2013 Was Quite a Year.

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This year was  identifying the medication that helped to shrink the nerve in her neck. We saw she has greater use of her neck and able to open her jaw wider then ever before. She is able to use her arm off to the side and below the shoulder. If she puts her arms above her head for to long she does show pain. She has been able to identify her medical symptoms clearer then ever before. So  this year our visits to the Neurologist we will bring these symptoms to her attention. With Chloe being in what appears to be much less pain she is able to identify and describe her symptoms with more clarity.

Chloe will continue to work with Molly her fitness trainer to develop stamina in using her arms away from her body. We will also start to investigate a job coach who might help her start at a 10 hour a week job that would help with this arm stamina. Also Chloe continues work on I pad educational games and improve her skills on other computer tasks while trying to improve her skills not able to do before  like folding laundry and zipping her coat.

Chloe accomplish a lot this year but still has more to do!

Merry Christmas

The treatment appears to be working! We will go to two sessions with the fitness trainer in the New Year to check out Chloe's endurance and how much work we can get out of her shoulders and arms. So far never expected her big smile so who knows what we will find!

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Working through headaches one arm at a time!

Treatment is working! Never saw her able to smile so much and in enjoy taking pictures

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As we exercise the arms we maybe seeing a pattern emerging. The exercise is Chloe sits on an exercise ball lifting her arms one at a time. to reach,stretch and hit a ball the fitness trainer holds at different positions for a 30 minute session.

Getting up the next day she was crying but able to point where it hurt on her forehead. With medication she handle a short shopping trip well.
Day 2, Heighten  sensitivity to noises and pointing to middle of her fore head as the issue, Doctor gave Chloe pain medication slightly strong then over the counter which help with her excessive repeating of questions which might be a gauge for her pain levels. Still workable  went on another short shopping trip.
Day3, Sensitive hearing middle of fore head issues. Workable went out for breakfast with her dad and another outing with me later.

Chloe wears ear plugs on community outing. We will keep track of this symptoms for the next couple of weeks then report to the Neurologist our finding. These headaches were much more intense  when we started. We hope with exercise they will lessen and Chloe can builds endurance in her arms and shoulder which will help with a future job! 

How much recovery can we get?

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This is Chloe older cousin with her at Thanksgiving. Chloe could not control her face to smile on demand. She either had closed eyes or a frown on her face. This is one of the major improvements since she has been on these medications and using her Tens Unit.

Is it Pain or Fear that if she moves her left side wrong the pain will come.

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  Second session with  fitness trainer!

How could we tell if Chloe was in pain or if she is just scared that her movement of her left side would cause pain. Chloe for years she would hold her upper arm tight against her side to and pivot her arm out at the elbow just using her forearm and hand away from her body. No weight, or excessive use of arms over her head the goal is to use her arm in space away from her body. Majority of activities only as high as shoulder level. In this last session we saw a lot of fear and we need to encourage her and build her confidence so we can report back to the  Neurologist what we see. We still are wondering how much more we might do and not stress the left side of her body and neck.

Nerve Headaches

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Chloe woke up this morning complaining of pain right above her eyebrow and her left eye had sparks or yellowish thing floating in it. We tried the "Tens unit" putting two probes on each side of her forehead. After 30 minute treatment Chloe said her left eye cleared up and her forehead was more manageable pain wise. This is her about 2 hours after. Amazing new gadgets to help headaches

How Far We Have Come!

                                       
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 The neurologist who saw Chloe on July 1,1993 described her this way. I saw Chloe for evaluation of developmental delays and hypotonia. Early milestones were markedly delayed. She did ,however, sit up by 7 months and has not crawled yet.  On her abdomen, she pulls to her hands, but does not attempt crawling. When she started physical therapy, it was noted that the left side was weaker but showed improvement with therapy. Currently, she moves around the room by scooting. On the other hand , she appears to be very verbal and repeats several words and uses 4 or 5 words spontaneously..

Fast forward to today, Chloe is being treated for a nerve issue on her left side of her neck ,left shoulder and tinnitus in her left ear .She is being treated with two antidepressants one that replenishes the serotonin in her body  and the other antidepressant  shrinks swollen nerve ending.  Her complaint was headaches that caused her to collapse on the floor in pain. She still has headaches but they are much less intense and we are beginning to get her to describe them so we can report back to her neurologist. Chloe is 5 feet 9 inches and has a T-shaped body which aggravates this condition also.

Our daughter at birth was diagnosed a floppy infant at birth. We would like to share how we got to this point and what we are working on right now. Chloe is now trying to figure out what job would work with her health issues .

Please let us know if we could share our story with other families who are trying to understand their child’s health issues.

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Symptoms

Let us recap what we know. Chloe was born with a generalized weakness on her left side of her neck and left shoulder. Her rapid growth made the problem worse. Floppy infant is a symptom of a neurological problem but there are many so figuring out which it was took time. She needed rehabilitation to meet all her milestones which she did. For her to smile and keep her eyes open on photos is quite an accomplishment.
The facial nerve problems also can create sensory problems with this treatment we see lessen.

Our goal now is to figure out if the pain can be triggered by any arm or head movement while showing Chloe the pain is not there anymore. Chloe will be working on stretching and coordinating arm movement with a personal trainer at the YMCA. We having been doing this already so the trainer will be the next step which she starts in November. We are doing community activities like picking up items we need around the house and going out to eat working or walking with street light. So far building Chloe's confidence in herself has been a big issue but improving daily.

So far so good!

Improvements continue!

Chloe has much greater control of that facial nerve and it shows  that she is on the right doses and the tens unit is very helpful. Chloe is able to have fun taking pictures and not always look like she is in pain (which she was)!

What are the noticable changed and what are we working on!

So what is different?
 Being able to take a picture and not have eyes closed or looking like someone is killing her.
We find her not holding her ears as much but still has a scared look or look of disbelief that nothing is happening.
Her ability to listen to a lesson and take a quiz after it that shows she understood what was said.
Still working through a lot of fear that the pain will come back and the surprise that it has not yet.
She wears a bracelet on her left arm because she seems more aware of the left arm and will use it more.
What are we working on now?
Figuring out what is the optimal dose of the two medications to treat this issue.
Go back to the YMCA and see what the arms can do stretching and hopefully not uncover any other pain issues.
Then go back to volunteer at the thrift store and see how they respond there.
The next would be to find a part time job and hopefully Chloe will have confidence in her arms too!

Treatment is working

As you can see by the picture Chloe took of herself, we seem to be on the right track! We are beginning to revisit the places where the swollen pinched nerve caused her to fall on the floor in pain the place where we exercise. We also hope to get back to the thrift store where she used her shoulders and arms pretty intensively. We need to check out if the pain issues are gone by first dealing with her hysterical reaction to these place.
 Goals are to let her left arm do what it can and see if any problems arise. Bracelets on her left wrist m makes her more aware of that arm and she appears to use it more voluntary. So far  this seems like the  right combination  but I will be more comfortable when we get through hurdles mentioned above.

Pictures can show how the treatment is working

Smiling and interested in how things work. This tells the Doctors and me we are on the right track!

Since Birth:

Since Birth means you are born with certain problems. Chloe had symptoms of

http://www.ncbi.nlm.nih.gov/pubmed/19078754

J Clin Neuromuscul Dis. 2004 Dec;6(2):69-90.

Floppy infant syndrome.

Igarashi M.

Source

From the Department of Pediatrics and Neurology, University of Tennessee, Memphis.

Abstract

Floppiness/hypotonia is a common neurologic symptom in infancy. A variety of neuromuscular disorders and central nervous system (CNS) disorders cause floppy infant syndrome (FIS). CNS disorders are the much more common causes of the syndrome than neuromuscular disorders. On long-term follow up, cerebral palsy and mental retardation turn out to be the 2 most common causes of FIS. This review focuses on neuromuscular causes of FIS. With the advent of molecular diagnosis, a few conditions can be diagnosed by DNA analysis of the peripheral lymphocytes (myotonic dystrophy, spinal muscular atrophy); however, for the most part, electrodiagnostic studies and muscle biopsy remain as essential diagnostic tools for FIS. Immunohistochemical study of the biopsied muscle also improves diagnostic capability. Management for most conditions remains supportive.

PMID:

 

19078754

 

[PubMed]

 

 

Secret weapon!

The key ingredient for us to help us figure out our unique health issues


 Since birth, I have been dealing with genetic blood disorder that gives me a greater chance of a stroke. I worked with my health insurance through my 30 years of employment to stabilize this disorder.

My daughter since her birth, worked with her Dad’s health insurance to uncover her spinal cord issue that caused some nerve damage and treatment to stabilize this medical problem.

I believe in Obamacare, the ability to get health insurance. I believe everyone has a right to get medical treatment to live their lives to the greatest potential.

Jacqueline Skubal Anderson ( Author)

Chloe The Kinesthic Learner How Her Health Issues Interfered with Her Learning Style

Recovery continues

Hi Everyone,
Labor Day has past and our progress update is showing Chloe's improvement continues. The fall allergy season of weed allergies and mold allergies continues to interfere with her recovery and a factor in the  intensity of her headaches. Hopefully this season will pass and we see even more improvement.

Some medication adjustments were needed. The night time medication was increased to see how this effects her left arm mobility, opening of her mouth and neck rotation.
We had to adjust her morning medication that was affected by the increase of the night time medication.
 The Tens Unit she now takes twice a day morning and evening, we see her asking for it at those times too.

Symptoms
1. She is able to open her mouth to the low end of normal but can get it wider if she needs to. I have her use an extra large tablespoon for soup. So when there is a need to open wider she can do it.
2. Headaches still are there less intense. She averages one major one a week. Now we have warning that she has problems by her eye lids unable to lift up in mornings. She actually walks around looking at things with her eye lids three quarters shut. This is what I am tracking and need to discuss with the neurologist at her next appointment. Overall headaches are still there but much less intense and she is able to describe them better. We continue to talk about staying calm to be able to describe more accurately.
3. Left arm we are now doing stretching exercises over head. I am not pressuring her to use the arm but trying to get her to use it naturally. She is working on folding Clothes, dishes, typing and playing recorder and keyboard. She is working with an I pad and Laptop too. We are working on building up stamina in hopes she may get a part time job.
4. The nerve is improving and we are seeing other symptoms improving. She is not holding her ears as much. She seems to be overcoming fear of TV. She is back playing her music loud and is less apprehensive  of people talking around her. We are able to do community outing like eating out or going to store so Chloe can see other's at work. This is  when her headaches are under control.

Slow and steady progress have her do activities naturally has been the best approach!

Chloe is responding to treatment!

Updated the neurologist as to what we see Chloe doing different with the meds and use of the tens unit.
1. Smiling and laughing occasionally and actually surprising herself. Doctor agrees it shows pain issues seem to be improving!
2. Headaches are less intense able to talk about them and get what she needs to help them lessen even more.
3. Handling changes in plans by wanting to know why's behind the action.
4. Arms are responding better and not causing sudden pain when she moves them. We are still not working over head which is the major problem area. She has begun to read in bed which gives her great back support.
5. The neurologist agree to increase the medicine that reduces the nerve swelling. To see if her mouth can open wider, arms continue to move with out pain.

Chloe had the best dental appointment she ever had because she could open her mouth wider then  ever before. She saw the eye doctor for a yearly exam and he said she showed slight improvement reading the eye chart. He was not sure she was able to see better or she is now out of pain so could focus on the whole exam better.

Optimal dose of the medication

The dose Chloe is now taking may be her optimal level to decrease the nerve swelling. We will report back to the Neurologist every 2 weeks, as to what Chloe is working on and symptoms we may see. Here are some examples of this!

Chloe has resumed playing keyboard and recorder which she left because of pain issues. She has good hand control and reacquainting herself to note positions and not value. Slow going but looks promising.

She uses her right arm for lifting wet clothes from the washer to the dryer but uses a spoon or fork with her left hand. She rarely puts her fingers in her ears but does when she sees someone attempting to laugh. She now prefers an earplug in her left ear where the tinnitus is.

She now handles music practice then working on Ipad and finishing up with the laptop doing email and facebook with much more independence and her confidence grows daily.

In the community outings she is handling abrupt interruptions that would of caused behavior outburst and before that falling on the floor like she was having a seizure.

We will keep challenging Chloe with different activities and report back what we are seeing to the neurologist!

Certificate of Registration under the seal of the Copyright Office!

I should of thought of this but glad my publisher did!

Increase dose is showing increase improvement with some adjustments!

The doctor warned us that the one medication she takes in the morning is affected by this medication that works to reduce swelling in nerve ending. Once we lowered the dose of the morning med the problems she was having settled down  and we were able to get more information

Chloe is still complaining about pain in her forehead but gets relief from pure natural muscle pain cream. She is able to describe what hurts and confirm which treatment works the best. She is able to describe  symptoms more accurately . Example we went to an area that is quiet but Chloe is uncomfortable there. We got out of the car and I asked her. "Is it to bright (pointing to my eyes)"? "Does it smell (pointing to my nose)"? Or"Is it to loud ( pointing to my ears)"?  After the demonstration she pointed to her nose and confirm it smelled. There is a small pond with standing water. Chloe has mold allergies so this could be the real issue.The goal is have Chloe give us accurate information is a vital part of her recovery, When the pain medication at the start worked the Neurologist questioned where all the pain is coming from. Clearing up concept confusion and keeping Chloe as pain free as possible, she can now open her mouth and relax her left shoulder which is helping to get the left arm to respond more normally then ever before.

Now that we have reached the 2 week mark this dose has decreased swelling in the nerve ending as far as this level will go. We will now challenge the left arm doing stretching over the head exercises. Before the medication over head arm movement could trigger Chloe to have a lot of pain very suddenly. This will show us if we may need to discuss with the Doctor a higher dose. We go into retail and check out other lines of work that might be interesting for her after we complete this medical treatment  with the Neurologist.

Improving with Treatment

Surprising update on treatment what it might actually be improving. The neurologist increased the old time antidepressant that is not used for that anymore but to shrink swollen nerve ending. What we have seen with this medication is Chloe is able to open her mouth wider with each increase dose and also her left shoulder seems to be more even with her right and she is able to now swing her left arm like her right arm back and forth as she walks. Her intense pain from her migraines has lessen in intensity and she is able to describe them better. We have suspended physical therapy for now and watch how much the medication improves her abilities and headaches. We are  keeping her busy in the community and long walks. Each dose increase takes 2 weeks to see it full effect. Tens Unit she is still using 4 half hour sessions a day too, this seems to help and she likes it and asks for it when it is time to use it.
What possibly may of happen is the nerve in the neck from bulging disc area is decreasing in size allowing her to open her mouth, lessening the intensity of her headaches and not to cause her left shoulder to be higher then her right shoulder.

 Time will tell if we are right but it sure is promising. Chloe is the one handling the medication if she couldn't handle it we would not be this far. It is fun to be the observer/reporter.

Elusive disorder has a name " Trigeminal neuralgia"

Definition

By Mayo Clinic staff

Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve, which carries sensation from your face to your brain. If you have trigeminal neuralgia, even mild stimulation of your face — such as from brushing your teeth or putting on makeup — may trigger a jolt of excruciating pain.
You may initially experience short, mild attacks, but trigeminal neuralgia can progress, causing longer, more frequent bouts of searing pain. Trigeminal neuralgia affects women more often than men, and it's more likely to occur in people who are older than 50.

Because of the variety of treatment options available, having trigeminal neuralgia doesn't necessarily mean you're doomed to a life of pain. Doctors usually can effectively manage trigeminal neuralgia with medications, injections or surgery.

Right now for Chloe this tens unit seems to be the best form of treatment. This has been considered by others as behavior. Behavioral techniques help us get Chloe to explain the problem so we could finally be able to stop calling it the elusive disorder and it's actually name "Trigeminal Neuralgia". This has been a long and for Chloe painful journey from a floppy infant to confirmed bulging disc which probably caused the nerve issue is the timeline we had to uncover this problem.

Elusive Disorder with"Sciatica Like" symptoms

 Like the sciatic nerve pain Chloe has similar issues in her cervical nerve which comes out of her left side of her neck and shoulder to her left arm.

Treatment is a select pain management system "tens device" which delivers a low dose electric stimulation to the muscles in question shown to us by a physical therapist. Chloe is responding to the 4 half hours a day treatment positively and starting to ask for the treatment too. This is actually week one of treatment

Chloe experience these "sciatica like" symptoms but in her left side neck,shoulder and arm.

The symptoms of sciatica pain stem from impingement of the sciatic nerve which runs from the lower back area to the feet. What one feels is pain or a tingling sensation that starts in the upper buttocks then radiates toward the feet.

This maybe one of the causes of Floppy Infant since birth but it appears very treatable and took a long time to finally get the elusive symptoms straight. It interfered with muscle development and was unpredictable when she would get shots of pain through that region of her body. 

Cervical Convergence Theory

Just as I am beginning to promote the book, and now we have an explanation for Chloe's left side of her face neck and shoulder which when triggered can cause a whole lot of pain. The physical therapist who specializes in TMJ issues called it the above name but said it is treatable. He plans to give me information so I can pass it on when I understand it better. Chloe is now going through 20minutes 4 times a day of this tens device one of the probs is on her left jaw where it opens and closes the other is on the left side of her neck at the base. So far all treatment she is totally smiling after.. Stay tune!

Select Pain Management system

Timing is always amazing the device I am suppose to have Chloe use came by UPS. We are suppose to take it to the physical therapy session to get ideas how to use it. It is really nice when these things work out!

Happy 4th of July! Understanding and describing the problem!

Chloe with the medication to shrunk nerve ending now she can open her mouth 50% more then before but now she can only open her mouth about 50% what average person can. The Neurologist increase the medication to decrease nerve swelling and pain. She also referred us to a physical therapist who deals with TMJ issues. The left side of the face and left shoulder seem to be the problem area. We will keep you all posted on our progress!

Possible Diagnosis

Chloe's left side of her face pain issue maybe what is called Trigeminal neuralgia. She has these attacks that seem to come out of nowhere. She has a chronic pain spot varies intensity daily located between her end of left eyebrow and top of her left ear. She has experienced dropping left eye, jaw locking on the left and feeling like she needs to throw up. The way she tries to get out of it if by biting on something. So we are either dealing with fear of having an attack or actually having one. This will be the discussion I have with her neurologist at Chloe's next appointment, Here is the link to this neuralgia!

This information was finally gotten because the neurologist gave Chloe medication that decreased swelling in nerve ending for treating peripheral nerve damage. We finally got a better description from Chloe as to her symptoms are and maybe why it got her to open her mouth and better control of her neck.

http://www.mayoclinic.com/health/trigeminal-neuralgia/DS00446

Update from the trip

Chloe is able to do more things with this new medication for peripheral nerve damage. She still has pain especially if she moves her left arm over her head wrong. Unfortunately there is no way to identify where the problem is but her neck moves better and her mouth opens wider. The pain is less intense and she is able to describe what is going on more clearer. Questions we have for the neurologist is maybe increase slightly the medication to see if pain is more manageable and maybe we will get more accurate information and pinpoint where the problem is.

Day trips all week long

Lots to tell the neurologist about! Here are a couple of pictures!

Traveling around the state

Here are some pictures of what helps Chloe with these muscle/nerve issue on our day trips!

Hammock and walks

Example of Peripheral nerve damage

Let us first look at the MRI which told us that Chloe's brain was fine but she did have a bulging disc between  C6-C7 in her neck. This may of caused her left shoulder from developing correctly so the Neurologist was willing to try a medication that works on nerve ending that have peripheral nerve damage to see if it helped.

This is an example of how much it helped! Chloe sees a male dental hygienist for several years at her dentist office. This is what he said was different this time.
1. Chloe was able to open her mouth fifty percent or more wider then she ever did before.
2. She did not fatigue. Her ability to follow directions through out cleaning and she was able to keep her mouth open and her abilities improved through the whole 30 minute session.
3. He stated this was the best cleaning he ever done due to he could access every area in the her mouth.
4. She even took ex-ray which had her biting down on a gadget while he took the ex-ray .

Chloe before looked like her jaw was locked. It was hard for teeth cleaning tools to get in. We worked on teeth flossing and electric toothbrush as a way to get her to open her mouth. Now she is doing it with this medication.

The Neurologist said we should be thankful that Chloe tolerates these medications and we sure are.

Chloe's 21 years old finally have a great working relation with a Neurologist. Finally got medication to deal with the bulging disc that caused the peripheral nerve damage in her neck and left shoulder.

Slow and Gradual Improvement

Medication to treat the peripheral nerve damage due to the bulging disc that may have effected the cervical spinal nerves seem to be a big help. Her neck turns easier and mouth can open much wider so less problems with eating. She has less complaints of headaches or they are less intense and she is able to describe them better. Her hearing seems to be less sensitive to laughing, clapping and crying. She still has a disbelieving look on her face that she does not seem effected by these events.

The neuropsychologist did mention a learning disability that is difficulty in making decisions. Chloe's major outburst come from having to make a decision or having to change a decision. He suggested we need to continue to practice decision making and work on slowing her speech down and using a softer voice.
This is our behavioral approach, she needs to calm herself down in a quiet room for 60 minutes then she needs to earn back her computer by typing how a 21 year old should act which is not grinding her teeth,
yelling,crying and threatening to throw up.

 The whole purpose is to get her back in better control of her emotions so she can improve in making adult decisions.

Chloe The Kinesthic Learner. How her health issues interfered with her Learning Style

Revised book cover!

Change Author BIO

This slant focus on my professional experience.

Author BIO:

I was born on May 9, 1953 and raised in a rural area twenty five miles southeast of Green Bay, Wisconsin. I was fourth of five siblings raised by our father, a veteran with a college degree and our mom who got her GED in her 40’s. After graduating from Mishicot High School, I attended the University of Wisconsin-Oshkosh and graduated 1976 with a BS degree in psychology.

  My degree, and certification had me working as an AODA counselor in several different jobs till I meet my husband and we married in 1983 and have two daughters. I switched into the developmental disabilities and then worked as a facility program manager till leaving in 2000.

Couple of pictures share in book to show how much growth was an issue

Book Cover

Assets in treatment!

The Neurologist claims an asset of recovery for Chloe is how she  handles taking  medication. She is able to take what the doctor prescribes maybe at a low dose because of headaches but still able to utilize what she gets without so far serious of life threatening reactions.

Chloe has agreed to  guardianship with medical and financial, but limited in other areas. We agreed to review every year when filling out the form to see if it is still needed. Medication she takes needs to be monitored and not let fall in the wrong hands.

She is able to better describe the health issues so the doctors can figure out appropriate treatment.

The cover for the book is completed they expect to finish the inside of the book in the next couple of weeks.
Then I will have to give them the go ahead before the book is printed. The book will be on display at the International Book Seller Convention in Germany and the National Book Seller convention in New York State both in Fall. I will doing homework on  my author platform and what that all means. I will keep you posted on my progress

Busy week!

My book has moved to the production specialist who ask me for several things. Such as a better picture of myself and since I lost weight since the first one I thought that was a good idea too. Also he wants a more descriptive book title. Hopefully I can email that today.

Chloe's neurologist has prescribed what she calls a old time antidepressant that has been found more useful in peripheral neuropathy and dealing with chronic pain. Chloe takes it at bed time and it will work gradually over time. What we noticed first is able to open her mouth wide which has been a concern at the dentist. She also is speaking clear. Overtime we will hopefully use less pain medication for her left shoulder to and see a reduction of headaches possible nerve related

Start of the treatment!

Peripheral neuropathy, a result of nerve damage, often causes numbness and pain in your hands and feet. People typically describe the pain of peripheral neuropathy as tingling or burning, while they may compare the loss of sensation to the feeling of wearing a thin stocking or glove.

Peripheral neuropathy can result from problems such as traumatic injuries, infections, metabolic problems and exposure to toxins. One of the most common causes is diabetes.

Chloe, small and slightly raised left shoulder due to problems of developing her shoulder because of a bulging disc in her neck convinced the neurologist. She felt treating the peripheral neuropathy was a next step in hopes to deal with some chronic pain related to it and Chloe's headaches when she moved her left arm certain ways. 

Chloe had to get an EKG which had to rule out a heart arrhythmia that is a genetic abnormality that could be aggravated by taking this medication. She was cleared so she is gradually starting the medication.

Hopefully I can report good progress in the weeks to come.

Cluster headaches or migraine or peripheral neuropathy?

Cluster headaches are rare, extremely painful and debilitating headaches that occur in groups or clusters. They often appear during seasonal changes. They are also described as suicide headaches, a reference to the excruciating pain and resulting desperation that has culminated in actual suicide.
A migraine is a form of vascular headache. Migraine headache is caused by a combination of vasodilatation (enlargement of blood vessels) and the release of chemicals from nerve fibers that coil around the blood vessels. During a migraine attack, the temporal artery enlarges. (The temporal artery is an artery that lies on the outside of the skull just under the skin of the temple.) Enlargement of the temporal artery stretches the nerves that coil around the artery and cause the nerves to release chemicals. The chemicals cause inflammation, pain, and further enlargement of the artery. The increasing enlargement of the artery magnifies the pain.

At Chloe's every three months visit to her Neurologist the focus was what else needed to be done. Chloe's reoccurring  left side headache and shoulder pain was our focus. The Doctor asked what I thought it was Cluster headaches or migraines? I shared that I thought it was peripheral neuropathy due to the bulging disc in her neck since birth the shoulder never developed properly. This also results from problems such as traumatic injuries, infection,metabolic problems and exposure to toxins. Chloe's left shoulder is still asymmetrical to her right and her shoulder as a whole looks crooked or twisted. Chloe showed the doctor what we were talking about and the neurologist agreed we might be right. The problem has improved with exercise but still noticeable but now easier to hide.

The doctor wants to try and control Chloe's pain from this problem. So the next step, a test will be set up to check  that Chloe does not have a certain problem. Then the Neurologist will try a small dose of and old antidepressant that decreases nerve swelling. Hopefully this will do the trick. If we can control the left side of her head and shoulder pain Chloe will be able to do more things.

What Therapy works!

Motivation is to give reason, incentive,enthusiasm,enthusiasm,or interest that causes a specific action or certain behavior. Motivation is in every day function likes of eating is motivated by hunger. Education is rewarded by a desire for knowledge. Rewards to coercion can be used as motivators.

Two main kinds of motivation: intrinsic and extrinsic. Intrinsic motivation is internal occurs when people are compelled to do something for pleasure, importance, or desire. Motivation that is extrinsic are when external factors compel the person to do something. Reward motivation where you reward the person for some action they accomplished.

"Howletts Hierachy of work Motivators" in the work site helps supervisors in the work force to lead or motivate there workers.Teachers also implement motivational techniques to increase participation, effort and grades. Without motivators,we would simply not care about outcomes,means,accomplishment, education,
success, failures and employment.

Our reward system with Chloe has motivated her to keep working on what she needs to do.

Missing the Obvious!

One of the personal trainer at the YMCA suggested Chloe might have problems with the moving arm movement on the elliptical exercise machine but she does not have problems the elliptical exercise machine where the arms remain in a stationary position. So she tried the elliptical with the movable arms only for five minutes. She got off this machine very upset and took about 30 minutes to have her finally calm down then she was able to describe a cluster headache in her right eye and double the pain on the left side of her head.
Again this only 5 minutes on the exercise equipment with the movable arm component appear to have caused this.So the next time the personal trainer suggest something maybe test it or leave well enough alone.

The next day Chloe's shoulder still hurt but now she was able to point to where it hurt so I put on an over the counter pain patch which she said was great. We went to her volunteer job and she had a good day. We are learning a lot from from Chloe now that she has a voice to describe what is going on. Thanks again to the neurologist and neuropsychologist  for all the suggests they gave us. We have seen the neurologist for years and was extensively interviewed and testing of Chloe by the neuropsychologist. They have come up with this treatment plan that has really help us figure out and work through issues that we could not of before.

Understanding the problem

Chloe through her exercising at the YMCA and her volunteering at the thrift store. She is finally understanding her ears are protected by ear plugs. So she doesn't need hold her ears when she sees people talking and laughing. That took a lot of activities in the community for her to understand and believe these ear plugs would protect her ears. The ultimate  goal would be to wear one ear plug in her right ear to protect her tinnitus.  We also are working on that they are laughing about something they are discussing and not her. Her first explanation of why she held her ears was, "Stop laughing at me!"

Chloe's exercise routine is called the abrupt work out. Six laps around the track is a mile. We will go 3-6 laps stopping at workout rooms to do 5-10 minute exercising with the equipment in the room we stopped in.
Chloe had problems with abrupt changes so this exercise routine really seems to be helping this issue. Shopping in the mall below we also change up the stores we stop at where we look for items we may need.

Chloe's understanding of concepts is helping her navigate her world and she is able to explain why she does what she does. Her medication seems to be a big help here.

So far left arm working below her left shoulder does not trigger the nerve pain in her head only when she lifts her arm above her head and twists the wrist and elbow

Slow going but Definition still holding

We are working on the premise that when Chloe raises her left arm over her head to stretch she does not get  nerve pain on the left side of her head but if she raises her left arm with any twisting or rotation or lifting  of objects she gets shooting pain in the left side of her head.

Today we went to target Chloe pushed the cart, put items on the belt at the check out and put bagged items in the trunk. She was using both arms and did complain of left side pain at home. She was lifting about 5 pounds and swing the bag into the trunk. Next time we will use only right for any lifting or twisting. With her becoming more interactive with her world we are getting more information.

Chloe's hearing appears to be visual issue too.  Now wearing ear plugs she is able to identify a baby crying, someone laughing or clapping around her but she still may cover her ears if she sees them. I would have to remind her that she is wearing ear plugs. The tinnitus in her right ear probably becomes louder with these type of noises. She may need to wear an ear plug in her right ear to prevent that from happening in the future.  She now wears two earplugs to help her see the difference.

With the medication to improve her focusing, she is now able to understand right and wrong answers. If she gets to many wrong answers she will have to repeat the exercise. She is doing math, geography, Spanish and typing independently and with little redirection but tries to get over 70% correct so she does not have to repeat the assignment.

With proper medication Chloe's life is more confident and she is attempting to do more thing

Definition holding!

So far what we have is when Chloe raises her left arm over her head and rotates the elbow and wrist she gets a shooting pain on the left side of her head. If she stretches her arm over her head but does not rotate it, she does not get that pain in the head. At the thrift store she used her right arm extensively in all different positions and worked with the left below her shoulders. We did that without problems. Now the training of her as to how to uses her arms and avoid this shooting pain begins.

Hearing is a condition response too. If Chloe sees a group of people coming toward her she holds her ears even though she is wearing earplugs. If she does not see a person laughing or talking loud she does not react. She reacts to TV person's voice qualities but likes Talk radio. She complains of tinnitus in her right ear but the left ear normal hearing. We are working on lectures on line and DVD protecting the right ear with an ear plug so far she is enjoying this too.

We are attempting to show her how to avoid these issues and as you may guess it is a very slow process.

Lots have happen since my last update! Now that we are straightening these issues out finally getting back to  updates:

The first step in our daughter's recovery was to stabilize her sleep to achieve good quality sleep and addressed focusing issues. Her neurologist prescribed medications that works.

Then our daughter got an MRI that showed a bulging disc between C6 and C7 which suggested a pinched nerve. The occupational therapist felt the area and suggested I ask the Doctor if we can assume it is a pinched nerve. Since the MRI showed the problem we can use pinched nerve to describe it.

Now that we understand the problem we are working together to better describe it and figure out where the headaches start. So here is what we think if she raises her left arm over her head and rotates the elbow and fore arm she experience noticeable pain over the left side of her forehead and temporal area. Raising her arm over head to stretch without rotation we do not see quick on set of a headache on the left side of her head.

We are figuring  out ways of testing the right arm overhead to make sure we do no see quick on set of headaches when we use the right arm over her head.

This is where we are at so far!

Happy 2013,

The editing department explain everything that they did mainly focusing on  grammar and what they did and why. I am getting a real education on sentence structure. This is very detail work and needs to be gone through one comment at a time. So it is time to get through it and send it back the holidays are official done so my break is over. Got a call from the publisher  wondering when I plan to send it back, so time to get through this phase.

This is called an author's BIO that I submitted with the book! You will see I got a lot of practice documenting client's progress in my previous jobs. They told me to keep it to 100 words this is what I came up with!

 Born May 9, 1953, and raised in rural area 25 miles southeast of Green Bay Wisconsin. I was the fourth of five siblings and  worked on mink farms, a waitress and grew crops for cash were some of my early jobs. After graduating from Mishicot High School, I attended University of Wisconsin Oshkosh and graduated 1976 with a B. S. degree in psychology.

I worked in human service jobs in Oshkosh, Manawa, Sheboygan, and Waukesha before marrying my husband in 1983. Then I was a program manager of a group home and raised my 2 girls till leaving in 2000 .