#michelle lyons

Original:

A tape of early digital abstraction as played out through the PA system of Zenway Supermarkets, a popular small chain of shops in the UK during 198X. It was dubbed "Cracky II" in the semi-famous routine of a semi-famous ex-pat US alternative comedian who named himself after Zenway's.

Said stand-up's observations on the tape reduced many county council meetings to hilarity, and reportedly impressed the board of London Weekend Television (though advertising rules forbade him from appearing on both ITV and the BBC).

Zenway Supermarkets (the comedian) took his name from the shop as it was the only place he could get US-style baked beans. Zenway Supermarkets (the company) never sued, as thanks for the comedian stopping a nasty case of conjunctivitis that the CEO's son had contracted from a pencil case.

Salvaged from a skip in an unofficial tube station, this tape has been restored using methods.

omg really?? that's amazing. I'm happy for her. it's funky to think how much of my experience with her bizarre videos was through other people reuploading them. bless all that weird shit and that she still keeps making it.

There are multiple reasons one can have pain "down there". I saw down there, because the source of the pain can come from multiple areas of which will be explained more below.

A few weeks ago I was watching a video from Michelle Lyons (a women’s health physical therapist) on an interview about pelvic pain she did with another PT, Sandy Hilton. As usual, my notes are below but if you prefer to watch it yourself, here is the link.

First off, Dr. Hilton established that the approach to care that patients like the most, tends to be the mostly likely to help the patient (which simply means if two studies show that neither treatment is more effective than the other, the therapist can choose to do either one with the patient, and see which one the patient likes more because that will determine which one works best).

The two PTs talked about how manual therapy and the therapy of touch (such as massage (with consent before obviously)), while extremely important, also need to be reigned back to help promote self efficacy (or the ability of the patient to continue on in their lives without constantly needing the PT to cue/adjust them).

They also went into discussion about the Top Down Approach, or that there needs to be emphasis for the patient on enjoying the little things (like smelling a fragrant tea, etc) as well as emphasis on proper breathing techniques, because these are activities that help reduce stress and promote relaxation. There also need to be specific measurable goals for people in pain to work towards. The goal of “not being in pain” is admirable but hard to focus on, so instead picking goals like “be able to sit for 10 minutes without pain” or things more concrete like that are important to be able to see progress.

The PTs also talked about Pudendal Neuralgia (pain of the pudendal nerve). This condition has such a large impact on pelvic health and subsequently can really make people suffer. Unlike nerves in the arm and legs, there isn’t a nerve tension test one can do on a patient to assess nerve irritation because the pudendal nerve goes through curved muscles and because it’s a relatively short nerve (in contrast there are things called limb tension tests that can be done to the upper and lower body to determine nerve tension). For pudendal neuralgia, there seems to be a focus on neurodynamics, such as squats (and maybe lunges) which if effective, would be because there are changes in tension but of the tissues around the nerve, and not usually of the nerve itself.

The other day I also watched a webinar done by the International Pain Society (hosted by Amy Stein) where researcher Melanie Morin was interviewed about her paper Heightened Pelvic Floor Muscle Tone and Altered Contradictability in Women with Provoked Vestibulodynia. For those that prefer videos here’s the link.

The talk was all about provoked vestibulodynia (or pain with penetration also known as vulvodynia). The pain patients reported was frequently described as being sharp, shooting, stabbing, or aching.

The research started using a dynamometer (kind of like the speculums at the gyno's with a measuring device attached to it) to measure pain. The results showed overactivation, stiffness, and slower relaxation in the women with pain, which were explained by using the physiology (the actin-myosin cross bridges and the muscle fascicles and fibers). What that means is that the muscles are not at their optimal length, and aren’t behaving as smoothly as they should, which causes pain when they are used.

The study wanted to understand if provoked vestibulodynia caused the pelvic floor reaction (stiffness, etc) or if it was the other way around, and Melanie responded she thinks it is both, as in they both work on one another. So the pelvic floor could stiffen/be overactive/relax more slowly and thus cause pain, or the pain could cause the pelvic floor to stiffen/be overactive/relax more slowly.

She also mentioned how fear avoidance can contribute to some of the pain meaning that someone trying to avoid an activity that causes them pain is more likely to have pain for a multitude of reasons (including that when you are afraid a physical activity will hurt and you avoid it, you use those muscles less which makes them more likely to stiffen up and hurt later on when you do try the activity; aka it's a vicious cycle).

The study also went into the 2 types of tone, which dictates which modality a therapist will pick to help try to relieve a patient’s pain. With active tone, the patient shows high levels of electrogenics, or electrical activity in the muscles, and basically the patient needs to be taught to relax the muscles to which the therapist would use biofeedback (think like how when electrodes are placed on your leg muscles and you are told to tight your muscles when you feel the buzz of the electrodes, and relax when you don’t feel it). Passive tone is all about the viscoelastic properties of the tissues, meaning that the muscles and fascia are “tight” all on their own (it’s a physiological thing) and even if you physically tried, you wouldn’t be able to relax them just by contracting and relaxing your muscles. In this case you need something to help passively stretch the tissue, like a dilator.

In regards to how to know how much to stretch the tissue, the therapists relied on the patient’s perception of tolerance, so if you are saying you can’t handle any more stretching, they wouldn’t go any further. The researchers noted that pain can influence the measurements and that in other studies that used transperineal ultrasound caused no pain because ultrasound is external.

The last takeaway that Melanie had was that this type of treatment isn’t just working on the muscles and getting them to relax, or working on helping the patient overcome fear avoidance, but is also about nerve re-education, or retraining the nerves to fire better so they don’t cause pain from overactivity.

Also, since we are deep into chatting about women's health physical therapy, I watched this cool youtube video the other day posted by Dr. Brianne Grogan, of Femfusion Fitness (again, for full disclosure, I currently work for FemFusion Fitness as an information specialist). She was interviewing another physical therapist named Dr. Susan Clinton, who is the creator of Embody PT. Dr. Clinton talked about how you can use your voice to affect your pelvic floor. My notes are below, otherwise you can watch the video here.

In the video Dr. Clinton discussed how she started focusing on helping patients to stop holding their breath when doing transitional movements (like getting up from sitting, getting out of bed, etc). The logic behind not holding your breath is that when you do hold your breath, it increases the downward pressure in the abdominal cavity, and as a result puts more pressure on the pelvic floor. Dr. Clinton had patients try to talk while they stood up from a chair to show them if they were holding their breath, and then she began training patients to use their voices to raise/shorten the pelvic floor (by raising the pitch of their voices) and also practice lengthening the pelvic floor (by lowering their voices).

Her and Dr. Bri discussed how it’s important that the pelvic floor be able to accommodate a range of motion and be supple, and not just always be lengthened or shortened, hence why singing can be useful as one can sing a range of notes that require different pitches to affect their pelvic floor. Another alternative to singing that Dr. Clinton proposed was reading a children’s book or fairy tale and making sure to do all the different voices (for example, in Little Red Riding Hood, giving the wolf a deep, low voice, and Red a high voice).

Dr. Clinton explained how using voice modulations to helps train pelvic floor because the voice gives insight into tension that the patient is holding in their body. She likened it to how you can tell someone is in pain from their voice when they talk. She also stressed that the cool thing about doing this kind of vocal training is that it provides a biofeedback loop; it makes the patient more aware of themselves and they adjust accordingly. So when someone starts to get stressed/wound up, they can hear it in their own voice and change their pitch and stop holding their breath, which can have an impact on not only their pelvic floor, but can also help to kick in a parasympathetic response (the one that we say controls the "rest and digest" functions) by triggering their automatic nervous system. The vagus nerve (a nerve that runs from the brain to the digestive organs and has a parasympathetic response when engaged) can be stimulated by lowering the vocal pitch to some extent, and this parasympathetic action can help for better uptake of serotonin (the chemical that makes us feel happier).

For a patient that may be in pain or very new to this kind of training, Dr. Clinton suggested using humming first, because humming also produces vibrations, and vibration has been studied in healing. That and vibration is provides more tactile feedback because we can feel ourselves humming.

Dr. Clinton’s two takeaway tips were to:

use your voice- talk while you move to make sure you have no break in your voice/speaking with transitional movements (like getting out of bed, etc), and

practice with voice going up and down - this helps to breaks breath-holding patterns.

A takeaway quote Dr. Bri and Dr. Clinton referenced was “use your glutes not your glottis” (a quote from another PT named Michelle Lyons), meaning get those butt muscles engaged rather than holding your breath (with your glottis) to get you through those transitional movements.

Owned?: No, library Page count: 294 My summary: Michelle Lyons has been a death row observer and prison journalist for many years. She witnessed nearly 300 executions, working for the Texas Department of Criminal Justice in Huntsville. She was there in the death chamber for the last moments of many notorious criminals. This is her story. My rating: 1/5 My commentary:

What a let-down. What a cruel, cowardly book. I picked this up for a couple of reasons, but the primary one was my ongoing morbid fascination with the death penalty. I live in England, and we have not had the death penalty as a punishment within my lifetime. I am also staunchly anti-captial punishment, and pro-prison abolition while we're at it. I wanted to see what death row and the mechanisms of execution were like from the point of view of someone who clearly has a lot of experience with the subject matter. What I didn't want to see was some wishy-washy half-baked centrism, sensationalising other people's deaths for the purpose of selling books. But here we are.

Title: Death Row: The Final Minutes Author: Michelle Lyons Series: N/A Number of Pages: 296 Genre:  Murder & Mayhem True Accounts Publisher: Blink Publishing Date of Original Publication: December 27, 2018 ISBN: 978-1788701495

Not usually a nonfiction reader but it seems to be how my TBR pile is panning out. Here is the second one for January.

Death Row: The Final Minutes is a nonfiction book written by Michelle Lyons that goes over her accounts of witnessing nearly 300 executions in the Texas prison system. She started off working as a journalist where she witnessed and wrote about each execution in a local paper. She eventually ended up working in the prison system and got to know a lot of people on death row up until their execution.

I liked this book. It was not boring and the accounts were interesting. She was not biased at all and it shed a good light on the prisoners. It was factual when it came to their crimes but it also showed that in the end they were still human and some of them accomplished great things even while in prison.

I also liked that she brought in the view point of her boss, Larry Fitzgerald and his accounts of death row and the inmates. Even though he passed away before the book was published, it was still tasteful and showed him in a positive light.

★★★★ I would recommend.

~

Up Next:  

-Dark World by Zak Bagans

-Cherish by Tracy Wolff – (Crave #6)

-Gender Outlaws: The Next Generation by Kate Bornstein & S. Bear Bergman

Yearly Goal Markers:

Book Goal: 6/75  = 8%

Page Goal:  1.9/15k = 12.7%