to keep them on the medications, since that is the thing that most people forget and which causes their symptoms to come back again.  Setting up a life-long plan would be imperative in keeping everything in track for him to keep the symptoms at bay.

<http://psychcentral.com/disorders/sx31t.htm>

Diabetes Blog Week 2012! – One Thing to Improve

Yesterday we gave ourselves and our loved ones a big pat on the back for one thing we are great at. Today let’s look at the flip-side. We probably all have one thing we could try to do better. Why not make today the day we start working on it. No judgments, no scolding, just sharing one small thing we can improve so the DOC can cheer us on!

Yesterday the topic for the day during D-Blog Week 2012 was One Great Thing, meaning something that we do really well for our diabetes.  I talked about how I’ve gotten good at paying attention to what I eat since my diagnosis.  Granted, we all realize we have to pay attention to what we eat, so its really not that spectacular of a feat, but compared to the way I used to eat, even at the beginning of my diagnosis, its spectacular for me.  But today, for One Thing to Improve, I’m going to talk about the same thing… watching what I eat!

For all my talk of being so proud of having the ability to pay attention to what I eat, I still don’t make the choices that I know I should make.  Sure I look at the carbs and the calories of everything I eat, and I try to keep them down.  I use the MyFitnessPal app on my phone to keep track of my calories (and other stuff), and I use the OnTrack Diabetes app to record all my numbers.  I look at all these numbers all day long, but I don’t really look at them beyond just looking at them.  Sure, I eliminate foods or cut my portions sometimes to fit in with what I need to be doing, but the foods are still the wrong ones.  I still eat the same foods from my favorite restaurants, even though their healthier options are just as good.  I still loooove my desserts, even when I should be skipping them.  Sometimes I think I slip into the mindset that as long as I cover what I eat with insulin, its ok to do what I want.

I know that I need to change this habit.  I need to stop looking at food and really start LOOKING at food.  For my health, for my weight, as well as for my diabetes.

D-Blog Week 2012! One Great Thing

Today’s D-Blog Week topic is “One Great Thing”

Living with diabetes (or caring for someone who lives with it) sure does take a lot of work, and it’s easy to be hard on ourselves if we aren’t “perfect”.  But today it’s time to give ourselves some much deserved credit.  Tell us about just one diabetes thing you (or your loved one) does spectacularly!  Fasting blood sugar checks, oral meds sorted and ready, something always on hand to treat a low, or anything that you do for diabetes.  Nothing is too big or too small to celebrate doing well!

I have to say that nothing I do for my diabetes is “perfect”… I think this is a disease that unfortunately just can’t be classified like that.  No matter what you do, no matter how hard you try, sometimes its just not going to work. Sometimes it does, though, so you have that to look forward to!

One thing that I feel has been helpful to me since my diagnosis though, is that being a diabetic makes me aware of what I’m putting in my mouth to eat!  I may not always eat what I should… I certainly don’t put down desserts like I should! … but I am hyper-aware of what I’m eating every day.  Every bite that I put into my mouth, be it good or bad, I have to account for.  I have to make a conscious decision as to whether or not that item will be good or bad for my blood sugar, and do I really feel like poking myself AGAIN just to be able to eat it??  Its much more difficult to hold yourself accountable for the foods you eat as a diabetic than if you are not.  Ahh to be able to just eat something without thinking about it first.. but we do what we have to.  And one a personal level, I kind of like having that little bit of structure to hold me up… usually!