A Bit About Gunshot Wound Mechanisms

The penetration of a projectile(bullet or fragment) into tissue is categorized as a special form of blunt trauma.
 
A gunshot wound consists of:
  • tissue penetration,
  • crushing and rupturing of tissue,muscle, capillaries, nerves and bones(depending on size and density),
  • the formation of a primary cavity or more accurately a permanent wound tract or channel,
  • the formation of a secondary cavity and
  • for close range shots, greater injury as a result of the blast effect from the bullet’s propellant gases. If the bullet is retained, tissue burning takes place.
 
The movement of the projectile through tissue follows fluid dynamics, a complex engineering topic. The immersed projectile is considered to be moving forward with surrounding tissue “flowing” around it.
The chances of survival depend on the nature of the injury. This in turn depends on how deep was penetration, the type of gun and bullet, the distance, the type of tissue into which the bullet entered, the degree of “yawing” and tumbling of the bullet as well as the amount of blood lost before the victim is treated.
Here is an illustration of the mechanism of a bullet wound for one type of bullet.
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Today is World Mental Day, 2016 and there has been a host of information coming at me from the newspaper, Facebook posts and a Radio programme.

For the first time I delved into the pages of activists for mental health. I am amazed and impressed by the few I have had time to look at for today only.

I was diagnosed with Post Traumatic Stress Disorder in 2013. I accessed excellent psychological, medical and social support, through the public system, friends and family.

Truth be told though, upon careful examination of my life, I think I may have been experiencing bouts of depression for a much longer time than I can recall.

Over the years I can recount many, many occasions when my thinking was fuzzy and there was mental fog.

I would be hard on myself, always believing that I was just anti-social. Anti-social, because I would avoid going out, refuse to answer telephone calls and generally withdraw from many activities.

Activist/comedian based in the United Kingdom, Ruby Wax, likes to quote that  1 in 4 persons are suffering with some form of mental illness and, in the same breath, suggest that the figure is really 4 in 4. In other words, almost all, if not all, of us have some degree of mental problem.

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If those figures are to be believed, then there are several implications with which we need to deal. I will focus on just one for today’s post.

If so many of us are ailing in this aspect of our lives, then we should be more compassionate toward each other. All of us are hurting, why do we need to add to that hurt by placing negative labels?

The stigma of a diagnosis associated with mental health is real. It is so real, that many are unwilling to admit it even to themselves. It is so real that it is a flowing source for comedic relief.

We do not hear of jokes about heart health, kidney health or other physical illnesses. In fact to laugh at any of these physical problems would be highly insensitive.

Yet…we continue to cajole or even badger those who are experiencing mental challenges to shrug it off, get going, stop being lazy and just get over it. We get impatient and intolerant when they begin sharing their situation with us.

Sadly instead of being supportive, what is needed, we become less available and less encouraging to those who have real mental challenges.

A mental health diagnosis is not necessarily a sign of being totally out of control of your thinking, beliefs and actions. Dr. Hanif E. A. Benjamin expressed it so well this morning on a local radio programme.

He said that mental health illness can be considered as falling along a continuous spectrum. There is a wide range of problems, from minor to severe. Some problems allow a person to function at a high level in society while other problems reduce that level so  that a person is unable to function according to societal norms.

The statistics are real and are a reflection of the times in which we live as well as only accounting for those who actually seek help. This means that the figures are probably much higher in reality.

There is help. We all can help. Ignorance and lack of compassion are unacceptable in these so-called enlightened times.

Let us all join in  fanning the flames of passion lit by the activists for and professionals in mental health. Let us start developing our compassion, humanity and respect for all life. Let us nullify the stigma as we stand in solidarity with each other for mental health issues.

Are you on board? Are you willing to help educate and support in the field of mental health? Are you already doing your part? Please leave a comment and let me know.

 

Six Weeks to a 5K Venture for a Novice

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For anyone wanting to enter their first 5K, an admirable but grueling task, I have put together some tips that helped me with my first race.

These tips are targeted for those who do not usually exercise or who have not done so for a while.

I decided to do this in light of the upcoming annual 5K sponsored by a credit union in Trinidad. On the day before there is also a 5K sponsored by another group.

This plan could be used for either of those upcoming races, in which case it should be started on Monday 3rd August. However it could be deferred for use for another future date, it depends on your preference.

The struggle to begin exercising, or to reach to the point of deciding to take it a step further and enter a race, is real. Many of us agonize over taking that first step.

My own mother went through the motion of buying good walking shoes, a suitable track pants and matching tee-shirts but has never gotten past that stage.

I just listen to her whenever she makes a pronouncement that, “I will start to walk from Monday morning.”

It is always that she will start on some Monday and in the morning. She does not even normally get up early, so I know it is a delaying tactic. Her latest declaration should have her starting this coming Monday, when this plan is scheduled to begin.

Enough of the negativity! You have taken the reins of control and are about to challenge yourself.

You are ready to put your resolve, endurance, perseverance and grit to the test.

Congratulations! You are about to plunge into a courageous battle with a most formidable foe, yourself.

To prepare for a race, you need to train, eat properly and hydrate yourself. In addition to these, rest, a good massage routine and stretching are vital to help you comfortably and successfully be victorious in completing the race to the best of your ability.

Remember at every step that the objectives are to challenge yourself to compete and complete; to reduce the odds of injury or of giving up; and to build up your endurance and level of fitness.

Let’s talk about diet first. Over the next few weeks you need to pay particular attention to your eating habits – food is your fuel. Less fuel equals less energy which translates into less productive training.

I kid you not when I advise a good hot doubles with your choice of slight, medium or heavy pepper. Personally I prefer heavy pepper.

For those of you who may not know, doubles is a local street food. It contains curried channa or chick pea, sandwiched between two ‘bara’ or flat fried dough. Doesn’t sound mouth-watering but it is.

This one is my preference: the occasional “sahaina” or “saheena” (pronounced sah-he-nah) or two is my first choice – great roughage, great taste.

Again, a “sahaina” is something like a burger patty made out of bhagi (taro or dasheen) leaves layered with a seasoned paste of powdered split peas. The layered product is rolled into a cylinder then sliced into rounds and deep fried before serving with a hot sauce.

Anyway for those who may consider these foods unhealthy, a well-balanced diet is recommended. You need to include sufficient protein, especially if you are vegetarian – meat, fish and eggs, and peas and beans for the vegetarians.

Carbohydrates can be your friend; just make wise selections. Choose pasta, rice, sweet potato, green bananas and other ground provisions. Avoid refined carbs. In fact I strongly recommend eliminating refined sugar and caffeine.

On a side note I have to confess that prior to February this year I was a strong proponent for sweet treats and the number one soda, Coca cola. I used to drink at least one Coke daily. Thank goodness learning is life-long.

Increase your intake of fresh fruits and vegetables but remember to eat fruits alone and not after a meal. You want it to work for you not against you by fermenting on a full stomach.

Drink lots of water, more in the day, less in the night, especially if you tend to get up to use the washroom at night. For really spectacular results, you need to replace lost electrolytes by drinking an isotonic drink. I recommend, for those of us in Trinidad, coconut water.

Because our foods today are not as nutrient rich as we expect, a good multivitamin becomes a necessity not an option.

Apart from paying attention to what you eat, how much and when you eat is a guaranteed way to reap dietary benefits. Eat smaller portions more regularly and try to cut off eating early in the evening, that is do not eat after about 5:00 or 6:00 pm.

A reliable, proven training guide must include advice on resting and the importance of being well rested especially just before the race. So try to keep regular sleep times.

Avoid standing unnecessarily; standing is an isometric exercise which would cause you to become tired. Sitting for long periods is not advised as it interferes with blood circulation.

Now that you have all the information on hand as to how to prepare as you go into this battle, you need to actually begin to train.

I have worked out a six week training plan as a guide. Use it wisely. You know your body better than anyone else can. Listen to its protests, its requests and respond accordingly.

If you see areas where you can up the training, then do so cautiously to suit your physical level of acceptance. If there are steps that seem too difficult then cut back.

The training guide will be out  later but I will prepare you for the first day at least so that the mental focus can begin.

On Monday, if you have never run before or if you have not run for a while then you will start with a short fifteen minute walk. If you know you can handle more, then adjust the schedule to suit yourself.

Good luck. Congratulations on this new venture.

Let me know your level of interest and tell me, what prompted you to make this decision?