Wednesday, August 14, 2013

How Conscious are You?

One of the first things I do when I enter my patient's room is assess their level of consciousness.  If the person is awake, I usually start by asking him/her their name and date of birth, the month and year, who the president is and if they know where they are. If my patient is sedated or on a ventilator, I ask them to open their eyes, squeeze my hands, wiggle their toes and if they can speak, tell me their name. We score these actions on what is called a Glasgow Coma Scale.

12345
EyeDoes not open eyesOpens eyes in response to painful stimuliOpens eyes in response to voiceOpens eyes spontaneouslyN/AN/A
VerbalMakes no soundsIncomprehensible soundsUtters inappropriate wordsConfused, disorientedOriented, converses normallyN/A
MotorMakes no movementsExtension to painful stimuli (decerebrate response)Abnormal flexion to painful stimuli (decorticate response)Flexion / Withdrawal to painful stimuliLocalizes painful stimuliObeys command

You can see by this scale that the medical community doesn't have a lot of expectations and still gives you points for being conscious even if you are laying there doing nothing; a person who isn't even alive can score a 3.  Now, there are numerous definitions of consciousness. The free online dictionary defines conscious as "Having an awareness of one's environment and one's own existence, sensations and thoughts." I like this definition a little better; at least there is an expectation that you are actually aware of your own existence. There are many activities in our daily lives that require us to be conscious; working, communicating with others, raising children, exercising, driving, shopping, etc... The activity I want to talk about today focuses on what we put in our mouths.
First of all get your mind out of the gutter, this isn't that kind of blog; second, lets be serious. Think of all the things that can enter a person's body through their mouth on a daily basis; food, drinks, toothpaste, pills, alcohol, cigarettes, gum, pollution, bacteria, our fingers, other people's finger's (or other body parts), bugs; if you are a baby or have pica, the list goes on. How often do you stop and think to yourself, "why am I putting this particular substance in my mouth and how is it going to affect my environment, sensations, thoughts and my existence?" What we put in our mouth has everything to do with our level of consciousness; our mere existence relies on food and water.  What can we do to make ourselves more conscious of the substances that are entering our body?
  • The food you eat on a daily basis will probably be one of the most important choices you make and will most likely have the biggest impact on your health and happiness now and in the future.Most people put more thought into the TV they buy than the food they consume. Here are a few questions to ask yourself before you take a bite: Why am I eating this? Am I really hungry or am I maybe just thirsty or bored? How does this food make me feel? Will it make me feel sluggish or give me energy? How will my body benefit from eating this? Is it rich in vitamins and minerals or is it just empty calories? Where did this food come from? Is it local, organic or flown in from New Zealand? (I still can't believe our food flies all the way from New Zealand). How many vegetables have I eaten today? Vegetables are the most missed food in the standard american diet today. They are full of vitamins and very beneficial to your body. Please eat more vegetables. 
  • Alcohol not only alters your level of consciousness but it also takes a toll on your heart, liver, pancreas, immune system and is linked to certain cancers; not to mention legal fees associated with DUI's and other drama you may have caused while you were intoxicated. The CAGE questionnaire is a short 4 question assessment form that is used to help people identify if they have a problem with alcohol dependence. This website http://counsellingresource.com/lib/quizzes/drug-testing/alcohol-cage/  has the questionnaire for those of you who might questioning your drinking habits (The fact that you are questioning them is probably a sign that you should visit this website). Even if you are not questioning them I still encourage everyone to take the quiz anyway in the name of consciousness. 
  • Smoking cigarettes is one of the most deadly habits you can possibly have. Like alcohol, many people use smoking as a coping mechanism making it highly addictive. Some questions to ask yourself are, "why, when and where do I smoke." If you are smoking because you are stressed out, try and find another coping mechanism like exercise, meditation, counseling, drawing or writing. Try using suckers to fulfill your oral fixation or those electronic cigarettes to get your fix. I don't know how safe they are but if it helps you quit then I'm all for it. Some people smoke when they drink; try drinking less. I don't know a single person who smokes for fun so dig deep and find the root cause. Here is a website from the American Cancer Society on how to quit smoking  http://www.cancer.org/healthy/stayawayfromtobacco/guidetoquittingsmoking/guide-to-quitting-smoking-toc
  • Pills, pills and more pills. I am absolutely astounded at how many medications people take. What shocks me even more is the fact that most of the time people don't even know why they are taking them. Get familiar with your medications. Learn the names of them and the reasons you are taking them. If your physician prescribes you a new medication please ask him/her the following questions: what is the name, why am I taking this, what will it do to my body, and what are serious side effects that I should look out for? If your physician doesn't have time, you can also ask your pharmacist or even google it. Maybe there is an alternative to taking certain pills; for example, changing your lifestyle or diet. The next thing you should do is keep an UPDATED list with the name, dose and how often you take your pills with you so in the event you get admitted to the hospital we know what you are taking. The hospital can be a dangerous place. The more information we know about you the safer you will be.

  • I think it's important to remember that your body is an amazing machine. Your body loves you and is doing everything in its power to keep you alive; the least you can do is take the time to think about the substances that you are putting into it and how they are going to affect your very existence. Try enjoying your conscious behavior while you have it because you never know when you will end up scoring a 3 on the Glasgow Coma Scale.