Brief Answer:
Many thanks again for returning a visit

Detailed Answer:
Good evening dear xxxxxxx,

It's so very nice to hear from you once again and to know that by reading your story that you are doing so very well through the years and following rehabilitation following the accident.

Body symmetry is always a concern for patients who have suffered from stroke or similar illness where either a specific area of the brain or spinal cord has been affected since this will translate into a very specific body part or parts (depending on how extensive the damage is) losing muscle tone and strength due to lack of we call UPPER NEURON CONTROL or innervation. In lieu of the term HYPOTROPHY my guess that a more appropriate term for your particular situation would be body region ATROPHY. This is where an area of the body (once symmetric with its sister side) becomes shrunken in terms of size, bulk, and even loses tone due to the lack of signal connection with the brain or spinal cord.

HYPOTROPHY would be more akin to a body part that did not GROW or MATURE to the same symmetric size as the sister side. This would occur in a fetus where actual growth or maturity of a body part becomes stunted due to some mishap of metabolic or other phenomenon. However, in your case you started in a normal SYMMETRICALLY matured form but following the accident developed focal issues of DENERVATION resulting in loss of muscle size, tone, and strength.

However, symmetry can be regained at least to a certain degree by very focused and intense therapy and work as you seem to have fortunate enough to have accomplished. I wish there were a way to guarantee a full and complete gain in your breast size from one side of the body compared to the other, however, that would be speculation on my part. All I can say is that in my own patients I always encourage as much persistence and perseverance to staying fit and healthy with exercises, stretches, and diet. Sometimes I will also recommend patients use interventions such as electrical stimulation devices which can be applied either TRANSCUTANEOUSLY (on top of the skin) or even embedded into the muscles where weakness and loss of bulk have occurred.

This is referred to as FES or FUNCTIONAL ELECTRICAL STIMULATION and has been shown to work quite nicely in post stroke and other types of patients where UPPER NEURON DISEASE has affected the body. Studies on FES, however, suggest that there may be a limit in time with respect to effectiveness. For example, in poststroke patients FES therapy does not seem to have very much positive long term outcome effect after 9-12 months post incident.

At any rate the above information is merely a preface to the questions as far as general aspects of both pathophysiology and common approaches to therapy are concerned.

In terms of your 3 B's.....I don't know of any specific relationship between the BROW, BREAST, AND BICEPS on one side except to say that it would likely be best explained by going to either a brain or spinal cord scan to detect areas of INFARCT or SCARRING and matching that with the regional parts you've listed. Otherwise, there is no functional linkage that I know of between those specific body parts. In fact, the asymmetry in the eyebrow region would likely be best explained by atrophy to the orbital muscles which are referred to as the ORBICULARIS OCULI or possibly the FRONTALIS or even CORRUGATOR muscles of the face. These are controlled by cranial nerve VII or the facial nerve and this has both an upper as well as lower motor neuron that exists within the brain as well as outside the brain that must have been somehow damaged in the accident. The biceps and breast are similarly connected by way of regional closeness in both the spinal cord as well as the motor cortex of the brain so it is not surprising that both of those parts were simultaneously affected.

With respect to the question on any relationship between the slang for drugs and DOPE and the chemical compound DOPAMINE referring to the neurotransmitter produced by the body which typically has a stimulating effect upon target neurons I do not believe there is any connection with those 2 words other than coincidence in how both words begin. I did a search in the Oxord Dictionary for the etymology of DOPE in slang usage as it refers to street drugs and here is what I was able to find:

"Turning to dope in its specific drug sense: in 1886 (according to Green’s Dictionary of Slang), we first heard of a dope fiend – a drug user. A few years later, we find dope referring to opium or a morphine derivative. The link between the syrup and the drug may not be immediately obvious, but it relates to the ‘the thick treacle-like preparation used in opium-smoking’; as early as 1872, dope had referred to ‘a preparation, mixture, or drug which is not specifically named’. In 1933 we encounter dope addict. Dope eventually stood on its own, coming to mean any drug (1900) or medicine (1902). Dope came to refer specifically to marijuana only in 1950 (according to the Historical Dictionary of XXXXXXX Slang); to the extent that dope is used today to refer to a drug, it most commonly means heroin or another opiate. In this general vein, dope has long been used as a verb, first meaning to poison (1862 in HDAS) and then slightly later to administer a stimulant or sedative to a racehorse. The meaning has broadened in recent years to include the use of any banned athletic performance-enhancing drugs by athletic competitors, human or not."

The full citation which very interestingly also explains at least 3 other definitions of the words DOPE can be found at:

XXXX

The origin of DOPAMINE actually goes back to its originally being published and named in 1959 and is the combination of the acronym DOPA+Amine.

DOPA stands for the abbreviation of the chemical constituents of the neurotransmitter DiOxyPhenylAlanine. The descriptor of an AMINE refers to class of chemical compound from which this substance is fundamentally derived.d

Therefore, the combining of those 2 concepts has resulted in the term DOPAMINE. I see no relation of that word derivation to the slang usage for DOPE but it certainly is an interesting observation, isn't it though?

Once again my sincerest hopes for ONGOING recovery and success....and as always in this forum your kind words in the form of positive feedback are gratefully accepted if I've answered your questions satisfactorily.

I would be very honored to make your acquaintance some day if there were a way of contracting the world by roughly 10,000 miles! XXXXXXX Ohio is actually sparkling this time of the year...not uncomfortably hot and certainly not at all cold. What a shame it can't stay like this the year through!

Cheers young lady!


This query has utilized a total of 55 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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Brief Answer:
Thank you for your return message

Detailed Answer:
I appreciate hearing patients' perspectives on what works for them and techniques they have that could be interesting and possibly effective for others. I am a big fan of water therapy types of exercises.

Again, congratulations on all of your marvelous achievements and don't stop continuing to reach for more....I am certain that persistence and patience will ultimately build more neuronal innervation in your pectoral muscles and help balance out the asymmetry in your chest sooner rather than later.

Cheers my dear XXXX! Ha!

This query has utilized a total of 61 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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