Julius Arnold (1835-1915) was a German pathologist.
His name is affiliated with Type II Chiari malformation (Arnold–Chiari malformation).
With a primary interest in pathology and anatomy, Arnold made contributions in a number of areas, including the anatomy associated with gunshot wounds (1870).
Biography Born 19 August 1835 Zurich, Germany Son to German anatomist Freidrich Arnold (1803-1890) Studied under Rudolf Virchow and Nikolaus Freidrich in Heidelberg Later became Professor of Anatomy at Heidelberg Died 3 February 1915
Medical associations Arnold–Chiari malformation (1894) – Type II Chiari malformation associated with myelomeningocele Friedrich-Erb-Arnold syndrome [aka Uehlinger syndrome; Pachydermoperiostosis or primary hypertropic osteoarthropathy] Characterized by pachydermia (thickening of the facial skin and/or scalp); digital clubbing; and periostosis (swelling of periarticular tissue).
Key Medical Attributions: In 1894 Arnold described his pathological post-mortem findings of an infant with herniation of the cerebellar tonsils and 4th ventricle through the foramen magnum. The infant also had spina bifida. The similarities between this and the findings of Hans Chiari lead to this being named the ‘Arnold-Chiari Malformation‘. Alternatively known as Chiari malformation II. The findings Chiari had previously described involved brainstem herniation with associated spina bifida. However, the infant in that case had associated hydrocephalus, which was not the case with Arnold’s findings.
Hans Chiari (1851-1916) was an Austrian pathologist. He is named after and affiliated with the Chiari malformations; Type II Chiari malformation (Arnold–Chiari malformation) and Budd–Chiari syndrome (1899).
Biography Born November 4, 1851 in Vienna, Austria Studied medicine in Vienna and worked as an assistant at the Vienna Institute of Pathology under Karl Rokitansky (1804–1878) 1875 – Graduated medical school from the Unviersity of Vienna 1878 – Habilitated in pathological anatomy in Vienna 1882 – Professor extraordinarius of pathology at the German University in Prague 1883 – Appointed professor ordinarius and superintendent of the pathological-anatomical museum in Prague 1906 – Commenced as professor ordinarius at the University of Strasbourg Died May 6, 1916 in Strasbourg following a throat infection
Hans Chiari published a case series of three patients with hepatic vein thrombosis, and a literature review of seven additional patients. He named the disease ‘phlebitis obliterans‘, and postulated that the thrombosis was a complication of endo-phlebitis likely from syphilis. Lange postulated an inflammatory process in hepatic vein thrombosis prior, in 1886.
Chiari published across a wide range of pathology, including malformations of the brainstem and cerebellum, hepatic vein thrombosis, aortooesophageal fistula, choriocarcinoma, carotid artery plaques and thrombosis, autodigestion of the pancreas, and connections between the eustachian and thebesian heart valves.
Pathology of showed congested and necrotic livers, porto-mesenteric circulation congestion, large volume ascites, and minimal adventitial reaction without perivascular involvement on histology. Chiari provided the first clinical and pathological correlations of this syndrome.
Chiari malformations – abnormalities of the brain stem and cerebellum identified by Chiari on post-mortems. Type 1 (1891) – peg-like elongation of the cerebellar tonsils into the spinal canal through the foramen magnum; Type 2 aka Arnold Chiari malformation and Type 3 and 4.
Chiari network – mobile net-like connections between the valve of the coronary sinus and the valve of the inferior vena cava. An anatomical variant, usually of no clinical significance.
Territories Talk is a unique online forum with host from around the Overseas Territories, discussing social, economic and political issues pertinent to the people of the Overseas Territories. Today we will be speaking with Daniella Jade Lowe about life in the UK and her advocacy on several issues.
What is Scoliosis? Scoliosis is a condition that causes an abnormal curvature of the spine. In most cases, scoliosis develops in childhood or adolescence and can progress over time. It is often detected during routine physical exams, and early detection is important to prevent the condition from worsening.
There are different types of scoliosis, including:
Idiopathic scoliosis: This is the most common form of scoliosis and has no known cause. Congenital scoliosis: This type of scoliosis is present at birth and is caused by abnormal spinal development. Neuromuscular scoliosis: This type of scoliosis is caused by underlying conditions that affect the nervous system or muscles, such as cerebral palsy or muscular dystrophy.
Symptoms of Scoliosis In many cases, scoliosis is not painful and may not cause any noticeable symptoms. However, as the curvature of the spine worsens, it can lead to a range of symptoms, including:
Uneven shoulders or hips A visible curve in the spine Back pain Difficulty breathing Fatigue
Diagnosis and Treatment of Scoliosis If scoliosis is suspected, a doctor will perform a physical exam and may order diagnostic tests such as X-rays or an MRI. Treatment for scoliosis will depend on the severity of the condition and the age of the patient.
In mild cases, scoliosis may not require any treatment. However, in more severe cases, treatment may be necessary to prevent the condition from worsening and causing health problems.
Treatment options for scoliosis may include:
Observation: In some cases, the doctor may recommend regular checkups to monitor the progression of the condition. It’s important to note that observation is not a treatment, and is only appropriate for very small curves which may not progress. Bracing: For moderate scoliosis, a brace may be worn to prevent the curvature from worsening. Surgery: In severe cases, surgery may be necessary to straighten the spine and prevent further health problems.
Scoliosis Awareness Month Scoliosis Awareness Month is observed annually in June to raise awareness about scoliosis and promote early detection and treatment. During this month, organizations and individuals around the world work to educate the public about the condition and the importance of early diagnosis and treatment.
One of the primary goals of Scoliosis Awareness Month is to educate parents and caregivers about the importance of screening for scoliosis in children. Early detection and treatment can prevent the condition from worsening and improve the long-term health outcomes for those affected. Since there is no national screening program in the UK, it’s down to the general population to screen for Scoliosis.
Scoliosis Awareness Month also provides an opportunity to support those living with scoliosis and raise funds for research into new treatments and a better understanding of the condition.
Spinal Fusion surgery has been recommended to me to fix scoliosis, where they cut the spine open and put metal rods in your back to fix the curvature of the spine.
It can have respiratory complications.
Spinal fusion surgery may lead to respiratory complications such as pneumonia, respiratory failure, atelectasis, and worsening of pre-existing chronic lung conditions. These issues could be more indicative of long-term mortality post-surgery than cardiac complications, particularly in elderly patients. The occurrence of Adult Respiratory Distress Syndrome (ARDS) may also elevate the risk of in-hospital mortality. It is crucial for patients to be informed about these risks before undergoing spinal fusion surgery.
Disability History Month is observed in October, while Disability Pride Month takes place in July. Let’s explore the reasons behind each:
Disability History Month (October):
Purpose: Disability History Month aims to raise awareness about the historical context, achievements, and challenges faced by people with disabilities.
Origins: It began in the United Kingdom in 2010 and has since spread to other countries. The choice of October is significant because it includes World Mental Health Day (October 10) and International Day of Disabled Persons (December 3).
Focus: During this month, educational institutions and organizations highlight disability-related history, activism, and advocacy. It’s an opportunity to learn about disability rights movements, legislation, and the contributions of disabled individuals.
Disability Pride Month (July):
Purpose: Disability Pride Month celebrates the identity, resilience, and achievements of people with disabilities. It’s a time to embrace pride and self-acceptance.
Origins: Disability Pride was initially celebrated for a day in 1990 in Boston, USA, coinciding with the signing of the Americans with Disabilities Act. It gained recognition as a month in 2015.
Symbolism: The Disability Pride Flag features vibrant colors representing various disability experiences and needs. For instance:
Red: Physical disabilities
Gold: Neurodiversity
White: Non-visible and undiagnosed disabilities
Blue: Emotional and psychiatric disabilities
Green: Sensory disabilities
Charcoal background: Protests against ableism
Importance: Disability Pride Month promotes visibility, counters ableism, and encourages celebration within the disabled community. Allies also play a crucial role in raising awareness.
Pride in general is in July for the LGBTQ+ community. There are different pride celebrations for different sectors within the community also which include those with disabilities. Like there’s also black pride in August for people of colour.
Is a flag needed?
Do you think this is patronising?
Both months are important. Both months contribute to a more inclusive and understanding society, recognizing the diverse experiences of people with disabilities. Both months show a level of intersectionality.
Disability, belonging, fitting in, and inclusion are all important concepts that relate to creating a more equitable and inclusive society. While they are related, they each have distinct meanings.
Disability refers to a physical or mental impairment that limits a person’s ability to perform certain tasks or activities. It is important to recognize that disability is not a personal failing, but rather a natural part of human diversity. This usually makes people ‘stand out’ by default.
Belonging, fitting in, and inclusion are all important aspects of creating a positive and productive work environment. According to a report by Bain & Company, building inclusive teams improves performance and is the right thing to do. It also pays off in recruitment, retention, and better teamwork. People describe what being included looks and feels like in remarkably similar ways. Helping everyone feel included is deceptively difficult, but organizations can navigate the complexities by marrying systemic change with more inclusive behaviours.
In summary:
Fitting in means conforming to group norms.
It can lead to suppressing one’s true identity to gain acceptance.
People may prioritize conformity over individuality.
Being included celebrates diversity and uniqueness.
It promotes a sense of belonging based on shared values of respect and empathy.
Allows individuals to feel valued for their authentic selves.
Prescription glasses are just as much of a mobility aid as a wheelchair is.
Why is one so stigmatized and the other isn’t?
In my opinion, both prescription glasses and wheelchairs are mobility aids that help people with different types of disabilities.
However, the stigma attached to wheelchairs is more than that of glasses. According to an article on Nautilus, the stigma attached to wheelchairs is due to the cultural understanding of disability and the way it is portrayed in the media. Disability can be deemed as a cultural construct not a social construct.
It all started with a street art campaign by Sara Hendren and Brian Glenney, who redesigned the commonly accepted symbol for disability, called the International Symbol of Access, to change the way people perceive wheelchairs.
On the other hand, there is no stigma attached to wearing glasses, and people who wear eyeglasses do not feel any shame in walking out of the door.
However, studies show that there is plenty of stigma attached to hearing aids. It is important to note that the stigma attached to mobility aids is not only a result of cultural understanding but also a result of the lack of accessibility and inclusivity in our society. We need to work towards creating a more inclusive and accessible environment for people with disabilities.
That pressure injury or sore was 7cm deep, it resulted in me being in bed rest for seven months to heal, that was quite a traumatic experience in its own way and I can talk more about that
I think I spend a large proportionate of my time either managing my care situation, or managing the medical situation that I’m in so dealing with appointments, dealing with scheduling appointments, dealing with getting hold of doctors, chasing things up when things don’t happen, all that sort of thing. That I think I consider these days to be my full time job.
I do try to keep it as consistent as I can only because with the number of carers that come through, we do struggle to find continuity of care, we do struggle to find people who are consistent that come back and I think that is again, back to the pressure side of things, that can be a challenge too when you’ve got new people coming in.
The quality of the care varies just depending, I’ve had some very good carers and some of them will have done very minimal care, they will have just come from domiciliary and then gone to a training course in an office and then shipped out there. So I do end up doing a lot of the training if you will myself because everybody’s routines are slightly different.
Interviewer: It sounds like you’re carrying a huge amount on your shoulders, that you’re managing your care package, you’re managing your own health, you’re having to train carers who are coming into you where the knowledge isn’t the standard that you require, on top of running your life like everyone has to do which isn’t straightforward. That’s a huge amount for one person to carry.
It is and I can do that now, if you ask me that in 10 years’ time, I don’t know if that answer would be the same. I don’t know how I’m going to be doing this in 20 years from now, you know?
There’s only so much you can physically you can do yourself, there’s only so much bandwidth that you’re bringing and if you’re in pain, which I am sometimes, that becomes even more difficult because the pain is your focus, it’s not really necessarily the carers, again that’s when mistakes get made because you’re just trying to deal the acute rather than you need to be able to see something, say something, whatever.
So yeah, mental health wise, I think fortunately, I do speak to a therapist, a speaking therapist weekly, that helps me sort of destress in a way or at least get out all the frustrations and whatever that are going on. What I’ve found since I’ve been talking to her and I’ve known her for a while now, is that I would say if we have four monthly conversations, out of those, at least two of those would be spent talking about care and that’s not really where I want it to be. I would like be talking about other things rather than, “this is what’s going on this week because of my care ..”, blah blah blah.
That’s how much of an impact and an influence if you will the care situation has in my particular life. It’s difficult, it is difficult.
We don’t know if the man had always been paralysed – for some people disability is life-long, for others it happens through illness or accident or later in life.
Being paralysed, he wouldn’t have been able to move around by himself, leave the house or earn a living – he would be completely dependent on others for everything.
It is likely that the only way of him being able to get his basic needs to survive would be to be carried outside into the town square to beg.
This same situation happens today in many developing countries where disabled people are still treated as outcasts.
Through the Roof ‘Wheels for the World’ mission trips constantly meet people who are in this situation. The trips take refurbished wheelchairs and mobility aids, along with Bibles, for people just like the paralysed man in Luke 5.
What did the paralysed man need – he needed to know Jesus.
What do our Wheels for the World recipients need – the need is still exactly the same – they need to know Jesus – demonstrated through the love of Christians providing a wheelchair and a Bible.
2. The Four Friends These men were true friends – they saw past the man’s disability. They saw the man himself as a friend and responded to what he needed. They treated him with love, respect and compassion.
It probably wasn’t easy carrying the man on the stretcher.
We don’t know how far they had to carry him.
They worked together and they were determined, because they knew how important this was for the paralysed man.
When they arrived and couldn’t get into the house, they must have felt they were never going to succeed in getting their friend to Jesus.
It was a brave idea to break through the roof – what would the owner of the house say, or do to them?
They put their friend’s needs before their own safety or reputation. They knew how important it was for him to meet Jesus.
The situation is exactly the same today – it is just as important for disabled people to meet Jesus today as it was then
Through the Roof’s ‘Roofbreaker’ project is exactly this – to break down the barriers that might prevent disabled people from meeting Jesus.
It goes further than that too… once someone meets Jesus, they will want to serve Him and tell others about Him too – so barriers need to be removed so that disabled people can not only come to faith, but grow in faith and share that faith in the same way as everyone.
3. The Crowd The Bible account says that those who were present when the man was lowered through the roof were ‘amazed and gave praise to God. They were filled with awe’.
The Pharisees and teachers of the law who were present didn’t recognise who Jesus was. Jesus chose a disabled man to demonstrate exactly who He was.
Jesus could have just healed the man, but He didn’t. Jesus chose this moment to demonstrate that He was indeed the Son of Man and that He did indeed have authority to forgive sins.
What an honour for the paralysed man to be chosen to display Jesus’ authority in this way.
How much more important it is to meet Jesus, to know who He is, and to have your sins forgiven than just to be physically healed? Physical healing can only be temporary – our earthly bodies will one day die – but when Jesus forgives our sins, He is giving the gift of eternal life.
So, what impact did it have on the lives of those who witnessed this?
Imagine you were one of the people in that crowd. That moment would be a transforming point in your life because of what you had witnessed. That’s why it’s important today to hear about how God still works in and through the lives of disabled people.
The personal stories of disabled people whose lives have been changed by Jesus are incredibly powerful. We need to hear more of them, so that Jesus can work through those to transform other lives too.
4. Our Response
How does the account of the paralysed man affect us even today as we hear it and respond to its message?
What do we learn from the paralysed man – are we seeking our own encounter with Jesus that will transform our lives completely? Jesus can take our weakness, transform it, and glorify God. Like the paralysed man, our lives will never be the same again once we have had a life-changing encounter with Jesus. And of course, then we need to respond and make sure others can come to know Jesus too.
What do we learn from the four friends?
God can use us if we have faith in Him. We may not need to break through roofs, but there are still barriers today that prevent disabled people from coming to Jesus – what can we do?
Let’s dig through that roof! Let’s break down the barriers!
The barriers might not always be what we would think. The barriers in our churches are not always to do with the building, there can be other barriers too – we need to ask disabled people themselves so that we can break through those barriers as the four friends did.
And what do we learn from the ‘others’ in the story?
Are we people who are amazed and give praise to God?
Are we ‘filled with awe’ by observing Jesus in action as they were?
Or are we like the Pharisees and teachers of the law clinging on to our traditionalism and not being willing to change?
If we see Jesus for who He really is, all this will be turned on its head. How will we respond? It’s time for churches to make sure there aren’t any barriers for disabled people coming to Jesus. Take an honest look, but most importantly ask disabled people if there are any barriers they are facing. And remember there’s lots of help available – Through the Roof will be delighted to help. We all need to be transformed by Jesus and that’s exactly what Through the Roof is aiming for.
Through the Roof’s mission is: ‘Transforming lives through Jesus with disabled people’. That is exactly what we see in the account of the paralysed man. It is Jesus doing the transforming, but Jesus not only transforms the life of a disabled person, Jesus also works through this person to transform the lives of others too.
Stay tuned for our next Disability Awareness Sunday Service on the 17th of September 2023!
This year The WindReach Bermuda and Bermuda Riding for the Disabled, is celebrating 50 years of Therapeutic Riding in Bermuda!
Therapeutic Riding is recognized world wide for its positive contributions to an individual’s well-being; cognitively, physically and emotionally. In fact, the impact therapeutic riding has on an individual with special needs is profound. Not only does riding improve physical strength, balance and coordination, it goes as far as to increase self-esteem, concentration levels, health and social interactions. Therapeutic riding is available to a large sector of individuals living with special needs and should be encouraged as we look to celebrate all abilities.
WindReach Bermuda’s Therapeutic Riding Programme is accredited by The Canadian Therapeutic Riding Association (CanTRA) and their Instructors are also CanTRA certified. We strive to provide a high quality programme that promotes challenge, achievement, empowerment and independence for individuals with special needs. Lessons, whether individual or group, follow an individualised lesson structure; including warm up exercises, a progression of skills and games designed to further those skills. Accompanying the participant and instructor in each lesson are trained volunteers ensuring safety at all times. Lessons are designed around the participant’s unique needs to maximize the outcomes and therapeutic benefits.
WHY HORSES?
Because they are fun! But more importantly, a well trained therapy horse is rhythmic, symmetrical and organized. Each step the horse takes provides strong sensory and physical input in many dimensions – up and down, side to side, and back and forth. The Instructors balance these movements in specific orders to achieve positive results with the rider’s body mechanics that cannot be duplicated in any other setting.
WHAT ARE THE BENEFITS TO THE THERAPEUTIC RIDING PROGRAMME:
The physical benefits include: improved balance, strengthened muscles, improved coordination and motor planning. It also stretches tight/spastic muscles, increases joint range of motion, respiration and circulation, as well as sensory integration.
Therapeutic riding also improves: social skills, self confidence, increased interest in the outside world and increased risk taking abilities. In addition, it develops skills of patience, emotional control and self discipline; enhances friendships, communication and enjoyment and develops respect and affection for animals.
The educational benefits include: improved remedial reading and math, sequencing, patterning and motor planning, improved hand/eye coordination, improved visual and spatial perception, increased attention span and concentration, as well as improved verbal skills.
I remember when I used to go horseback riding at Bermuda Riding for the Disabled, as a wheelchair using, primary school student. During my time there, I got to ride three different horses: Dusty, Squirrel and Sandy. It was a form of physical therapy for me.
In the picture below, I am riding on a horse named Squirrel in my school P.E uniform. This took place every Wednesday at lunchtime for about an hour. Unfortunately, I stopped when I transitioned to Middle School to focus on my studies.
Purple Badge for Bravery Award
One technique that I learned while there was Trotting. There is a difference between Trotting and Galloping. The difference between gallop and trot is that gallop is (intransitive of a horse, etc) to run at a gallop while trot is to walk rapidly. I even won a purple ribbon Bravery award for Trotting during a contest. I learned a lot and made great relationships while there. Congratulations to them for 50 years and best wish for a whole lot more!
If you are interested in participating in our Therapeutic Riding Programme please contact Samantha Hillier at shillier@windreach.bm or call 238-7433.
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