Step 1] Learn to recognize the pattern of odd behaviour.
Step 2] Take the patient to a place where basic physical examination, medical detective work and physical care and physical rehabilitation is done.
Step 3] Search for the medical issue responsible for the odd behaviour; the Kraepelin/Paula biomarker will determine if a ventilatory defect or injury is preventing a normal response to hypercapnia. Please look at our blogpost on Minute Ventilation-The New Biomarker for Manic Depressive [reversible] attacks. Please read the blogpost We have a potential new 2 step biomarker for bipolar illness. Ventilatory issues and [hidden] hypercapnia can cause specific patterns of “odd behaviour”, mood and locomotor activity.
Step 4] Treat the medical issue and/or provide medical assistance if the ventilatory system cannot be fixed. Since we know from Kraepelin’s studies [ done over 100 years ago] that this is a remitting/relapsing syndrome, we know that the odd behaviour, mood and locomotor activity will spontaneously resolves itself when the hypercapnia attack resolves. https://archive.org/details/manicdepressivei00kraeuoft, 1921Topics Psychiatry — Early works to 1900, Manic-depressive illness, ParanoiaPublisher Edinburgh : LivingstoneCollection gerstein; toronto; medicalheritagelibrary; university_of_torontoDigitizing sponsor MSNContributor Gerstein – University of TorontoLanguage English Some supportive medical care to enhance ventilation and infection control may even resolve the attack quickly, effectively cutting short the attack.
Unfortunately, and this need further study, the ventilatory neural defect of injury is , I believe, permanent, so the patient needs to be regularly followed by health professional should the patient get another attack later in their life.
In order to illustrate the care, the detective work [using the Kraepelin/Paula biomarker [minute ventilation] and treatment needed to save a manic depressive life, please read how a life was saved…albeit, in a very different type of poisoning…….
A Sick Swan Is Saved After a 23-Mile Odyssey by Foot, Car and Subway
A woman with the right training noticed a bird’s odd behavior and made it her mission to undertake a very urban rescue.
By Troy Closson
Ariel Cordova-Rojas had planned to spend last Thursday afternoon immersed in nature. It was the day before her 30th birthday, and her intention was to ride her bike to Jamaica Bay Wildlife Refuge in Queens, watch birds fly overhead and hike amid the vibrant fall foliage.
Instead, she spent a good chunk of the day in a frantic race to rescue a sickly swan, rushing by foot and then subway from Queens to Brooklyn before ultimately arriving at an animal rehabilitation center on Manhattan’s Upper West Side.
She was not upset that the day had not gone according to plan.
“If there’s an animal in need,” she said, “I’m going to do whatever I can.”
Ms. Cordova-Rojas had not been at the refuge that long when she encountered a female mute swan that looked as though it might be sick. The bird caught her attention because it was sitting alone on some grass near the water’s edge, surrounded by other birds on the water.
Ms. Cordova-Rojas had been trained to spot a bird in distress. She spent five years as an animal care manager at the Wild Bird Fund rehabilitation center in Manhattan, rescuing geese in Central Park, red-tailed hawks in Brooklyn and other species elsewhere in the city.
So when the swan did not move or make a sound when she approached, she knew something was not right. Mute swans are typically territorial and aggressive. As she got closer, the bird tried to drag its body forward with its wings in a feeble bid to swim off.
There was “obviously something wrong” with the swan, Ms. Cordova-Rojas said. Despite her background, she was unsure what to do. She had her bike but not her rescue gear, and she was around an hour’s drive from the Wild Bird Fund center.
She decided to approach the swan slowly, take off her jacket and place it over the bird. The swan tried to move its wings and it made faint sounds, but Ms. Cordova-Rojas said she was able to wrap the coat around the animal quickly and pick it up.
“Well, I’m carrying a swan,” she recalled thinking. “I have no idea what to do. I guess I’m just going to walk.”
The one-mile hike back to where she had left her bike “was a bit of a struggle,” she said, especially carrying an animal that later weighed in at around 17 pounds.
Josh Spector was also at the refuge, having traveled there from the Park Slope section of Brooklyn earlier in the day. He said he was immediately confused when he saw Ms. Cordova-Rojas with the swan.
“Is this actually her pet and she’s walking it through here?” he recalled thinking. He said that he and a friend had considered shrugging off the scene “as another crazy New York thing, but decided not to.”
Mr. Spector said he had struck up a conversation with Ms. Cordova-Rojas and had taken some pictures of her and the swan, but could not offer much help because he had also biked to the refuge.
After making it back to her bike, Ms. Cordova-Rojas said she called various animal rescue services without any luck. The ranger stations in the park were closed, and an animal care center in Brooklyn was unable to send anyone out.
Help arrived after about a half-hour in the form of a husband and wife who offered to drive the swan to the subway. When Ms. Cordova-Rojas, the swan and the bicycle could not all fit in the couple’s car, the woman, who happened to volunteer rescuing cats, persuaded a friend to drive over and help.
They all drove to the Howard Beach subway station, where the husband, a Metropolitan Transportation Authority employee, helped Ms. Cordova-Rojas lug her bike and the swan to the platform and then onto the A train.
Ms. Cordova-Rojas placed the swan, still wrapped in the coat, at the end of a long seat. She called friends and former colleagues at the Wild Bird Fund and asked that they meet her.
“Meanwhile, there’s a few people on the train and nobody seems to be fazed,” she said. One man, she added, was “sitting right in front of me and he’s just on his phone. I don’t even know if he noticed there was a swan in front of him.”
Tristan Higginbotham, an animal care manager at the Wild Bird Fund, met Ms. Cordova-Rojas at the Nostrand Avenue station in Brooklyn. Ms. Higginbotham, too, was unfazed by the sight of Ms. Cordova-Rojas holding the swan in her left hand while propping up a bike with her right.
“That’s just like the perfect summary of who she is,” Ms. Higginbotham said.
Two car rides later, the swan, and Ms. Cordova-Rojas, reached the Wild Bird Fund. Staff members there determined that it was a bit underweight; tests also found signs of lead poisoning, which can happen when swans ingest weights used on fishing lines, among other things.
On Tuesday, the bird was undergoing treatment and would be reassessed in a few weeks, Ms. Higginbotham said.
Ms. Higginbotham said that the New York City Audubon Society, where she volunteers, had received reports recently about a sick mute swan at the refuge, but staff members had not been able to find it.
Mute swans are not native to North America. They were introduced to the northeastern United States from Western Europe in the 19th century as pets and as decorations for parks and ponds.
As an invasive species, the mute swan has stirred debate in New York. In 2014, state conservation officials set a goal of eliminating virtually all of the birds within 11 years, largely because they are known to destroy the habitats of native ducks and geese and can pose a risk to passenger jets. But the proposal attracted strong opposition, and Gov. Andrew M. Cuomo ultimately signed legislation blocking it.
Ms. Cordova-Rojas was happy to rescue one swan.
“That was kind of the perfect culmination of my 20s,” she said. “It was the perfect birthday present to be in nature and be able to save a life.”
Troy Closson is a reporter for the Metro desk, and a member of the 2020 New York Times Fellowship class. @troy_closson