WEBVTT

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[sil.]

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[music] He uh, was twice the
human being that I was.

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That is when we grew up like, I was the
older brother. I was a little rowdy,

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didn\'t do homework, stuff like that. Uh,
I had good friends. I wasn\'t a bad kid

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but my brother was he
was me plus two of me.

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On the corner away from the
house was an old lady who was

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I think beginning to be senile.
She spoke to me I thought,

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it\'s like the outer limits. Uh, the, the name
of the game was stay on your side of town don\'t

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go were the rich people are. But
um, somehow I got all upset

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and uh, I went Rancocas Valley. And
you what? I was in Rancocas Valley

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Hospital. Huh. They have good OT there.

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I knitted a rug that said, love. The
mental illness came as a horrific

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shock, horrific shock because there were no

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indications ahead of time.

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[music] Schizophrenia is probably the most

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severe uh, mental, so
called mental disorder.

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Uh, which is known for many, many
years but has been coined, the term

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has been called schizophrenia
for about uh, the beginning

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of this century. And it is
a disorder that develops

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most time without any
notion that something like

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that might happen to a healthy person.
Bill is a patient who has been ill

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at least 20 years or so.
He became ill um, in late

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adolescents which is, is very, very typical. He was a college
student at the time. He had done well in high school

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um, academically he was thought to
be certainly well above average.

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And became ill um, in college
and has never really recovered

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since. I\'ve been in 7 different hospitals.
They say that\'s a symptom of Paul, uh,

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Saint Paul was uh, sometimes confined.

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I think I read that. But I
would prefer to be just me.

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I don\'t want to suffer like that.
One must think about the effect

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that the behavior of
individuals with schizophrenia

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is a burden to dysfunctional
or different, abnormal,

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not in one specific way
but in many, many ways.

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So, that what you have is sort
of an ocean or a storm of

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disruptive activity. If an
individual is in turmoil, who can

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not think and solve problems the way
he or she wants to. With bombarded

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with various stimulation and
concerns about their safety,

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the safety of their loved ones. Who
feels in many ways that they have

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no control over anything that happens around
them. Well it sounded like it was a raccoon

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in me or either a mice. At one
time it started off it felt

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like a mice it was small. I\'m serious, it
really felt like something was in my stomach.

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And then it um, it went,
I went to the doctors,

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and went to emergencies part of the
hospital got myself seen. And they told me

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just go home and eat. There\'s nothing wrong with you.
Then I went home and ate, it felt like it got bigger,

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it, you know, as the days went on
it got bigger. And then all of

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a sudden it just went away.

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[music] This can be looked at, as

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far as what happens to the brain of an individual
with schizophrenia. Can be looked at from

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various levels. When one looks at the
relationship between brain and behavior,

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we\'re talking about the relationship
between the structure of the brain

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and behavior. We call the
structure of the brain anatomy.

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And we can also look between the
relationship of the function of the brain,

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the physiology. The rate in
which various chemicals work in

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the brain. The rate in which blood
flow, flows in the brain and behavior.

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We know that it is not going
to be a very simple component

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of brain structure or brain function.
That is going to explain

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all of this richness and extensively

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abnormal behavior. I\'m hearing voices
all the time, night and day until I

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go to bed. They tell you won\'t you go to
bed. They get smart and nasty, you know.

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And then they, they, they threaten you.
Then they do it. They mess you up.

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I\'m in danger. So, right now you\'re hearing people
talking. That\'s right. I\'m hearing\' people.

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What are they saying? They um,
saying you stupid. They um, saying

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they should put a mice uh, in
my stomach and stuff like that.

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If you know somebody with schizophrenia,
respect this person as an individual.

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There\'s no reason to be scared of
people like that. Many times I am aware

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of the media, explains, may try to explain

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a crime or irrational
behavior by saying this

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is a mental patient with schizophrenia. People
with schizophrenia are not more violent

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in fact they are less than the majority
of the population. They are scared of us.

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They\'re scared of society and do
not feel that society is accepting

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of them. I have toothbrush and toothpaste,
that\'s about all I own. So, I brush

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my teeth and I said, it was my cousin
who had been kind of like a sister.

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I brush my teeth for her I said,
somehow I can create a miracle.

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But of course that was just a sick
person\'s thoughts there probably.

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I feel that it\'s worse than cancer.
With cancer

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a person gets it there\'s a uh, logical thing
and there\'s a termination. With mental

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illness what happens is it\'s uh, like uh,

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you take a person and all their, a lot of
their thoughts, motivations, and values.

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It\'s kind of like uh, you take an
egg beater put in inside their head

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at least with my brother,
and it scrambles things.

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And uh, once the eggs are scrambled
it\'s, it\'s really tough to uh,

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to look for the parts that where. You
know, I still love him very much,

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he\'s my brother and I always will.

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[sil.] I think the most horrible
thing about being depressed

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is feeling you\'re totally
alone with a mood that is

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never going to go away.
That time is dragging,

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that you are always going
to be this way, and no one,

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in your normal group of
friends or family could

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convince you that the depression was
going to be finite. People at first

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don\'t recognize it. They may be waking up a
little earlier, they may not be as hungry

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or maybe too hungry or their
interest in sex disappears.

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Or they find that they just don\'t have the usual
energy they had. They don\'t have the motivation

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to pick up the telephone and call a friend. In
fact, what happens is that when friends call

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they rather they didn\'t. You don\'t
want to have contact with anybody.

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You want to be by yourself, at least I do.
Um, I don\'t

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want to talk to people. If someone calls me on the
phone I don\'t want, I don\'t want take it. I don\'t

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want take the call. Um,

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you just feel sort of like a non-person.

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It\'s uh, very debilitating uh, illness.

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Where most of one\'s daily routines are
lost. Many are just the opposite,

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it\'s uh, an extraordinary um,
amount of energy available to

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the individual. In fact, early on
uh, manic people are funny and

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they are uh, socially uh, intrusive.

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Mania is a whole lot more fun
than depression until it gets

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away from you. Uh, there\'s a
certain point in mania that

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you are full of ideas and you\'re very
productive and you\'re witty and you\'re bright.

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And you\'re on stage and you\'re the
life of the party and that\'s fun.

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Beyond that you lose touch with reality and

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that can be kind of scary. What happens
next is the energy begins to continue

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and accelerate and the spe-, speech
and the thinking accelerates.

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Other drives accelerate, becomes sexually
preoccupied very often inappropriately.

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And soon what seemed to be
a wonderful person becomes

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an intrusive person. I tend not to think
about what time it is when I call people.

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I remember calling a friend one
morning at 6:00 o\'clock and

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saying, I just read this wonderful passage. Oh, it\'s
wonderful. Let me interpret it for you. Let me read

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it to you right now. Let me, let me.
And she was like, uh, are

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you okay. That\'s the time when
people then call upon the manic to

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get some help or indeed very often these
individuals are taken involuntary

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to hospital. And they become
sort of disorganized.

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[sil.] Self-blame can play

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a large role in depression. Uh, part of that comes
from inside you. Where you say I brought this

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on myself. It\'s something I did.
I am an unworthy individual.

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And part of that bl-,
self-blame comes from what

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society on the outside can impose upon you.

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The illness of manic
depressive disease as it

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progresses um, tends to get worse.
Without treatment

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the periods of mania and depression get closer
and closer together and they get longer

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and longer. So that before modern
treatments were available an

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individual who had, had the illness for 20 or 30
years probably would be continuous in hospital

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and continuously ill. That\'s not true
today. Lithium has revolutionized the

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treatment of manic depressive disease.
And even those who do not respond

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to Lithium alone there many other
treatments that can help them.

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The hardest thing for me about manic
depressive illness has been to accept

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that I have it. To accept that it\'s going

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to be with me for the rest of my life.
We can find out about these illnesses.

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We can determine what it is that
actually goes wrong. What is programmed

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incorrectly and people who have the
vulnerability. How we can change the nature

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of the uh, chemistry through
specific medications.

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Even better than those that we have
now and we have some very good ones.

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I just feel a lot needs to be done to um,

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make people aware that mental illness is a

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tough problem, made tougher by people\'s

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lack of knowledge, and
lack of interest and fear.

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And that um, one

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of the reasons for the fear is I
think that, that people have a sense

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that there\'s a very fine
line between what is sane,

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and acceptable, and what is over the edge.
And they realize somewhere

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in there, in the deep part
of their heart and mind that

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they have sometimes come
very close to that line.

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Or that they have actually
crossed it and come back.

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[sil.]

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Not only did I get hooked on cocaine
immediately, I\'d say the second day,

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the second. The first day I used it, the second I went
out and got it but it was a continually haunting feeling

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that I kept wanting it and wanting
it and wanting it day after day,

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year after year.

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In some ways it shouldn\'t
be surprising to us

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that drugs can be so
compelling because really

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from what we\'ve been able to learn from research
is that they are activating the very same systems

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in the brain that helps us experience
our normal pleasures in food, and sex,

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and relationships. The things
that normally make us feel good.

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[music]

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I always thought that I had it under control. You
go out, I go out on my taxi cab, I\'d make money,

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I\'d spend my money. I wouldn\'t care
about paying the rent on the taxi

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or paying my electric bills or
paying my rent. My rent was

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months and months behind. I think
the hallmark feature of addictive

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disorders is regardless of the
substance that you\'re talking about.

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So, there\'s a narrowing of the person\'s
focus, of their behavior. So that

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they do less and less of what they
usually would do and more and more

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of their thoughts and their behavior
are directed toward getting the drug,

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using the drug, getting over the effects of the drug,
thinking about the drug. Thinking about ways of getting

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the drug. You\'re looking
for quick happiness.

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And at night you lay in bed you think, well, this will bring me happiness
and this will bring me happiness. But everything that brings happiness

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would be something I\'d have to work at.
That I couldn\'t get any immediate

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rewards. We\'re wired to pursue
things that are pleasurable.

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These drugs activate our pleasure reward systems
in a very efficient way, much more efficiently

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then many of our natural pleasures and
rewards. And can begin to supplant them.

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And that\'s where the trouble begins.
Every time I used cocaine

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it wasn\'t the perfect shot.
It wasn\'t the ultimate

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thing that you were after and that\'s one reason
why you kept doing it because you kept trying

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to achieve the, the perfect high, which
was. The perfect high descriptively is,

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is the death shot. Is very close
where you almost die and that\'s like

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quite a rush.

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[music] The brain after having
experienced a huge infusion

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of this chemical substance that now
activates these systems in a big way,

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and a bigger way then all our natural rewards.
Says uh, whatever you did to get that

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feeling do that again. The, the sensation
or rush that I get in having sex

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during orgasm is the same exact feeling
that I get while I\'m injecting

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the drug into my body. As a
result of having had this

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experience, things that signal
the availability of that drug

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come to be able to do profound things to the person
which we\'ll call craving. The person when they see

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something that says drug is coming
can begin to feel a profound desire

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to repeat that experience.
The ironic thing is,

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is that before I would use, I\'d feel

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like I was using. I\'d be driving up,

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I\'d be getting sweaty palms, my
heart would pound, I\'d be rushing.

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I\'d get higher and higher and higher
the closer I got to getting the drugs.

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As I was getting the drugs
I was almost, I was high.

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This cravings state is an important one to
understand because it\'s a hallmark feature of

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addictive disorders. It\'s not the
only reason a person might use,

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it might not be the only reason that a person
would relapse. But it should help us understand

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that this disorder has very
important biological roots.

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[music] Craving is the reason why

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you continually go back and use drugs.
There isn\'t a moment in my

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life that it\'s not telling me

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that it\'s all right to go and use.
I think another thing

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that is important to recognize is about these addictive
disorders is that what we\'re seeing there and the more

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extreme form is something that we all
are experienced in our daily lives.

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We all experience craving states even
if we\'re not pursuing cocaine. Um,

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we have you know, a very successful
industries for legal drugs in our country

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that people pursue in a regular basis. And other
things that people do compulsively as well.

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For which they have strong craving, whether it\'s
pursuit of gambling or sexual compulsions or food.

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The near chemistry of those states,
those desired states may be similar.

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[music]

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I guess one of the things to understand about
addictive disorders is that they tend to be

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chronic and that there\'s this potential for
relapse. And that for friends and family

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of patients who have a relapse
rather than framing that as,

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Oh my gosh, this is the end.
Very often that\'s the

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beginning. I can tell you that this,
you start off, you don\'t look

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at the first year. You start
off with the first second

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and then you make it the
first five minutes.

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And then you deal with it 10 minutes
at a time. And just every thought

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that you have, every
breath you take, you just

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keep yourself in check and practice the

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tools that you have. You
totally rethink your thoughts.

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Because for two and a half years I\'m
surprised that it\'s still there.

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And I don\'t know why it\'s still there.
But I know I don\'t want to use.

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[music] You panic and, and the more you panic the
more you feel like you\'re going to have a seizure.

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All of a sudden, I mean it\'s so quick I can\'t control
it. There\'s no way. I can control it. I\'m just sitting

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there and all of sudden I\'ll just blank out. Before
I know it I\'ll wake up and I\'m in the nurses office

00:19:50.000 --> 00:19:54.999
or I\'m sitting on the floor in the kitchen or
something. And I\'ll be like, yeah, that\'s right I had a

00:19:55.000 --> 00:19:59.999
seizure. A good way of thinking about
a seizure is picturing somebody at,

00:20:00.000 --> 00:20:04.999
at a baseball diamond with a baseball
bat hitting a single ball out.

00:20:05.000 --> 00:20:09.999
Uh, one ball is sending a single message.
If you had 10 people up there

00:20:10.000 --> 00:20:14.999
uh, the way the normal brain would work is that
each one would hit in turn maybe two or three

00:20:15.000 --> 00:20:19.999
would hit it at the same time and the ball would go out but
they would go different distances and there\'s randomness there.

00:20:20.000 --> 00:20:24.999
It, in epilepsy during a seizure
what you have is those 10

00:20:25.000 --> 00:20:29.999
batters swinging their bats and all 10
balls are hit at the same time to the

00:20:30.000 --> 00:20:34.999
same spot. While I\'m having a seizure it\'s
just a very panicking feeling. You feel,

00:20:35.000 --> 00:20:39.999
you feel, you\'re feel like you\'re claustrophobic or something like
you\'re closed in and you don\'t know, you don\'t know what to do.

00:20:40.000 --> 00:20:44.999
And that\'s why you want to walk around because as much as I walk
around I feel like I have a lot of space and that\'s why I really don\'t

00:20:45.000 --> 00:20:49.999
want to talk to anybody because I want to
just concentrate on the seizure and make

00:20:50.000 --> 00:20:54.999
it go away. Most people with
epilepsy can take medication

00:20:55.000 --> 00:20:59.999
and have their seizures completely controlled.
That happens about 80% of the time.

00:21:00.000 --> 00:21:04.999
A small percentage of people have seizures that
are not completely controlled by medicine.

00:21:05.000 --> 00:21:09.999
That provides a reason for them to look for other methods
of treatment. Surgery is another way of treating

00:21:10.000 --> 00:21:14.999
people who don\'t respond to medicine.
We had her to a number of doctors.

00:21:15.000 --> 00:21:19.999
Uh, our experience was that
the doctors uh, uh, early on

00:21:20.000 --> 00:21:24.999
where very interested in treating Melanie but
didn\'t seem to be particularly receptive

00:21:25.000 --> 00:21:29.999
to our concerns for her as a normal child.
Uh, they would uh,

00:21:30.000 --> 00:21:34.999
prescribe medication and lots of it. Uh,
we were not happy about that at all.

00:21:35.000 --> 00:21:39.999
Subsequently we came to uh, uh, to the current
doctor. Doctor Sperling, had told me that there was

00:21:40.000 --> 00:21:44.999
no chance of getting better. He had
told me, you know, you have like 0%

00:21:45.000 --> 00:21:49.999
of being on medication and have it control your
seizures. So, that, that right there had told me

00:21:50.000 --> 00:21:54.999
well basically I\'m just going to find more information
about this surgery. What it\'s going to do my memory,

00:21:55.000 --> 00:21:59.999
stuff like that. I had really worried
about and see if it will work out for me.

00:22:00.000 --> 00:22:04.999
We then did a series of test, seeing if we could find out where
her seizures came from. And if can identify the spot in the brain

00:22:05.000 --> 00:22:09.999
that triggers the seizures we can then
remove that spot. And most of the time stop

00:22:10.000 --> 00:22:14.999
the seizures. In Bob\'s case we have EEG

00:22:15.000 --> 00:22:19.999
recorded from the depth of the brain with electrodes
placed within the substance of the brain itself as well

00:22:20.000 --> 00:22:24.999
as electrodes placed on the surface of the brain. There
was an abnormal electrical discharge in the brain

00:22:25.000 --> 00:22:29.999
that began in one area. In his
case the right temporal lobe.

00:22:30.000 --> 00:22:34.999
And this electrical discharge spread rather quickly to
involve other regions of the brain as the frontal lobes

00:22:35.000 --> 00:22:39.999
and some of their connections become involved
in this seizure then we begin to see posturing

00:22:40.000 --> 00:22:44.999
where the hands came up in that praying
position. The head and eyes turning

00:22:45.000 --> 00:22:49.999
to the right and, and as different structures of the
brain are involved we see different manifestations

00:22:50.000 --> 00:22:54.999
of the seizure. Bob, can you tell me
your last name. As both sides of the

00:22:55.000 --> 00:22:59.999
brain come involved in the seizure his
ability to interact with his environment,

00:23:00.000 --> 00:23:04.999
to answer questions, to follow commands, and
to know what\'s going on about him is lost.

00:23:05.000 --> 00:23:09.999
Bob, do you know where you are.

00:23:10.000 --> 00:23:14.999
I, I, might. I, I was just, just

00:23:15.000 --> 00:23:19.999
in here. I. That mumbling
uh, is an indication

00:23:20.000 --> 00:23:24.999
that the seizure has ended. At this point
he\'s confused immediately after the seizure.

00:23:25.000 --> 00:23:29.999
This is known as a postictal state, post meaning
after, ictal for ictus, which is Latin for seizure.

00:23:30.000 --> 00:23:34.999
And very typically people are confused after
seizures. And he really can\'t follow commands

00:23:35.000 --> 00:23:39.999
or understand questions properly.

00:23:40.000 --> 00:23:44.999
[music]

00:23:45.000 --> 00:23:49.999
I had uh, two or three accidents.
Last accident really did me in.

00:23:50.000 --> 00:23:54.999
It\'s when I hit my head in the windshield and I hit
it uh, a big oak tree in the front. My car hit,

00:23:55.000 --> 00:23:59.999
right. I\'ve been through a lot.
And to hear about surgery

00:24:00.000 --> 00:24:04.999
really it\'s going to make me feel
a lot better. When making the

00:24:05.000 --> 00:24:09.999
decision to do epilepsy surgery you want to try to
find an area of the brain that contains a scar.

00:24:10.000 --> 00:24:14.999
The basic idea is that
the scar is triggering

00:24:15.000 --> 00:24:19.999
the seizures. And since that area of the brain is
scarred it\'s not doing anything terrible useful.

00:24:20.000 --> 00:24:24.999
So, you can safely remove it. Uh, it looks like all
of your seizures seem to come from the right temporal

00:24:25.000 --> 00:24:29.999
lobe. Right about there. And uh,

00:24:30.000 --> 00:24:34.999
we\'ll be able to bring you back and offer
you the surgery that we talked about.

00:24:35.000 --> 00:24:43.000
[music] I had the seizures for 19
years and now I have this surgery

00:24:45.000 --> 00:24:49.999
and it\'s like all of a sudden it\'s like I don\'t have to
worry about anything. It\'s like somebody threw a switch.

00:24:50.000 --> 00:24:54.999
Melanie is really a very different personality
now. Uh, before she was uh, insecure

00:24:55.000 --> 00:24:59.999
and not sure of herself. The difference now is that now
although she is the same person she\'s much more outgoing,

00:25:00.000 --> 00:25:04.999
much more confident. It\'s a delight having her
around. Melanie was in the hospital for about

00:25:05.000 --> 00:25:09.999
a week for her surgery. People usually
go home five or six days after surgery

00:25:10.000 --> 00:25:14.999
and in fact she was up and walking around the next day. As
serious as brain surgery sounds it\'s amazing how quickly

00:25:15.000 --> 00:25:19.999
people bounce back from it particularly young, young
people like Melanie. Uh, Melanie has been very fortunate

00:25:20.000 --> 00:25:24.999
in it that surgery has been a big success.
She\'s not had any seizures since the surgery.

00:25:25.000 --> 00:25:29.999
Uh, she continues to take her medicine of
course. I\'m more happy, more cheerful.

00:25:30.000 --> 00:25:34.999
I\'m just constantly skipping around. I\'ll turn the radio
on and I\'m just popping my head, dancing constantly

00:25:35.000 --> 00:25:39.999
or something.

00:25:40.000 --> 00:25:44.999
[music] It\'s very frustrating.

00:25:45.000 --> 00:25:49.999
It\'s frustrating and you get angry.

00:25:50.000 --> 00:25:54.999
You\'re just angry that it happened to

00:25:55.000 --> 00:25:59.999
you. I was devastated, my kids
were devastated at that point.

00:26:00.000 --> 00:26:04.999
I felt like I feel into a chasm,

00:26:05.000 --> 00:26:09.999
you know. And I thought, I thought
she died but she wasn\'t dead.

00:26:10.000 --> 00:26:14.999
[music]

00:26:15.000 --> 00:26:19.999
A stroke is the sudden loss of blood supply
to an area of the brain caused either by

00:26:20.000 --> 00:26:24.999
blockage in the blood vessel because of
a clot or a rupturing of a blood vessel

00:26:25.000 --> 00:26:29.999
with a hemorrhage.

00:26:30.000 --> 00:26:34.999
We had a wonderful day Sunday, we played a
little cards, we went to bed Sunday night.

00:26:35.000 --> 00:26:39.999
About 1:30 in the morning for some
reason I couldn\'t sleep very well

00:26:40.000 --> 00:26:44.999
and my wife nudged me. And she says,
Honey I\'m cold on my one side.

00:26:45.000 --> 00:26:49.999
Well, when I realized I couldn\'t move
my arm, I just went into a panic.

00:26:50.000 --> 00:26:54.999
Right then and there I knew she had
a stroke. Her mouth was drawn down,

00:26:55.000 --> 00:26:59.999
no pain. So, immediately I
called the doctor and an

00:27:00.000 --> 00:27:04.999
ambulance. Of course, all the doctors are coming
in and working on you and taking your vital signs.

00:27:05.000 --> 00:27:09.999
And somebody\'s always there right with you, you know.
So, you don\'t really have time to really think,

00:27:10.000 --> 00:27:14.999
you know, much right away.

00:27:15.000 --> 00:27:19.999
Then afterwards you have plenty of time to
think. When the people leave you\'re just there

00:27:20.000 --> 00:27:24.999
thinking.

00:27:25.000 --> 00:27:33.000
[music] In Elizabeth\'s case the
stroke affected the right side of the

00:27:35.000 --> 00:27:39.999
brain both motor and sensory
portions of the brain.

00:27:40.000 --> 00:27:44.999
Both a little to the front and a little
to the back. So, that she lost dexterity

00:27:45.000 --> 00:27:49.999
and power in her left hand,
primarily dexterity.

00:27:50.000 --> 00:27:54.999
When I came here I had to really
get started on level one therapy.

00:27:55.000 --> 00:27:59.999
There\'s different levels of therapy
that they put me on. So, I uh,

00:28:00.000 --> 00:28:04.999
I did real well then once, I didn\'t do
well here either at first because I

00:28:05.000 --> 00:28:09.999
was still down.

00:28:10.000 --> 00:28:14.999
There are a number of different

00:28:15.000 --> 00:28:19.999
frustrations and problems that occur in the
process of rehabilitation from stroke.

00:28:20.000 --> 00:28:24.999
Those include all the frustrations that anyone
who has taken for granted a number of physical

00:28:25.000 --> 00:28:29.999
functions you would experience if all
of a sudden those things were absent.

00:28:30.000 --> 00:28:34.999
It\'s clear a loss of part of one\'s self. And
the way one identifies one\'s self is in

00:28:35.000 --> 00:28:39.999
terms of one\'s abilities
and one\'s function.

00:28:40.000 --> 00:28:48.000
[music] Emotional liability
is frequently seen in

00:28:50.000 --> 00:28:54.999
patients with stroke. The right side
of the brain, the part of the brain

00:28:55.000 --> 00:28:59.999
that was damaged in Elizabeth\'s
case also controls

00:29:00.000 --> 00:29:04.999
the emotional tone of one\'s voice.

00:29:05.000 --> 00:29:09.999
I found a lot about
strokes, after I had mine.

00:29:10.000 --> 00:29:14.999
And this is normal too, crying.
Some people laugh

00:29:15.000 --> 00:29:19.999
and some people cry

00:29:20.000 --> 00:29:24.999
for a while you get over
it as you get stronger.

00:29:25.000 --> 00:29:29.999
I just figure it was a twist of fate. Life
dealt her kind of a bad hand at the moment.

00:29:30.000 --> 00:29:34.999
And I said to myself, I
can\'t think about what

00:29:35.000 --> 00:29:39.999
happened that\'s over. So, my
first thought was to go forward.

00:29:40.000 --> 00:29:44.999
All right. Big step with your right.
Excellent. Up nice and tall.

00:29:45.000 --> 00:29:49.999
Now stiffen that up. At a girl.
Big step. Walk up. Left leg.

00:29:50.000 --> 00:29:54.999
Up nice and tall on that left leg.
Up. Big step with the right.

00:29:55.000 --> 00:29:59.999
There you go. Much better than before. That\'s more like it. You
used to stiffen that leg like up like that. You\'ll get it.

00:30:00.000 --> 00:30:04.999
[music] Like many other patients

00:30:05.000 --> 00:30:09.999
with stroke there\'s an early recovery phase
when brain swelling that accompanies uh,

00:30:10.000 --> 00:30:14.999
a area of damaged subsides.

00:30:15.000 --> 00:30:19.999
She\'s shown tremendous ability to
compensate and to use the remaining

00:30:20.000 --> 00:30:24.999
uh, functional aspects of her, of her brain and
body. She has tremendous support from her husband

00:30:25.000 --> 00:30:29.999
and family support. And, and
rehabilitation is critical

00:30:30.000 --> 00:30:34.999
because patient\'s feel isolated. They have
difficulty getting back into mainstream

00:30:35.000 --> 00:30:39.999
without good support from the family.

00:30:40.000 --> 00:30:44.999
We really can do everything
we did before. We can.

00:30:45.000 --> 00:30:49.999
I mean, I can take her to the beach and
she loves to get a Sunday every Saturday.

00:30:50.000 --> 00:30:54.999
Sunday on Saturday. So, when she comes home Friday
I\'m taking her right out and getting her a Sunday.

00:30:55.000 --> 00:30:59.999
We can really do everything. Only thing
she can\'t do is dunk a basketball.

00:31:00.000 --> 00:31:04.999
That\'s about it.

00:31:05.000 --> 00:31:09.999
[sil.]

00:31:10.000 --> 00:31:14.999
I uh, sometimes think my whole
life just got yanked away and out

00:31:15.000 --> 00:31:19.999
from under me. And a big empty
space got shoved back in there.

00:31:20.000 --> 00:31:24.999
And I have to figure out what,
what I\'m going to do with it all.

00:31:25.000 --> 00:31:29.999
There are times that I think he really wishes
that I would of taken him off the respirator.

00:31:30.000 --> 00:31:34.999
I mean, he has said it not
in so many words but,

00:31:35.000 --> 00:31:39.999
but he makes comments to why am I
still alive, I\'m only half a man.

00:31:40.000 --> 00:31:44.999
Well, Ed, uh, had a very severe head injury.
He was driving down one of the secondary

00:31:45.000 --> 00:31:49.999
highways uh, when I believe some
equipment fell off of a truck and

00:31:50.000 --> 00:31:54.999
struck his car. Ed uh, was thrust
forward, I think pushed uh, at

00:31:55.000 --> 00:31:59.999
the windshield or through the windshield
and was immediately unconscious.

00:32:00.000 --> 00:32:08.000
[music]

00:32:15.000 --> 00:32:19.999
Uh, when I woke up my wife
had, had me uh, transferred to

00:32:20.000 --> 00:32:24.999
Bryn Mawr Rehab Hospital.
And I didn\'t recognize her.

00:32:25.000 --> 00:32:29.999
My brother Steve stopped in to see me,
didn\'t recognize him and didn\'t recognize

00:32:30.000 --> 00:32:34.999
my own mother and father, so.
Talk about having to start

00:32:35.000 --> 00:32:39.999
all over again from ground
zero and that was me.

00:32:40.000 --> 00:32:44.999
Life was pretty normal. Um, Ed
was going for his doctorate,

00:32:45.000 --> 00:32:49.999
I was working overtime, many, many hours
to get him through Temple University.

00:32:50.000 --> 00:32:54.999
And um, the accident happened.

00:32:55.000 --> 00:32:59.999
And all of a sudden I was thrown into uh,
something called closed head injury trauma.

00:33:00.000 --> 00:33:04.999
The skull itself uh, has some
smooth surfaces and then some

00:33:05.000 --> 00:33:09.999
rough surfaces. You know, sharp areas.
When there is force, when the brain is

00:33:10.000 --> 00:33:14.999
moving within the skull and pushed against
these sharp ridges in the skull uh,

00:33:15.000 --> 00:33:19.999
we can get bruising. Something called
contusions. In the frontal lobes especially,

00:33:20.000 --> 00:33:24.999
in the front part of the brain and then the temporal
lobes. Which would be on the side uh, lower down.

00:33:25.000 --> 00:33:29.999
Now these areas of the brain are particularly
important for higher forms of thinking,

00:33:30.000 --> 00:33:34.999
memory, concentration,
judgment, and, and insight uh,

00:33:35.000 --> 00:33:39.999
creativity. The uh, Ed before
the accident was uh, 98%

00:33:40.000 --> 00:33:44.999
immersed in advanced mathematics.
Uh, I was teaching it. I was almost

00:33:45.000 --> 00:33:49.999
living it. I mean that uh, everything that
was in those books and in my head just

00:33:50.000 --> 00:33:54.999
took a vacation. The hardest
part was knowing that Ed

00:33:55.000 --> 00:33:59.999
would never have his memory back. Um,

00:34:00.000 --> 00:34:04.999
it\'s just, it, it\'s a tough
time I now, I live for memories

00:34:05.000 --> 00:34:09.999
but I think a lot of people do.
And Ed didn\'t know me,

00:34:10.000 --> 00:34:14.999
he didn\'t know that we were married.
Um, he didn\'t

00:34:15.000 --> 00:34:19.999
know anything about our
home, our the last 8 years.

00:34:20.000 --> 00:34:24.999
It was tough on my wife, I mean.
She got a call from the uh

00:34:25.000 --> 00:34:29.999
, State Police saying that uh,
I was in critical condition

00:34:30.000 --> 00:34:34.999
at uh, at Jeff. And uh, she

00:34:35.000 --> 00:34:39.999
was all worried for those thirty days \'cause
nobody knew if I was going to live or die,

00:34:40.000 --> 00:34:44.999
or anything. And then, it\'s been uh,
for me it\'s been tough but for her

00:34:45.000 --> 00:34:49.999
it\'s been uh, like a real nightmare. It
was very difficult but I had to become

00:34:50.000 --> 00:34:54.999
his eyes and his hears. And I had to be
able to speak for him because he couldn\'t.

00:34:55.000 --> 00:34:59.999
And I had a lot of decisions to make.
Especially when he was on the respirator.

00:35:00.000 --> 00:35:08.000
[music] Well in head injury

00:35:15.000 --> 00:35:19.999
because of all the uh,
difficulties with thinking and

00:35:20.000 --> 00:35:24.999
the changes in personality that occur. Um,

00:35:25.000 --> 00:35:29.999
it\'s the, the person\'s disintegrated
and, and they no longer react, interact,

00:35:30.000 --> 00:35:34.999
um, or, or behave, uh, in ways
that they, they typically did.

00:35:35.000 --> 00:35:39.999
Uh, and so, the mature uh, person who,

00:35:40.000 --> 00:35:44.999
say in Ed\'s case whose uh, uh, you
know, dynamic teacher who was going on

00:35:45.000 --> 00:35:49.999
to get his PhD in math uh, is now in the,

00:35:50.000 --> 00:35:54.999
he\'s a child. I never know when Ed\'s going to
wake up whether he\'s going to be in a good mood

00:35:55.000 --> 00:35:59.999
or a bad mood. It\'s a lot
of mood swings. Um, he

00:36:00.000 --> 00:36:04.999
has outburst. Um, a lot of times he will

00:36:05.000 --> 00:36:09.999
look at me with a real blank stare and

00:36:10.000 --> 00:36:14.999
I, I really think he doesn\'t know who I am but
he\'s not going to admit that. Many patients

00:36:15.000 --> 00:36:19.999
don\'t even recognize their deficits. They aren\'t able
to appreciate the memory impairments that they have.

00:36:20.000 --> 00:36:24.999
Uh, and this can lead to anger when someone
directs them to act in a certain way

00:36:25.000 --> 00:36:29.999
or reminds them that they have a uh, they
have a certain task to do. Uh, sometimes

00:36:30.000 --> 00:36:34.999
they may react um, with uh, an apathy.
They just don\'t, they don\'t care

00:36:35.000 --> 00:36:39.999
and that has a physiological,
a biological basis.

00:36:40.000 --> 00:36:44.999
Now I figured I\'d have a uh,
glorious and famous life being a uh,

00:36:45.000 --> 00:36:49.999
uh, a PhD mathematician but

00:36:50.000 --> 00:36:54.999
we both know it didn\'t turn out that way.

00:36:55.000 --> 00:36:59.999
No, it didn\'t. What about the chances of it
turning out that way. What do you think? Well,

00:37:00.000 --> 00:37:04.999
if my um, memory

00:37:05.000 --> 00:37:09.999
comes back. What do you think
the chances of that happening?

00:37:10.000 --> 00:37:14.999
What does that mean? Not good.
Not good. No guarantees.

00:37:15.000 --> 00:37:19.999
No guarantees. Not with head
injury, right. No. Mmm.

00:37:20.000 --> 00:37:24.999
Well uh, when my dad died that was a big deal on my
life and that was a couple years ago. But he died

00:37:25.000 --> 00:37:29.999
and we buried him and we mourned him. And
I, I mourned him and we got over it.

00:37:30.000 --> 00:37:34.999
I mean he\'s in the ground
or where ever he is.

00:37:35.000 --> 00:37:39.999
And when this happened to Ed, Ed died but
he\'s still with me every day. I mean I see

00:37:40.000 --> 00:37:44.999
him every day and every night I\'m taking
care of him. But he\'s not the same

00:37:45.000 --> 00:37:49.999
Ed. He\'s not the same husband that I know.

00:37:50.000 --> 00:37:58.000
[sil.] I lay there and, and the
room has to be dark because

00:38:00.000 --> 00:38:04.999
um, light makes my head fell uh, a blasting

00:38:05.000 --> 00:38:09.999
pain. Where all thought stops and
you just feel like something sharp

00:38:10.000 --> 00:38:14.999
is driven into your head.

00:38:15.000 --> 00:38:19.999
[sil.] The majority of people have
very benign headaches and never

00:38:20.000 --> 00:38:24.999
come to the attention of the medical
profession. The most seriousness of headaches

00:38:25.000 --> 00:38:29.999
generally represent hemorrhage into
the head. And so, an aneurism a

00:38:30.000 --> 00:38:34.999
weak spot in the wall of the blood vessel can
develop. That is the kind of headache that we have to

00:38:35.000 --> 00:38:39.999
really handle surgically. There are other
kinds of headaches from brain tumors,

00:38:40.000 --> 00:38:44.999
those are relatively rare.
The most frequent problem is

00:38:45.000 --> 00:38:49.999
migraine. My mother says that I um,
started to get migraine headaches

00:38:50.000 --> 00:38:54.999
from um, the age of 3 on.

00:38:55.000 --> 00:38:59.999
And my father always had migraines. And I
can always remember that when he would

00:39:00.000 --> 00:39:04.999
lay on the coach that I would lay with him.
We don\'t always

00:39:05.000 --> 00:39:09.999
know who in the family had them. Many people don\'t
talk about them. But if you follow carefully

00:39:10.000 --> 00:39:14.999
about 8 to 10% of the population
has a genetic tendency

00:39:15.000 --> 00:39:19.999
to a migraine headache type problem.

00:39:20.000 --> 00:39:24.999
No noise, no smells, no food, nothing.

00:39:25.000 --> 00:39:29.999
I\'d lay there and, and try not to focus on the
pain which just comes in waves real regular.

00:39:30.000 --> 00:39:34.999
And I think I\'d laid there for half
an hour and it\'s really been like 5

00:39:35.000 --> 00:39:39.999
minutes. A migraine headache is

00:39:40.000 --> 00:39:44.999
an electrical discharge in the brain.
In, in actuality a polarization

00:39:45.000 --> 00:39:49.999
change. We can measure
magnetic changes by the

00:39:50.000 --> 00:39:54.999
polarization in the brains electrical system.
That starts in the back of the brain

00:39:55.000 --> 00:39:59.999
and gradually spreads forward. There seems to
be a release of certain kinds of chemicals.

00:40:00.000 --> 00:40:04.999
The chemicals are released in and around the
blood vessels and in and around the membranes

00:40:05.000 --> 00:40:09.999
over the brain. And these chemicals
produce an inflammatory response much

00:40:10.000 --> 00:40:14.999
as if you skinned you chin and then got all
swollen and painful. Only the membranes

00:40:15.000 --> 00:40:19.999
around the brain are now
equipped to feel this pain very

00:40:20.000 --> 00:40:24.999
intensively. I put something um,
cold on my head which helps

00:40:25.000 --> 00:40:29.999
for a minute but your whole
face feels tight. And I get

00:40:30.000 --> 00:40:34.999
very restless. And this is after
I\'m lying in bed and I\'ve

00:40:35.000 --> 00:40:39.999
already put myself in a dark quiet room.
They become very aware

00:40:40.000 --> 00:40:44.999
of their ability to become
disabled, not to keep functioning.

00:40:45.000 --> 00:40:49.999
So, they very often seek ways of preventing

00:40:50.000 --> 00:40:54.999
themselves from having so many headaches. One of the
earliest things they learned is they can go down

00:40:55.000 --> 00:40:59.999
to the drug store or the supermarket and there they
see huge numbers of analgesic types of medication.

00:41:00.000 --> 00:41:04.999
And they will try taking some of these the
first sign of a headache. And often times

00:41:05.000 --> 00:41:09.999
this will work and they will be able to
keep functioning. But psychologically

00:41:10.000 --> 00:41:14.999
they very rapidly become dependent on
the idea that they need medication

00:41:15.000 --> 00:41:19.999
to turn off these headaches.

00:41:20.000 --> 00:41:24.999
[music] After a headache that\'s
gone on for two or three days. Um,

00:41:25.000 --> 00:41:29.999
wake up in the morning and open your
eyes and it\'s still there. It\'s just

00:41:30.000 --> 00:41:34.999
despair.

00:41:35.000 --> 00:41:39.999
A lot of people know that if they take
alcohol, particularly things like red wine

00:41:40.000 --> 00:41:44.999
very soon thereafter they will have a terrible migraine.
A lot of people have the same problem with chocolate.

00:41:45.000 --> 00:41:49.999
Others have the same problem with nicotine.
Many people have

00:41:50.000 --> 00:41:54.999
to much caffeine. They\'re
all kinds of triggers.

00:41:55.000 --> 00:41:59.999
Uh, psychological stresses often times
been blamed. Having a migraine is totally

00:42:00.000 --> 00:42:04.999
disruptive to my family life. I
am incredibly short tempered

00:42:05.000 --> 00:42:09.999
with my um, children. When
I have a headache I go

00:42:10.000 --> 00:42:14.999
upstairs and I lay down or I
lay down on the coach and they

00:42:15.000 --> 00:42:19.999
play quietly uh, or get
themselves something to eat,

00:42:20.000 --> 00:42:24.999
or um, just leave mom alone.

00:42:25.000 --> 00:42:29.999
The headache problem becomes an
extreme one psychologically. It is a

00:42:30.000 --> 00:42:34.999
chronic problem that tears into
the family fabric that somebody

00:42:35.000 --> 00:42:39.999
can\'t really be a partner and be a totally
healthy partner. Then there are a lot

00:42:40.000 --> 00:42:44.999
of frustration. The way that these headaches
have really affected my marriage is

00:42:45.000 --> 00:42:49.999
um, the level of frustration that
my husband has to live with. Um,

00:42:50.000 --> 00:42:54.999
there\'s nothing he can do. He can
point me in the direction of um,

00:42:55.000 --> 00:42:59.999
a doctor. But he, he

00:43:00.000 --> 00:43:04.999
can\'t help when it hurts. Certainly any
kind of time there\'s a chronic disease

00:43:05.000 --> 00:43:09.999
it produces a major stress
to families and headache is

00:43:10.000 --> 00:43:14.999
one of the many problems. Especially,
especially active since the

00:43:15.000 --> 00:43:19.999
stress of the psychological
upset will be in of it\'s self

00:43:20.000 --> 00:43:24.999
another trigger for more migraines.
The biggest impact that um, having

00:43:25.000 --> 00:43:29.999
all these headaches has had on my life is

00:43:30.000 --> 00:43:34.999
that I never can plan anything

00:43:35.000 --> 00:43:39.999
ahead because I never know when
they\'re going to come. The careful

00:43:40.000 --> 00:43:44.999
neurological evaluation with
the most considered approach

00:43:45.000 --> 00:43:49.999
to the avoidance of the
pitfall of to many drugs is

00:43:50.000 --> 00:43:54.999
the way they should handle their problems.
The migraine patient has to take

00:43:55.000 --> 00:43:59.999
good stock of who\'s working with
them and be totally upfront about

00:44:00.000 --> 00:44:04.999
all the plans and rules as far as
how to go forward and get those

00:44:05.000 --> 00:44:09.999
headaches controlled.

00:44:10.000 --> 00:44:18.000
[music]

00:44:20.000 --> 00:44:25.000
[sil.]