Last post about funtional disorders

Functional tremor

Functional tremor is the most common type of FMD. Tremor associated with typical neurological disorders is defined as a rhythmic and oscillatory movement of a body part with a relatively constant frequency.

Functional tremor is typically a complex resting, postural, and action tremor. The only known organic tremor with such physical findings is a cerebellar outflow or midbrain tremor (ie, rubral tremor) [45]. Any body part may be involved with functional tremor, but hand tremor, leg tremor, and whole body tremor are common sites . Remarkably, the fingers are often spared with much of the upper limb tremor occurring at the wrist.

A characteristic that suggests functional tremor rather than organic tremors is abrupt onset with immediate maximal severity, often precipitated by trivial emotional or physical trauma [44]. By contrast, essential tremor typically starts bilaterally, though one side usually is affected more than the other, and gradually worsens over years to decades

With functional tremor, a classic but not universal finding is complete remission or entrainment (ie, a shift of tremor frequency to the speed of contralateral rhythmic movement) with distraction maneuvers such as repetitive tapping tasks with an uninvolved opposite hand or foot. In some patients with functional tremor, restraining the affected limb may precipitate tremor in other previously unaffected body regions. Another sign of a functional tremor is that it can be “chased.” That is, when an affected hand is restrained, the tremor may move to the arm, and when the arm is restrained, the tremor may move to the shoulder. Additionally, the affected limb may “fight” with the examiner when it is restrained.

Electrophysiologic studies may be helpful in documenting the frequency of the functional tremor and distractibility.

Life here last week boring as it is

Woke at 7am so a bit of asleep in Tim got up half an hour later and left for work at 8am.

Been a nice day, not hot nor cold, wrote 6 letters today.

Feeling stuffed up in the head.

Awake before the alarm, got up and dressed in the bathroom so not to disturb Tim, who got up when Leo went in to say goodbye before leaving for school.

At 11am Tasha came down in tears her car is catcus and she doesn’t have the money to repair it so we told her to clean it up park it out the front with a for sale sign on it and advertise it on Facebook for sale. Sell it for whatever she can get for it.

Tim said she can use our car while she looks for another car. He also said he will loan her the money for another cheap runabout.

Leo walked in at 2.20pm I was shocked I wasn’t expecting him, I had just said to mum I would need to hang up and head up to meet him . Damn I hate Mondays…………

I woke up at 5.45am and got up and dressed in the bathroom so not to disturb Tim. While in the bathroom I heard someone come in the front door, I thought it was Leo but it turned out to be Tasha. She helped me get my breakfast stuff ready and also put my socks on for me.

Tim said this morning that he is thinking again about trading in his bike sometime soon.

Someone came this afternoon and replaced the loungeroom smoke detector.

Went to wait for Leo, Tasha turned up while I was waiting and said she would wait while I came and started Blain’s pizza.

I am so exhausted I just want to sleep

I woke up at 5.45am and got up and dressed in the bathroom so not to disturb Tim. While in the bathroom I heard someone come in the front door, I thought it was Leo but it turned out to be Tasha. She helped me get my breakfast stuff ready and also put my socks on for me.

Tim said this morning that he is thinking again about trading in his bike sometime soon.

Someone came this afternoon and replaced the loungeroom smoke detector.

Went to wait for Leo, Tasha turned up while I was waiting and said she would wait while I came and started Blain’s pizza.

I am so exhausted I just want to sleep

I woke just before my alarm went off and got dressed in the bathroom again, yesterday I remembered to take my deodorant into the bathroom. I now have it in both the bathroom & my bedroom.

Not a cool day, kinda nice not warm either just nice.

Spoke to Mum she is alright sounded a little confused at times but generally ok.

Woke with the alarm, got up gathered my stuff and went to dress in the bathroom. I came out and opened the front door and turned the security camera off.

I was washing my face when I heard a knock at the door, it was Tasha she had already prepared my breakfast stuff and helped me get my socks on before she left.

Tim got up at 6.45 and left for work at 7.15am.

More internet trouble, just no service, I am connected but no service so frustrating. I ended up rebooting the computer and that fixed the problem.

Not a cold day

Woke up at 5.45 and decided to get up anyway, got dressed in the bathroom again.

Leo has an out of uniform day at school cost of a gold coin, although he still wore is school pants just took his school shirt off.

Had a melt down because I was shaking so much and wasn’t able to do anything.

Jess has asked for a Thompson’s Pies order in that I will do soon like tomorrow or Sunday.

Last day of school for term 2 two weeks off now.

Had a good nights sleep, woke at 4 for a visit to the loo, I went straight back to sleep till 5.45 laid there for half an hour when I decided to get up.

I got dressed in the bathroom again except for socks and arm brace.

Jess is working today, Leo decided to stay home alone.

Kathy came over and gave me a shower, it has been a week since my last shower.

At 1.20 when Tim rang to check on Leo he didn’t answer, so Tim drove over there to check on him. He was fine just too busy playing his Xbox. Jess said she was glad that Tim went over to check up on him.

Another week in the life of Jo-Anne

I woke when Tim got up but laid in bed till 7.15.

Kathy arrived at 8.45to give me a shower, before driving Tasha down to Coles while gone Tasha had a mini breakdown snapping at Kathy.

After Kathy left Tasha came down and broke down crying everything is getting to her. She needs a fridge,washing machine, new bed and now her car is cactus. Of course she has no money

I woke up at 5 something and got up at 5.30am,a bloody cold day at that. Jess dropped Leo off at 7.40am and he left for school at 8.10 as per usual

This afternoon I had no idea what time Leo got out I went up at 2.20 in case he was out at 1.50 but he wasn’t so I thought he might get out at 2.20 but no at 3pmi came home for a while went back at .3.35. he use to get him by 3.40 but last week and yesterday it was 3.45 before he arrived.

It was bloody cold waiting for Leo , Jess wanted him to stay tonight instead of tomorrow night but he didn’t want to do so.

I have felt stuffed up in the head all day, sitting outside in the cold didn’t help.

Jess arrived at 7.40 this morning with Leo she hung out with Tash for a while and was able to wait with Leo this morning. She even went and bought Macca’s for her and Tash. I didn’t want anything.

I reset my afternoon alarm to 3.40 to go meet Leo , today he arrived at 3.43pm so not much of a wait.

After a couple of days having trouble getting my audiobook to play I think it is now right I had to delete and reinstall a program/app.

I woke around 5.45 am could hear Leo in his room so I called him and he came in and put the heater on so the chill could be taken off the room.

Another bloody cold day here.

Man came and checked the smoke alarms he sprayed the smoke alarms with surface spray, since then it has been beeping. Ihope it stops soon. .

This afternoon I was late getting Leo again he was walking down when I was going up.

I woke at 4.30 but didn’t want to get up to visit the loo, instead I stayed in bed till 6am dozing on and off till 6am.

I thought I had a Dr’s appointment today but realised it is tomorrow and now Tasha says she can’t take me,she wants tome change the appointment but I don’t think I will be able to do that.

Tim has arranged to take tomorrow off so he can take me to my appointment.

Had problems with the internet for a few hours today very frustrating.

Tim home at 2pm

Leo here tonight

I woke at 4.30am but didn’t get up till the alarm went off,Leo was already awake and Tim got up about 45 minutes after me.

Tasha came down and helped me get dress and get my shoulder brace one and get my breakfast stuff ready.

I went to the appointment about my bladder and had the test down to see how I hold urine uncomfortable but not too bad. I will get the results when I go back to the hospital.

Tim bought two more fan heaters one for the bathroom and a spare.

He also went to the post office and the woman who served him stuffed up, he asked for 10 local stamps and 2 overseas stamps,she gave him 10 overseas stamps and he too three and attached to the local letters before he realised the mistake. I had to open those letters and I am able to reuse them for the overseas letters I have here to answer.

I am feeling very tired and frustrated this afternoon.

I woke at 4ambut managed to go back to sleep after a trip to the loo but woke again at 6am and laid there for a bit till I heard Tasha, in the laundry so I got up at 6ish.

Tasha helped me get dressed and got my breakfast stuff ready

.

Kathy came over at 9am and gave me a shower and shaved my legs for me.

Been a long ass day, Jess had work but Leo didn’t want to come here or at Kelli’s so he stayed home on his own.

Burden or not

We know we are not considered a burden by our families but sadly we often do, it is the sigh in your voice or see the roll of your eyes or just a look may come over your face. These things tell us you really don’t want to do something we have asked. So we feel we are asking too much and putting you out. Our feelings are real we can help feeling the way we are at that time

Just another night

Had a shocking nights sleep was ok till 11.30pm when I got up and went to the loo but found after I went back to bed I was unable to get back to sleep. I dozed on & off till I got up at 7.30am when Tim got up.

Kathy came over and gave me a shower and vacuumed out for me as well, Summer put my socks on for me.

Had a couple of boiled eggs for lunch.

Mum sounded a lot of happy today when we spoke, we had a good long chat.

I’m still in pain.

Ice cream for tea again that’s become a bit of a habit

Had a better nights sleep last night thankfully, woke up at 7.30am when Tim got up and h e was able to help me dress but he didn’t put my arm brace on.

Had a good chat to mum this afternoon about when her parents split up and when Enid left Tom.

Tasha h as been sick all day she feels very tired

Up and dressed with the alarm, Tim got up and left for work around the same time I got up.

Found a heap of socks in my sock basket this morning, Tasha brought them down for me, they were hers but she doesn’t like them so gave them to me.

I was late getting Leo in fact I was still at home when he walked in the door, I was surprised. I sent his driver a text apologising about not being there. He didn’t reply which I feel is rude.

I woke at 5.45am and got up before the alarm, I got dressed in the bathroom with the heater on. Tim got up at 6am for work. Jess & Leo arrived around 6ish.

Blain’s throat looks really inflamed so Tasha took him to see Dr Wabbas who sent him to have a Covid 19 test. Which he did, he said it wasn’t all that bad, they only swabbed up his nose.

He will get the results in a couple of days

Tasha is going to ring the after hours GP and see what they day.

Awake and up at 6am, Tasha came down to put the arm brace on me and she told me that the after hours GP came and said Blain has tonsillitis gave him a script.

A warmish morning but a wet and coolish afternoon, because of the rain I asked Tasha to meet Leo but of course she was late .

I am feeling like shit this afternoon

Had a good night sleep woke at 4 something when Tim was getting ready for work but managed to doze off again till the alarm went off. I got dressed in the bathroom with the heater on. Leo arrived at 7.35 an hour later then expected.

Mum told me that Michelle is going to call her daughter Skylar Alexandra

Tasha going to help me shower when she comes down to get me ready for bed.

Tim home at 2pm a short day kinda he did start at 5am.

Had a good nights sleep woke at 5 when Tim left for work to visit the loo, I then went back to bed till the alarm went off.

Found Leo laying on the floor outside the kitchen when I walked into the bathroom but when I came out he was gone,i thought he had gone back to bed but when I went to the laundry he jumped out and gave me a fright. He likes to scare his nana.

I rode the scooter down to post letters and I also took Tasha’s washing to her using the scooter.

Tim found his motorbike was leaking oil when he got to work, he took it to be repaired it could take 2 or 3 weeks to be repaired.

Tasha came down and told me that it looks like her car is cactus and she doesn’t know what to do.

I am in so much pain this afternoon.

Had a nice sleep in this morning got up at 7.20am, a nice day warmish.

Jess & Tasha have gone to check out cars, Leo stayed home mowing the lawn. He rang Papa to go over because he was lonely.

Around 2pm Papa and Leo returned here. Just as I was ringing mum, we talked about going shopping on Friday, like me she is nervous about going out after being stuck at home for 3 months.

Sent Kathy a text asking if she will come and help me shower tomorrow.

Thursday’s Words

A friend is a precious possession

whose value increases with years.

Someone who doesn’t forsake us

when a difficuilt moment appears.

and our road willl be smooth and untroubled

no matter what care life may send;

If we travel the pathway together,

and walk side by side with a friend.

BY: Henry Van Dyke

More Functional Stuff

Functional dystonia

True dystonia is defined as a movement disorder characterised by sustained or intermittent muscle contractions causing abnormal, often repetitive, movements, postures, or both. Dystonic movements are typically patterned, twisting, and may be tremulous. Dystonia is often initiated or worsened by voluntary action and associated with overflow muscle activation.

Functional dystonia may affect any part of the body or be generalised. Features that suggest a functional etiology include inconsistent dystonia movements over time, dystonia presenting as a fixed posture or a paroxysmal disorder (not due to a known paroxysmal movement disorder), the presence of incongruous dystonic movements and postures (eg, facial grimacing with pulling of the mouth to one side), excessive slowness, marked resistance to passive movements, and multiple somatizations.

While not necessarily pathognomonic, additional features suggesting functional dystonia include fixed foot dystonia in an adult, the presence of other atypical movements or postures such as a bizarre gait (not fitting the gait pattern of other movement disorders, including true dystonia), dystonia occurring when the affected body part is at rest, and pain as a prominent aspect.

Muscle atrophy or joint contractures may be present in longstanding functional dystonia due to disuse or prolonged maintenance of the tonic posture. Muscle hypertrophy may be present due to sustained contracture. Since true dystonia historically has been misdiagnosed as functional dystonia, the examiner should be aware of this diagnostic pitfall.