Everybody in Nigeria would at least have free primary education. Yes. You because you would see that that's what the children need You would that like I was saying before the children are future until it's time for you to give them the resources to actually let They make it change.  You are the change Gen Z stand up and do what? Like everybody in Nigeria would at least have free primary education Yes, you because you would see that that's what the children need Like I was saying before the children are future until it's time for you to give them the resources to actually let them make it change Yeah, you're letting you're like you are the future. You are the change Gen Z stand up and do what? Many young people may feel like they are too small or insignificant To make a change or make a difference in the world They may feel like the political system is rigged or their voices don't matter and you can't really blame them Nigeria is blessed with many young people who are passionate about making a difference in the world however The situation of things in a country like Nigeria has stifled that dream and pushed many to a state of Epity and disengagement now while we know that national affairs can be complex and confusing And it can be difficult for young people to understand the nuances of the issues technology has and Continues to bridge a huge part of the problem, which is ignorance Nonetheless, it is important that more young people start to pay attention to the governing of their affairs and tonight We're asking how can we get young people interested in national affairs? Please let's hear what you have to say. Remember you can join the conversation send us an SMS or what's up? So 081 8038 466 3 3 that was at wish you Africa one with the wish with the hashtag wish you Hey, you know, I Listened in on the team's takeover and honestly, I was I was proud. It was so good. I was like, oh wow And these is this I mean, you know how people have been talking about the Gen Zs Gen Zs Oh, yeah, these get that I've in as much as I I kind of like understand But I've never really bought into that school of thoughts. Yeah, right because listening to them speak The past few days. I was like, wow, I'm motivated, right? No, I have to even call my brother like you come So I called him because I wanted to hear his opinion on something and I was impressed as well because to me Seeing them doing something like this. You can tell that these are bright minds Yeah, these are people that have a future a bright future ahead of them And they are ready to take the bulls by the horn. Like it is really really Exciting. Yeah, and I'll say it given the chance Well, if I agree But there's just something I noticed about them. Yes, and it kind of reminded me of myself when I was young guys Just that that believe they can take the bull by the horn. Yeah But I think eventually getting older. There's just something about the society that cripples that and makes you More maybe not afraid, but I'm not sure of the better word to use a bit more reserved and you know But yeah, I definitely enjoyed I didn't watch all the episodes I watched a couple of them and I think it was two episodes and it was just amazing I love how they handle the japa syndrome and you know what I really have to give what credit Always like the creator of the show Like she is the brain behind that team take over and I think it's the first time we're getting such done on national TV Where it's just young people Gen Z. Everybody's scared of Gen Z. Yeah So you will take a lot of guts to put Gen Z on TV alone There is no adults monitoring them or saying no, don't say this No, don't say it was just them and that took a lot of guts. So big up Oa big up ways About talking about National affairs basically politics and the current state of the of the country and the economy, right? I know grain of Parents to tell us. Oh, you need to read newspaper You need to watch news and a lot of us didn't really want to do any of that because I mean we also felt like it wasn't Business, right? It was not a concern. We had parents who were looking after us and if anything was happening in the country Parents were there with it to to shield to shield us, right? Yeah, but then that's just my own side and how My own upbringing rather well, how was it like for you? Did you have access to? To information to know what is happening in the country what had happened in the past what history was like Actually, no because I think by the time I got into school They had white history So it was just government that we had and government most of the history was not exactly You know when they give you textbooks they filter the history they make it such that everything looks rosy and all what not so Yeah, I think my childhood It was just TV you watch on I think Minaj watch the cartoons then go for Bible study That was pretty much we didn't have that much room So it was much later in my late teens that you know, I was exposed to radio You know, then I could tell my parents could take decisions and I'm like, you know I'm not I'm not about to do this. I had just graduated from secondary school and I got a phone So now I have like some level of exposure, you know some level of freedom not exposure It was the freedom that led to me getting exposure and on that's what that's when I became more aware of events going on in the world How about you anything? Well, I think it's not very different because we grew up around the same time So I would say for us then we were we grew up at the time of locked TV and TV having the padlock and all this thing and then we used to have access to it at 4 o'clock Just before 4 o'clock it opens and they have all the So for us that was and you get to watch TV from I think about 4 o'clock where they have the children's program So I think about six or something like that The likes of taste by Melinda and the rest of them and then I think we were exposed to news I think about nine o'clock. I think it was Sunday only say on a Sunday and then you had this other shows some of these interesting shows that they used to talk about different topics And then you have the news So we were exposed to as much as we were allowed to view So that's that's how I put it we were exposed as much as we were allowed to view and It's not like we were exposed to like newspapers newspapers were like daddy's thing So when my dad has finished reading maybe like a few days later You know what we were interested in them were probably the crossword or something some of the other Some of the other small cartoons and all those were the things we're interested in so the news were the news is never really your Issue at a young age. So the kind of national affairs that we're talking about now is like the gen You know the Gen Z teens take over from that age at the age where you're able to make a couple of decisions And for them, they are actually able to make decisions a bit earlier We couldn't make decisions until even while you are in school Decisions where they were to decide in a whole lot of things, right? So it's until even when we did have access to phones all that did for us was exposure So we could now view what we wanted to do a view, you know Join some of this social media high-five and the rest of them Even the phone that you had and then we didn't even have phones I didn't have phones so way much later then we didn't have phones even our phones at home. We're like coded You're exposed to as much as your parents allow you to view yeah That's how much news we had but now today. Oh my god, the accessibility to news and information I'll tell you what Wow, sorry to cut you but my sister's four-year-old Knows how to go turn on the TV get to YouTube select whatever he wants to watch and watch it Something you're talking about a four-year-old. I have a two-year-old cousin and a nephew He would take your phone that he has never used before All you need to do is unlock it. He knows the YouTube. He knows exactly the YouTube logo This you can't to tell you how smart he is. I tried once I downloaded the kids YouTube And he so he said he wanted to use my phone for YouTube So I went to the kids one and I opened it for him and gave it to him He looked at him and after a few minutes he just zoomed it out like he just went out of the page Wow did my screen like this and found the right one I opened it and said puts he has minions so he loves Without put a second book over me And I'm looking at him like how did you get here? He knows so and For even when my nephews were little they were the ones that told me how that it was from them That I knew that when you lock your iPad screen, they can still go to the pictures So the thing about it is that right now we have a population I think 60% of Nigeria's population are under 25 At this moment. So we have the youngest African population in Africa I think or one of the youngest population in Africa and to see that the Teens can actually pull off something like this for a whole week I was really amazed because for the longest time like he's rightfully said we just take Gen Z as a bunch of Internet driven unruly Emotion, you know imbalanced people The thing is that is also nothing is very important for us as individuals and as we grow not to generalize For at least we have been able to put that to the test And they have shown us that they are capable of doing that they are capable in terms of that They have the capacity to be able to actually think for themselves and make the right decisions if led a right now from what You know, she said Yes, yes mean said all through the week She made a statement that you say you keep telling us to stand up and stand up stand up for what and that's where we've come To because even when it's time for the youths and the teenagers to actually take over by you doing something like this Actually letting to see if all that you've been teaching them has been absorbed You actually have to give them the opportunity to actually show what they are capable of doing then you know How to correct direct instruct and guide them But if we keep Shushing them and shushing them and expecting their opinions not to be heard We are still expecting them to be the leaders of tomorrow because we're not going to be here forever So if you don't give them the opportunity to actually rise to the occasion make their own mistakes and come to a Realization that this country is for us all and not just about everyone may be jab-bying and running away And then coming back much later. You're still going to meet the same thing So if you don't walk if we all don't put hands together to walk at it now you go you come back your next generations will still be here So whatever you think you're avoiding and running away from it's going to be here waiting for the next couple of generations But you can't leave outside the country forever. Yeah, so right now writing up what you just what you just said I love what you just said, right? So I want us to link link these things together. Yeah, we're talking about how How four-year-old you're two years old, right? They're able to go into your phone and search for these things, right? Now it shows that things are changing. Yeah from when we were little kids or teenagers or young adults to Who the Gen Z's are right now or to the young? I don't know. What do you call it? Who they are right now, right? Now if you look at that to picture, what can you say is different? Right. What is costing this this recent curiosity? This needs to want to know more to to want to be different I think it's partly because the world has been demystified You know, there isn't a lot of things that are hidden or you know denied access or something Like we are in a place where back in our time You didn't even you had to be of a certain aid before you can enter the cafe And then you need to have the money to pay for 30 minutes or one hour To have access to information and some zones don't even have cafe at all. They don't have power You know, but right now that's not the case, right? I just open your phone and just get data or you don't even need this I have Wi-Fi at home because your parents need data right just connect to the Wi-Fi and Literally the world is one click away You know, so I think that is one of the major changes that you know that happened With Gen Z and millenials and even the gem a that is coming after Gen Z Yeah I think I was also going to say that one of the ways that we could so easily gets Stop what happened with the millenials and the baby boomers and all what generation one of the easiest ways to stop That is to ensure that there is a merge with Gen Z and the millenials Because if the millenials keep saying oh is that what on a me a me look what's that? You know if we keep going for that then we're going to end up doing what the baby boomers We're going to push them out and then eventually they're going to be like, you know what? I don't I don't care about what is going on here You guys do your stuff and maybe they end up doing the japa syndrome, you know So yeah, we definitely need a merge of both generations To clear something that you said You know one of the ways I would say we can bridge this gap is the kind of communication Yeah, communication is very key now Gen Z's We see them and we say or the younger generation now We see them and we say, you know, they're always tied to their Communication tools so they're always on their phones. They're always on there on the Internet looking at different things Tiktok so I think one of the ways that we can include them is to start bringing it also depends on the mode of communication We use now if you know that they're always on the Internet What kind of information are we putting out on the Internet? What kind of information at the different agencies that want that the way you want to affect them like when we when we Talk about politics now for example, who are those younger people? How much? Inclusion is there for the younger generation when we talk about we have youth leaders We had to hear about them most of the time when we hear about them then support of the government What are they doing for the people? How are they bridging the gap between the younger generation and the older generation? I think that is one of the things that people like youth leaders youth advisors when people in the youth Department of any organization or agency in Nigeria Okay, so just hold that right so we'll take a short break and we'll see you shortly If you just tuned in if our ladies night out and we are discussing the topic How can we get young people interested in national affairs? Please let's hear what you have to say remember you can join the conversation send us an SMS or what's up? To 08 1 8 0 3 8 4 6 6 3 To that I was at way show Africa one with the hashtag way show So ladies remember I mentioned that I had a conversation with my brother Sorry, so when I have to when I saw this when I saw this topic I called my brother because I really wanted to hear where he had to say I mean I have my own ideas on how we can get the young people Interested I mean I'm young so people like me to Interested in national affairs here and so when I asked him right I was like, oh, when was the first time you got really interested in politics and what's happening in this country? He said a recent election and I was like, huh?  So how were you informed and updated about what what's happening right now? He said oh that most of his his updates. He got most of his news update on social media and He you know on Instagram or Twitter, but he just made sure that whenever he saw something about the coming election Or what's happening even during election? He made sure he listened because like I said he had hope He had hope that that things were going to we're going to change So when I had and I asked him I said, okay, okay, that's interesting, right? Well It has always been said that the Gen Z's are not interested in what is happening that kind of thing that Selfish lots right, but what do you think? How do you think we can get? Young people like you more interested in national affairs interested in what's happening in the country, right? To care and he said oh just get people like me to talk about it. I'm like, okay Explain and he says oh that most of us are on social media We spend a lot of our time there you find a lot of young young adults who are ready influencers And they have a lot of following yeah, right people listen to what they say and he said if they for us it will be better if Whoever is passing across that information whoever is educating us or enlightening us is of the same age group When you see someone he was like oh when you see that this is him speaking when you see somebody like me speaking on national TV or talking about Politics or what's happening in the country? I want to listen right because what is going on at the back of his head? Or back of his mind rather is if this person can't do this Then I can't do if this person believes that there is change Then why not and I will be more important for them to see things like that I was like okay interesting that I should have actually sent you this Teen takeover that we did right because it's something that we are currently doing on ways I it was very enlightening to actually see young adults Speak on things like this and I found out very again talking to him gave me some form of Form of motivation you saw me. I don't know if you saw my comments that they went away speaking and I was like ah We It means that we have a bright future Right, we have people who would actually who would actually stand and people who want to see Change so another thing that I noticed when I was listening to one of the shows I think it was a topic about modeling morals modeling moral Leaders and his corruption born or bred and alpha had shared a story about Him and his dad they were in the car They were driving and then one of these law enforcement agents had to stop him Stops the car and they use his gun So to hit him and asked him to come down from the car So the the law enforcement agent had assumed That alpha was a whole boy based on how he was stressed and alpha had a laptop with him And he thought that his dad was his Driver Right, and he was asking him. Oh, what's your name? What do you do and he goes? Oh, I'm a student or what school and he mentioned his school and the guys are okay He's just making inquiries and Now looking at it and seeing that a young Man of his age has experienced something like that Right and even on that show a lot of them spoke about The corruption in the country and things they have witnessed and honestly I honestly don't blame them if they don't want to be associated with what is happening in the country Because for them it's like I have a dream and I've seen a lot of people have seen my parents dream Being bashed. I've seen people who have come out to protest and they've lost their lives I've seen that old the government has said they would do this before they got into into the seat of power And by the time they got there nothing happened, right? He's like, oh, you're looking at yourself a lot of them want to also leave the country because they feel like if I stay here I'm just going to be the same way exactly I'm doing something right because it's when he's talked about like watching dreams shatter I Realized like personally, I've had a couple of my dreams shattered, right? Well, maybe in the future to still pick up but for right now I realized that just because of the configuration of the country There are certain dreams you cannot achieve because you're not rightly positioned to achieve it And why are you not positioned because your country hasn't considered the fact that these things people need these things So let us make these things available, right? So that's sort of like a disadvantage and you also said something about value about listening to them And I think we are in in the era where Again, I'll go back to what baby boomers did to us because there's millennials and then our parents baby boomers in the era Where you would have something valuable to say, but they'll be like sit down.  Yeah, you understand. They're literally Like shut you down. There wasn't any room for you to express yourself for you to feel like oh I'm human. I mean I'm an independent person who has like a brain that functions like give me room to exercise What I've learned to school my human rights my experiences Let me open up and tell you this is who I am There wasn't any room for that, you know And I have to applaud millennial parents because right now we see them not Replicating the same thing in in Gen Z and Gen Alpha, which gives them more makes them more audacious And makes them more open to saying okay, like look at Yasmin imagine if her mom or any kid says Oh, you don't do that you cannot go on live TV You're too young to do that that is because that young lady was so amazing as a host I wasn't all right So imagine if she had a parent that didn't nurture that at the end of the day At the end of later would have been a talent that has just gone down the drain or they had said you must be a doctor You must be a doctor imagine if that was a story, you know, so I think we are to a place where one of the very important ways to let Younger people get involved in national affairs is make them feel like they matter Listen to them because when you listen to people, they feel valuable and they want to add more or they want to become better And make it worth your while to listen to them. Yeah, yeah, very true you know just in connection in line with what We've both, you know commented on like I was saying about some of the ways that we can actually bridge this gap and I still go back to the communication how we communicate with them. First of all, we have to figure out Exactly, how do we reach them? Like you said you were having an interaction with your brother and he said Have people like him talk about it because they watch themselves talk about different things things that are very irrelevant and very But they watch it they watch tiktok every day they spend hours they're on Instagram They're on social media consuming a lot of information. So when they have information It's just like during the week we realized that there was a lot of you know They had a lot of their mates and their you know People within the same age brackets Call a lot and have a lot of comments and opinions about what they were the topic of discussion. So it means that when they get involved a Everybody gets involved That's the rest of the group. So I'm not saying is a ship mentality But you are able to use one to conquer a lot So the major thing is for us to look out for ways like this avenues like this create opportunities Do surveys find out how best to reach out to the younger generation Change the news change the communication pattern if you know that how many of how many People still watch TV a Lot of people have gone online a lot of people don't watch TV anymore or arise. Everything is online So these people are watching TV. So direct them in those Environments create an avenue for them to feel like you're listening to them for them to feel like they're whatever They are saying on social media. They are back lashes and everything Don't just see the bad side of it the fact that they're abusing the government Based on the fact that they are not They don't feel good with the way the situation of things but tell them some of the things that you are about to do Bring it to light You don't have to finish all these things and take eight years and then tell us you did one school before you bring it to light at the end of the Election year or at the end of the your term As you're doing things carry people along carry them along make them feel like sit down have Have youth councils, you know, you know, they have all these youth councils leadership discussions Sit down in their midst hear what they have to say here Some of the ideas that they're going to throw out there because time has passed technology has changed Technology has evolved and a lot of things have evolved. So also partner with the youths partner with the younger generations They're the ones that if you look at the technological world, the youths are the ones driving right there The ones creating innovation bringing our solutions to problems that we never thought we could ever we thought at the best during our time We thought that the light was going to be one of the best in Inventions, but look at it now Did you go to some of these exhibitions and everything and you see some of the technologies coming out? You see driverless cars it's already been used in some world how to keep up So we need to get to the point where we give our generation at the younger generation an Avenue to explore That is where you know true innovation actually comes out from so an avenue to express them So that is where confidence to even speak comes from right just let them be a bit more expressive from there You learn quest they have questions those questions create some level of m of What's the word? inquisitiveness From there they research from there if there's a solution they bring it to light if there's no solution They start to seek for a solution because they are always looking for an answer to everything from the littlest things You have conversation a lot of parents have even you've been doing something tirelessly for years And your child just asks you one question for me. Have you ever tried doing this? This this this I know how many problems I've even helped my parents to solve when it comes to like technology you have been having an issue for years and Some small child just takes your phone locks it then swipes like this engine You just realize wait when my screen when my phone is locked. I can actually still see my picture You know and it was a puzzle for me for a while until I actually told my nephew here Here's my phone. I locked it and I gave it to him and I just saw the process for the first time I actually saw how to work on my own phone from someone who has never held the phone before So it already tells you that the next couple of generations down the line. They're coming in Because of the exposure that they allowed because of the level at which their brain is allowed to function on and the technological advancement as They're coming in it's almost like they become adults from the tummy. So they're asking questions the questions We never asked they're asking the questions So they're very curious and that curiosity is what births a lot of innovation Creativity and what have you so we need to get to the point where we listen to them Not just I feel like the communication and another major point is that the communication has to be a two-way street Yeah, so we grew up in a generation whereby the communication was a one-way street is obedience. That's it Yeah, you obey or it's not even not a corner now. They do not a corner came straight Zaza some You will cry and you will come back Communication has to get to the point where is a two-way street? You notice that when you have a communication I have some certain communications with my nephews or I hear how my sister has communication with her kids and I'm like this I mean all because it's like they're like adults. So do you know what you do? They know what they did Do you know what you did? Yes. Do you know it was wrong? Yes. Tell me what how you feel they would express themselves maybe they were They was a miscommunication or they knew that they were wrong, but they thought they could get away with it Tell you it tells you that they already know so all you need to do is to Learn how to communicate with them communicate with them in such a way that at the end of the day We don't always have to end up with the whip. Yeah, you communicate with this Generation now and they come to you and they tell you I'm sorry and they tell you I'm sorry. I apologize They apologize to you eventually which means that they know they have certain their avenues They have compartments within their system that opens up because of how we communicate with them So it's very very important in my opinion. That is one of the major thing that we have to Use as a tool in order to get to the younger generation because if we do not excite them with what is Their reality they keep living a life thinking that everybody's gonna go away. Yeah, everybody's not gonna have the opportunity to go away All of us didn't have the opportunity if not there would have been nobody remaining here So we all a group of us all have to Come together and I agree that we're the ones that we stay here and try and make that change If not, there's nothing for our next generations to come back to Yes We have a message good evening, my dear beautiful beautiful sisters of what are you saying hashtag ways? How can we get young people interested in national affairs? There is not too much talk about it My dear beautiful sister wajaga made mention of communication, which is very key Another thing is what information are we making available in the internet? Thirdly to be aware of what the government is willing to do for the young people and the elderly ones My dear beautiful sister Jennifer said that people are determined to relocate because staying in the country They are unable to achieve what they have planned to achieve and it is and it is also key Thank God the show is back fully so happy and excited to see my dear beautiful sister Jennifer And Karen the show nice job. My dear sister. My name is Daniel illo ways regular fan Thank you Yeah We're just a round of right back in off words what NG said right communication is very key And if we are going to communicate It also means that we need to also implement some of these ideas That the younger generation are going to bring to the table because I know sometimes when I was younger My dad would ask us for our opinion and guess what? He's not he's never going to use it Right. He just like he just felt like my in my question exactly So if you asked me and I gave you my opinion, why are you not using it? Why did you ask me to begin with and I've never been comfortable with it, right? I had a conversation with him two weeks ago. We had a little clash and he was just talking and I told him see The reason why I sit back and I don't see anything these days is because you don't listen, right? I give you my opinion and I'm so sure hundred percent sure it would work But you don't do it, right? And at the end of the day, you come back to me with the same problem with the same issue Advise you again, and you don't take it, right? Sometimes you tell me oh, you need to be an adult now blah blah blah Another time he's like, I'm just like And I feel like that's what's happening with a lot of the Gen Z's and because it's a pattern A lot of people don't want to speak up anymore So it is very important that they feel heard They see that their ideas are being implemented because you know when you see something and you see someone actually Implementing it and it works hundred percent. You're proud. Yeah And you're you're you are motivated to want to dig deep and do more, right? Well, yeah, well, thank you so much No, it's been a great week and yeah, yeah, they've proven to us that they are actually people capable of doing this They just need to be given the opportunity Yeah, we should have one for a full summer Yeah Well, anyway, thank you so much. Thank you. Thank you. Thank you so much for being here today, and I love your smiles today Thank you Anyway, before we go to ensure to follow us on Instagram, I wish you Africa You can interact with us for that drop a comment and most importantly Follow all our social media engagements and remember to like share Comment and invite your friends and family to watch us and follow us if you miss today's quote here It is again Never doubt that a small group of thoughtful committed people can change the world Indeed, it is the only thing that I ever has and this was said by Margaret Mead See you tomorrow at 8 p.m. As we bring another great conversation to your screen. Bye


Next, we're going to hear about the peculiar pediatric Pablo Dama from our own Rachel Patel. She's currently winding up her stint as a resident on the pediatric ophthalmology service. We'd love to have her on the service. We'll be sorry to see her go, but it's what happens. And I'm glad to get her up here to speak in grand rounds before she leaves us. So I just wanted to talk about a few cases that we've seen recently over the past few months. When I was asked to do this talk, I was looking in the list of interesting cases that I have. And there was a whole series of kids with papillodema. And I said, well, this is fascinating. I don't see this that often. But apparently, each resident collects things on call. I've apparently collected pediatric papillodema occasions. So I'm going to talk about three different cases. And I'm going to go over them fairly quickly. We don't have a ton of time. But then at the end, I'll have a little bit more of a discussion about some things to take away from what I got out of seeing these kids. The first one is an infant with sudden onset, esotropia. And so it's a nine-month-old girl. She's super cute. Unfortunately, I have no pictures of her. One week ago, she had some fever and vomiting. It went away. But then four days ago, she had her left eye turn in. And this was originally intermittent. And then for the last three days, it's been constant. She had a head ultrasound because she still had somewhat open fontanelles. And the pediatrician found that it wasn't a great view, but everything looked totally normal. And she was otherwise doing fine in terms of her visual and medical development. So on examination, she could fix and fall with both eyes. But she did have an abduction deficit in the left eye. She had about 60 prison adapters of ET by Krimsky and a very mild, hyper-opic, psychopathic refraction. And on dilated examination, her nerves looked like this. These are not actually her nerves. But they were very similar in that she had bilateral discodema. So to answer Griffin's question, to image or not to image, I think we're stuck imaging with the papillodema. So she got admitted. She had an MRI. You can actually see the esotropia on the MRI. But other than that, her MRI was fairly unrevealing. She also had a lumbar puncture. Her opening pressure was off the charts of what a pediatric little scale for opening pressure would be with over 38. But she didn't have very much else on her LP. A white blood cell count of only one protein was fine. There was no infectious etiology that was discovered there. So at this point, fairly not a whole lot of contributing information here. But just some thoughts about what a differential for this kiddo could be. Any thoughts? OK, so the ones that I had. IH. I'll have people on cases 2 and 3, sounds good. There are cases of IH have been documented in kids like one-year-olds. That's a possibility. Menegitis, her profile didn't look exactly like that from her CSF. Leukemia, of course, when we worry about leukemia in kids who are especially that age, some other ones that are less likely that I'll get to later on. But in conclusion, we kind of came to the thought that this is presumed like post-viral meningitis. She was fever and vomiting a couple of weeks ago. It did get better. She then had the intern in the eye. So she was then, she did have more of an extensive work up when she was admitted by neurology. And then she was discharged on a diamox taper over the next few weeks. She was patching the right eye just to make sure that her left eye was still being used, even though it was permanently interned for that time. And then one week later, her isotropy had completely resolved. Her optic nerve edema had almost entirely resolved. And she was doing great. One quick interesting thing about infants with elevated intracranial pressure is their head circumference. I don't really think about this, because most of the people I see with elevated ICP have fused fontanelles. But she had a six-month well-child check. A few months ago, and had been in the 60th percentile for head circumference. And then right before admission, she was up at the 95th percentile. So there are other signs that we can measure in these kids. OK, so I'm going to come back to some thoughts about her case later on, but I'm just going to jump ahead to the next one. And admittedly, I did not actually see this kid. So thanks to Tina Mamelis for helping me out with this one. So this is a kid with an ectopic pituitary. He's a 12-year-old boy. He came in for evaluation for blurry vision for the last two or three months. He has a history of obesity and this known ectopic pituitary gland that resulted in growth hormone deficiency and hypothyroidism. And he had been off growth hormone for the past nine years and was just restarted on it two months ago. So he is on that growth hormone and then an astrosol. And he says, I have no pulse feltenitis. I just have some occasional transient visual obscurations on my left eye and that's it. So his vision was actually excellent in both eyes. He had no APD, full color vision. He was orthotropic with full motility. Blood pressure was normal. And then on RNFL, he has grossly swollen nerves. Segmentation is pretty bad on that RNFL there, too. So thoughts about him. OK, differential. There are lots, what do people think? Very true, could be. It's a 12-year-old obese kid. Oh yeah. OK, what else? Of course, exactly. He's obviously got pituitary stuff. What if he has adrenal problems as well? That can also cause elevated ICP. Brain tumor is on there as well. And cerebral venous sinus thrombosis, of course. So he had imaging. His MRI was just done recently. And he, of course, has an empty cell because he's always had an empty cell. But he also had a read which showed there's a little bit of narrowing of the transverse venous sinuses, but there's normal flow voids. There's no collusion in any of his vessels. So he was diagnosed with growth hormone-related intracranial hypertension. And this is kind of an interesting entity because it's often, in kids, within the first couple of months of them initiating treatment with growth hormone. And this kid had been off of it for a long time. He was just restarting it. In one series of 23 kids who had growth hormone-related intracranial hypertension, when they all had their first eye exam, they all had papillodema. So it correlated their ICP, often resulted in papillodema. And then interestingly, when they stopped their growth hormone, their papillodema and their symptoms go away pretty quickly. And so in his case, just a few days after C-sync therapy, he's already started having some subjective improvement. And then he's going to be seen later this week. And we'll see how his vision is going from there. OK, last case, this guy. So it's an 18-year-old. He has a history of Bell's palsy, two concussions. He was weightlifting. And then shortly after that, he developed right-sided weakness, tingling, and aphasia for 30 minutes. His parents flipped out, brought him to the ED. He had another episode of headache and aphasia in the ED. And so he got TPA. He had a normal CT, MRI, TTE with bubble study. And he was discharged on amatric, lean, and sumentript. And this was outside of the university. The next week, he had intermittent headaches. He kept having this tingling. He was constantly vomiting. And then he developed laryvision. And so another ophthalmologist diagnosed him with bilateral dyskidema. So he got an LP. Opening pressure was 29. Interestingly, he had a white count of 122. His protein was also high at 99. Glucose was fine. He was started on a pseudazolamide and two pyramids. And then he was referred to neurophthalmology. So when we saw him, he had 20-30 visions, right eye, 20-60 on the left, no APD. He's had some estropia that was more prominent in right gaze, but also in left. And his nerves actually did look like this. Pretty dramatic. And then let's see. Catherine, do you want to read this macrosyth for me? Yeah, absolutely. So dramatically, yes, you can see the swelling of the nerve over there. And then there's a little bit of intraretinal fluid there and then some subretinal fluid as well. And so he was seen by a retina specialist who said, you know, although there is subretinal fluid, this is most likely spillover from the nerve. Probably not something that's actually coming from the macula itself. He had enlarged blind spots on his visual field. And he had an extensive million-dollar work up. The abnormal parts were an ANA and RPR, an alignment of audio screen. The second two were thought to be biologically false positives. He had a repeat opening pressure of 33. His whites were again elevated. His protein was again elevated.  And an MRI which showed maybe some subtle enhancement in the ninjies and some fluid in the optic nerve sheets that otherwise was fairly unremarkable as well. So his is a little bit more complicated, but differential for him. I'm not going to ask anyone to do this at this point. But by the meningitis, he's, of course, got the white count. But all of his infectious workup from the CSF was normal. Handle. Neurosophilus, of course, Lyme norobereliosis. Someone threw out the idea of VKH at one point, but this doesn't look like VKH. So the diagnosis that we came to was this headache with neurologic deficits in CSF, lymphocytosis, or handle. And for a full discussion on that handle, I will refer you guys to Tara Hahn's presentation from last year, which was most excellent and goes into this in more depth. But just to tell you a little bit more about it, it's a syndrome of episodic headaches, transient neurologic deficits that tend to come, they're temporarily related to the headaches which tend to come in clusters. And then a CSF with an elevated white blood cell count, but there's no, nothing on MRI or any other diagnosis that would explain this. And so it is kind of a diagnosis of exclusion here. There can be some, leptomine angiolansin, but that's about all that you can have. It's typically in young to middle-aged adults, so this guy does fall in that age. 15% of them do happen in kids though. They often have an elevated opening pressure, and they can, but don't always have papillodema. And they spontaneously resolve with supportive therapy over the next few months. So in his case, he was given diamox, he was eventually tapered off of it, his vision improved, he ended up being 20-20. He did have residual distortion, of course, which is most likely from this outer retinal irregularity from the leftover edema. So just some closing thoughts about dyscadema in kids, in particular papillodema in kids. The differential for this, although I've been bugging guys about it all day, is pretty broad. So there's of course primary, like IAH, idiopathic, and then there's all these secondary causes for it. And there are some that are more common in kids, so of course, I didn't show you a case of this, but like hydrocephalus or cerebral venous thrombosis, kiara malformations, as we've kind of seen as well, tumors, leukemia, and then a whole bunch of meds, including growth hormone, not to freak anyone out, but at one tertiary referral center of the kids who came in with papillodema from a secondary cause, over a third of them did have a brain tumor. So it is there that we do image these kids for a reason. So does papillodema correlate with actual intracranial hypertension? And so this was actually interesting. There was an intracranial hypertension registry in the Pacific Northwest, and they enrolled 203 pediatric patients. And they found that papillodema was present in 89% of those who had IAH, and about 78% of those who had secondary intracranial hypertension. So there's a strong correlation with it. And then normal opening pressure in kids. So when the first kid was sent into the hospital, neurology called me and said, I don't even know what we're looking for for an opening pressure for her, like in a nine month old, what do we do? And so there are studies that suggest that for kids less than eight, a normal opening pressure should be less than 18, whereas if they're older than eight, it's closer to adult values. But actually recently there was an article that was a prospective anesthesia study about determining a reference range. And they said 90th percentile for routine LPs and below should be considered normal. And they found that for kids who are sedated or obese, less than 28 centimeters of water was considered normal. And if they're not sedated and not obese, then it would be a little bit less than that. Okay, so finally, last closing dots, pearls. MRI with and without contrast, of course, super helpful. And kids maybe like who have bilateral dyskinesia, you wanna make sure it's not also bilateral optic neuritis and with and without contrast could evaluate for that. Venus imaging is also super important because there of course is the possibility for occult venous sinus thermosis, even in kids who don't necessarily have symptoms making you think that that's the number one on the differential. You don't wanna be missing that. Don't forget to check blood pressure that can also cause dyskidema, of course, even in kids. And kids also take medications, so make sure growth hormone, retinoic acid, tetracycline is all on that list of things that you should be reviewing. All right, thanks to these people who helped me see these patients. And I'll take any questions. Thank you.


Erin knowing Corey Cooper had pitched you guys tough in the past and what's been going on with this team What type of jolt is it to put up six runs in that first? Yeah, awesome Just great at bats from everyone just moving the line Was it seven straight there reaching base and then a great play on on Higgy and to To put a stop and on G to end that inning So it was just a collection of just really good at bats and good to strike at bats But certainly, you know put us in a great spot Donaldson a part of that ending with a single he had home run next time up scored on a wild pitch Considering that he has not seen live pitching in about five days Just how impressive impressive is it for him to come in and have that type of impact? Yeah, that's big and you know, I brought a lot of energy with him today You know, I think guys kind of fed off it a little bit and You know, we need that we need that from him. He's he's a premium player when he's going and and we got a You know continue to get that from him But it was really good to see him just in sync at the plate and and you know real simple stroke And I thought he looked great John Carlos Stanton is such an important part of this lineup Especially in protecting Aaron judge what encouraged you most about his afternoon? Really? It's the last few days, you know, I even go back to the pinch hit at bat where he struck out against Deal bar with Minnesota Just I thought he was in the In and on a lot of pitches same thing. Yeah, yesterday when he pinch hit and he smoked the ball Right up the middle and then a couple couple balls today that he really hit well to right at people. So Yeah, I mean to me watching them I just feel like his collection of last six eight of bats now Are closer to what you know when he's going really good Lindsay And we've asked you about this a few times, but Aaron judges batting average is now up to 307 What do you make of that and you seen him sort of step on it like different gear lately? I Don't know about different gear.  I think he's I just think his focus and and Plan of attack of what he wants to do when he walks up there is is very clear for him And and he really does a good job of kind of slowing it down and know what know what he's looking for and Delivering Susan What was special about James and Tyone today John Carlos said it was he was awesome to watch him. Yeah, I Thought he I thought he won. I thought he used his change up. Well, you know, it's not Necessarily his go-to pitch, but I thought he threw a lot of good change ups to some of their lefties I thought the combination of the of the sinker and the foreseam fastball were really good Didn't seem like he used his breaking ball a whole lot. I thought the slider was good But then he was just on the attack, you know got that lead I think he came out and walked that lead off hitter which is not like him But other than that, you know, he was he was getting after it and and getting himself into good counts But I thought I thought his two fastballs and his change up Were were effective form today to the right there Judges reached base three times in seven straight games the first Yankee to do that since Mickey Mantle 57 Just how impressive a feat is to do that, you know run chase and the way pitchers are pitching them Yeah, I mean that's it's it's just a You know, it's taken what the game gives you, you know, obviously, you know Every team's a little bit different in how they attack and pitchers are a little bit different But you know, we've seen teams in some cases really pitch around them and stay away from them You know the race tend to go after him a little bit more But he's Take what the game gives you, you know, Mike Schmidt used to always say that to me when I was a kid He used to say take what the game gives you, you know, you sometimes you want to get that out Or you want to get that take what the game gives you and he's doing a great job of that right now


Hey, Psych2Goers. Have you ever felt like you're cruising through life on autopilot? Do you no longer find joy in the things that you used to? When you're running the marathon of life, you will at some point feel exhausted or unsure of yourself somewhere along the way. You might lose touch with your real authentic self and lose sight of one of the most important things in life happiness. So if it's been a while since you last checked in with yourself, let's find out if you're truly happy or not. Would these six tell tale signs? Number one, you're always trying to be excessively busy. Are you always running to cross off task after task on your to-do list? People who are subconsciously struggling to find happiness or satisfaction in their lives often try to stay overly busy. This may be because you're trying to avoid addressing any unhappy feelings you may be experiencing. When you want to escape how you feel, you may use productivity as a measure of success. Author of Daring Greatly, a research professor, Brene Brown, shares that one of the most universal numbing strategies is what she likes to call crazy busy. We are a culture of people who've bought into the idea that if we stay busy enough, the truth of our lives won't catch up with us. Number two, you engage in addictive behaviors. Seemingly addictive behaviors can be a huge sign of hidden unhappiness. When you hear the word addiction, the first thing that may come to mind may involve substance abuse, such as drugs, alcohol, and a smoking addiction. But addictive behaviors can come in all shapes and sizes. According to the American Addiction Centers, behavioral addiction is the compulsion to continually engage in an activity or behavior despite the negative impact on the person's ability to remain mentally and or physically healthy and function in the home or community. Addiction can look like binge eating your favorite unhealthy foods, sleeping too much, or the excessive use of social media. Number three, you try too hard to show others how great your life is. You may often notice the sign in others when scrolling through social media. Someone's overly hyped up and bubbly posts or stories online aren't necessarily an accurate reflection of their mental state of happiness. In fact, a recent study conducted by the University of Pittsburgh found that heavy social media users tend to be far more likely to be lonely and unhappy compared to those who spend less time on the sites. Showing how great your life is could be a way to overcompensate for the dissatisfaction and lack of pleasure you feel in life. By outwardly showing others that you're doing and feeling better than ever, you effectively avoid addressing any lingering sense of emptiness you feel. Number four, you start to overlook self-care. When's the last time you had a self-care day? They're important a whole day for you. What about even just some time to yourself? Overlooking self-care may be a sign that you're struggling to feel a sense of satisfaction in your life. Despite the common misconception that self-care is a luxury or an indulgence, it is a necessity that can truly help you feel back in touch with yourself. When you're feeling unhappy, deep down, self-care is the first thing that can start to slip out of your hands. This is most likely because it requires you to take a moment to step back. While you're busy going through your list of tasks, running away from taking good care of yourself may distract you from coming face to face with your unexplainable lack of contentment with life. Oof, I know you felt that. Number five, you have unrealistically high expectations of yourself. Do you always need things to turn out perfect? Another source of unhappiness can come from setting too high of expectations for yourself. This is because it can lead to excessive self-doubt and feelings like you're not good enough when you don't or are unable to reach those goals. You may even become hyper aware of your weaknesses and feel less than because they exist. Number six, you experience physical pain and or discomfort. Our bodies are hard-working machines that are programmed to do their part in keeping us well. When you don't do your part and letting your body help you, it will speak up in its own way. According to the myoclinic, some of such symptoms can include mood swings with irritability and frustration, typically over more seemingly insignificant issues, reduced or increased appetite, sleep disturbances, back pains, headaches, and fatigue. These are just some of the ways in which your body may be trying to tell you that something is wrong and needs to be addressed. If you find yourself experiencing one or more of the symptoms listed above for a certain prolonged period of time, it might be a good idea to seek help from a medical or psychological professional. Did you relate to any of the signs mentioned above? If so, we highly recommend that you reach out for help. If you find this video helpful, be sure to like, subscribe, and share this video with those who might benefit from it. And don't forget to hit the notification bell icon to get notified whenever Psych2Go posts a new video. The references and studies used in this video are added in the description below. Thanks for watching and see you in our next video.