Lesson 1-27-09 and so fine-driving dog

The driving dog- yes he is here. I was a little shaky and let Kelly do most the work. Couldn't ask for a better trainer. Yes, we zoomed in- he is doing some mighty fine driving.

Hope you enjoy the adventures of Usher- I sure do and if no one reads this - I don't care. It's just a diary for me and my dog.

Usher's lesson today 1-20-09

We used some lighter sheep today, which was good for Usher. This was our best lesson so far. I am so pleased how quickly Usher is coming around. That furry guy loves to drive, he pretty much knows his flanks even when off-set, but his out runs are the problem at this point. Not real trustworthy.

I really enjoy my Tuesdays. I wish I could afford the time and money to go out more. I'm sure Usher would be trialing by now. Kelly is a great trainer. Here I thought "I knew it all" and it turns out I knew nothing.

the other woman

This is "the other woman" I hate her. She is going through about this time until November. The guy in the pic is my BF. I love him dearly, but HATE this car. The grand boys love it. Oh wow, Tommy's cool. I spend a lot of time in the pits. I really don't mind, but now that "dog days" are coming up.........it's going to divide us- dog vs. car. PLUS he has another car- he wants me to drive- LMAO. Oh, I can see that happening. I have trouble getting INTO the car. Special car seats, fire suits, mine would have to be pink- PLUS- dog's for dystonia on the front. Sponsors are few and far between. The "doggy bar" sponsors Tommy. Little Dutch Garden.

I would have to complain. Girlie stuff, then I don't know if I'd have enough "balls" to get in the car. Many women have- but they are much better than me.

I think I should stick to one sport at a time. Thank you, honey, for trying to get me to race. I'm too chicken. Also, thanks to the BC people for reading this mush.
Dianne

ok- I messed up

I saw my old rescue yesterday

See how frightened he looks? Well, he has come a long way! Randy adopted him about 6 weeks after his old dog died. It was love at first site. His name is now "Blue" and when I took him in to be neutered I said his new owner would be picking him up, same time as Usher was due for his shots. When Randy came in, they asked if Randall was his new owner and said I couldn't have found a better home.

Blue is 1/2 Border Collie and 1/2 Aussie. He is still very shy, but got to have some pets and meet some other dogs. So, he is coming along nicely and is truly loved by his new owner.

Today was pretty exciting

No pics- it was so foggy. I actually got lost getting on the freeway. Typical. Finally made it to Kelly's. We tried to poop Usher out, but Usher hadn't seen sheep for 2 weeks. He's excited. We worked on everything we could (well, Kelly did- then let me step in)

It was time to go to Dianne Deal's. I got lost- what a surprise. I met two gals there, bad with names, good with dogs- a young BC and a cute red Aussie. We were doing close work. Luckily Don had called Dianne this morning and Dianne asked if Usher could work in a 40 acre field -no problem, he said. She asked about his trainer and Don said he was very good- I tend to agree.

Dianne has a great set-up there. She worked Usher first, then I asked "Do you mind if I show you what I'm doing with him?" Of course not. So I set him up for an outrun, he cut in a little tight at the top, but then I had him drive the sheep away for the next outrun. I don't think she expected a drive. She said "He's his Daddy's boy"

Not sure if I got the quotes right, but I think this pretty much tells the story.

I am SO thankful to Kelly for running some piss & vinegar out of Usher before and also with only a few lessons under our belt, even the people in the BC world think highly of you.

I am also very, very thankful to Dianne for inviting me to her place. It's beautiful, even in the fog. I thank Ellie for putting up the website or I never would have found her.

I thank all of you for putting up with my shaky head and slurred speech-
I can't help it.

I've learned different techniques. None are wrong, each are different. I've learned some new rules, also. This makes it easier for me to get out there on the trial field.

So, thank you everyone. Usher's still ready. I need a nap.

My oldest son

Kelly called this morning asking if I wanted a lesson- normally I would JUMP at the chance. I have a bad cold and that makes me shake worse and I would probably fall down- not pretty. My oldest son, Matt (he's shaky in his hands) took his Grandma out to lunch. I guess I raised my boys OK. My Mother has been depressed and this is just what she needed. I, of course, stayed at home, filled up with cold medicine. Looking forward to next Tuesday.

a little bit about spasmodic torticollis aka dystonia

This is what I live with every day- it's not fun- it won't kill me. But I will die with it. My speech is slurred because of the meds, I walk funny- I shake. Plus my balance isn't good. Thus I have Usher. I'm afraid of the DBS. (Deep brain stimulation) as I have heard good & bad about it.

I am fortunate I have a trainer that will accept me for who I am. Also a wonderful boyfriend, or engagement guy- who helps me with stairs. My service dog loves to herd and I am trying to give him the best life that he gives me. My obedience trainer, Alice Peterson, has helped me in ways I can not explain.

Spasmodic torticollis
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Spasmodic torticollisClassification and external resources
ICD-10
G24.3
ICD-9
333.83
DiseasesDB
13180
eMedicine
emerg/597 orthoped/452
MeSH
D014103

Muscles of the Neck
Spasmodic torticollis is a chronic neurological movement disorder causing the neck to involuntarily turn to the left, right, upwards, and/or downwards. The condition is also referred to as "cervical dystonia". Both agonist and antagonist muscle contract simultaneously during dystonic movement. [1] Causes of the disorder are predominantly idiopathic, a small number of patients develop the disorder as a result of another disorder or disease. Most patients first experience symptoms midlife. The most common treatment for spasmodic torticollis is the use of botulinum toxin type A.
Contents[hide]
1 Signs and Symptoms
2 Incidence and Prevalence
3 Classification
3.1 Primary
3.2 Secondary
3.3 Head Positions
4 Evaluation of Spasmodic Torticollis
5 Pathophysiology
6 Treatment
6.1 Sensory Trick
6.2 Oral Medications
6.3 Botulinum Toxin
6.4 Deep Brain Stimulation
7 References
8 External links
//

[edit] Signs and Symptoms
Initial symptoms of spasmodic torticollis are usually mild. The head may turn or tilt in jerky movements, or sustain a prolonged position involuntarily. Over time, the involuntary spasm of the neck muscles will increase in frequency and strength until it reaches a plateau. Symptoms can also worsen while the patient is walking or when during periods of increased stress. Other symptoms include muscle hypertrophy, neck pain, and tremor. [2] Studies have shown that over 75% of patients report neck pain, [1] and 33% to 40% experience tremor of the head. [3]

[edit] Incidence and Prevalence
Spasmodic torticollis is one of the most common forms of dystonia seen in neurology clinics, occurring in approximately 0.390% of the United States population in 2007 (390 per 100,000). [3]Worldwide, it has been reported that the incidence rate of spasmodic torticollis is at least 1.2 per 100,000 person years, [4] and a prevalence rate of 57 per 1 million. [5] The exact prevalence of the disorder is not known; several family and population studies show that as many as 25% of cervical dystonia patients have relatives that are undiagnosed. [6] [7] Studies have shown that spasmodic torticollis is not diagnosed immediately; many patients are diagnosed well after a year of seeking medical attention. [1] A survey of 59 patients diagnosed with spasmodic torticollis show that 43% of the patients visited at least four physicians before the diagnosis was made. [8] There is a higher prevalence of spasmodic torticollis in females; females are 1.5 times more likely to develop spasmodic torticollis than males. The prevalence rate of spasmodic torticollis also increases with age, most patients show symptoms from ages 50-69. The average onset age of spasmodic torticollis is 41.[1]

[edit] Classification
Spasmodic torticollis is a form of focal dystonia, a disorder that is described by sustained muscle contractions causing repetitive and twisting movements, and abnormal postures in a single body region. [9] There are two main ways to categorize spasmodic torticollis: age of onset, and cause. The disorder is categorized as early onset if the patient is diagnosed before the age of 27, and late onset there after. The causes are categorized as either primary (idiopathic) or secondary (symptomatic). Spasmodic torticollis can be further categorized by the direction and rotation of head movement.

[edit] Primary
Primary spasmodic torticollis is defined a having no other abnormality other than dystonic movement and occasional tremor in the neck.[1] This type of spasmodic torticollis is usually inherited. Studies have shown that the DYT7 locus on chromosome 18p in a German family and the DYT13 locus on chromosome 1p36 in an Italian family is associated with spasmodic torticollis. The inheritance for both loci is autosomal dominant. These loci are all autosomal dominant inherited with reduced penetrance. Although these loci have been found, it is still not clear the extent of influence the loci has on spasmodic torticollis. [10]

[edit] Secondary
When other conditions lead to spasmodic torticollis, it is said that the spasmodic torticollis is secondary. A variety of conditions can cause brain injury, from external factors to diseases. These conditions are listed below:[1]
Perinatal cerebral injury
Kernicterus
Cerebrovascular diseases
Drug induced
Central nervous system tumor
Peripheral or central trauma
Infectious or post infectious encephalopathies
Toxins
Metabolic
Paraneoplastic syndromes
Central pontine myelinolysis
Secondary spasmodic torticollis is diagnosed when any of the following are present: history of exogenous insult of exposure, neurological abnormalities other than dystonia, abnormalities on brain imagining, particularly in the basal ganglia. [1]

[edit] Head Positions
To further classify spasmodic torticollis, one can note the position of the head. Torticollis is the horizontal turning (rotational collis) of the head, and uses the ipsilateral splenius, and contralateral sternocleidomastoid muscles. This is the "chin-to-shoulder" version. Laterocollis is the tilting of the head from side to side. This is the "ear-to-shoulder" version. This involves many more muscles: ipsilateral sternocleidomastoid, ipsilateral splenius, ipsilateral scalene complex, ipsilateral levator scapulae, and ipsilateral posterior paravertebrals. The flexion of the neck (head tilts forwards) is anterocollis. This is the "chin-to-chest" version and is the most difficult version to address. This movement utilizes the bilateral sternocleidomastoid, bilateral scalene complex, bilateral submental complex. Finally, retrocollis is the extension of the neck (head tilts back) and uses the following muscles for movement: bilateral splenius, bilateral upper trapezius, bilateral deep posterior paravertebrals. This is the "chin-in-the-air" version. A combination of these head positions is common; many patients experience turning and tilting actions of the head.[11]

[edit] Evaluation of Spasmodic Torticollis
The most commonly used scale to rate the severity of spasmodic torticollis is the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). It has been shown that this rating system has widespread acceptance for use in clinical trials, and has been shown to have “good interobserver reliability.” [12] There are three scales in the TWSTRS: torticollis severity scale, disability scale, and pain scale. These scales are used to represent the severity, the pain, and the general lifestyle of spasmodic torticollis.

[edit] Pathophysiology

PET scan of the human brain.

Coronal sections of human brain labeling the basal ganglia.
The pathophysiology of spasmodic torticollis is still relatively unknown. Spasmodic torticollis is considered neurochemical in nature, and does not result in structural neurodegenerative changes. Although no legions are present in the basal ganglia in primary spasmodic torticollis, fMRI and PET studies have shown abnormalities of the basal ganglia and hyper activation of the cortical areas. [13] Studies have suggested that there is a functional imbalance in the striatal control of the globus pallidus, specifically the substantia nigra pars reticulate. The studies hypothesize the hyper activation of the cortical areas is due to reduced pallidal inhibition of the thalamus, leading to over activity of the medial and prefrontal cortical areas and under activity of the primary motor cortex during movement. [14] It has also been suggested that the functional imbalance is due to an imbalance of neurotransmitters such as dopamine, acetylcholine, and gamma-aminobutyric acid. These neurotransmitters are secreted from the basal ganglia and travel to muscle groups in the neck. An increase in neurotransmitters cause spasms to occur in the neck, resulting in spasmodic torticollis. [10] Studies of local field potentials have also shown an increase of 4-10 Hz oscillatory activity in the globus pallidus internus during myoclonic episodes and an increase of 5-7 Hz activity in dystonic muscles when compared to other primary dystonias. This indicates that oscillatory activity in these frequency bands may be involved in the pathophysiology of spasmodic torticollis. [15]

[edit] Treatment
There are several treatments for spasmodic torticollis, the most commonly used being botulinum toxin injections in the dystonic muscle of the neck. Other treatments include sensory trick, oral medications, and deep brain stimulation. Combinations of these treatments have been used to control spasmodic torticollis. [15] In addition, selective surgical denervation of nerves triggering muscle contractions may offer relief from spasms, pain, and limit damage to the spine as a result of torqued posture. Spinal fibrosis (i.e., locking of spinal facets due to muscular contortion resulting in fused vertebrates) may occur rapidly. Therefore, it is important to seriously evaluate the option of surgical denervation as early as possible. The leading neurosurgeon, Dr. Carlos Arce, practices at Shands Memorial Hospital in Jacksonville, Florida. A visit to Dr. Arce may include an initial evaluation, a second evaluation under general anesthesia to evaluate the full range of motion without muscle contractions, and a third visit for the selective denervation procedure, if deemed appropriate.

[edit] Sensory Trick
One distinctive feature of spasmodic torticollis is the use of a sensory trick to temporarily ease dystonic contractions. Patients will often touch their chin with the hand that is contralateral to the direction of the title or turn, this leading to correction of the abnormal head deviation. [16] It has been shown that sensory trick desynchronizes pallidal oscillatory activity in the 6-8 Hz range only during the beginning and end of the trick. This suggests that the desynchronization of the frequency range is movement related. [14] Sensory tricks offer only temporary and often partial relief of spasmodic torticollis. 74% of patients report only partial relief of spasmodic torticollis compared to 26% of complete relief of torticollis. The sensory trick must also be applied by the patent themselves. When the sensory trick is applied by an examiner, only 32% of patients report relief comparable to relief during self-application. [15]

[edit] Oral Medications
In the past, dopamine blocking agents have been used in the treatment of spasmodic torticollis. Treatment was based on the theory that there is an imbalance of the neurotransmitter dopamine in the basal ganglia. These drugs have fallen out of fashion due to various serious side effects: sedation, parkinsonism, and tardive dyskinesia. [17] Other oral medications can be used in low doses to treat early stages of spasmodic torticollis. Relief from spasmodic torticollis is higher in those patients who take anticholinergic agents when compared to other oral medications. 50% of patients who use anticholinergic agents report relief, 21% of patients report relief from clonazepam, 11% of patients report relief from baclofen, and 13% benzodiazepines. [18] Higher doses of these medications can be used for later stages of spasmodic torticollis; however, the frequency and severity of side effects associated with the medications are usually not tolerated. Side effects include dry mouth, cognitive disturbance, drowsiness, diplopia, glaucoma, urinary retention. [16]

[edit] Botulinum Toxin

Target molecules of botulinum (BoNT) and tetanus (TeNT) toxins inside the axon terminal.[1]
The most commonly used treatment for spasmodic torticollis is the use of botulinum toxin injection in the dystonic musculature. Botulinum toxin type A is most often used; it prevents the release of acetylcholine from the presynaptic axon of the motor end plate, paralyzing the dystonic muscle.[17] By disabling the movement of the antagonist muscle, the agonist muscle is allowed to move freely. With botulinum toxin injections, patients experience relief from spasmodic torticollis for approximately 12 to 16 weeks. [19] There are several type A preparations available worldwide; however BOTOX is the only preparation approved by the FDA for clinical use in the United States. Some patients experience or develop immunoresistance to botulinum toxin type A and must use botulinum toxin type B. Approximately 4% to 17% of patients develop botulinum toxin type A antibodies. The only botulinum toxin type B accessible in the United States is Myobloc. Treatment using botulinum toxin type B is comparable to type A, with an increased frequency of the side effect dry mouth. [11] Common side effects include pain at the injection site (up to 28%), dysphagia due to the spread to adjacent muscles (11% to 40%), dry mouth (up to 33%), fatigue (up to 17%), and weakness of the injected or adjacent muscle (up to 56%). [17]

[edit] Deep Brain Stimulation

Insertion of electrode during surgery
Deep brain stimulation to the basal ganglia and thalamus has recently been used as a successful treatment for tremors of patients with Parkinson’s disease. This technique is currently being implanted in patients with spasmodic torticollis in clinical trials. These patients are subjected to stimulation of the globus pallidus internus, or the subthalamic nucleus. The device is analogous to a pacemaker, an external battery is placed subcutaneously with wires through the skin and enter the skull to a region of the brain. To stimulate the globus pallidus internus, microelectrodes are placed into the globus pallidus internus bilaterally. After the surgery is performed, multiple trips are required to program the settings for the stimulator. The stimulation of the globus pallidus internus disrupts the abnormal discharge pattern in the globus pallidus internus, resulting in inhibition of hyperactive cortical activity. Globus pallidus internus deep brain stimulation is the preferred surgical procedure due to the lower frequency of side effects.[17] Advantages of deep brain stimulations include the reversibility of the procedure, and the ability to adjust settings of stimulation. [18]
In one study, patients who have developed immunoresistance to botulinum toxin underwent globus pallidus internus deep brain stimulation showed improvement by 54.4% after three to six months.
There is a low rate of side effects for those who undergo deep brain stimulation. The most common side effect is headaches, occurring in 15% of patients, then infection (4.4%), and cognitive dysfunction (4%). Serious side effects seizure (1.2%), intracerebral hemorrhage (0.6%), intraventricular hemorrhage (0.6%), and large subdural hematoma (0.3%).[17

Tribute to my trainer- Kelly Orr

No pics- I've used them all.
I just wanted to say that I am an only child and if I could have a younger brother- this is the man I would choose. He worries about my health, my dogs and me driving on snowy roads. His wife and children are lucky to have this man in their life.

I just want to let Kelly know that even though I will be seeing Dianne Deal occasionally, that he is my MAIN trainer. Thank you so much for your patience, your understanding and for being a friend.

Strange relationships grow between "dog friends" and you have been my best bud. I still keep in contact with my Oregon trainers. Once a dog friend, never to be removed, well........in most cases- LOL.

Thank you Kelly- See you Tuesday!!!
Dianne

We missed our lesson today

This is my beautiful Bliss dog. She doesn't get much talking about- she's a lovely gal and a great "foot warmer.
Here is Usher-He is guarding the ball. As you can tell we have a lot of snow here. Not enough to put on the sweatshirt and go out and play.