How Does it Feel to Have PTSD?

In our second Unit of our STEAM course, Disease, we learned about mental disorders. This Unit was about the mind. We learned about different kinds of mental disorders, learning disabilities, and mental illness. We also learned about different brain waves and when they manifest. We used this information to learn how to plot these waves on a graph and solve a piecewise function. Another thing we learned about was the DSM-5 This is the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. This is a manual of many mental disorders that have criteria used to diagnose people. We had a 2nd-year medical student come in and talk to us about diagnosing and talking to patients. I really liked this experience and got to show off my medical knowledge. For this project, we had to pick a mental disorder. I chose Posttraumatic Stress Disorder or PTSD. We then had to create a lesson and simulation to try to get our peers to feel the effects of the disorder. We also had to graph the brain waves that we thought our lesson would provoke. We then graphed these as a piecewise function. We filmed the lesson so we could document the experience. I thought this action project was fun. I thought it was different than the usual slideshow or essay. We also got to see everyone else do their simulation.

CM. Flyer. (2018)

My definition of PTSD would be: PTSD is a disorder in which a person has triggering flashbacks, memories, dreams, or hallucinations about a traumatic event in their past. According to the Veterans Association: "PTSD (posttraumatic stress disorder) is a mental health problem that some people develop after experiencing or witnessing a life-threatening event, like combat, a natural disaster, a car accident, or sexual assault."

PTSD can be very difficult to live with. I wanted to find out what it was like to take care of someone with PTSD. I found an interview with a woman named Rebecca McCoy. Her husband Craig was diagnosed with PTSD. She states, “I basically guide him through each day, do things that he cannot do for himself or help him complete the tasks he cannot finish on his own. I am his primary emotional support, the person who he can talk to openly. I also help him realize and remember that he is worth the fight PTSD brings." This quote shows how hard it is for people who take care of someone with PTSD is. Rebecca and Craig's relationship is much different now that he has been diagnosed with PTSD.

According to the DSM-5 here are 3 criteria for diagnosing PTSD:

Criterion A: stressor

The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, as follows: (one required)

1. Direct exposure.
2. Witnessing the trauma, in person.
3. Indirectly, by learning that a close relative or close friend was exposed to trauma.

Indirect exposure to aversive details of the event(s), usually in the course of professional duties (e.g., first responders, collecting body parts; professionals repeatedly exposed to details of child abuse).

Criterion B: intrusion symptoms

The traumatic event is persistently re-experienced in the following way(s): (one required)

1. Intrusive thoughts: Recurrent, involuntary, and intrusive memories. Note: Children older than six may express this symptom in repetitive play.
2. Nightmares. Note: Children may have frightening dreams without content related to the trauma(s).
3. Dissociative reactions (e.g., flashbacks) which may occur on a continuum from brief episodes to complete loss of consciousness. Note: Children may reenact the event in play
4. Intense or prolonged distress after exposure to traumatic reminders.
5. Marked physiologic reactivity after exposure to trauma-related stimuli.

Criterion C: avoidance

Avoidance of trauma-related stimuli after the trauma, in the following way(s): (one required)

1. Trauma-related thoughts or feelings.
2. Trauma-related external reminders (e.g., people, places, conversations, activities, objects, or situations).

Different parts of the brain are affected by PTSD. The parts of the brain that are most affected are the stress response centers like the Amygdala, Hippocampus, and Prefrontal Cortex. These are the areas of the brain that have Norepinephrine and Cortisol systems. These systems are known to have a dysregulated function after years of stress, according to US National Library of Medicine National Institutes of Health.

Below is my lesson plan for my simulation. You can follow this so you can also host your own simulation.

For my simulation, I decided to turn PTSD into something good. I didn't want to actually scare anyone or do something that might be traumatic. I decided to ask them about the happiest day of their lives. I asked them to think about all the sensory details they could think of from that day like, what was the weather like, what were the smells, what food did you eat, etc. I had people relax and think about this for a couple minutes. I then told them this is what PTSD could feel like. I then told them about PTSD and why this simulation relates to the disorder. I told them: "What if this day that you were thinking about was the worst day of your life?" I told them that PTSD is like repeating the worst day of your life over and over again. I then had them reflect on the experience and what it would be like to actually have PTSD.

Here is the graph of the expected brain waves of my peers throughout the activity.

CM 'Piecewise Function" (2018)

For the graph, I put the 5 brain waves on the graph. These are Delta, Theta, Alpha, Beta, Gamma. These are the 5 brain waves that manifest at different times. Delta usually happens in deep sleep. Theta happens in light sleep or hypnosis. Alpha happens in meditation and relaxation. Beta happens in regular consciousness, thinking, and observing. Gamma happens in conversation, learning and problem-solving. I plotted each brainwave at each minute of the presentation. I then separated each piece into sections. I ended up having 7 sections. I then wrote their range. For each of pieces, I calculated the slope from their 2 points using y2-y1 over x2-x1. I then calculated the equation of that line and solved until I got what y equaled. I then put that into the f(x).

I think that if I had PTSD, daily life could be very hard. I think how difficult would depend on what kind of trauma I had gone through and what kind of triggers I would see in my day-to-day life. I could have a very severe case of PTSD or a rather mild one. I think my life would be different because I would be more anxious than I usually am. I would probably be looking for triggers and seeing how I could get out of situations that might trigger me. I would probably think about the trauma, definitely more than I would like to. I would have to make sure I had time to work my schedule so I could go to therapy to help deal with my symptoms. I might also have to pick up medication like anti-depressants to also help manage my symptoms. I might have night terrors or nightmares about the event that would make me emotional. I would have flashbacks and remember the incident. I would even sometimes be depressed and lose interest in activities and struggle with day-to-day life. I even might be struggling with survivors guilt depending on what kind of trauma I went through in the past. I think my life would be very different if I were having to deal with PTSD. I hope that I will never have to go through it, and if I do, I know the support I need to help get me through this difficult time.

In conclusion, I really liked this project. It was different than the usual projects we do and that was fun. There were a lot of different pieces to the project which did make it hard to keep track of. The part I struggled the most on with this project was coming up with how I was going to simulate PTSD. I talked with my teacher and he helped me with the idea. In the end, I enjoyed this project and have really enjoyed this class. I look forward to the next action project.

Works Cited:

"An Interview About Post-traumatic Stress Disorder: Rebecca McCoy." (2014) Women's Health.gov. U.S. Department of Human Services. Web. 14, March 2018. https://www.womenshealth.gov/blog/spotlight-rebecca-mccoy

Bremner J. Douglas M.D. "Traumatic stress: effects on the brain." National Center for Biotechnology Information. Dialogues in Clinical Neuroscience. Web. 14, March 2018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181836/

Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, DSM-5, American Psychiatric Association. Washington D.C. (2013) 14, March 2018. 

"DSM-5 Criteria for PTSD" (2018) Brainline.org. Bob Woodruff Foundation. Web. 14, March 2018 https://www.brainline.org/article/dsm-5-criteria-ptsd

"PTSD Statistics." (2013) PTSD United.org. Web. 14, March 2018. http://www.ptsdunited.org/ptsd-statistics-2/

"Treating Posttraumatic Stress Disorder."(2018) PTSD Alliance.org. PTSD Alliance. Web. 14, March 2018. http://www.ptsdalliance.org/treatment/

"What is PTSD?"(2018)PTSD Alliance.org. PTSD Alliance. Web. 14, March 2018 http://www.ptsdalliance.org/about-ptsd/

Multiple Sclerosis: A Personal Perspective

In the second STEAM class of my sophomore year, we are learning about the body. This class is called Disease, the first unit is called Body. In this unit, we learned mostly science. We learned about cancer and how that affects the body. We also learned about each organ system and the organs included in them and what they do. I am a total surgical junkie, so I already knew all of the material in this unit, I did break off a little bit and did some extra research for myself. We also learned a math concept called completing the square. This is another way to solve quadratic equations. I have done a lot of work in quadratics in the past, but I have never learned this technique. It was actually really easy to learn and same a lot of sense. We did not take any FEs this unit, but I hope for some cool ones in the following units. For this action project, we were asked to conduct an interview. It had to be anonymous but we had to find someone with a disease and interview them about it. We then had to write up their profile and classify their disease in accordance with what we learned in class. We also had to draw a picture of each of the body systems that the disease affects. I made the outline of a human body and then used transparencies to draw the affected organ systems. I interviewed a woman in her late 40s with Multiple Sclerosis. I really liked this project, I was able to talk about the things I love to learn about. I really didn't have any issues with this project and I look forward to the rest of this class and the next class.

For this action project, I thought about who I could interview. I have some family members and some friends who have or have had diseases. I decided to interview someone with Multiple Sclerosis.

Multiple Sclerosis

Multiple sclerosis or MS is an autoimmune disorder of the central nervous system or CNS. The CNS is the body’s control system. An autoimmune disease is when the body’s immune system attacks a healthy system or organ in the body. In the case of MS, the body’s immune system is attacking the myelin, which is the protective sheath on the nerve fibers, brain, and spinal cord. The myelin is damaged and interrupts the signals from the brain and the nerves, eventually leaving the nerves damaged. MS patients may have a wide variety of signs and symptoms depending on which nerves and how many nerves are affected. It could be a very small localized area or large areas. MS can have drastic effects on life. The loss of motor function or blindness are some extreme symptoms of MS. Some less severe cases can be managed with medication with little or no symptoms in day-to-day life. The most common type of MS disease course is a relapsing-remitting course. This means that symptoms of the disease come and go. Symptoms will appear over time and then get better. These periods of quiet time can last weeks to years. According to the Mayo Clinic, 60-70% or relapsing-remitting MS have steady progression and no relief time: this is called secondary progressive MS. There is also a course where people have a gradual onset and steady symptoms, this is called primary-progressive MS.

Symptoms

Symptoms of MS can vary from person to person. The most common type of symptoms a patient will experience are:

• Numbness and weakness in limbs
• Partial or total vision loss and pain when moving eyes
• Double vision
• Headaches
• Tingling in extremities
• Tremors
• Fatigue
• Dizziness
• Slurred speech.
• Problems with bladder and bowel function.

Classification

This disease is a genetic disease. MS is a non-transmittable disease. The cause of this disease is still unknown. The only way the disease is linked to other people is genetically. If you have a sibling or parent who had had MS, you are at higher risk of contracting the disease. MS is not transmitted through the air or bodily fluids. Some risk factors for contracting MS include:

• Family history - people with an immediate family member that has or had MS you are more at risk.
• Viruses - certain kinds of viruses have been connected with MS like the Epstein Barr virus that causes infectious mononucleosis. 
• Autoimmune diseases - diseases such as Type 1 diabetes, Thyroid disease, or Inflammatory Bowel Disease. Smoking also causes a higher risk of contracting MS. 
• Age - people between the ages of 15 and 60 are the most at risk for MS
• Gender - women are twice as likely of getting MS than men.

MS is most common in areas with temperate climates such as the northern US, Canada, south-eastern Australia, New Zealand, and Europe. The most common racial group to contract MS is people of Northern European descent. People who are of African, Asian, or Native-American descent have the lowest risk of contracting MS. There is no geo-economical link to MS at this point.

Nobody really knows why people contract MS but there are some risk factors like I stated before. The person I decided to interview is a 48-year-old female named Lynn. She has 2 teenage daughters and a husband. Lynn was diagnosed with MS 8 years ago in 2010. Lynn is a woman which means she was already at a higher risk. She also is of Northern European descent which it the most at risk racial group. She also lives and is from the northern United States which is one of the most at risk geographical locations. Lynn’s grandmother always had an undiagnosed neurological condition that could have been MS. Lynn also had Mononucleosis when she was in high school. This disease is caused by a bacteria that might be related to MS.

Lynn

It was the summer of 2010 and Lynn was living her life normally. She one day started to notice something funny with her vision. “It was weird,” she said. “Because for a couple days, I had been like feeling like something was weird with my vision. It was just, I couldn’t quite put my finger on what was going on, but it was like when I would turn my head quickly, my eyes weren't tracking right. We went to a dance recital and I really realized I was seeing double.” These are both very common symptoms of MS. Lynn also had a strange tingling feeling on her thigh. “It was like I had had a Novocaine shot.” she described. “ I did mention it to my doctor, and she said (“Well, I’m sure you don’t have MS.”)” It turns out the doctor was wrong. Lynn also experienced numbness and tingling on her extremities, another very common symptom. She was finally diagnosed later in the summer.

Lynn was diagnosed by the results of a series of tests. She underwent several MRIs which stands for Magnetic Resonance Imaging. These scanned her brain to look for lesions. She also underwent a Lumbar Puncture or Spinal Tap. This is a minor surgical procedure in which a large spinal needle is inserted between 2 lumbar vertebrae into the spinal canal to collect a sample of cerebrospinal fluid, this is the fluid that is on the outside of the spinal cord. The fluid is tested to rule out other neurological diseases such as meningitis.

Lynn’s treatment consisted mostly of medication and follow up imaging. MS is an incurable disease. Symptoms can be managed and pain can be relieved, but the disease is always going to be in the body. She was prescribed Copaxone which is a medication that blocks the immune system from attacking the brain or an Immunosuppressant. This medication must be taken daily and is administered by an injection beneath the skin. Lynn could give herself these injections at home. She would take this injection every night, she would rotate between her thigh, buttock, stomach, and arm.She recalled, “It was scary the first time I had to do it because I didn't know how it was going to feel. I was relieved that it was not as bad as I thought. I found that I had injection site reactions. Early on I had pancake sized welts that were red and itchy.” The side effects of this medication are bruising and skin irritation at the injection site.

When she was first diagnosed, Lynn was admitted to the hospital for a little over a week in the summer of 2010. This was because the intravenous steroids they were giving her called Solu Medrol needs constant blood testing and can damage the liver. “It was mostly annoying because I actually felt fine and didn’t feel like there was a reason I needed to be in the hospital. I was mostly worried about my kids because they were only 8 and 5.”

Today, Lynn lives life much like anyone else would. She has to take her Gilenya pill every night. She now takes this pill instead of the injection. Lynn’s symptoms are managed by the medication and she has no side effects in her day-to-day life. Lynn still has to go to frequent doctor’s appointments for MRI’s neuro exams and blood testing. These are all precautions to make sure she is prepared and aware if she has a relapse.

CM "Nervous System" (2018)

MS affects a few systems of the body. The main one is the Nervous system. The nervous system is bodies control system. The brain makes all of our decisions and our nerves make us move and feel pain. Our sensory organs pick up on external senses and turn that into information to our brain. The lymphatic system attacks the coating on the nerves and causes damage and can eventually destroy them. The coating on the nerves Myelin also coats the brain and spinal cord. This is the coating that deteriorates and leaves the nerves damaged.

CM. "Lymphatic System." (2018)

The Lymphatic System is the body’s defense system. It protects us from diseases. The Lymph nodes produce the chemical lymph that fight diseases. Sometimes the immune system attacks healthy parts of our bodies. This is called an Autoimmune disease. In a person with MS, the immune system attacks the healthy coating on the nerve fibers causing them to become damaged.

CM. "Digestive System." (2018)

The Digestive System is the body’s processing system. Food goes in and is processed and the waste comes out. The intestines absorb nutrients from the food and add water. They then empty the waste out the anus. In patients with MS, one symptom might be problems with bowel control. This means patents might have a hard time controlling when they defecate..

CM. "Renal System." (2018)

The Renal or Urinary System is the body’s liquid waste system. The kidneys filter the blood and absorb the nutrients. The waste from the filtered blood then goes down the Ureters into the Bladder, which is a holding place for the liquid waste. When the body has to urinate, the liquid is released into the urethra where it exits the body. Some patients with MS might have trouble with bladder function. This means patients may have a hard time controlling when they can urinate.

In conclusion, I really liked this project and didn't really have any trouble with it. The only problem was that I included too much information. I was over 400 words over the limit. I had to take out a lot of information that I thought was valuable, so I didn't like that much. Other than that, everything went smoothly and I am proud of how it came out.

Works Cited:

“Diagnosis.” (2017) Mayo Clinic. Mayo Foundation for Medical Education and Research. Web. 15, Feb, 2018.
https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/diagnosis-treatment/drc-20350274

Moody, C. (2018, February 11) Personal Interview.

“Multiple Sclerosis.” (2017) Mayo Clinic. Mayo Foundation for Medical Education and Research. Web. 9, Feb, 2018.
https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/symptoms-causes/syc-20350269

“What Causes MS?” (2018) National MS Society.org. National Multiple Sclerosis Society. Web. 9, Feb, 2018.
https://www.nationalmssociety.org/What-is-MS/What-Causes-MS