That's not what it sounds like, is it?
Inventory is your friend. You don't need to be smart. Just be diligent. Check each bit for something nasty. You'll find it and then you can pretend to be smart.
Also remember General Custer! When you report an arrow through your chest:
I have an arrow through my chest General Custer!
Ever had a distended bowel? Wasn't it called a 'belly ache'? So what do kids do, who already have dystonic posturing, when they have belly pain? They posture HARDER and they posture LONGER and they posture FURTHER.
OK, that's logical enough. But what happens when hips get adducted as part of that harder, longer further posturing?
They wear down and eventually dislocate. Poop hip.
The main point, though, is easy to miss. The bowels have their own nervous system and also are hugely influenced by sympathetic and parasympathetic nervous system events which are very much attuned to the VISCUS!
Viscus? What's a viscus?
Viscus is a very important word. Not being aware of this word and what it means can cost you or somebody you know - their life. Any inner organ that's hollow is a viscus. A urinary bladder is a viscus. A gallbladder is a viscus. The esophagus, the small intestines, the colon are all viscus structures. So in the movies the boat will soon explode and the good guys jump in the water. Safe! No. The shock wave through water will cause viscus structures to explode. Sorry. The guy who hasn't hit the water yet has a better chance.
In neck injury type quadriplegia, a distended urinary bladder can kill. The disconnected (untempered) lower spinal reflexes can cause such severe reflex response and cause rapid and extensive stroke. Blood pressure goes right off the chart. Response to viscus distention is real and generally not reasonably proportioned to its cause. Run amok it does severe things.
But in CP and other neurologic conditions the reflexes are not detached, right? Well maybe. At least not fully and well tempered as normal. Certain things can still magnify. So windswept postures ... grind ... and then grind away.
But it is worse than that. As the colon distends - over time - propulsion is lost. No one part can fully squeeze closed so that the next squeeze downstream causes anything to go any where. Solid waste bloats the colon. Fluid may well go around this and disguise the blockage severity. Symptoms are often poor eating and reflux (that's way upstream). So folks are chasing reflux and gas and poor nutrition is just a skinny kid - they're all skinny General Custer!
But that large bloat also contains a big clump of bacteria whose natural properties are way off. So toxins are being produced in a dead pool. The condition is called 'Toxic Megacolon'. It saps the life out of children. It kills. This may be the whining of your whining kid! We have had to argue with G.I. specialists to fix this as the hip x-rays were getting worse. They do not make this connection. We have frequently seen hip problems reverse (early) when this was the only treatment.
The river has to run or else it turns green. Basic, huh? Plugged ears ( eustachian tubes ) infect. Same here.
<=(Peristalsis, the movie. Click on it.)
Peristalsis ( the sequential squeezing of the viscus to move things along) must be effective. Just tossing in water retaining (sponge) mixtures does not fix this. Once the megacolon is emptied (probably needs a hospital stay to actually do it) it needs time to shrink. The distended stretched viscus walls are poor for power and need to thicken as the viscus shrinks and become able to fully squeeze tightly.
So do we give this one item an eponym? (PLEEEESE not MY name. I would like my name on something more upbeat - like a - mmmmm - Harley! brummmmmmm brummmmmmm.). Anyway, that would miss the bigger picture once again.
Urinary tract infections can also do this. Renal stones can and do do this. Stuff that does not feel good does this.
But here's the trick. The circuits that convey the FEELING of feeling bad (the conscious awareness of it) may be down. There may well be no pain, no feeling of bloating or aching or whatever. The reflexes, intact, carry on in an exaggerated way when they are NOT monitored from above by higher neurological mechanisms.
That is where you come in. Pit bull inventory taker. Attention to details. Why is all this posturing happening now? What has changed?
Hot weather: renal stones and dehydration are the biggest ones to just pop up. And remember, narcotics just about knock out motility. That a short course of narcotic began the process which then maintained itself is a common story. When giving narcs, put on your plumbers hat.
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