Sensory Challenges and Medical Procedures

The Spanish Inquisition – Surplus Equipment

Ever wondered what they did with all that left over equipment of torture when the Spanish Inquisition wound up? Well it appears much of it was taken up by medical technicians (I bet you’re not surprised by that!). If you are in ‘normal’ health some basic medical tests can be a bit daunting, but image how that is compounded by a degree of cognitive impairment particularly when that is impacting on how you process sensory stimulus.

Recently I had cause to visit with a specialist medical practitioner. I will not mention his or her speciality as this would easily identify the person in question. Early in the consultation I ask if my diagnosis of Semantic FrontoTemperal Dementia would be relevant to a diagnosis. The reaction was to go down the path of behavioural symptoms. I pointed out the impact on sensory processing being of a more relevant and important issue to me, but he/she wanted to pursue a litany of behavioural problems. At this point I suggested that if he/she wanted to see behavioural issues, I would show him/her some. They quickly got back on track!

The first outcome was a suggestion that I travel to hospital approximately 100 km away for a set of overnight tests and observations. My reaction was simple, and to me obvious. Any attempt to observe or measure a normal response was not going to be valid in that environment, because it would by its nature be extremely stressful and uncomfortable.

One fundamental tenant of science is you cannot make any observation without changing the behaviour of the subject, be it an electron or a more complex system like a human.

The next alternative was an overnight home based observation using a bunch of electrodes etc. attached to my body. This was more viable and preferable.

Come the day of the tests I presented myself at 3:00 pm for the fitting of the equipment for the overnight study. I had been given a basic set of instructions to prepare for the fitting of the monitoring equipment. The most important part seemed to be not to have any acrylic nails or nail polish. Fortunately I had refrained from their use for the last 60 odd years of my life.

The first issue was the nature of the equipment, while not heavy it was very bulky and I feel would restrict my movement and in itself impact on my ability to have a ‘normal’ night’s sleep. Despite my concern I proceeded with the fitting deciding to at least wait to I was in bed to gauge its impact.

The next issue involved shaving bits of me to fit electrodes. I suggested if this was necessary, then I was not going any further with the procedure. A reason was eventually given, in that it provided better electrical contact for the electrodes, but probable wasn’t necessary. I suggested maybe better electrodes would be simpler. After all the bits were fitted and tested it was discovered that the electrical contact was very good anyway.

Next three electrodes were fitted to my forehead and temples and one to the top of my head. Interesting that there was no requirement for a shave here. The issue here was having the leads tucked behind my ears etc. and minor miss-alignment of my glasses. (The impact here I discovered was the ability for close focus – i.e. reading a book). The next sensor was attached to my finger to monitor pulse and oxygen levels. Here the first issue was simple. I’m left handed, the ignition button on my car is on my left and such controls as navigation and parking sensors etc. are all touch activated. The solution was simple to move to my right hand. A new problem presented itself in that once fitted it was taped into place. This dis cause a level of discomfort. I then discovered that it was a ‘good’ quality tape being used and was not easily removed. It was then agreed not to use any tape to attach the lead to my arm or finger. In hind sight the use a non-adhesive gauze tape particularly if it was ‘rubberised’ would have resolved these issues, in that they would not adhere to my skin and hair and would be flexible enough to allow for normal movement.

At this point it was decided that attaching electrodes to my leg to monitor movement was not going to happen.

So after about 50 minutes I was wired up and ready to calibrate. All things worked (with the exception of the leg movement sensors that were not attached). I was now sent on my way, the system would switch on five hours later to record my night’s sleep.

I had a short 2 km drive home. The first minor issue I noted was the leads on my temples moved in and out of my peripheral vision. Not a good idea for any serious driving, but for someone with impaired sensory processing – a real annoyance and potentially dangerous in this situation. The real problem came on the first right-hand turn at a roundabout. The silicon finger sleeve and trailing lead had a high co-efficient of friction (almost sticky) with the leather steering wheel, and became entangled with my left hand in this turn. Fortunately, there was no traffic and I was able to disconnect this lead while driving.

Now the real fun began. At home just sitting, it soon became apparent of the annoyance factor of the harness. The bulk interfered with normal motion, it was difficult to read a book or magazine.

I then attempted to deal with some e-mail. The finger sensor got the finger. My typing skills are deteriorating anyway, but were almost non-existent with this sensor on my finger.

All the electrodes except the ones on my face where causing irritation and itches, above the normal. A casual scratch of an itch on my scalp nocked of this electrode. This was interesting as it was supposedly held the most firmly. It was not possible to accurately determine where this electrode came from as my sense of touch could easily identify the ‘gluey’ spot. So I coiled up the 10 meters of electrode lead and pocked it into the harness bag. This occurred almost 1 hour after I left the surgery. Within the next ten minutes while brushing the annoying leads from around my ears the three electrodes on my forehead and temples literally fell off. This in itself was quite distressing and annoying.

At this point I decided that there was no point in trying to re-attach the electrodes and to abandon any plan to continue with this test. Fortunately, when I tried to remove the harness, I was in the bedroom and not in my study where I would have had easy access good quality wire cutters.

In hindsight, I don’t believe that the equipment used was satisfactory for the job. I also believe that if my FrontoTemperal Dementia or any other form of cognitive impairment was taken into consideration in designing and implementing this testing procedure the outcome may have been better.

In future, I will not deal with any medical practitioners who have not adequately considered our needs.  – No One Expects The Spanish Inquisition – (Monty Python)

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