Seminar

Last week was hellweek for all of us. We were required to join in a sing-and-dance fundraising concert that featured faculty, administration, maintenance and staff at San Pablo. So it means wasting a lot of energy on after class practices that may last as late as 10 or something in the evening. Everynight for more than a month. Of course, I only joined in the group chorale and not in any vocal solo or group dance. That means I got to go home earlier than almost everyone their including my PT colleagues. Fast forward to the presentation. Errr... it was successful. Errr... nothing much to say about it really. Except, I get some LSS from the songs we sang, particularly St Francis Prayer. Anyway, I'm going to write about some things I've learned from the seminar I attended last Saturday at L'Fisher Bacolod. We were sponsored by Doc G as this was a seminar by the Philippine Academy of Rehabilitation Medicine (PARM).

Here are new things I've learned:

1. The following things (in direct order) are protective against Parkinson's Disease: caffeine, green tea, smoking and aspirin/NSAIDS ----- mroe reasons to drink coffee and smoke
2. The following events may be indicative of PD in the early stages: constipation, sleep disturbances, swallowing difficulties; we also have to take note of olfactory disturbances as it may present even before the motor symptoms arise ( such as bradykinesia, nystagmus, postural instability) ; drooling is also a manifestation of bradykinesia
3. 2 major subtypes of PD have been identified:

• Tremor dominant type- this is more common in younger patients; possible mental status impariment
• Gait difficulty/ postural instability dominant type

4. Poor response to Levodopa treatment may suggest other types of clinical conditions

5. PD is not a purely motor disease; there are underlying sensory and cognitive deficits as well

6. Speech and Gait disturbances cannot be cured by medicine; Rehab is still important in these field of PD treatment

7. Punding- is a term used for obessessive-compulsive traits in PD; fascination, repetitive manipulation of technical equipment, continual examining and handlling of common objects

8. After five years of L-dopa tx- 50% of patients will develop motor fluctuations

9. Polio foot is mostly inverted; the good foot is everted (for wider base of support)

10. Most severe pain in post polio syndrome: knees, legs, wrists; pain is caused by overfatigue or overexertion

11. Foot deformity-most common deformity in polio (not genu recurvatum)

12. Magnets are effective in tx of pain et fatigue; Non-swimming exercises are indicated ( cold intolerance)

13. One sign of migraine is a common fear to stay in a dark room ( claustrophobia); migraine is a throbbing headache accompanied with nausea et vomitting with a pain scale of at least 6; lower than 6 p/s is not a migraine

14. Headache alarms:

• sudden onset - may indicate a stroke
• associated fever- may indicate meningitis or other infectins
• worst headache ever- subarachnoid bleed/ anuerysm
• late onset new headache (for old people)- stroke
• headache associated with mental status changes - tumor/stroke
• increasingly progressive headache- stroke
• focal neurologic signs - tumor/stroke
• assoc. with exertion, valsalva, after sex- aneurysm

15. All anti-hypertensive drugs cause impotence particularly beta-blockers

16. a BP of 160/100 requires combination therapy ( 2 drugs or more)

17. Hypertensive crisis- has a diastole of 120 or 130; Hypertensive emergency - very high BP secondary/ leading to end organ damage requiring immediate BP lowering; Hypertensive urgency- no end-organ damage; correct BP within 24-48 hours

18. If your child is obese by age 14, 80-100% obese for life

19. Signs of arterial occlusion/ disease: pallor, pulselessness, parestheisa, paralysis, polar sensation

20. Venous ulcers of the foot=normal pulses; found usually in peri-malleolar area; arterial ulcers=abnormal/absent pulses, distal digits first affected

I hope you learned something from here. Till I write again. Baboooh