DOCSLIB.ORG

An Ethnodrama Exploring a Couple's Transition from Alcoholism to Long

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
An Ethnodrama Exploring a Couple's Transition from Alcoholism to Long Whiskey & tangerines: An ethnodrama exploring a couple’s transition from alcoholism to long- term recovery. by Paul A. Maxfield B.A., University of Windsor, 2003 M.S., Texas A&M University - Corpus Christi, 2012 AN ABSTRACT OF A DISSERTATION submitted in partial fulfillment of the requirements for the degree DOCTOR OF PHILOSOPHY Department of Special Education, Counseling, & Student Affairs College of Education KANSAS STATE UNIVERSITY Manhattan, Kansas 2018 Abstract According to SAMHSA statistics, about 22 million people in the US meet the criteria for a Substance Use Disorder (SUD), with alcohol use disorders (AUDs) being the most prevalent form of SUD. Of those with SUDs, only 10% or two million receive formal treatment. It is estimated that 64% of those completing treatment for SUDs relapse within the first year of sobriety. However, for individuals who manage to make it five years without relapsing, the risk of relapse reduces to 14%, suggesting that the needs of individuals in short-term recovery differ from those in long-term recovery. It has also been found that family involvement in the treatment and recovery process is beneficial to individuals in recovery. However, SUDs contribute to elevated levels of stress and dissatisfaction in couples and families, which puts them at high risk for divorce or dissolution prior to individuals seeking treatment. For families who remain intact until the individual completes treatment, the transition to a recovery lifestyle that supports the individual’s recovery presents a different set of challenges. Additionally, lingering frustrations and resentments from the period of active addiction may also serve to destabilize the couple or family, contributing to the high levels of divorce among those recovering from SUDs. In short, few couples are able to sustain their partnerships through active addiction, and the transition to recovery. While these couples are in the minority, their successful experiences can provide valuable insight into the recovery process. The present study examines the successful transition from active addiction to long-term recovery for one such couple. In particular, the study investigates the shifting narratives related to family roles, couple-hood, communication, alcohol, alcoholism, and recovery. The data is presented in the form of an ethnodramatic script. Ethnodrama is used to engage audiences both on emotional as well as informational levels. While ethnodrama may not provide specific answers, it is intended to provoke awareness, insight, and discussion by allowing audiences to vicariously experience the represented lives of the participants. Following the ethnodrama, an analysis of the script is presented, incorporating narrative theoretical frameworks so that the ways in which narratives function to facilitate (or frustrate) change within the individuals as well as the dynamics of the couple relationship can be expanded. The result of this analysis is the production of a Narrative Change Model, which can be useful in understanding the ways that narratives operate within the transition from active addiction to long-term sobriety and may have broader implications in explaining the narrative mechanisms behind other, more subtle change processes. Whiskey & tangerines: An ethnodrama exploring a couple’s transition from alcoholism to long- term recovery. by Paul A. Maxfield B.A., University of Windsor, 2003 M.S., Texas A&M University - Corpus Christi, 2012 A DISSERTATION submitted in partial fulfillment of the requirements for the degree DOCTOR OF PHILOSOPHY Department of Special Education, Counseling, & Student Affairs College of Education KANSAS STATE UNIVERSITY Manhattan, Kansas 2018 Approved by: Major Professor Doris Wright-Carroll Copyright © Paul Maxfield 2018. Abstract According to SAMHSA statistics, about 22 million people in the US meet the criteria for a Substance Use Disorder (SUD), with alcohol use disorders (AUDs) being the most prevalent form of SUD. Of those with SUDs, only 10% or two million receive formal treatment. It is estimated that 64% of those completing treatment for SUDs relapse within the first year of sobriety. However, for individuals who manage to make it five years without relapsing, the risk of relapse reduces to 14%, suggesting that the needs of individuals in short-term recovery differ from those in long-term recovery. It has also been found that family involvement in the treatment and recovery process is beneficial to individuals in recovery. However, SUDs contribute to elevated levels of stress and dissatisfaction in couples and families, which puts them at high risk for divorce or dissolution prior to individuals seeking treatment. For families who remain intact until the individual completes treatment, the transition to a recovery lifestyle that supports the individual’s recovery presents a different set of challenges. Additionally, lingering frustrations and resentments from the period of active addiction may also serve to destabilize the couple or family, contributing to the high levels of divorce among those recovering from SUDs. In short, few couples can sustain their partnerships through active addiction, and the transition to recovery. While these couples are in the minority, their successful experiences can provide valuable insight into the recovery process. The present study examines the successful transition from active addiction to long-term recovery for one such couple. The study investigates the shifting narratives related to family roles, couple-hood, communication, alcohol, alcoholism, and recovery. The data is presented in the form of an ethnodramatic script. Ethnodrama is used to engage audiences both on emotional as well as informational levels. While ethnodrama may not provide specific answers, it is intended to provoke awareness, insight, and discussion by allowing audiences to vicariously experience the represented lives of the participants. Following the ethnodrama, an analysis of the script is presented, incorporating narrative theoretical frameworks so that the ways in which narratives function to facilitate (or frustrate) change within the individuals as well as the dynamics of the couple relationship can be expanded. The result of this analysis is the production of a Narrative Change Model, which can be useful in understanding the ways that narratives operate within the transition from active addiction to long-term sobriety and may have broader implications in explaining the narrative mechanisms behind other, more subtle change processes. Table of Contents Table of Contents ......................................................................................................................... viii List of Figures ............................................................................................................................... xii List of Tables ............................................................................................................................... xiii Acknowledgements ...................................................................................................................... xiv Dedication ..................................................................................................................................... xv Chapter 1 - Introduction .................................................................................................................. 1 Subjectivity ................................................................................................................................. 5 Study Background ....................................................................................................................... 7 Rationale for the Study ............................................................................................................. 11 Research Purpose & Significance ............................................................................................. 13 Research Questions ................................................................................................................... 14 Theoretical Framework ............................................................................................................. 14 Methodological Frameworks .................................................................................................... 16 Operational Definitions ............................................................................................................. 18 Chapter Summary ..................................................................................................................... 23 Chapter 2 - Literature Review ....................................................................................................... 24 Historical Overview .................................................................................................................. 24 History of Alcohol ................................................................................................................ 24 Early History of Treatment ................................................................................................... 34 The Development of Alcoholics Anonymous ....................................................................... 37 Modern Treatment ................................................................................................................ 39 Models of Addiction and Treatment Options ..........................................................................
Load more

Recommended publications
  • Standardized Field Sobriety Testing
    This Page Left Intentionally Blank Instructor Guide DWI Detection and Standardized Field Sobriety (SFST) Testing Sobriety Refresher October 2015 Save lives, prevent injuries, reduce vehicle-related crashes This Page Left Intentionally Blank Preface The Standardized Field Sobriety Testing (SFST) training curriculum collectively prepares police officers and other qualified persons to conduct the SFST’s for use in DWI investigations. This training, developed under the auspices and direction of the National Highway Traffic Safety Administration (NHTSA), and the International Association of Chiefs of Police (IACP), has experienced remarkable success since its inception in the early 1980s. As in any educational training program, an instruction manual or guide is considered a “living document” that is subject to updates and changes based on advances in technology and science. A thorough review is made of information by the IACP Technical Advisory Panel (TAP) of the Highway Safety Committee of the IACP with contributions from many sources in health care science, toxicology, jurisprudence, and law enforcement. Based on this information, any appropriate revisions and modifications in background theory, facts, examination and decision making methods are made to improve the quality of the instruction as well as the standardization of guidelines for the implementation of the SFST curriculum. The reorganized manuals are then prepared and disseminated, both domestically and internationally, to the states. Changes will normally take effect 90 days after approval by the TAP, unless otherwise specified or when so designated. The procedures outlined in this manual describe how the Standardized Field Sobriety Tests (SFSTs) are to be administered under ideal conditions. We recognize that the SFST’s will not always be administered under ideal conditions in the field, because such conditions do not always exist.
    [Show full text]
  • Non-Invasive Assessment of Liver Fibrosis with 31P-Magnetic Resonance Spectroscopy and Dynamic Contrast Enhanced Magnetic Resonance Imaging
    Linköping University Medical Dissertations No. 1351 Non-Invasive Assessment of Liver Fibrosis with 31P-Magnetic Resonance Spectroscopy and Dynamic Contrast Enhanced Magnetic Resonance Imaging Bengt Norén Faculty of Health Sciences Division of Radiological Sciences Department of Medicine and Health Sciences and Center for Medical Image Science and Visualization Linköping University, Sweden Linköping 2013 Non-Invasive Assessment of Liver Fibrosis with 31P-Magnetic Resonance Spectroscopy and Dynamic Contrast Enhanced Magnetic Resonance Imaging Linköping University Medical Dissertations No. 1351 © Bengt Norén, 2013 Published articles have been reprinted with the permission of the copyright holder ISBN 978-91-7519-705-0N ISSN 0345-0082 Printed by LiU-Tryck, Linköping, Sweden, 2013 CONTENTS Background 1 Diffuse Liver Disease 4 Liver Fibrosis, Cirrhosis, Complications and HCC 4 Evaluation of Liver Function and Prognostic Scores 7 Assessment of Fibrosis: Present ‘Gold Standard’ 8 Assessment of Fibrosis: Non-Invasive Techniques 9 Nuclear Magnetic Resonance 12 Basic Physics 12 The Spectroscopy Technique – MRS 13 Chemical Shift 13 Spin-Spin Coupling 14 Localization Methods 14 Liver Metabolites of Interest in 31P –MRS 14 Dynamic Contrast Enhanced MRI – DCE-MRI 16 Gd- EOB- DTPA (Primovist®) 16 Hepatocyte Uptake and Excretion Mechanisms 17 Quantification Procedures 18 31P –MRS 18 DCE-MRI 19 Aims of the Study 21 Materials and Methods 22 Localized In Vivo 31P NMR Spectroscopy 22 Data Acquisition 22 External Referencing 23 Processing 23 Absolute Quantification
    [Show full text]
  • Nonalcoholic Fatty Liver Disease (NAFLD): a Comprehensive Review William B
    JOURNAL OF INSURANCE MEDICINE Copyright Q 2004 Journal of Insurance Medicine J Insur Med 2004;36:27±41 REVIEW Nonalcoholic Fatty Liver Disease (NAFLD): A Comprehensive Review William B. Salt II, MD Nonalcoholic fatty liver disease (NAFLD) is de®ned as fatty in®ltra- Address: The Ohio State University, tion of the liver exceeding 5% to 10% by weight. It is a spectrum of Columbus, Ohio; e-mail: disorders ranging from simple fatty liver (steatosis without liver in- [email protected]. jury), nonalcoholic steatohepatitis (steatosis with in¯ammation), and Correspondent: William B. Salt II, ®brosis/cirrhosis that resembles alcohol-induced liver disease but MD; Ohio Gastroenterology Group, which develops in individuals who are not heavy drinkers. NAFLD Clinical Associate Professor in Med- is likely the most common cause of chronic liver disease in many icine. countries. NAFLD may also potentiate liver damage induced by oth- er agents, such as alcohol, industrial toxins and hepatatrophic vi- Key words: Nonalcoholic fatty liver ruses. disease (NAFLD), nonalcoholic stea- The lack of speci®c and sensitive noninvasive tests for NAFLD tohepatitis (NASH), insulin resis- limits reliable detection of the disease. It is often diagnosed on a tance syndrome, liver transaminas- presumptive basis when liver enzyme elevations are noted in over- es, liver biopsy, life insurance. weight or obese individuals without identi®able etiology for liver disease, or when imaging studies suggest hepatic steatosis. NAFLD is now considered to be a component of the insulin re- sistance syndrome (metabolic syndrome X). Controversy exists rel- ative to optimal recognition, diagnosis and management of these conditions, and treatment recommendations are evolving.
    [Show full text]
  • Horizontal Gaze Nystagmus: the Science and the Law a RESOURCE GUIDE for JUDGES, PROSECUTORS and LAW ENFORCEMENT
    Horizontal Gaze Nystagmus: The Science and The Law A RESOURCE GUIDE FOR JUDGES, PROSECUTORS AND LAW ENFORCEMENT National Traffic Law Center 2nd Edition, February 2021 Horizontal Gaze Nystagmus: The Science and The Law A RESOURCE GUIDE FOR JUDGES, PROSECUTORS AND LAW ENFORCEMENT The first edition of this manual was prepared under Cooperative Agreement Number DTNH22-92-Y-05378 from the U.S. Department of Transportation National Highway Traffic Safety Administration. This second edition was updated under Cooperative Agreement Numbers DTNH22-13-H-00434 and 693JJ91950010. Points of view or opinions in this document are those of the authors and do not necessarily represent the official position or policies of the U.S. Department of Transportation, National District Attorneys Association, or the National Traffic Law Center. National Traffic Law Center Table of Contents NATIONAL TRAFFIC LAW CENTER . iii PREFACE . iv ACKNOWLEDGMENTS . v FOREWORD TO THE SECOND EDITION (2020) . vi FOREWORD TO THE FIRST EDITION (1999) . vii INTRODUCTION . 1 THE SCIENCE . 4 Section I: What are Normal Eye Movements? . 4 Section II: What is “Nystagmus”? ...........................................5 Section III: Intoxication and Eye Movements.................................7 Alcohol Gaze Nystagmus (AGN) . 7 Positional Alcohol Nystagmus (PAN) . 8 AGN and PAN Compared ................................................9 Section IV: The HGN and VGN Tests . 9 Development of the Standardized Field Sobriety Test Battery .................9 Administering the HGN Test . 11 Administering the VGN Test . 14 Section V: Other Types of Nystagmus and Abnormal Eye Movements...........15 Nystagmus Caused by Non-Alcohol Related Disturbance of the Vestibular System . .15 Nystagmus Caused by Non-Impairing Drugs ..............................15 Nystagmus Caused by Neural Activity ....................................15 Nystagmus Due to Other Pathological Disorders .
    [Show full text]
  • Swiss Cheese: the Addict’S Brain on Drugs
    NowWhat_FINAL:Layout 1 8/28/12 9:40 AM Page i Now What? An Insider’s Guide to Addiction and Recovery William Cope Moyers ® NowWhat_FINAL:Layout 1 8/28/12 9:40 AM Page ii Hazelden Center City, Minnesota 55012 hazelden.org © 2012 by William Cope Moyers All rights reserved. Published 2012 Printed in the United States of America No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means—electronic, mechanical, photocopying, recording, scanning, or otherwise—without the express written permission of the publisher. Failure to comply with these terms may expose you to legal action and damages for copyright infringement. Library of Congress Cataloging-in-Publication Data Moyers, William Cope. Now what? : an insider’s guide to addiction and recovery / William Cope Moyers. p. cm. ISBN 978-1-61649-419-3 (softcover) — ISBN 978-1-61649-452-0 (e-book) 1. Addicts—Rehabilitation. 2. Substance abuse—Treatment. I. Title. HV4998.M693 2012 616.86—dc23 2012027417 Editor’s note The names, details, and circumstances may have been changed to protect the privacy of those mentioned in this publication. This publication is not intended as a substitute for the advice of health care professionals. Alcoholics Anonymous, AA, and the Big Book are registered trade- marks of Alcoholics Anonymous World Services, Inc. 16 15 14 13 12 1 2 3 4 5 6 Cover design by David Spohn Interior design and typesetting by Madeline Berglund NowWhat_FINAL:Layout 1 8/28/12 9:40 AM Page iii To people ready to change, and those ready to help them NowWhat_FINAL:Layout 1 8/28/12 9:40 AM Page iv NowWhat_FINAL:Layout 1 8/28/12 9:40 AM Page v CONTENTS Acknowledgments ....................................................
    [Show full text]
  • Accountants Confidential Assistance Network
    ALCOHOLISM, SUBSTANCE ABUSE, STRESS, AND DEPRESSION IN THE ACCOUNTING PROFESSION (and how the confidential peer assistance program can help) license to practice accounting may open doors that might otherwise be closed, but it cannot A shield a CPA from the three most widespread career killers: substance abuse, depression, and stress. One’s physical and mental health directly influences client relationships and job functioning. Any impairment of a CPA’s performance ultimately harms the client, the profession, and society. An estimated 10% of CPAs will experience one or more of these treat- able illnesses themselves, and many more will have a colleague or client who does. Virtually all CPAs find themselves facing stress on a daily basis, and stress, if not effectively managed, can grow into paralyzing distress or debilitating burnout. Chemical dependency, stress, Recognizing the signs of sub- and depression can take a stance abuse and depression and tremendous toll on lives and seeking or recommending help can livelihoods, but in Texas, there save lives and protect the public from the frequently destructive effects of is a way for CPAs to get the these illnesses. help they need. We encourage In Texas, the Concerned CPA anyone dealing with chemical Network can help. Most volunteers dependency, stress, or depres- in this peer assistance program are sion to contact the confidential CPAs who have survived one or more hotline of the Concerned CPA of these illnesses, and they are dedi- Network for assistance. cated to helping their fellow CPAs, as well as exam candidates and TSBPA Peer Assistance accounting students, find treatment Oversight Committee through a wide range of outside resources.
    [Show full text]
  • ENHANCED IMMUNITY EXERCISE: Keeping Your Immune System at RECREATION VS
    ENHANCED IMMUNITY EXERCISE: Keeping your immune system at RECREATION VS. AMUSEMENT optimal strength the natural way. —and the winner is . Lifesource Health and Wellness Life And Other Phenomena he pace of this life has sped up so dramatically that sometimes it feels as though you are on a ride that progressively speeds up, spins faster and faster; and in the end only makes you feel not exhilarated, but exhausted and nauseated, leaving you to wonder, “Why did I even get on this thing in the fi rst place?” TSometimes it feels as though we are being pulled in many directions at the same time; everybody wants a piece of us, and all we want is a bit of peace. As a woman, wife, mother, dental nurse (in a very busy dental clinic), volunteer, kid’s taxi driver, cook, cleaner, ironing lady, laundry lady, walking encyclopaedia, banker, disciplinarian (judge, jury, and sometimes executioner), to name a few, sometimes I feel that in being “all things to all people” I have lost a little of myself in the process. This is not a phenomenon designated to one person only. Most people, especially women, often feel as though they are pulled and stretched in all directions, like a rubber band; and when the stretch reaches the point of no return, the band will then either snap or will “ping” into the outer reaches of space. Yes, I know; this phenomenon is called “life,” and at times it can get hectic and stressful. But what happens when it feels as though life has gotten a little out of control, when you sometimes feel overwhelmed even by the most innocuous chore, when you begin to cry and can’t stop and you don’t even know why you’re crying? In this edition of Lifesource Health & Wellness magazine we cover important topics such as understanding and identifying both qualitatively and quantitatively the difference between sadness and depression; dealing with stress and grief; the importance of physical exercise and the best type of exercise; how our bodies deal with waste matter, and the benefi cial effects of helping others, to name but a few.
    [Show full text]
  • Introduction
    Intoxication and Incapacitation • Eve Fichtner, Partner VanDermyden Maddux Law Corporation, Sacramento; • Keith Rohman, President Public Interest Investigations, Inc., Los Angeles. Introduction • Focus on alcohol – “Most widely used and abused drug on earth.” • Highlight key issues • Interview questions and concepts • Red flag inherent difficulties T9 MASTERED | 1 If recreational drugs were tools, alcohol would be a sledgehammer. Few cognitive functions or behaviors escape the impact of alcohol.” - Aaron M. White, Ph.D. Effects of Alcohol • Impairs cognition and psychomotor skills AND • Affects parts of brain responsible for: – Judgment – Inhibition – Personality – Intellect – Emotional states Effects of Alcohol T9 MASTERED | 2 Basic Biology • Ethyl alcohol is a small, water-soluble molecule • Readily absorbed and distributed by the blood to the water-containing components of the body. • Eliminated by metabolism, excretion and evaporation Basic Biology • Metabolism – Chemical process which converts food and liquids into nutrients – Alcohol metabolism begins at nearly the same time the alcohol is absorbed. • About 20 percent is rapidly absorbed into the bloodstream Basic Biology • Alcohol absorption – Primarily absorbed from small intestine into veins • The veins carry it to the liver • Liver processes what you eat or drink, and “either repackages it for your body to use, or eliminates it.” T9 MASTERED | 3 Pace and Volume Matter • Whatever the liver can’t metabolize is carried by blood stream and… – On to the brain! • Which gets the party started. Basic Biology • Un-metabolized alcohol goes to: –Urine – Breath Basic Biology • Food in stomach is the key factor affecting rate of absorption – Food requires digestion; it slows alcohol absorption. – Peak BACs generally within 30 – 60 minutes of the cessation of drinking.
    [Show full text]
  • College Alcohol Risk Assessment Guide
    College Alcohol Risk Assessment Guide ENVIRONMENTAL APPROACHES TO PREVENTION The Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention Funded by the U.S. Department of Education College Alcohol Risk Assessment Guide Environmental Approaches to Prevention Barbara E. Ryan / Tom Colthurst / Lance Segars College Alcohol A publication of the Higher Education Center for Alcohol and Other Drug Abuse Risk Assessment and Violence Prevention Guide Funded by the U.S. Department of Education. The Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention Funded by the U.S. Department of Education This publication was funded by the Office of Safe and Drug-Free Schools at the U.S. Department of Education under contract number ED-04-CO-0137 with Education Development Center, Inc. The contracting officer’s representative was Richard Lucey, Jr. The content of this publication does not necessarily reflect the views or policies of the U.S. Department of Education, nor does the mention of trade names, commercial products, or organizations imply endorsement by the U.S. government. This publication also contains hyperlinks and URLs for information created and maintained by private organizations. This information is provided for the reader’s convenience. The U.S. Department of Education is not responsible for controlling or guaranteeing the accuracy, relevance, timeliness, or completeness of this outside information. Further, the inclusion of information or a hyperlink or URL does not reflect the importance of the organization, nor is it intended to endorse any views expressed or products or services offered. U.S. Department of Education Arne Duncan Secretary Office of Safe and Drug-Free Schools Kevin Jennings Assistant Deputy Secretary 2009 This publication is in the public domain.
    [Show full text]
  • 1 Reasons for Substance Use Among People
    1 REASONS FOR SUBSTANCE USE AMONG PEOPLE WITH PSYCHOTIC DISORDERS: METHOD TRIANGULATION APPROACH Louise K Thornton 1 Amanda L Baker 1 Martin P Johnson 2 Frances Kay-Lambkin 1,3 Terry J Lewin 1 1 Centre for Brain and Mental Health Research, University of Newcastle, University Drive, Callaghan NSW AUSTRALIA 2 School of Psychology, University of Newcastle, University Drive, Callaghan NSW AUSTRALIA 3 National Drug and Alcohol Research Centre, University of New South Wales, Sydney NSW AUSTRALIA RUNNING HEAD: Reasons for Substance Use For re-submission to Psychology of Addictive Behaviors: 22/06/2011 Word count without extracts, tables and references: 5,827 Correspondence concerning this article should be addressed to Louise Thornton. Email: [email protected] 2 ABSTRACT Background: Substance use disorders (SUD) are common among people with psychotic disorders and associated with many negative consequences. Understanding reasons for substance use in this population may allow for the development of more effective prevention and intervention strategies. Aims: We examined reasons for tobacco, alcohol or cannabis use among people with psychotic disorders. Method: Sixty-four participants with a diagnosed psychotic disorder completed a self-report reasons for use questionnaire. A subset of eight participants completed semi- structured qualitative interviews. Results: Both the qualitative and quantitative data indicated that reasons for use of tobacco, alcohol and cannabis differed considerably. Tobacco was primarily used for coping motives, alcohol for social motives, and cannabis for pleasure enhancement motives. Conclusions: Prevention and intervention strategies targeting co-existing psychotic disorders and SUD may improve in effectiveness if they addressed the perceived beneficial effects of tobacco use, the strong social pressures influencing alcohol use and encouraged cannabis users to seek alternative pleasurable activities.
    [Show full text]
  • Nbenign Paroxysmal Positional Vertigo (BPPV)
    Ear Structures of importance Otologic Dizziness (Dizziness from Ear) Timothy C. Hain, MD Northwestern University, Chicago [email protected] The ear is an inertial navigation Vestibular Reflexes device n Semicircular Canals n VOR: Vestibulo- are rate sensors. ocular reflex n Otoliths (utricle and n VSR: Vestibulospinal saccule) are linear reflex accelerometers n Bilateral symmetry means redundant design. Positional Vertigo Otologic (Ear) Dizziness The most common syndrome n BPPV (benign paroxysmal n positional vertigo) -- about Benign Paroxysmal 50% of otologic, 20% all n Meniere’s disease -- about 20% Positional Vertigo n Vestibular neuritis and related conditions (15%) (BPPV) -- bed spins n Bilateral vestibular loss n Orthostatic hypotension (dizzy upright) (about 1%) n n SCD and Fistula (rare but Central positional nystagmus (dizzy everywhere) worth knowing) n Low CSF pressure syndrome (dizzy upright) 1 Benign Paroxysmal Positional Positional Vertigo Vertigo (BPPV) Dix-Hallpike Maneuver 61 Y/O man slipped on wet floor. LOC for 20 minutes. In ER, unable to sit up because of dizziness Hallpike Maneuver: Positive Benign Paroxysmal Positional BPPV Mechanism: Utricular debris migrates to Vertigo (BPPV) posterior canal n 20% of all vertigo n Brief and strong n Provoked by change of head position n Definitively diagnosed by Hallpike test BPPV treatment Unilateral Vestibular n Medication (e.g. antivert) – n Vestibular Neuritis/Labyrinthitis (common) minor benefit n Meniere’s disease (unusual, 1/2000 – May avoid vomiting by pretreating prevalence) n n Excellent response to PT Acoustic Neuroma (rare) n Surgery – canal plugging if n Vestibular paroxysmia (not sure how rehab fails (need more common) rehab after plug). Rarely done.
    [Show full text]
  • Understanding the Nature and Impact of Alcoholism : Implications for Ministry in Kenya Margaret Kemunto Obaga
    Luther Seminary Digital Commons @ Luther Seminary MTH Theses Student Theses 2008 Understanding the Nature and Impact of Alcoholism : Implications for Ministry in Kenya Margaret Kemunto Obaga Follow this and additional works at: http://digitalcommons.luthersem.edu/mth_theses Part of the Counseling Commons, Practical Theology Commons, and the Substance Abuse and Addiction Commons Recommended Citation Obaga, Margaret Kemunto, "Understanding the Nature and Impact of Alcoholism : Implications for Ministry in Kenya" (2008). MTH Theses. Paper 1. This Thesis is brought to you for free and open access by the Student Theses at Digital Commons @ Luther Seminary. It has been accepted for inclusion in MTH Theses by an authorized administrator of Digital Commons @ Luther Seminary. For more information, please contact [email protected]. UNDERSTANDING THE NATURE AND IMPACT OF ALCOHOLISM: IMPLICATIONS FOR MINISTRY IN KENYA by MARGARET KEMUNTO OBAGA A Thesis Submitted to the Faculty of Luther Seminary In Partial Fulfillment of The Requirements for the Degree of MASTER OF THEOLOGY THESIS ADVISER: DR. ROBERT H. ALBERS ST. PAUL, MINNESOTA 2008 This thesis may be duplicated. CHAPTER ONE INTRODUCTION Background Alcoholism is generally characterized as a family disease in the sense that it affects every one in the family in all aspects—socio-economically, spiritually, physically, psychologically, and emotionally. Families and homes of alcoholics suffer much from the degradation and stigmatization attached to the individual alcoholic. To some extent, this may reflect the negative perception held by society about alcoholism. The relational and communal nature of our Kenyan cultural thinking and practice also emphasizes, as in family systems theory, the fact that whatever affects the individual member of the family affects the whole family and also the community.
    [Show full text]