Category Archives: General

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A Personal Account of Living with Tourette Syndrome & Associated Disorders, Part 3: Quality of Life


This blog article was originally posted on New Jersey Center for Tourette Syndrome’s TS Parents Online Blog and is republished here with kind permission.

In my first two posts, I talked about what my life was like early on and the various phases of treatment I had to go through leading up to present day. Now, I’ll talk about how Tourette Syndrome can hinder one’s quality of life, especially when it comes to work,

Tourette Syndrome is not life threatening, but it can be living threatening — and what I mean by this is that it can seriously hinder you from living to your full potential.

Probably the most difficult time for a person with Tourette Syndrome is the period of transition from school to the workforce and life, because Tourette Syndrome really hinders you during these periods of significant transition. For people with Tourette Syndrome this period is commonly referred to as a “transition cliff.”

I know this as a fact because right from the time I graduated university to the time I was diagnosed and started treatment for Tourette Syndrome some 15 years later, I was in a void of not being able to function properly — a period where I had various jobs, many of which were part-time, so my career development suffered immensely.

Many aspects of Tourette Syndrome including the mental anguish of emotions that we go through on a daily basis are very difficult for someone who doesn’t have the disorder to understand, which is why properly educating people about the disorder is very important.

Even my wife, who’s known me for many years, doesn’t fully understand the many facets of Tourette Syndrome and everything I go through on a daily basis. If I myself had to describe Tourette Syndrome, I would say the following:

Tourette Syndrome is faulty wiring somewhere in the brain that manifests itself in various motor and vocal tics, and that makes you feel — in varying degrees — constantly jittery. All this taken together interferes — anywhere from a little one day to a lot another day — with your ability to function normally.

However, individuals with moderate to severe symptoms like me can, with the proper medication and family support, be sufficiently treated to allow them to enjoy a pretty normal life. I can’t stress enough how important family support is to individuals suffering from moderate to severe Tourette Syndrome, and in fact if I had support early on, it would have made a huge positive difference in my life.

By not having the support I needed and because as a child the disorder makes you sensitive, I in turn often felt mistreated, misunderstood, confused and alone. Even today, I still feel alone at times because I still can’t tell everyone about my Tourette Syndrome.

To make things even more interesting, starting in the Spring of 2011 my wife was insisting to me that based on everything she now knew about this disorder she was quite certain that Tourette Syndrome alone did not explain all my behaviors and mannerisms.

So in early Spring 2012 I went to talk to my neurologist about this, and he referred me to another neurologist that specializes in related disorders. After a lengthy evaluation, this other neurologist confirmed the fact that I also suffer from a good case of Attention Deficit Disorder or ADD.

Now I know why whenever I worked on multi-subject problems in school I always had a difficult and frustrating time in processing all the information presented in them — it required me to re-read those type of problems so many times just to make all the information stay in my brain.

This other neurologist put me on Ritalin, but right from the start the side-effects — namely confusion and dizziness — were too strong, so I stopped taking it and I have decided not to try anything else for my ADD. Luckily, there is some benefit I get for my ADD from taking Clonidine, so I will stick to taking this med only.

I’m very glad all is better now, but I have to say that up to the time I started treatment for Tourette Syndrome — which was in my late 30s — my life was especially difficult. But I’m very proud to say that during that very difficult time of my life, I still managed to look after my severely mentally ill father, complete a university degree with solid grades and attain a graduate-level professional designation.

Looking back, I must say that one of the most difficult parts of living with the disorder is the frustration and loneliness one feels because of the ignorance of people in understanding the disorder. Trying to convey to them that Tourette is more than just a tic is still difficult today, and many more people still often associate the non-tic parts of the disorder — which are often more of an hindrance — as being character weaknesses rather than medical disorders.

The last thing I want to say about my experience living with Tourette Syndrome and its associated disorders is that I will always be grateful to my caring wife for pushing me to seek the medical help I so very much needed and for having a great amount of patience to put up with my tics and associated disorders. With no family member to turn to, it goes without saying, that without her support I never would have made it this far.

Below is a favorite quote of mine which if practiced by the public would certainly reduce a good part of the ignorance it has towards individuals with Tourette Syndrome:

We observe only what happened, and not how it happens. When we are doing something it has in fact already been done.
– G. L. Lichtenberg

General

A Personal Account of Living with Tourette Syndrome & Associated Disorders, Part 2: Treatment


This blog article was originally posted on New Jersey Center for Tourette Syndrome’s TS Parents Online Blog and is republished here with kind permission.

In my post yesterday, I talked about what having Tourette Syndrome was like in my early life. Now, I’ll talk about how it started to be treated leading up to present day.

My initial treatment was as follows: I was on Pimozide for a few months, and it turned me into a virtual zombie. Then I was put on Sulpiride for about 4 years, and it was better, but it took a good part of the life out of me. Then I was put on Olanzapine for 5 years, which was better again, but it still took a good part of the life out of me.

In May 2010, my new neurologist put me on Tetrabenazine because at that point in time I had been taking neuroleptics for a little more than 10 years and with continued use I would be at an increased risk of developing Tardive Dyskinesia, a very unpleasant, debilitating and irreversible condition.

Tetrabenazine was the best med up to that point with regards to its side-effect profile, which was more tolerable; however, it wasn’t really effective with regards to my motor tics and jitteriness.

Then, about 14 months into taking it, I started having terrible Parkinson-like side-effects, which led me to immediately stop taking this med. I was doing well for a couple of months thereafter, but then the tics and jitteriness came back in full force.

This led my neurologist to put me on Clonidine, a medication originally developed to treat high blood pressure having a more tolerable side-effect profile and which, in my case — from the eighth month on — has been by far the best med to date.

However, as is the case with virtually all meds taken for Tourette Syndrome, I had to experiment and try different doses and methods of taking it in order to find the dosing solution that would provide maximum symptom control with the least amount of side-effects. (That’s another part of having Tourette Syndrome that really stinks — whenever trying a new med, one has to go through a frustrating process of finding their proper dosing solution.)

Anyways, the irony of this more tolerable med is that it has been around for decades, but my initial neurologist didn’t put me on it first — he instead put me on neuroleptics that did help me, but at a big cost in terms of the quality of life I didn’t have.

It takes on average around six months for Clonidine to attain its maximum benefit, and I must say that for the first time in my life, I can say that my Tourette Syndrome is under good control with virtually none of the terrible side-effects associated with the previous meds I had taken.

I still experience days where the tics and jitteriness are pretty strong, but the great majority of the time they are under good control. It took about the first 50 and best years of my life to get to the point where I feel and function as close to normal as possible and to finally know what it’s like to have virtually all of the normal functionality that all individuals have from birth. Better late than never, I guess.

General

A Personal Account of Living with Tourette Syndrome & Associated Disorders, Part 1: Early Life


This blog article was originally posted on New Jersey Center for Tourette Syndrome’s TS Parents Online Blog and is republished here with kind permission.

I hope the essay that follows about my experience dealing with Tourette Syndrome serves to help the individuals suffering from the disorder and their parents. I’ve made the essay as detailed as possible while at the same time not making it too long to read.

I’m a male in his early 50s, who for virtually all of his life has had several motor and vocal tics, and I’ve lived with these tics not knowing where they stemmed from for most of it. The primary motor tics are: eyebrow raising and squinting, shoulder shrugging and torso moving. The primary vocal tics are: stammering (at times severe), rapid speech, altered (higher) speech volume, word emphasizing and the repetition of words or phrases.

The motor tics have caused peer rejection at times (especially during my younger years). The vocal tics, however, I’ve found to be most debilitating to my social life and career because of not being able to communicate effectively; many times not being able to communicate at all because of severe stammering (causing me to freeze-up when trying to speak as if experiencing speech paralysis).

If you can’t communicate, there is no point in how much you know because you can’t express it properly to anyone.

In social and business settings, you fall short because you can’t express yourself properly without feeling humiliated, so you avoid speaking as much as possible. (If I had a nickel for every time I decided against speaking because I knew I would severely stammer, today I would have a really big box filled with nickels).

In addition, I also suffer from some of the disorders often associated with Tourette Syndrome, and they are as follows:

  • Anxiety in the form of a constant feeling of jitteriness or edginess (heightened in social situations)
  • Impulsive behavior
  • Being easily overwhelmed and frustrated
  • Obsessive-compulsive behavior
  • Restlessness
  • Awakenings during sleep.

All this taken together really hinders me from functioning normally.

The first sign of tics, a stammer, occurred when I was about 5 years old. Facial tics started to show up when I was about 9 years old and prompted my mother to take me to see many doctors, who according to her all said that I would grow out of it and therefore nothing further was done.

When I was in my early 20s and I felt that these tics (especially the vocal ones) were severely limiting me, I approached a close relative that I looked up to for help. This individual ignored my plea for help and instead told me in a disparaging way that it was I who was to blame for these tics and associated disorders.

This had a very negative impact on me and prevented me from seeking further help and I went through the best years of my life thinking that I was responsible for these tics and associated disorders.

Also, I must say that when I told my mother about these tics and associated, I didn’t get any real support from her either (but this was mostly because of her “old country “ mentality that made her unable to fully grasp and understand the situation, plus she had her hands full with my father’s serious mental illness). So up until I met my wife I was always on my own in having to deal with this difficult medical disorder.

During the summer of 1999, my wife pushed me to go see a doctor because it was hard on her seeing me perform these tics. So during September 1999, I decided to go see my family doctor, who after listening to what I had to say mentioned that I most likely had Tourette Syndrome and he referred me to a neurologist.

The neurologist confirmed the fact that I have Tourette Syndrome. Hearing the diagnosis was a huge relief for me because up to that point in my life I was living with this major difficulty thinking it was a personal weakness instead of a medical disorder in need of proper treatment, which I will discuss in my next entry.

General Resources

Not Enough Data for Accurate Estimate of TS Incidence: Dr. Tamara Pringshiem


Dr. Tamara Pringsheim

Hot off the presses is “Prevalence of Tic Disorders: A Systematic Review and Meta-Analysis,” an article published in the journal Paediatric Neurology by several physicians, including Dr. Tamara Pringshiem. Dr. Pringshiem is a member of the Tourette Syndrome Foundation of Canada’s Professional Advisory Board. The TSFC community has the chance to hear Dr. Pringshem speak at the upcoming National Conference in October where she will present on the latest treatment guidelines for TS.

Dr. Pringshiem’s recent article focuses on the problem of under-diagnosis of TS and other tic disorders. The under-diagnosis of TS is a complex issue. Many people with TS are unaware that they have the condition. One study even puts the percentage of people who do not know they have TS at 30%. Tics can, and often are, suppressed or disguised in public. Additionally, they often decline with age. On top of that is the problem of people hiding the fact that they have TS due to fear of social stigma. All these factors combined make it extremely difficult to get an accurate estimate of the prevalence of the condition in the Canadian population.

Rather than relying on one or two studies to establish the current prevalence, Dr. Pringshiem and her colleges examined several different incidence studies in order to obtain the most accurate estimate possible.

Their main findings were:

  • Tic disorders, including TS, are more common among children than adults; and more common among males than females.
  • Tic disorders are more common in special education settings, among those receiving institutionalized care, and among those with Autism.
  • The most common type of tic disorder is transient tic disorder (approximately 2.99%), followed by chronic tic disorder.
  • TS is the third most common tic disorder.
  • There is no consensus among experts about the prevalence of TS and other tic disorders.
  • According to most school-based studies, 2-11 people out of every 1000 have TS.
  • The highest numbers, reported in three academic studies, put the incidence of TS at 3.8%. The lowest reported prevalence was 0.1%.
  • Very few studies focus on figuring out how many adults have TS.
  • Because the definition of TS has changed over time, prevalence hasn’t been consistently measured from study to study.
  • There is no current Canadian prevalence data; instead, incidence studies primarily focus on American and Western European populations.

Dr. Pringshiem and her colleagues recommend more studies on the prevalence of TS and other tic disorders. They also argue for the simplification of how we classify tic disorders. Making TS, chronic motor tic disorder, and chronic vocal tic disorder separate and distinct conditions, Pringshem et al. contend, is of “debatable value” because there are so few differences in the conditions and in how they are treated.

Perhaps as the TS community is more and more successful at eliminating stigma, more people will feel comfortable being “out” about their condition. As we as a country become more aware of the condition, those who do not know they have TS will come to understand why they do what they do. In time, perhaps, new studies may come to better understand the actual prevalence of condition in Canada. For now, we have to make do with only a few studies of the US and Europe and try to remember that the actual prevalence of TS is likely much higher than our best guess.

General

James Durbin’s Debut Album Out Today


When he first graced the stage on American Idol, James Durbin instantly made TS cool and sexy. His confidence, talent, openness about his disorders (he also has Asperger Syndrome) and other great qualities made him the perfect role model for TS+. Our community was so heartbroken when he lost in the finals. J-Lo wasn’t the only one shedding frustrated tears, that’s for sure. But then James did something that embodies the spirit of our community. He gathered himself together, shrugged it off, and prepared himself for the road ahead: his dream, his challenges, his future to shape with his actions.


Today marks the next phase in his musical career, the release of his first album, Memories of a Beautiful Disaster. The reviews are super positive, like this one in the USA Today.

Have you heard the album yet? If you have, then please let us know what you think of it by commenting on this blog entry. We’d love to hear from you.

For those with TS about to rock, we salute you!

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Welcome to our blog!


This blog is a brand new way for you to stay informed about Tourette Syndrome and the Tourette Syndrome Foundation of Canada. We’ll publish news, stories, event photos, videos and more. We’re even going to showcase guest bloggers from the TS community.

Our goal is to provide fresh, informative and entertaining content at least once a week.

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