Tag Archives: university

Saint George Vet: Public Health

30 Jun

Public Health Essays:

If you have experience in the area you wish to study, describe that experience.

I volunteered once a week in the organic chemistry stock room when I was a freshman at the University of Nevada, Reno. I measured, prepared, and mixed solutions for student labs, transferred chemicals into bottles under the hood, checked lab materials out to students, re-stocked chemicals after labs, and washed dishes. I was trained to handle hazardous chemicals, spills, and waste in the laboratory environment, as well as the importance of lab procedure.

Chem lab-not mineMy semester volunteering in a laboratory setting gave me an advantage in my chemistry classes and gave me the motivation and confidence to pursue a minor in chemistry. Taking an additional chemistry lecture and four-hour laboratory to obtain that chemistry minor gave me the analytical skills and laboratory techniques necessary to excel in any research situation.

I have worked in animal laboratory settings as well. Besides my research jobs at University of Missouri, I was able to accompany Dr. Sharp on his rounds at Charles River Laboratories. He checked the stools of Cynomolgus macaques, Cynomolgus rhesus, and marmosets, looked for lesions and possible research-ending health problems, and prescribed medication. I was able to remove sutures from one of the primates and feed crackers to the monkeys in the group pens.

My background in chemistry and my extensive animal experience will enable me to pursue veterinary jobs in public health. Earning a concurrent degree would help me build knowledge and confidence in areas such as monitoring the production of vaccinations and antibiotics as they are researched, developed, and tested for use in both animals and people.

BAD Blogger!

7 May

I just moved.  Moving is crazy.  This is my excuse for such a long post-drought.  This is my timeline for past moves so I can tell the stories of this last month:

14

And it’s not like I haven’t done it (moved) before, on the contrary I have moved so much it portrays a wanderlust or flakiness that doesn’t really fit my true personality.

Polson- enteranceWhen I was 4, my parents and I moved away from all of our extended family in Montana, to Nevada for job opportunities.  Montana is beautiful, but you “can’t eat the scenery.”

I grew up in small-town Nevada, going to the same Kidron's NV pics 050school for 13 years.  Which is good and bad.  I have well-established roots, and I always knew everyone and all my teachers, and everything.  BUT everyone always knows you and your business too, so good luck trying to live down embarrassing moments, changing/growing, or keeping anything on the D.L.

RenoI went to the same college everyone goes to my first year, which required a short move to Reno (an hour away) but tried to branch out instead of staying with my same ‘ol click as most of my small-town counterparts did.

I wanted more opportunities and was chasing my veterinary dreams so I took a HUGE leap and transferred to mid-Missouri, site-unseen, my sophomore year.  That move was big-time, but I was still somewhat protected by the insular world of college:Mizzou quad  I moved right into dorms and worked for campus dining services.  When housing, jobs, and school all line up–moves are substantially less stress.  And emotionally, I had already been away from loved ones before (moving from MT at 4) so I wasn’t lost or lonely.  Plus, school and work kept me so busy, who had time to miss anything?!  The move from Nevada to Missouri required a 30 hour drive.  I made that drive with my mom carrying a few dorm essentials.  I made that 30 hour drive with Douche, in a U-Haul.  I’ve made that 30 hour round trip by myself and a car-load of essentials and a dog.  I made the return trip by myself and 2 cats.  I HATE that drive.

265173_2208001644072_1368379309_32588356_2533618_nThen, my Saint George acceptance pulled me out of Missouri–which I really liked the 6 years I was there.  I had to make that 30 hour drive once more, with my dad, in a U-Haul.  Never again!  I’m not sure anything else aside from vet school would have compelled me to ever leave the midwest.  But veterinary school was calling, so I temporarily visited my parents and dropped off my cats that summer.  Nevada was just a brief visit.

Except Saint George fell through a week before matriculation.  Suddenly, I had nowhere to go, but obviously I wasn’t going to live with my parents–that was never the plan.  I had to choose where to go–and not being based on any acceptance, it could be anywhere that had a vet school.  I didn’t really know, and my parents dictated that I decide immediately.

I had been watching a lot of Frasier, wanted to try out a more liberal and city environment, and Frasier saturation increasedliked Washington’s veterinary program.  So to Seattle I (blindly) went.  Driving a car-load of essentials the 15 hours by myself.  I lived with my great aunt, which I always saw as a temporary transitional set-up while I looked for my own place.  I had previously gotten along famously with my college roommate, so I wasn’t discouraged Seattle housing prices negated living alone like I had in Missouri.

bedroom darkI moved to 12th Avenue, and soon saw what real-life roommates mean.  I needed out of that place ASAP because it was ridiculous!  Around this same time, I met Cool.  We hit it off, and sometimes I stayed at her shared housing situation, which was WORSE then my 12th Ave scene.  I don’t think I ever completed a full sleep cycle in Seattle.  I was always tired, always grumpy.  It made me HATE the city.  I needed my own space, without crazy roommate scenarios.  I needed a reasonable housing cost.

So we moved 6 hours across Washington to Spokane (with cats in Cool’s car and me driving a U-Haul).  And it was so much better!Fremont Fest 114  We could afford our own apartment without roommates!  Vet school didn’t happen for me, and the job market in Eastern Washington is horrible.  There was nothing there for us–Spokane wasn’t home.  We needed out, but Western Washington is out of our price range.

So I wanted to show you, I’ve moved.  I have left those emotional connections and everyone I know.  I’ve moved out of state.  I’ve had to find housing from a distance.  I’ve known the expenses.  Which brings us to 2015 and my latest move.

AuD Interview Prep

23 Feb

Something has got to change!  I know it’s this swing shift schedule, but until that is possible, something else.  I slept almost 11 hours Sunday night, then was still so tired I took a 40 minute nap today.  I hate feeling low-energy and unmotivated so much!  I feel like I have more time then I’ve ever had before, but I’ve made very little of it.  By the time I almost catch up on sleep, I have to go back to work and that runs me down again.

Since September, I’ve tried to have good sleep hygiene and go to bed at the same time every day (12:30AM, b/c that’s what time I can on work days) but it’s for the birds.  I never adapted to becoming a night person.  Apparently you just can’t fight your body’s normal rhythms–and mine is an early bird.  My body wakes with the sun–no matter how tired I am.  And I’m very, very tired ALL the time.  So starting now (I took off work to go to my interview in Utah) I’ll be going to bed early on the days I can.

Here is my feeble attempt at preparing for interview questions I know I’ll get.  Normally, I would have liked to write good essay responses then attempt to memorize them to be super-prepared, but it’s just not possible when you’re tired all the time.  I feel lucky to have gained this much traction.  Anyway, I’m telling myself, too rehearsed won’t be authentic, so maybe it’s ok I just have general ideas this time.  Besides–even if I do perfectly and get accepted–who knows if I’ll actually be able to afford to attend.  Bummer, but realistic (see Saint George awfulness).

I’m mostly worried about the travel logistics at this point:  Will the Greyhound be cold?  Will I have to pay $40 +++ to check heavy luggage (I HAVE to take interview stuff), can we drop the rental car downtown or do we have to cab it to the airport and back, does the hotel have an iron (and do I know how to use it?), will campus driving and parking be slow, will I have to wear interview flats in a snow storm?!  So you see how the questions are a little bit of an afterthought.  I figure I’ll have plenty of time to think about them on the 18hr bus ride. . .

UU AuD Timeline Poster

1]  What are your strengths and weaknesses?

-4.0 S&H GPA

-experience in the Speech & Language Lab at Riverpoint

-tutoring my peers

-ambassador (presentation, camp, hearing screenings)

-clinical experience at vet hospitals

-organizational skills

-communication skills

-more life experience

-ability to prioritize

-I want to speak about reading/typing outlines of all my textbooks prior to each semester to familarize with the material and have good notes.  Also mention how I’m on 422 days in a row of running at least 1 mile first thing every morning. But without saying something cliche that everyone else will say, and without using any word which also has a negative connotation.[disciplined (conjures violence or spanking too much), industrious, persistent (coming from a place of adversity/failure or stubborn), intrinsically motivated (over-used), enterprising]

Cons:

-undergrad GPA that doesn’t reflect my potential.

-Because I switched career paths after earning my undergraduate degree, I do not have as much observation experience as I would like.  I am eager to participate in all the available career avenues and hone my clinical skills.

-As a perfectionist I have tended to fret about things beyond my control in the past.  Currently I am making a concerted effort to prepare for the things I can, and let the rest go.  I think gratitude is an enemy of worry as well, so I am working on thinking about things I am thankful for rather then fixating on details beyond my control.  

Write them down to organize your thoughts. Compose examples and situations where you have excelled in demonstrations of your strengths. Do not dwell or belabor weaknesses. It would be better to talk about areas you wish to improve and skills you want to perfect.

-example scenarios:

-areas I want to improve:

-My undergraduate GPA doesn’t reflect my potential, but I feel like my speech and hearing sciences 4.0 shows improvement in my time management skills.

-Because I switched career paths after earning my undergraduate degree, I do not have as much observation experience as I would like.  I am eager to participate in all the available career avenues and hone my clinical skills.  

 -Right now I’m working on worrying less.  In the past, my perfectionism made me fret over details beyond my control.  Lately, I am trying to prepare for things within my control, then let go of the rest.  Instead of defaulting to anxious thoughts, I’m making a concerted effort to have gratitude for what has gone right and what I do have.

2.  What is it about this particular job that interests you?

-personal fulfillment of helping people like my Dad who have NIHL, Menere’s DZ, and PTSD.

-it’s more regulated and standardized then vet med

-opportunity to work in many different areas, and across the age spectrum

 -autonomy

-the strategic aspect of finding the appropriate tests 

-getting to actually perform the clinical tests

-My favorite part of audiology is continuity of care.  It is a health field where you are autonomous and responsible for the patient throughout the process:  collecting a history and using it to strategically find and carry out the appropriate diagnostics, instead of refering.  Then, the education about the condition and treatment is carried out by the audiologist, and finally, the overall communication is remediated by an audiologist in order to improve quality of life.  It is personally gratifying helping people through the entire process.

A question like this is a good segue into informing the interviewer that you know something about the facility. It is appropriate to mention areas of expertise for which the institution might be known and how they might be of particular interest to you.


3.  What do you want to be doing five years from now?

-Five years from now would be my first year, completely out of school, as a professional.  I hope to be working in a place that offers the most aspects of the audiologists scope of practice.  Under someone willing to mentor me as necessary, but also willing to let me be independent when I am able.  Since I have undergraduate loans, expect to acquire more debt in an audiology program, and am confident I will have proficient skills, I also hope the pay in competitive.

-Before I cement a decision about what aspect of the career I want to participate in, I would like to gain more clinical experience in a variety of areas.

-Currently, my biggest interest is aural rehabilitation/habituation, but I feel that should be applied to any part of the field.

-Though I am not locked into any particular area right now, I see myself using my meticulus nature to identify hearing, balance, and overall communication issues, using the best clinical assessment techniques, and remediating those problems using a combination of technology and a long-term humanistic approach.  I’m eager to learn about each pathway!

This is a commonly asked question, the answer to which can be very telling about your thought processes as well as personal organization. If you cannot answer this question, you are possibly indicating a lack of direction. It does not give assurance to the prospective employer that you are worth the time and money they will be investing in you.

4.  Tell me about yourself.

-I have a bachelors of science in Animal Science with a minor in chemistry from the University of Missouri.  More recently, I completed my post-bachelorrette in the Speech and Hearing sciences at Washington State University.  

-Working in the Language Laboratory at Riverpoint opened my eyes to the type of research being conducted in the field, and combined with my more hearing-based classes, got me excited to contribute to this base of knowledge.  

-I am excited to enter into a profession where I have autonomy and can conduct my own diagnostics, because that was one of my favorite aspects of being a (paid) veterinary assistant for 14 years.

This is another revealing interview probe. It is called an open-ended question. You are forced to choose what you feel are the important aspects of your life and experiences. These questions are not just revealing about your past, but also show how you think on your feet and conduct yourself. Stay on the right track when answering this question. Talk about your professional life and not your personal interests. Begin by reviewing your educational background, clinical experiences and academic accomplishments. Sounds like your resume? It should, but with a personal touch.

5.  What can you contribute to this job?

-Tutoring my peers in speech & hearing sciences, used a lot of the same skills that will be required of an audiologist.  I looked back at my notes, flashcards, and study sheets which required organization.  I compassionately sensed deficits, and confirmed them through sensitive communication.  Then, I presented information and tips in a coherent and entertaining way, paying close attention to learning progress, attention, and remaining confusion.

-the same meticulous nature that helped me transcribe language samples of toddlers and their communication partners in the language lab will help me analyze symptoms and histories and carry out the proper diagnostic tests in order to diagnose and remediate communication issues.

-the same compassion for people that I show for animals.

Your emphasis in answering this question should be on your strengths and accomplishments, and how they might integrate with the job and the facility.

———–

What made you decide to pursue a career in [your profession]?

-I found the profession while researching potential careers.  Audiology fit me best because I can directly help people and there are many areas within the scope of practice.  Also, it did not hurt that my Dad has had hearing loss for as long as I can remember and I was motivated to give people like him a better chance.

How did you investigate a career in [your profession]?

-I was very driven to find a career path outside of veterinary medicine, because I had never entertained any other options for myself.  I made a list of things I liked about the veterinary field and those I really did not like, and sought out a profession that kept the positive traits while minimizing the more negative aspects.  

+ using my compassion to help, feeling like I am making a difference, educating, performing diagnostics, having many areas within the scope of practice.

–no upward mobility without a higher degree, people seeing pets as expendable objects that aren’t worth treating, little regulation, unrealistic work hours

What skills have you developed outside the classroom?
How have your personal and volunteer experiences strengthened your goal to enter [your profession]?

I recently observed at the local ENT and left with more enthusiasm for the profession.  I recognized a lot of the procedures and diagnostic tests from my textbooks and lectures, but became excited by the people.  For instance, I had severely underestimated the adorableness of VRA just reading about it.  Seeing a 20 month old react with such delight made me anticipate working with a real caseload.  Working with a geriatric CI-user also made me excited to work with that population.  I had already been interested in the procedures and the science, but adding the people made it that much better!

What has been your favorite non-science course and why?

I always enjoyed writing.  It is a useful skill, and there are many formats to use and gray areas.  Also, I think it’s a good skill to have.

Why do you want to become a [your profession]?
What is the greatest obstacle you have had to overcome?

I applied to veterinary programs many times, and was either rejected or could not afford to attend.  It was difficult looking beyond my childhood aspirations to find practical careers that exemplified my talents.  It also required a lot of diligence and a positive attitude not to let failure hold me back a make me bitter.  I started from square one and put my all into speech and hearing sciences.  Not only was it rewarding to achieve a 4.0 GPA, and work as a tutor to help others, I feel like this was my proper place all along–I just hadn’t known it existed.

What teamwork experiences have you had?

-camp Na-Hash-Nee, campus health fairs

What branch of [your profession] most interests you?

I’m hesitant to pick one because I do not want to limit myself before I have clinical experience.  —So far I like aural rehab, but I think that carries over into every aspect.  

-Seeing the children during my ENT observation made me entertain working with them.  But I also liked working with the geriatric CI-user.

What issues confront [your profession] today?

-I am reading a lot about insurance companies only covering one hearing aid for people with bilateral hearing loss.  At the same time I am seeing more and more research on the relationship between hearing loss and clinical depression and dementia.  I think the latter research will give more legitimacy to the audiology field and hopefully, with that appropriate funding will follow.

-Also, I read that the average person waits 7 years between the initial diagnosis of hearing loss and getting fitted with a hearing aid.  The dementia research in addition to the quick rise of technology, may help motivate people to get help sooner.

Why are you interested in this particular school?

I think it is important to gain clinical competency as early in school in possible, and I like University of Utah’s model of shadowing a 2nd year student during the 1st semester, then gaining direct hours starting the 2nd semester.  

I also read each student has clinical placements in 3 different settings prior to their 4th year externship, and I think that would be invaluable experience.  

Finally, the psychoacoustics and receptive speech research labs present unique opportunities to gain more knowledge and present possible funding opportunities that could offset tuition costs.

What have been the strengths and weaknesses of your college preparation?

-My hard-science classes such as chemistry, physics, genetics set me apart from many students and give me good background information for audiology.  

-My psychology courses combined with community service, teaching, tutoring, and veterinary experience prepares me well for human interaction across the age spectrum.

-If I had to determine a weakness it would be my undergraduate GPA.  But that number does not reflect what I learned from those courses, or my ability to succeed in a difficult program.  That GPA is actually a strength because I earned it while working at a demanding veterinary job (sometimes 3 at a time) and while participating in community service and extracurriculars.  I have shown that I am capable of earning higher grades, even while working, now that I’ve done it for years now.

What is your biggest concern about entering professional school?

Because I am not independently wealthy, I am concerned about my student loan debt accumulating to an unmanageable level.  Because finances play a big role, I am willing to do whatever it takes to secure the best package I can for myself.  That said, I came from a pre-veterinary background, where veterinarians (very competitive and saturated in small animal private practice jobs) are paid relatively low, and have the highest debt to income ratio of any professional.  Just as I wasn’t then, I am not in it now, for the money.  I am actually happy with the average salaries earned by audiologists and confident the AuD will enable me to secure a good job in a timely fashion.  

What has been your greatest achievement?

I am proud about earning 10 scholarships.  Because I am not independently wealthy, I worked very hard to apply for every scholarship I was remotely qualified for, and it paid off.  

Where do you see yourself in 10 years?

Describe an experience you had helping others.
If you are accepted to multiple schools, how will you make your decision?

I would love to pick the school that offers the best research, most varied clinical experience, and best externship opportunities, but ultimately I have to keep an eye on keeping my student loans to a minimum.

What have you read recently in the press about [your profession]?

-England’s audiology troubles:  More patients, less time/patient, and insurance covering only 1 hearing aid.

-How technology is evolving and smart-phones are being adapted to ALDs, mouth-gadgets are being produced and studied to remediate hearing issues.

-I read a study based in Australia that showed initial audiology appointments are following a paternal model, instead of a patient-centered one, despite research that shows having a voice in the decision-making process increases patient-compliance.

What do you believe in?

-Primarily I believe in ethics.  That extends from upholding my personal values, even when it is not easy, to practicing audiology in a compassionate, humanistic way.

What do you care about?
How does your sense of caring express itself?
What is your favorite type of teaching style? How do you best learn a new subject?

-I learn best through tactile or kinetic practice.  I write vocab words or statistics on flash cards to study.  I also draw pictures of mnemonics on study sheets in order to learn information.  It helps me to see how something is done, then to actually do it myself with some guidance and support, then do it in repetition individually.  

Who knows you the best in this world?
How would that person describe you, and what advice have they provided you?
Who are your heroes?
What person, past or present, would you most like to meet?
What makes you a better applicant than others?
How do you relax?
Describe your best teacher and what made her or him unique.
What was the last book you read?
Describe an experience where you were misjudged.
Who are your senators? Congressmen? Governor?
What was your most difficult or demoralizing experience?
What is the difference between sympathy and empathy?

Sympathy is having compassion for another’s situation.  Empathy is actually feeling what the other person does because you have personally experienced a similar situation–it is more extreme then sympathy.

Is there anything you want to brag about or that you need to explain?
What is the toughest thing about being a patient?

Putting your health in the hands of another, and having to trust someone else.  I think this difficulty can be combated with a lot of communication combined with compassion.  If someone feels educated about their condition, diagnostics, and procedures they feel more in control of their fate.  If they feel compassion they are more at ease. 

What type of criticism upsets you?
Why did you choose this school?
What will you do next year if you don’t get into this program?

I will continue to observe audiology and apply to more schools in the next application cycle.

Is this school your first choice?
Is there anything I haven’t asked you that you want to tell me?

————–
What you should NOT talk about at the interview:

Good conversation keeps things lively, interesting and informative. However, there are some issues and topics you should avoid during discussions about you and your job.

Your personal life
Gossip about other professionals or job candidates
Politics (professional or general) and religion
Anything you know nothing about
Negative conversational topics
What about when it’s your turn to ask the questions?

You should be prepared to ask questions, not just to impress the people with whom you meet, but to find out some very practical details about the job.

What are the specifics of my job duties, and what is expected of me?
What are the goals of the facility?
Where is this facility headed regarding managed care?
How secure and permanent are jobs?
What sort of interactions can I expect from my supervisors?
Is research done here?
Is there support for professional growth?
Are there educational benefits?
What are other benefits like health, pension, sick and holiday leave?

You Know How I Never Do Anything the Easy Way?

27 May

Well, this time maybe I’ll read the signs ahead of time and try things an easier way.  Maybe it’s not my initial plan.  Maybe it won’t be my optimal timeline.  And maybe things won’t end up as perfectly as I imagined.

Welcom to CO sunflowerBut big changes are afoot.  Since I looked into Colorado’s cost of living I’ve been in a state of shock and panic.  We are already financially behind by thousands of dollars a year out.  And I see no easy way to remedy that.  Old me would buckle down, push harder and make it happen anyway.  Because I have an ability to dedicate myself and persevere.  But then I stopped for a second and thought–what’s the rush?  There’s no reason we have to struggle around to make Colorado happen NOW.  Why not wait and do it properly?  After all, I was supposed to LOVE Seattle, but my financial situation precluded that and now I hate the thought of living there.

So without making any decisions either way Cool and I just opened our minds and broadened our search (I’m proud of us!).  We looked at the school locations, housing costs, job pay and prospects, then I looked into the AuD programs.

Breck sky

Here’s what I like about CO:  What don’t I like about it would be easier (distance from HERE and cost of housing).  I love most everything else.  It’s in the state we want to eventually live in.  I love that the AuD program has educational and clinical internships in addition to the externship.  Bears are a super-cool mascot (hey, it’s not right, but this stuff matters to me).  I have been studying this program and application process for over a year and am comfortable with it.  Again, it’s in Colorado.

 

import 6-17-10 085Seattle:  We’ve been down that road, and even though Cool (and her mom) would be in heaven (Cool thinks, she forgets about being poor and the crummy frat-house situation that necessitates) I would HATE it.  Again.

Oregon:  Very close move, but just as expensive housing as CO–so we might as well still go to CO.

parasailing 056Idaho:  Also really close move (and beautiful area and cool mascot), but despite cheap housing paultry amount of low-paying jobs.  Cool didn’t love that.  And which we knew about Idaho already.  Also a less than optimal situation where AuD students go from Pocatello 3.5 hours away to Boise after the 2nd year of school.  That’s two moves, another apartment to find, and another job to secure.  Even with the cheapest tuition of the bunch, and best grants/loans–that’s pretty rough.

CA:  expensive.  Obviously.

twisty

TX:  No.  Even though I like Austin, Cool vetoes crazy-Texas.

 

 

AZ:  Cool hates the politics and I would prefer not to be kidnapped.

 

580060-R1-24-25A_025

KS:  We looked as far east as Kansas.  And it’s a real possibility.  For a day we had decided upon it.  KS is cheap housing–AND I know the Kansas City area well.  Because it’s by the city there are a lot of jobs that pay decently.  We would have vet care (Noah’s Ark) and I could even still donate my eggs til I’m 35!!!  Drawbacks–Can you say 22.5 hour drive with cats?  Moving sucks no matter the distance, but this really started to sound sucky, and I said I would never make that drive again.  Plus, we’re over-shooting our eventual goal of CO by 8 hours.  And I would be a little sad inside to have to join my alma mater’s rival school and become *gasp* a Jayhawk.  Oh, and no WICHE deal means paying spendy out-of-state tuition.  Again.

Arches Natl Park

UT:  Utah is only a 10 hour drive from HERE.  That’s one long day or two really easy ones.  It’s also in close proximity to Colorado (4-8 hours), WY, ID, and NV (8 easy hours from my parents and storage unit).  The housing is the same or cheaper then here, and jobs were widely available and require NO commute.  Salt Lake City is maybe the only place that housing, school, AND jobs were within the same place.  The weather is similar to Nevada, and requires no 4×4, sowe wouldn’t have to worry about selling the HHR and buying a 4×4 while we’re planning everything else.  There is still the recreation of CO (well almost as good).  There is the added bonus of many professional sports teams.  Oh, and randomly I guess Salt Lake City is a gay mecca?  Not that we’re social butterflies, but it would be nice not to be murdered.  . .  I’m having a difficult time finding out much about my program, and think I’ll have to *shudder* make a phone call.  But it appears to have a class size between 5-8.  Oh and a really lame mascot–the Swoops?  To mean a falcon.  Which I wonder why they just didn’t go with falcons, because that’s much cooler than a shape.  I saw feathers on the logo and suspected P.C. rebranding, then looked into it and saw UU used to be the Utes.  Which is awesome, but only for the home school–you can’t have rival teams shouting “kill the Utes” and other such slander.  And their color is red–which I hate and I think goes back to some redskins slur.  But the mascot isn’t super-important.  Right?  That’s what I’m trying to convince myself.  I need to find out more about my specific program and the application procedure, that’s what’s important now.Roy-Utah

So I think for financial reasons I’m going to be applying to University of Utah.  Which means I have to start over in my program research, but also means we can stress out MUCH less about the move.  And you know what?  Thinking of other options and perhaps finding a better one didn’t hurt at all.  As a matter of fact, I’m more excited, because I’m not about to have a nervous breakdown about money and logistics–just that phone call. . .

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Goose Song

8 May

Cool and I are always talking to, and especially singing to our cats.  I’ve told you about our language of dropped liquids (/l/ & /r//) and how sometimes our MeowEEZE sneaks out of our apartment into our conversations with real people.  And how we don’t really care about being crazy cat ladys.  There are worse things.

Sloppy's electric throw 1

Sloppy-Joe Cool’s song (she had many, but her name-sake song) was to the tune of Beethoven’s 5th:

Sloppy Joe Cool

Sloppy Joe Cool

Sloppy Joe Cool Sloppy Joe Cool Sloppy Joe Cool

Kitty!

 

Choco-Luv’s song also features her name prominently:

Choco-Luv Choco-Luv Choco-Luv Choco-Luv

Choco-Luv Choco-Luv Choco-Luvups

Hay Hay Hay!

 

But I think Goose’s song is a real master-piece.  We are constantly calling this kitty different names, depending on what he’s doing at the time–he’s often doing funny or ornery things so in accordance his song goes:

Goose 2012He’s a goose

He’s a man

He’s a coon

He’s a Cat

He’s a turkey, he’s a lion, he’s a mongoose

He’s a big cat

He’s a fat cat

but he’s a real good buddy

+/- (‘cept when he’s not)

 

I just wanted to share how fun our lives are because of our beloved pets.  In other news, I got my Audiometry final exam grade back today.  I got 98%!!!!!!!!  So my final course grade is a 97.4% A+.  I am so proud of that because I really buckled down and worked so hard for it.  Throughout the semester, but BIG-time at the end.  I’m especially happy about it because I was afraid after losing so many points on exam 3, intimidated by the test format/grading/demeanor of the instructor, and worried about losing my overall grade and all-important GPA.  And despite the pressure, I stepped up and pulled it out.

I want to make clear that the course content was not as conceptually challenging as many classes, though there was a lot of things to cover.  Classes that have been more difficult:  Math of any type, physics, biochem, chem lab, chemistry, nutrition, animal physiology, anatomy, genetics, and speech & hearing sciences to name the most notorious in my memory.  All the same, because of the instructor, it’s been one of my most hard-fought A’s I’ve ever ever gotten (behind Physics 2 b/c math used to be my nemesis and Biochem b/c it was conceptually challenging, had TONS of material, and involved a lot of rote memorization of vocab/cycles/structures).

Even though I don’t have (much of) a job, I think I’m going to treat myself with a new pair of boots.  Boots because they go on clearance in the spring when stores are trying to clear the large inventory and they are something I can use this winter and especially in Colorado.  Now, it’s time to celebrate!

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Disgruntled Professors

2 Oct

Are the worst!

I honestly don’t know what is the matter with my entire department at Riverpoint.  I have no idea if these professors have a lot more responsibility and running around to do or if they are just turkeys.  This is the third University I Walking about-July 2012 034have attended, and I have never before encountered such belligerence to downright open hostility at meeting students.  As I’ve said before, I find it particularly strange behavior for a department whose emphasis is centered around. . .  Communication.

University of Nevada, Reno was the largest state school in a very population-sparse state whose focus was not really higher education.  So they were a smaller school–and those professors, wrote office hours on their syllabus, would make a meeting outside of the hours, and seemed to genuinely want to help students.  Especially those that took extra time to meet with them.  I never encountered as much as annoyance when trying to set up a time to talk to anyone.

The Quad 2University of Missouri-Columbia is a Big-12 college, probably the largest in the state, with more funds, and better facilities.  So a pretty big University–in a college town.  I think it was mandated that every professor had to specify office hours for each class they taught and make themselves available at those times.  Because those professors would try to entice students to come in and see them during office hours.  My chem professor was always posting on his Facebook page that he was having his office hours at the student coffee shop and stuff so please drop by.  Those professors were excited when you did come to office hours.

At Riverpoint, many of the professors won’t even put specific office hours on their syllabus.  They say, “by appointment” probably as a way not to be tied down and as discouragement for students to come see them.  Today’s professor had written hours on her syllabus, but after class when I confirmed those hours with her, she acted all sketchy like she didn’t know office hours existed.  Then, finally she said there was a sign-up on her door.  So I said, “Oh I didn’t realize your office hours were by sign-up appointment–do you already have someone for today?”  She was all covert again, and said she didn’t know, I would have to walk all the way across campus and check her door. . .  So I did.  And there were appointment slots, but most of them were for the preceding week, and the one future date was already taken.  Since I was unable to sign up, and I was already all the way over there, I sat outside her office and waited for her.  When she approached, I didn’t press for an immediate meeting, but did say there was no place to sign up so I wanted to schedule something.

My professor seemed really put-out and said we could meet now–even though it was 2:30 and she hadn’t eaten lunch yet, was really looking forward to her lunch, and by the way she was very hungry.  I told her I didn’t mind if she ate while I asked her some questions (she needed to microwave though) and I totally understood, as I attend her class AS my lunch break on Monday.  So I also miss eating half the time because of her attending her class during my lunch break from work.  She just looked annoyed and like I was a huge inconvenience to her, and this was a waste of her time.

I got out our last exam (which we did not go over at all in class) and told her I really wanted to make sure I understood everything for the future, because I want to be an audiologist.  She seemed unmoved, so I nervously rushed into my few questions.  I had, I think, 4 things I wanted further explanation on.  I did not, at any time, ask for or dispute any missed points.  Though I would have liked some for the 2 answers I do think I got right, I didn’t even broach the subject of points/grades.

So the whole thing made me feel awkward and horrible, as if I was totally a disruption to my professor’s time, and unwelcome and what a waste my questions were.  Which, as a person genuinely wanting to learn and eager to do well, (not to mention paying big money for) I would hope professors would appreciate.  But she did not.  And when I got to my last question, she was sort of short-tempered and rude.  Maybe her patience wore out at that point.  Maybe she was starving.  Maybe she didn’t have an answer so she fronted with anger instead.  Who knows.  At that point, things went (further) downhill in a hurry.  She had asked for the opposite anatomical term for “central.”  I put distal, which I thought was opposite.  Because proximal means point of origin or center and distal is the opposite of that.  So in my mind when two words are synonymous, they both have the same antonym.  She just got really crabby with me and kept saying, “I don’t understand why you just didn’t put peripheral.”  To which I was like–why doesn’t distal still work–it’s the same as peripheral and still opposite of central/proximal???  I would really like to know why that won’t work.  Like an explanation–not just “why didn’t you put the answer I say is correct?”  Anyway, she referenced the textbook and even though I think my answer is still correct (and I read and outlined the textbook) I just didn’t want to further poke the bear so to speak.

feed the bear

I said, “Thanks for your time, enjoy your lunch.”  And she was all, “I will!” as if I kept her from it for hours and hours and it was all my fault she wasn’t eating until after 2:30 PM.  So per the usual at this University, I left with adrenaline pounding, red in the face, and feeling awkward and embarrassed by the horrid way these authority figures treat me.  I seem to have a special talent for unintentionally making people belligerent.  I don’t TRY to make people pissed, but it happens a lot to me.  Anyway, I didn’t feel this behavior toward me was warranted or appropriate.  I was there during her effing office hours!  Making me feel bad about having questions is not right, and it shouldn’t happen.  I would complain–but this whole branch campus is that way so I don’t think it would do any good.  Riverpoint strikes–still. . .  Repeatedly.

 

This is Why I Won’t be Going to Grad School HERE

27 Feb

I can’t stand the mentality of any of my professors.  And because it’s ALL of them to one extent or another, I really evaluated myself, to see if I was the problem.  But this strife is recent.  And I’m pulling better grades then ever, so you would think the staff would like me MORE.  And I didn’t have a problem at Mizzou.  Most of my Animal Science profs were good ‘ol boys, which obviously I don’t really fit into their club, but they were friendly with me.  And the other departments at Mizzou had your typical liberal profs and instructors  and they were OK.  So I thought maybe the niceness was a mid-western benefit.  But no, that’s not true either–all of my UNR professors were cordial.  I wouldn’t categorize them as overly friendly, but they were helpful if you had a question.  And they seemed to care.

I can’t stand this one bitch in particular at Riverpoint.  And I’ve already had her for two semesters now.  Her tone sucks, she asks for participation, then gets snarly when you offer it, and she’s completely dismissive over e-mail.  So I thought maybe she feels like I’m questioning or challenging her.  There’s this one (flaky) girl in my class that the prof seems to genuinely like.  So I thought I should try to change my tactics from serious and earnest to light-hearted and slightly more playful.

For the most recent example.  We have to turn in chapter outlines to ensure we are reading the text.  And I always, outline the text for EVERY class, just to keep my mind focused.  But I do it in hand-writing because I’m not always reading at home, in proximity to my computer.  So for this kindergarten assignment, I am having to re-type what I’ve already outlined, just to turn it in.  That’s some background info for my e-mail–even though it’s pretty self-explanatory when you read it.  Also, this is the first time this semester (and third total) I have ever e-mailed this gal.  I tried to keep it light, and wrote:

Can we turn in hand-written outlines?

 
Here’s why you should say yes:
 
1.  Every time I read for every class, I outline the material to keep my mind focused and get down the important points.  Since I am reading wherever I happen to be at the time, these are not typed.
 
2.  After that, I make study sheets with the MOST important info, then make flashcards of definitions and lists.  I look at those walking from place to place, prior to class, while I’m getting my hair cut, etc., etc. . .
 
3.  Because I am taking the time to hunt-&-peck (not optimal, but that’s how I roll) my first outline into a format I can turn in, I no longer have the time to make the study sheets and flashcards that really help me study.  
 
So typing up an outline for turning-in purposes is actually taking away from my studying.  And the typed versions are scaled down a lot!  Thirdly, I never look at the typed version again, preferring my original, fleshed out hand-written ones.
 
So it would be helpful to me if we could turn in hand-written outlines.  You could still confirm we read, and I can have time to do my other studying tactics.  
Thanks for your consideration!
And her (probably inevitable) response:
While I appreciate your comments, this is a professional program and nothing is turned in handwritten except an in-class test.  I am not the only one to ask for typed work.  You need to turn in a typed copy and then you can have your own copy and take notes on that one in class.  That’s what several students have done and it seems to be working.
This response made me disgruntled and frustrated and worst of all made me feel icky inside, like some sort of college-impostor/loser.  And don’t get me wrong it wasn’t the no-answer I received.  When I wrote, I figured the answer would be no.  But I also figured if I didn’t even try, the answer would definitely be no.  And in the best case scenario the answer would be yes–saving me a lot of time.  And allowing me to prepare for class in the way I want/need to prepare.
It was the way the no was said.  Maybe I’m reading into based on past experiences, but I find this off-putting.  So she is saying I suck, other students are handling this just fine, and I’m not being professional.  Also, typing is not a high expectation and it will be in my future so deal.
As Cool said, this bitch could have said the no in a much nicer way.  She had many tones she could have taken, many reasons she could have used to support the typing, and a lot nicer words in which to say it.  She could have said she understands where I’m coming from, but feels the need to police the class in a consistent manner.  She could have written that not everyone was already as prepared as I am, or that type is easier for her to grade.  Whatever, but it didn’t have to attack me as a student for even asking and insinuate I’m out-of-line.
And it was all I could do not to say that in a professional program an instructor would not have to hand-hold to get the class to read.  Students would read on their own accord or pay the price come exam time.  It was also all I could do not to call her out on her (continuously) hostile and disengaging tone with me.  I really had to stop myself from poking the bear and asking if she has a problem with ME.  But I didn’t because with a person like this, it would only serve to make my life worse.
So what have I learned???  I just can never talk to this bitch in any medium.  It infuriates me every single time, and accomplishes nothing else.  I just need to jump through her hoops, ignore her shitty tones, and get my As so I can get the F out of here and go somewhere where they treat me like a person.

Oh, I Don’t Know

25 Oct

I’m not sure if I’ve just been oversensitive lately, or if this is a thing. People at school are annoyed and short-tempered, and too busy to “deal” with me. No one has said as much, but I just get the feeling.  There’s more then the following incidence, but I need to get on with studying–because I got delayed by this:

I sent the first e-mail of the semester to my adviser.  The same adviser who e-mailed me back and fourth all Spring semester and was super-friendly.  I have some serious concerns about next semester–> Sidenote:  needing to take a minimum of 6 credits to keep my undergrad loans on forbarance, being eligible to take only 2-4 of the offered courses, and of course the class I really need is offered–Monday.  The worst day possible (aside from Friday or Saturday) to miss work.  There is no way I can miss pieces of Tuesday, Thursday, Wednesday, and Monday at work.  End sidenote<–  So I e-mailed my adviser.  And she sent me a really curt and annoyed response that I need to sign up on the meeting request list on her door (which I didn’t know about and never pass by to have seen for myself).  I mean, you could type it in a friendly manner, at least.

No, and Fuck You:

Was the tone of that meeting.  Which she could have saved us both a lot of time and typed that in her e-mail.  I met with my adviser-after the afore-mentioned borderline nasty e-mail telling me no advising could be done over the internet.  Again–I shouldn’t have wasted my time.  After telling her that my job was really accommodating me by letting me cut back on my hours, and even hiring new people to cover my lost hours, so I really couldn’t ask them to do MORE.  I said Friday, Saturday, and Mondays were the busiest days of the week for the small business, so I wanted to find a creative scheduling solution to keep slowly taking my class requirements.

I asked if instead of attending Monday lectures in person, I could watch them online (we do this in anatomy all the time on Tegrity).  No.  I asked if I could take any of the classes at all that I need to get the post-bac online.  No, none of the required classes are online.  But I could take a class I don’t need via the internet.  I asked if any pre-reqs could be waved so I could take another class I need.  No.  I asked if ANY of the classes are available in the summer.  No.  Finally, my adviser told me this program does not accommodate in any way.  We are a lock-step program–and with good reason, she said.  Maybe you’ll have to quit working or find a weekend job. . .

So obviously, the school doesn’t understand me, or care about my needs.  It makes me want to yank myself right out and go to a school that DOES care.  Only I don’t have enough money to do that either.  So again, the headache of trying to get my life together continues.  Isn’t anything ever EASY?!  Or at the very least not tedious and impossible without the help of a sugar-daddy?  Damn it anyway!!!

 

Amyotrophic Lateral Sclerosis Info & Sources (Anatomy Paper) [Again and Sorry]

17 Jul

Excuse me for posting this one again.  And no pictures even–what a gyp for you!  I’m sort of at a stopping point on this paper until I go to the campus library.  And who knows when that will be.  It seems something (tiredness, weather, holidays, other fun stuff to do, running, laziness, everything) is always stopping me.  But I am determined to get it finished BEFORE the semester begins.  I want to get some legit (physical) journals in their entirety and use those.  Then, once I have those sources–the easy part–writing the facts in a cohesive order.  It’s the works-cited page that I think is the most difficult.  That, and the in-text citations.  USING the information in the paper will be easy.  So this is more for me, then you, my readers.  If you’re totally bored and tired of my Anatomy class ALS paper’s sources–you can always check out my blog archives.  There is plenty of interesting material there. . .

ALS (9,620 results) {note to self:  type out full name to get more and better results}

bilateral degeneration of the upper motor neuron in the primary motor areas also impairs further adjusted motor areas, which leads to a strong reduction of ‘swallowing related’ cortical activation. While both hemispheres are affected by the degeneration a relatively stronger activation is seen in the right hemisphere.

Source 1:  http://www.springerlink.com/content/w7fd9x9b1a2v1ew1/

-Dysphagia severity tended to be particularly influenced by dysfunction of the posterior tongue.

-early stage of dysphagia in ALS was mainly caused by oral dysfunction, and the oral phase disorders began in some cases with a decreased function of bolus transport at the anterior part of the tongue, and in other cases with a deteriorated function of holding the bolus at the posterior part of the tongue.

Source 2:  http://www.ncbi.nlm.nih.gov/pubmed/11681400

-abnormal lingual movement may result in pharyngeal residue that is aspirated after the swallow is completed and respiration is resumed. ALS patients with bulbar involvement demonstrate more severe swallowing problems (such as aspiration)

Source 3:  http://jama.jamanetwork.com/article.aspx?volume=234&issue=7&page=715

-Until a definitive treatment is found for amyotrophic lateral sclerosis, there will continue to be a need to provide symptomatic care.

Using amyotrophic lateral sclerosis as the search term:

Source 4:  http://www.ajcn.org/content/63/1/130.short

-fatal neurodegenerative disease characterized by progressive muscle atrophy and weakness.

-Although dysphagia is a universal feature of this illness, the nutritional and metabolic status of ALS patients has received little attention.  Regression analysis demonstrated progressive decreases in body fat, lean body mass, muscle power, and nitrogen balance and an increase in resting energy expenditure as death approached.

-We conclude that ALS patients have a chronically deficient intake of energy and recommended augmentation of energy intake rather than the consumption of high-protein nutritional supplements.

Source 5:  http://www.nejm.org/doi/full/10.1056/NEJM200105313442207

–  no cut & paste allowed

-good overview/history

Source 6:  http://ukpmc.ac.uk/abstract/MED/11854102

Amyotrophic lateral sclerosis (ALS) is the most common degenerative motor neuron disease in adults.

-The clinical picture consists of generalized fasciculations, progressive atrophy and weakness of the skeletal muscles, spasticity and pyramidal tract signs, dysarthria, dysphagia, and dyspnea. Pseudobulbar affect is common.

Nutritional deficiency caused by dysphagia can be relieved by a percutaneous endoscopic gastrostomy. Respiratory insufficiency can be effectively treated by non-invasive home mechanical ventilation. The terminal phase of the disease should be discussed at the latest when symptoms of dyspnea appear, in order to prevent unwarranted fears of “choking to death.” Psychological and spiritual care of patients and families are important. Collaboration with hospice institutions and completion of advance directives can be of invaluable help in the terminal phase.

Source 7:  http://www.ojrd.com/content/4/1/3/abstract

-whole abstract is good info for entire overview of DZ

Source 8:  http://www.ncbi.nlm.nih.gov/pubmed/9562665

-Amyotrophic lateral sclerosis (ALS) is a motor neuron disease with evidence of both anterior horn cell and corticospinal tract degeneration. The incidence of ALS is 1 to 2.5 cases per 100,000 population and the disease occurs primarily in adult life. The etiology of sporadic ALS remains unknown, although 5 to 10% of cases are familial. The diagnosis of ALS requires the presence of both upper and lower motor neuron findings and progressive motor dysfunction. Several theories regarding the pathogenesis of ALS have emerged including glutamate excitotoxicity, free radical oxidative stress, neurofilament accumulation, and autoimmunity. Clinical trials involving antiglutamate agents, antioxidants, immunosuppressants, and growth factors have shown no substantial benefit in slowing progression, with death usually occurring 2 to 5 years following the onset of symptoms. The management of ALS patients requires a multidisciplinary team that can provide the numerous medical and physical interventions necessary to treat weakness and fatigue, bulbar dysfunction, spasticity and pain, depression, and respiratory failure.

Source 9:  http://ukpmc.ac.uk/abstract/MED/7952238

-Therapeutic trials for amyotrophic lateral sclerosis have attracted much attention, but no drug tested has been effective yet. Three major theories of pathogenesis form the basis for these trials: autoimmunity, chronic excitotoxic stimulation due to accumulation of glutamate, and, in the familial form, peroxidation due to subnormal activity of superoxide dismutase. In striking contrast to the negative results of all of the other drug trials, riluzole (a glutamate antagonist) was said to benefit patients with bulbar onset but not those with spinal onset. Problems with the original trial may be clarified by other studies now in progress.

Source 10:  http://www.sciencedirect.com/science/article/pii/S0140673696916803

-In an initial study, riluzole decreased mortality and slowed muscle-strength deterioration in ALS patients. We have carried out a double-blind, placebo-controlled, multicentre study to confirm those findings and to assess drug efficacy at different doses.

-959 patients with clinically probable or definite ALS of less than 5 years’ duration were randomly assigned treatment with placebo or 50 mg, 100 mg, or 200 mg riluzole daily; randomisation was stratified by centre and site of disease onset (bulbar or limb).

-primary outcome was survival without a tracheostomy. Secondary outcomes were rates of change in functional measures (muscle strength, functional status, respiratory function, patient’s assessments of fasciculation, cramps, stiffness, and tiredness).

-The most common adverse reactions were asthenia, dizziness, gastrointestinal disorders, and rises in liver enzyme activities; they were commonest with the 200 mg dose

-Overall, efficacy and safety results suggest that the 100 mg dose of riluzole has the best benefit-to-risk ratio. This study confirms that riluzole is well tolerated and lengthens survival of patients with ALS.

Source 11:  http://www.sciencedirect.com/science/article/pii/S0140673610611567

-Substantial wasting of the tongue muscles in bulbar-onset ALS. Note the absence of palatal elevation present on vocalisation. Difficulty with mouth opening and dysphagia might require supplementary feeding through a percutaneous endoscopic gastrostomy. In further support of a corticomotoneuronal hypothesis, the tongue is often disproportionately affected in comparison to other oropharyngeal musculature in patients with bulbar-onset ALS. As with the thenar muscles in the hand, the tongue receives more extensive cortical input than other muscle groups in the oropharyngeal area.

-neurodegeneration in ALS might result from a complex interaction of glutamate excitoxicity, generation of free radicals, cytoplasmic protein aggregates, SOD1 enzymes, combined with mitochondrial dysfunction, and disruption of axonal transport processes through accumulation of neurofilament intracellular aggregates. Mutations in TARDBP andFUS result in formation of intracellular aggregates, which are harmful to neurons. Activation of microglia results in secretion of proinflammatory cytokines, resulting in further toxicity. Ultimately, motor neuron degeneration occurs through activation of calcium-dependent enzymatic pathways

 

Potential (Internet) Sources for Dysphagia Pathology Anatomy Paper

7 Jun

I found at least 3 reputable sources from Google Scholar and copy/pasted verbatim just to see which pathology would be easiest to research.

eosinophillic esphogitis (3,230 results)

Decreases the ability of the esophagus to stretch and accommodate mouthfuls of swallowed food probably as a result of the presence of so many eosinophils but also, perhaps as a result of some scaring that occurs in the wall of the esophagus.

source 1:  http://www.nature.com/ajg/journal/v95/n6/abs/ajg2000372a.html

-previously confused with esophageal inflammation due to gastroesophageal reflux, has recently begun to be distinguished from it.

-Presenting symptoms encompass vomiting, pain, and dysphagia (some with impactions or strictures). Allergy, particularly food allergy, is an associated finding in most patients, and many have concomitant asthma or other chronic respiratory disease.

-Differentiation from gastroesophageal reflux disease is approached by analyzing eosinophil density and response to therapeutic trials.

-Therapy encompasses dietary elimination and anti-inflammatory pharmacotherapy.

Source 2:  http://www.nature.com/modpathol/journal/v19/n1/abs/3800498a.html

-raw data

-Eosinophilic esophagitis is a disease with a predilection for young males with dysphagia and rings on endoscopy.

-Biopsies in eosinophilic esophagitis have high epithelial eosinophil counts, averaging nearly 40/hpf.

-Increased awareness of eosinophilic esophagitis is necessary, since treatment with allergen elimination or anti-inflammatory therapy may be more effective than acid suppression.

Source 3:  http://www.nejm.org/doi/full/10.1056/NEJM200408263510924

-This disease is differentiated from reflux esophagitis on the basis of the magnitude of mucosal eosinophilia and a lack of response to acid suppression.

-Approximately 71 percent were male, with a mean (±SD) age of 10.5±5.4 years. The patients presented with the typical symptoms and atopic history that have been described previously (Table 1TABLE 1Presenting Symptoms among 103 Pediatric Patients with Eosinophilic Esophagitis. and Table 2TABLE 2History of Atopy in the 103 Pediatric Patients.).1-4 However, our demographic analysis revealed a strong familial pattern

-first, a genetic predisposition and, second, a cause related to an unknown environmental exposure (e.g., infection or allergen). Both these possibilities now warrant pursuit.

schleroderma (6,550 results)

Can cause wasting of the esophageal muscle and poor contraction of the lower esophageal sphincter (LES). Often accompanied by heartburn.

Source 1:  http://ukpmc.ac.uk/abstract/MED/3491774/reload=0;jsessionid=KJfKOvTIjtnroRTv3GyC.0

-Abnormal motility characterized by loss of peristalsis in the distal esophagus was present in all patients with erosive esophagitis, including the 5 who were asymptomatic.

-The patients with erosive esophagitis also had significantly diminished lower esophageal sphincter pressures and increased frequency and duration ofgastroesophageal reflux episodes.

-The duration of disease, rate of gastric emptying, and fungal smear and culture were not significantly different in those with or without esophagitis.

Source 2:  http://www.annals.org/content/40/1/92.short

-Scleroderma is a systemic disease involving the collagenous tissues. The skin, gastrointestinal tract, and the cardiovascular, musculoskeletal, genitourinary and pulmonary systems may be involved. Dysphagia is a common complaint with esophageal involvement.

Source 3:  http://www.sciencedirect.com/science/article/pii/S0003497510639720

Source 3 (full text online):  http://ats.ctsnetjournals.org/cgi/reprint/22/2/120

-raw data

-Gastroesophageal reflux, not impaired motility, is the major cause of esophageal symptoms in scleroderma.

-The most common esophageal symptoms were heartburn and dysphagia.

ALS (9,620 results) {note to self:  type out full name to get more and better results}

bilateral degeneration of the upper motor neuron in the primary motor areas also impairs further adjusted motor areas, which leads to a strong reduction of ‘swallowing related’ cortical activation. While both hemispheres are affected by the degeneration a relatively stronger activation is seen in the right hemisphere.

Source 1:  http://www.springerlink.com/content/w7fd9x9b1a2v1ew1/

-Dysphagia severity tended to be particularly influenced by dysfunction of the posterior tongue.

-early stage of dysphagia in ALS was mainly caused by oral dysfunction, and the oral phase disorders began in some cases with a decreased function of bolus transport at the anterior part of the tongue, and in other cases with a deteriorated function of holding the bolus at the posterior part of the tongue.

Source 2:  http://www.ncbi.nlm.nih.gov/pubmed/11681400

-abnormal lingual movement may result in pharyngeal residue that is aspirated after the swallow is completed and respiration is resumed. ALS patients with bulbar involvement demonstrate more severe swallowing problems (such as aspiration)

Source 3:  http://jama.jamanetwork.com/article.aspx?volume=234&issue=7&page=715

-Until a definitive treatment is found for amyotrophic lateral sclerosis, there will continue to be a need to provide symptomatic care.

Using amyotrophic lateral sclerosis as the search term:

Source 4:  http://www.ajcn.org/content/63/1/130.short [abstract]

http://www.ajcn.org/content/63/1/130.full.pdf+html [full text]

-fatal neurodegenerative disease characterized by progressive muscle atrophy and weakness.

-Although dysphagia is a universal feature of this illness, the nutritional and metabolic status of ALS patients has received little attention.  Regression analysis demonstrated progressive decreases in body fat, lean body mass, muscle power, and nitrogen balance and an increase in resting energy expenditure as death approached.

-We conclude that ALS patients have a chronically deficient intake of energy and recommended augmentation of energy intake rather than the consumption of high-protein nutritional supplements.

Source 5:  http://www.nejm.org/doi/full/10.1056/NEJM200105313442207

–  no cut & paste allowed

-good overview/history

Source 6:  http://ukpmc.ac.uk/abstract/MED/11854102

Amyotrophic lateral sclerosis (ALS) is the most common degenerative motor neuron disease in adults.

-The clinical picture consists of generalized fasciculations, progressive atrophy and weakness of the skeletal muscles, spasticity and pyramidal tract signs, dysarthria, dysphagia, and dyspnea. Pseudobulbar affect is common.

Nutritional deficiency caused by dysphagia can be relieved by a percutaneous endoscopic gastrostomy. Respiratory insufficiency can be effectively treated by non-invasive home mechanical ventilation. The terminal phase of the disease should be discussed at the latest when symptoms of dyspnea appear, in order to prevent unwarranted fears of “choking to death.” Psychological and spiritual care of patients and families are important. Collaboration with hospice institutions and completion of advance directives can be of invaluable help in the terminal phase.

mysthenia gravis (7,320 results)

Antibodies block, alter, or destroy the receptors for acetylcholine at the neuromuscular junction which prevents the muscle contraction from occurring. Certain muscles such as those that control eye and eyelid movement, facial expression, chewing, talking, and swallowing are often, but not always, involved in the disorder.

Source 1:  http://jnnp.bmj.com/content/76/9/1297.short

-Oesophageal manometry was carried out in two patients and showed generalised weakness of peristaltic contractions which included the smooth muscle part of the oesophagus. These disturbances worsened with repeated swallows.

-They were partly reversed by intravenous edrophonium and by rest

Source 2:  http://jnnp.bmj.com/content/65/6/848.short

-In patients with myasthenia gravis with dysphagia, it was found that the time necessary for the larynx to remain in its superior position during swallowing and swallowing variability in successive swallows increased significantly compared with normal subjects and with patients with myasthenia gravis without dysphagia.

-a coordination disorder between normal CP sphincter muscle and the affected striated muscles of the laryngeal elevators may be one of the reasons for dysphagia in myasthenia gravis.

Source 3:  http://www.ncbi.nlm.nih.gov/pubmed/8017368

-Myasthenia gravis is an autoimmune disorder of the neuromuscular junction that causes muscle weakness. Involvement of oropharyngeal musculature is not uncommon, which leads to dysphagia. Timely consideration of myasthenia gravis in evaluating dysphagia is crucial to prevent complications and to improve the quality of life of these patients. We report four patients who underwent extensive investigations for dysphagia, by gastroenterologists as well as otolaryngologists, before the diagnosis of myasthenia gravis was established.

Source 4:  http://jama.jamanetwork.com/article.aspx?volume=134&issue=12&page=987

-some difficulty in swallowing being the first sign of abnormal muscular fatigue. The defect in the swallowing reflex is due to weakness of the buccopharyngeal muscles, usually with relaxation of the constrictors.

-Both the feeble power of the reflex act, as shown by the slowness of movement, and the relaxation, with dilation of the pharyngeal tube, are easily demonstrated by roentgenoscopic examination.

-The tightening of these muscles and the increased rate of swallowing, after stimulation by an appropriate amount of neostigmine (“prostigmine”) methylsulfate, was observed and recorded in cases of myasthenia gravis