Stress, Anxiety Disorders and Tourettes.

I tried to go to the art show of my friend Jacob. At 6:30 at Allegheny and Richmond. I realize if you’r not familiar with Phila. PA that location means nothing to you. However please read on.
I really wanted to be there I made plans to go with my woman friend Carol. She and I were to meet at a nearby transporation stop at 5:30 pm. I arrived five minutes early. I waited for close to fifteen minutes. I checked every where she could be. She was not to be found.

Then I walked home. Thought I must of misremembered the time and I thought it was 5pm we were suppose to meet. Then a little way when I home Carol calls me. She told me the time was 5:30. Then she says let’s go. She let me know too she missed her stop. I was okay with that. I too am guilty of not paying attention and missing my stop She felt guilty. I told her she was being too hard on herself. Heck to coin a phrase she or he is not guilty of not paying attention and misisng their stop on a public transportation vehicle cast the first stone.

At that point when she called I was dressed in my sleepwear ready for bed. Last thing I wanted to do was to go out She decided to go without me. Hour later I receive a phone call from her. She sounded very upset. From what she told me I’m glad I wasn’t at the art show

Looking back thinking of how I would have been alone in the dark in an unsavory neighborhood the scary situation would of most likely exacerbated my Tourettes. Of course I’ll never specifically know. I do remember when I’m in a tense situation, like most people with Tourette syndrome I do tend to tic more than usual. My tics tend to be more pronounced.

Emotions can play a huge part in this neurological disorder. I know from personal experiences. I am aware too that many people with tic disorders experience personally how stress can worsen their tics. Moreover a large majority of people with tic disorders suffer from anxiety orders to begin with. They seem to go together like that old song horse and carriage. I think its a song from :”Oklahoma”
Its not surprising that stressful situations can worsen this neurological disorder since stress can make virtually any situation worse. For one thing stress makes it very hard to concentrate. When one is stressed it can extremely difficult to think about one’s situation. Plus if one feels under pressure that ca make a situation even worse. It can make one feel one is in danger even when that is totally untrue. In other words stress can cause an increase in fearful emotions. Some stress can produce a heightened awareness of one’s immediate environment. An overload can make it virtually impossible to make rational decisions in one’s situation.

A tic is an involuntary vocal or motor movement. It is a movement one feels one needs to do and relief won’t come unless its done. Its like holding back a sneeze. Sometimes a sneeze can be suppreseed for a certain time. Eventually it needs to be expressed. Same with a tic.

I’m not saying it can make somebody clinically paranoid. On the other hand I bet if you’re walking by yourself in a strange neighborhood , late at night and its dark I bet you’re going to be at least a little suspcious of people you don’t know. I believe its not difficult to see how tics can worsen then.

Moreover many people with Tourettes suffer from other associated conditions. Some of these can anxiety disorders. In fact anxiety disorders are quite common with people with Tourettes. I don’t know what came first anxiety disorders worsening tics or tic disorders, especially Tourettes by its nature causes anxiety disorders. Perhaps more research will discover the truth.

I write a humor blog with my fellow writer Carol Bond at </a><a href=”http://societyfordaintydamsels.com:”>-Society for DaintyDamsels.</br>

 

		
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A Strange fluke concerning my dad and Ernie Kovacs.

My father, the navy and show biz.

When my father was stationed in the Navy in the early 50s one of his Naval mates happened to be a man who would a few years later launch his own local variety show in Phila.PA. His name was Ernie Kovacs. Back the Navy he wasn’t famous yet. He was just one of many sailors in the unit. It was a pure fluke him and dad were in the same Navy unit. But what a fluke!!! Now I wonder how many of you readers are familiar with Kovacs. He was and still is considered an improvisational comic genius by many. He was also one of the most engaging men you could ever know.

When Kovacs left the US Navy he started his own show “Kovac’s Corner” in Phila.PA. It was on that show that the funny man hired my father as the leader of the houseband. Below is a youtube video of dad and Ernie messing around. Enjoy. A few years later he would host the Ernie Kovacs show and then be featured in several movies. Some of these are “Our Man in Havana, “It happened to Jane” and “Bell , Book and Candle”

When ever one watches and enjoys improvisational comedy such as much of Comedy Central , Laugh-In, even Sesame Street and the original electric Company) one is laughing at this comedy because of Kovacs for his pioneering innovations. He was in his time considered by many to be too innovative. Or to express it more positively way ahead of his time. He was one of the first comic to invent his own characters. He didn’t rely on writers. He wrote his own sketches.

The comic, TV host is fondly recalled by his many admirers. You could say Ernie Kovacs was an influence on virtually every improvisational comedian there was and is and probably will be too. He bought humor into a style that was constantly pushing the boundaries. I think him, Jonathan Winters and Lenny Bruce was in their own way pioneers of what is funny.

It wasn’t as if my father just happened to be in the Navy with a celebrity. It was that the man became quite famous very soon from his Naval days. As for dad a few years later he became an executive in charge of artists and repretoire for Phila. PA Cameo Parkway. A&R means he chose the artists and decided what songs they would sing. He wrote too. See his bio in a different post.

Here’s a video of my dad. He comes out sweeping the floor. He and his group then bursts into an uptempo swinging love song. My father is playing guitar. Then they back into their janitorial duties. Kovacs was not too cheap to hire regular janitors. It was just a jokey set up.

This was one of Dave Appell’s earliest musical , show business gigs. Gig is a musician , show business term for work. Some years earlier when he was in his late teens, Appell was part of a “Gypsy” band. He played guitar for that group too. His ancestry was Romanian on his paternal side so that’s as close as Gypsy as he got.

My other blog with Carol  Bond is <a href=”http://societyfordaintydamsels.com”>Society for Dainty Damsels.  A rather weird but good hearted humor blog with wacked out humor.

Co Morbids, ie disorders that can a part of Tourette Syndrome.

Some co morbids associated with Tourette syndrome.

Mood disorders, ADHD, OCD, ASDs. These disorders are not consistent with TS. To be clear being diagnosed with of these condiions or any combination doesn’t necessarily mean Tourettes.  but they can be a part of the tic disorder.

Every one of these disorders can be co diagnosed with people with Tourettes and other tic disorders. Conversely one can present with Tourettes and no other tic disorders and never be diagnosed with these conditions. I , myself was given the diagnosis of every one of them.

Next I’ll briefly describe what each of these co morbids are. But first let me say I dislike the term comorbid. Well I suppose because it sounds so morbid. I mean none of these are life threatening. They can make life more difficult or to express somewhat more positively , more challenging.

I’ll start with the first co morbid I was diagnosed with.
Major depression. A psychiatric disorder where mood is very sad and bleak. One is very pessimistic and it is a long term condition. I think looking back it first manifested as a little girl. My mother didn’t know what to do with me. I was very different. Plus the fact she was on amphetimines for weight loss certainly exacerbated things. This is very emotionally painful for me to write. Then in high school I did little involuntary movements such as facial grimacing, head nodding, nose twitches and other twitches. Like most teens who were notably different I was teased. I mean I was teased big time. Looking back it was even worse because I didn’t know what was wrong with me. I didn’t know until decades later I was suffering from Tourettes. Clearly the teasing , bullying made me feel even worse. Looking back I think my depression was caussed by my situation.

Obsessive compulsive disorder

There are two parts to obsessive compulsive disorder. The Compulsions and the obsessions. First I’ll explain the compulsions. These are actions one feels one must do even though intellectually one realizes they arn’t truly necessary. The feeling is if one doesn’t do them, there will be a sense of anxiety. Or something terrible will happen. It isn’t just a harmless nursery rhyme for people with OCD when they hear step on a crack break your mother, or who ever feel is important to them, if you walk on a crack. The emotion is real even though the idea of cause and effect one knows is wrong. Its to me when the brain feels one way and the intellect knows otherwise.

Most common compulsions involve touching, avoiding certain things, especially lines and cracks on the ground and picking things up I did that one myself until my knees made it difficult for to do so.

A tic is an urge to do a movement or do a sound but there’s an anxiety involved. That is the difference between a tic and a compulsion.
An obsession is something someone thinks about and occupies much of their waking time. They think about the subject not because they want to but because its disturbing and they can’t get it out of their minds. By psychological definition an obsession must be of either something that is disturbing or something that causes disturbing feelings. Obsessing about one’;s favorite movie star is not an obsession if the only emotion it causes is pleasure. For example I obsess over Joaquin Phoenix. I get g great enjoyment doing that.

Diagnosed as an adult by a psychiatrist with ADD.  Actually with the symptoms I was borderline.   That doe not mean borderline personality.  It means I received half of the symptoms.  I really don’t recall every symptom on the list. I do know I am very distractible and easily frustrated and rather impatient.  I’m not proud of this but not ashamed either.. Its just part of who I am.

Autism Spectrum disorders are a group of disabilities concerning difficulty in every day social interactions. Autism is the most severe and Asperger syndrome is the least. The entire spectrum includes various degrees in difficulties in social interactions. For example picking up social cues, taking some expressions too literally or not being responsive enough.

To reiterate I’ve been diagnosed with every one of these comorbids in various times in my life by different psychiatric physicians.

My Eye Doctor appt. gave me an Opportunity to enlighten the technician about Tourettes.

A couple months ago, in Autumn of 2014 at my eye doctor’s appt my eyes were being examined. The reason I was there was I developed a macular edema. Well as virtually everyone who remembers going to get an eye exam at an ophthmalogist office you need to be perfectly still. Plus the heavy large \\\is really up close. In fact its in your face. Most anyone diagnosed with any tic disorder you know with tics keeping perfectly still can be quite difficult. I think you know where this is heading.

I was not only feeling uneasy about the exam but what it could find. I was there to see if my swollen macula was improving or not. This was a quite important examination for me. So that being the vase there was a definite feeling of disquietude.

A little background. December of 2013 I went to my primary for a painful teary, red left eye. She immediately sent me to the urgent care part of the nearest eye clinic. Fortunately it was on the same campus of the hospital where I saw the primary.

Walked my way to the clinic. Thank goodness, with the way my eye was feeling it wasn’t far. Presumed it was conjunctivitis since there a history of several bouts of it. Well to cut to the chase it turned out to be Iritis ie inflammation of my iris. The physicians told me if I didn’t take care of that eye I could wind up blind in it. Several months later same eye I developed macular edema or swelling of the macula. I don’t know if it because of the iritis or unrelated.

So here I am at the office getting my eyes examined. One thing to note is I saw a resident and each resident is supervised by an attending physician. I’m very nervous and worried to begin with. Its been close to a year since I first visited urgent care. Because of my earlier visits and what the health professionals told me I was truly of a worried mind. This made my tics even more pronounced. This was a major issue since I needed to be perfectly still for the dr. to examine me with their machines.

There was only one thing to do. I would explain my situation. It was not easy since I Felt self conscious. On the other hand felt there was no other choice. So I explained to to the tecnician giving me the exam, the resident and senior physician my Tourette syndrome.

What happened was I felt forced to mention my Tourettes The pressure of the equipment, the tight space, the trying to be perfectly still was a real challenge to me. The worry over the possible results plus the tight space really did a number on my vocal tics. I cleared my throat, coughed, snorted etc. The technician thought I was experiencing a terrible cold. Luckily she was easy to talk to. She was professional but friendly too. I politely told her it wasn’t a cold. That I a neurologist from the same hospital system diagnosed me with Tourettes. I was at Presbyterian in Phila.PA. Presby is a part of the U. of Penn Medical Center. Penn prides itself on beng one of the top ten hospitals in the US. Source S News and World Report. She understood and I was glad I took the opportunity to tell her of Tourettes

What I specifically let her know was that coughing and clearing the throat are quite common vocal tics. That Tourettes consists of both vocal and motor tics. I told her too that only a very small minority include the tic where swear words, ethnic slurs , other insulting words are spoken. The term being cropapralalia. My tone of voice was matter of fact. Last thing I wanted to do was to hurt her feelings. I realized that she wasn’t being mean so I didn’t feel I should be mean to her. She didn’t deserve that

My late hubby Jerry’s Teddy Bear.

This poem I am trying to convey an example of OCD the obsession part.  I think most little kids, both girls and boys are somewhat obessive about their toys.  I mean this especially toward their dolls and teddy bears. However I believe some kids go too far.  I think my late hubby when he was a small child was one of them.   Obession is being obsessed to an unhealthy degree over someone or something.   OCD is very common in Tourettes.   Its considered a co morbid.  Co morbid is a medical term for a health condition that is usually associated with another medical disorder.  Some other co morbids of Tourettes are ADHD,  Aspergers, mood disorders.   Let me know if you think I conveyed Jerry’s obsession with his toy.

Poem by Lynda Appell

Poem by Lynda Appell

Title “Jerry’s Childhood Teddy Bear “

The faded burnt umber felt teddy bear lays on Jerry’s side of the bed

The toy lays there in decrepit condition

His left eye missing. Right one a tan cotton flap.

He’s definitely not a first edition.

His cloth material and stitching

His face and body exhibits a sour disposition

Yet within his facade mysteries unfold.
He is the depository of so many memories

so many experiences so many times untold.

So many secrets to uphold.

I can still picture

a certain four year old boy

who absolutely cherished him

Heart filled with joy.

When his mother first gave him that fateful toy.
He’d be there, not judging, accepting

his every whim.
Being a faithful companion in bed when the lights went dim

.

Who’d be devoted

and do his owner’s bidding.

Including eating at a restaurant

the boy insisted the bear get his own seat

his parents sighed and let the boy do what ever he want.

One day when Jerry was five

His folks had enough

his mom and dad told him Teddy moved

to Baltimore MD

To the distraught little boy this was the end.

He felt he lost his very best friend.

So upset he called the operator

He wailed into the phone

He wanted to know where Teddy was in Baltimore.

That he was all alone.

The woman told him she couldn’t locate him without a last name.

Jerry with tears in his eyes said his last name was bear.

But that was the end of Teddy
Until Jerry ws grown he got back his Teddy

and now he lays on his side of the bed forever ready.

I co write with Carol Bond an offbeat humor blog <a href=”http://societyfordaintydamsels.com”>Society for Dainty Damsels><br>

Importance of being inner directed for people with Tourettes and similar disorders,

The other day I walked over to the front desk of the apartment where I live. The place is one building and the front desk or main office is in the east side of the lobby.  I went over there to see if my home health aide was there.  She comes there every Monday.  That day was Monday.  I wondered if she arrived yet.  I did an errand for her.  I wanted to let her know.

There was nothing  unusual about that.  I ceftainly was in my rights to want to know.   I felt it was important to see if she was there since I felt I need to give her an important message concerning what I did for her.  Be that as it may I noticed the woman on call was on the phone.  Of course I didn’t  see anything wrong with that.  Neither did I take it as anything  personal. Nor did I think she was snubbing me.  After all she was already on the telephone when I got there. It wasn’t like she was not making a call and then suddenly made the call to snub me.   In other words I took it as simply she was busy.  I took it in stride.

I personally took it as a nonchalant fact. Unfortunately my tics didn’t do so.  Unsure why but my vocal tics started to act up big time.  I started out with constantly clearing my throat and then quickly following with coughing. That is my usual pattern, clearing throat,, then coughing.   Next I began to start grunting, snorting and making gurgling sounds.  The woman scolded me and told me  I was being rude.  That I was bothering her while she was on the phone.

I wanted to tell her my situation but instead I involuntarily stammered and sputtered    She continued to loudly tell me how inconsiderate and how rude I was.   I felt terribly hurt.   As I walked to the door to the elevator I muttered fuck you. By the way that was not coprolalia.  I uttered those words on purpose.

Initiially I felt really hurt.   Then somehow I thought to myself.  There are two types of people.  Those who are outer directed and those who are inner directed  The latter type are not dependent on what others think of them.   The only thing that matters is how they view themselves.

I think its good for people with Tourettes and other tic disorders to be more inner directed.  I  realize it does feel good for other people to form a pleasing opinion of you.   Yet I am feeling its even of greater importance to realize that you are a decent person.   There is no guarantee one can control how one is perceived by those around them. However one can realize that no matter what people think  you can still know that you can realize you are a worthy person.

Yes it can be difficult but I still think its crucial to remind yourself that if you believe you are worthwhile then it doesn’t matter what other’s opinion of you is.