neuro

Movement and the Brain ⇒

A very interesting case study came out recently, looking at the neurological function of a particularly active 93-year-old woman named Olga Kotelko (she died in 2014 at age 95) . She became an athlete in her sixties playing softball, then started track and field at age 77. Exercise benefits are often assumed to apply to our physical state, and it also seems to be associated more and more with good mental health. This study took things a step further and looked at her overall brain function to see if her routine exercise had any impact on both the brain itself as well as cognition.

“In general, the brain shrinks with age,” [University of Illinois Beckman Institute postdoctoral researcher Agnieszka] Burzynska said. Fluid-filled spaces appear between the brain and the skull, and the ventricles enlarge, she said.

“The cortex, the outermost layer of cells where all of our thinking takes place, that also gets thinner,” she said. White matter tracts, which carry nerve signals between brain regions, tend to lose their structural and functional integrity over time. And the hippocampus, which is important to memory, usually shrinks with age, Burzynska said.

Previous studies have shown that regular aerobic exercise can enhance cognition and boost brain function in older adults, and can even increase the volume of specific brain regions like the hippocampus, Kramer said.

Kotelko’s brain offered some intriguing first clues about the potentially beneficial effects of her active lifestyle.

Though it wasn't strongly emphasized in the article, something else really grabbed my attention:

“During dinner after the long day of testing, I asked Olga if she was tired, and she replied, ‘I rarely get tired,’” [Beckman Institute director Art] Kramer said. “The decades-younger graduate students who tested her, however, looked exhausted.”

It really does seem that our culture has a problem with sleep. I'm as guilty of not getting enough sleep as anyone. I have a bad habit of getting only around 6-7 hours of sleep per night. I blame the amount of things I have on my plate at any given time for this, but the likelier truth is that if I would get enough rest, I could probably manage all of these things with greater efficiency.

In any case, one of my goals since transitioning settings has been to both increase the amount of sleep I get and also start to exercise more. Forming new habits is hard, but watching Olga herself on video shows that it's clearly worth it.

The Importance of Sleep ⇒

This New Yorker article (a 3-part series) has been showing up a lot in my internet world recently. It's a worthwhile read and one that's meaningful both for patients and for clinicians. For my part, I wonder how much adequate sleep might be helpful for preventing burnout.

★ One Little Victory

Cliches always seem to ride in pairs. "Practice makes perfect" and "Hindsight is always 20/20" are not only annoyingly accurate, but joined at the hip. When I look back to my first days of clinic in grad school, I think to myself, "Wow, have I come a long way." And then I look to my new colleagues at New Job and think to myself, "I wish I could do that."

I caught myself this week falling into the familiar trap of being met with new challenges and wanting to handle them like a seasoned pro. The problem? I'm not yet a seasoned pro. To borrow the words of my new favorite TV chef, I have been brought to a boil, but am not yet ready to reduce to a simmer. I'm getting there, though.

Last week I got to do several video swallow studies. During my CF, I was fortunate to have a number of opportunities to do videos, however the equipment was lacking and the overall support from both my department and the radiology department was poor. Hence, at New Job I have sought retraining, and have been very pleased, if a bit stressed, so far.

Here's how I've gone about starting fresh:

  1. reviewing and relearning anatomy (enormous hat tip to a new friend I met at ASHA in November)
  2. learning the procedures specific to New Job (every place does them differently)
  3. getting comfortable with new procedures
  4. learning to recognize the anatomy from fluoro view
  5. learning to spot instances of penetration
  6. learning to spot instances of aspiration
  7. learning to observe surrounding anatomy during swallow

Prior to this, I would require at least 2-3 viewings in order to see everything. As I've forced myself to focus only on one or two specific things during the study (versus afterward, when I could review the disc), I've discovered that my perceptions have improved. Initially it's very difficult to observe everything in the moment, and synthesize that information. The beginner's mistake is to panic, as I had been doing, and try to see everything. It's only when you relax, and breathe, that you realize that to do so is self-defeating.

So here I am. I picked one thing at a time and worked to get better at it. And it's finally starting to pay off. Of course, I'm only just getting started, and I know it will take a good deal of time yet to really get confident. Still, it felt good last week when a neuro patient I've been working with proved more difficult to assess than I anticipated, and rather than panic, I was able to work through and get the information I needed for a good study.

One little victory at a time. And the best part? Instead of dreading the process, I'm finally beginning to enjoy it. Here's to more challenges, and more little victories...