Thefastpharma. Health news blog

SENILITY IS DEMENTIA: SYMPTOMS

admin — Tue, 01 Jun 2010 11:30:45 +0000

The medical term for senility is dementia. Dementia refers to a set of symptoms, not a single illness – a generally progressive, irreversible decline in memory, reasoning, thinking. A number of diseases produce this inexorable intellectual deterioration. Though it has now become the popular catchword for everything, Alzheimer’s disease is only the most common of them.

When people have dementia (caused either by Alzheimer’s disease or by another illness) an early sign is trouble in remembering the ongoing events of daily life. A woman may forget she just made a phone call and call her daughter back. She may not remember driving to the store an hour earlier and may make a second trip.

Sometimes the first symptom is a change in personality. The person withdraws, becoming apathetic, abstracted. Or a life that had been tightly ordered seems to unravel. A fastidious housekeeper begins leaving the dinner dishes in the sink; her immaculate house is now in disarray. A dapper, punctual man regularly shows up at work hours late, disheveled, with a stained tie.

Changes like these are almost always either isolated incidents (How many of us have never blanked out on a phone call we made two seconds ago?) or signs that something is wrong with the emotional side of life. Personal problems may be preoccupying us, affecting our memory, our mood and our ability to handle life competently. It is very difficult to be sure a person is suffering from a dementing illness when the condition is in its earliest stages.

Strange or unusual behavior is often seen in retrospect as the first sign of the disease when, as the months pass, the victim’s mental processes deteriorate. For instance, when University of Michigan researchers interviewed family members of dementia victims, many said they had interpreted early symptoms in their loved ones, later diagnosed as Alzheimer’s disease, as emotional problems. When their mother became forgetful, children decided she was depressed or deliberately tuning them out. When a husband started behaving strangely, his wife might worry about their marriage. Some women even went for counseling or considered divorce.

Even if a family sensed what was really happening early on, they were often unable to articulate exactly what was peculiar or amiss and so had trouble convincing the doctor to take their worries seriously. Months might go by before the true condition was diagnosed.

If the problem is a dementing illness, things do get worse; eventually it becomes obvious that something is very wrong. As the illness reaches its middle stages, a person’s reasoning becomes strangely concrete. A man may be unable to follow simple instructions such as “turn right to Main Street” or “twist the cap to open the jar.” The advice to “just dive in” may be greeted by the puzzled comment, “I’m not near a swimming pool!”

Simple calculations become difficult. A woman may first have trouble making change, then forget that four quarters make a dollar, then not understand the word dollar. She may be unable to name objects correctly or remember their function – calling forks spoons, spearing steak with her knife, cutting food with her spoon. Judgment becomes increasingly unreliable, alarming family members. Children, worried at first that Mom might cross Main Street against a red light and be hit by a car, months later may find that their anxiety multiplies: “Will she run out on Main Street undressed?”

In the final stages there is profound disorientation, an inability to locate oneself in time or space. People are often unable to dress or feed themselves, control their bowels, remember their names, or recognize their families.

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GENERAL HEALTH

AGING AND DISEASES: DEMENTIA

admin — Tue, 01 Jun 2010 11:30:03 +0000

The person whose mind I have always envied most, my brilliant childhood friend who became a historian, has Alzheimer’s disease. Several years ago she began noticing changes in her teaching. She had trouble finding the right word for what she wanted to say. Sometimes she would pause in the middle of a sentence and begin a thought again. We all thought her complaints were psychological. She was too upset about her daughter’s divorce. We understood there was something seriously wrong only on our trip to Europe in the summer of 1984.

Janet had to ask the tour guide for the schedule several times a day. She could not keep the time the bus would leave in her head. She would ask questions about sights that had been discussed only a few minutes before. She seemed apathetic, not thrilled, when we visited the historical places I knew she loved. Restaurants were a problem. She had trouble finding her way back to our table after trips to the ladies’ room. Once we caught her about to walk out the door. Afterward I made excuses so I could take her there and back.

Over the next year or so she was able to handle life fairly well once back in the familiar surroundings of our town. She took a sabbatical from teaching but went to her office to “work” on papers several days a week. Everyone felt it would be good for her keep up the pretense, even though she could no longer really produce. Jack let her to do everything – shop, cook and take care of the house. He never stopped her from going out alone. But he was always upset. Would this be the time she took the car and wound up lost or dead? Would this dinner he the one where the stove was left on? By then she had been seen by specialists. Everyone knew what she probably had.

This year things have gotten much worse. My cool, rational friend now has outbursts of anger that come from left field. She sometimes is unable to sit still for more than a second at a time. When she is home she wants to go out. Once out, she wants to go back. She is like a person possessed – a firecracker of emotions without purpose or will.

Last week I invited Jack and her to dinner. When I would go into the kitchen, Janet would get up to go to the door. Jack would have to jump up, bring her back, and explain we were about to eat, only to have her pop up again. When I finally got dinner on the table, he had to cut her food and serve her. I was near tears by the time they left. What’s going on? Can’t anything be done to ease her suffering? What about me? What is my chance of getting this terrible disease?

Senility is everyone’s worst terror about old age. The flood of publicity about Alzheimer’s disease has multiplied this concern. We hear there is an epidemic; there is nothing medical science can do. But we know little else about this sword hanging over our later years: “Is my forgetting names more often a sign of beginning Alzheimer’s disease?” “Is becoming senile the inevitable price if we live to a ripe old age?” “What is senility?”

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GENERAL HEALTH

STRESSES AND CHANGES IN A CHILD’S LIFE: SHYNESS

admin — Thu, 21 May 2009 06:56:33 +0000

There is a great deal of individual variation in the way that children interact with others. Some seem to have boundless curiosity and confidence, while others are hesitant and literally cling to mother’s skirts. Shyness has been the subject of a great deal of study by researchers in recent times. Many have been concerned with the age-old argument of nature versus nurture. Are children the way they are because they were born that way, or as a result of their upbringing?

It is true that shy parents are more likely to have shy children. What is not clear is whether this is because of an inherited predisposition to shyness, or because there is something about the parenting style that makes a particular child shy. In addition, role modelling is very important. A child learns from the way his parents interact with other people, and is likely to emulate this style. Shyness as a particular style is more common in certain cultural groups, though again it is uncertain whether this is genetic or due to a particular style of parenting.

Shyness can be very painful for children who may find it very difficult to interact with others in a social setting, or take a long time to warm up. The worst thing that parents or teachers can do is to push these children into a strange situation, or else ridicule them in front of others. This only diminishes their self-confidence and makes things worse.

It is very important to respect individual differences in temperament and personality of children, to accept them as they are, and to support them in their efforts to negotiate the many transitions of their childhood successfully. A child’s shyness may so affect his confidence and interaction with peers that parents will be concerned about his social isolation. In such cases, it may be appropriate to consult a psychologist or other health professional. A number of professionals specialise in working with shy children, either individually or in groups. Your doctor will be able to refer you to an appropriate person.

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DEFINITIONS OF SOME EXPRESSIONS YOUR DOCTOR MAY USE – POSSIBLE SIDE EFFECTS OF PAINKILLERS (PAINKILLERS AND CONSTIPATION)

admin — Mon, 18 May 2009 06:40:11 +0000

By the way, almost all painkillers cause constipation, so changing painkillers is not a good way of dealing with this problem. You will probably need to take laxatives regularly. Read pages 130-31 for other suggestions.

Aim for the balance between pain relief and side effects that’s best for you. You may prefer to be completely free of pain, even if this means that you are drowsy and can’t concentrate on anything. Or you may prefer to have mild pain when you move about in exchange for feeling more alert.

It is almost always possible to relieve cancer pain with painkillers taken by mouth either in tablet or liquid form. Injections should be necessary only if you are vomiting, can’t swallow, or are too sleepy to take pills or syrup. An alternative to injections is suppositories. Some painkillers, for example, oxycodone, are available in this form. The painkiller is absorbed into the system through the lining of the rectum. Their big advantage over injections is that you can use them yourself at home. Another use for suppositories is as a supplement to painkillers taken by mouth. If you use a painkilling suppository last thing at night instead of your tablets or syrup, you are likely to get a longer stretch of pain-free sleep, because suppositories are longer acting.

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WARTS – TREATMENT

admin — Mon, 18 May 2009 06:09:27 +0000

There is some scientific evidence to suggest that some warts respond to treatment with a tranquillising drug.

All these treatments where success has been claimed are probably part of a placebo effect.

Local applications are effective and those prescribed by doctors and chemists contain either salicylic acid or podophyllin or both.

Where the local application fails to get rid of the wart more invasive treatment may be necessary.

It is possibly to cut it out and then sew up the wound.

This totally removes the wart and the virus that is causing it and is unlikely to recur.

However, if the warts are multiple this may be difficult.

Applying an ointment to remove the thicker layer and then curetting the base, or roots of the wart, may also be effective.

Electric diathermy or electric desiccation, usually done under local anaesthetic can totally destroy all the wart tissue.

If there are many warts it may not be practicable to inject each one with local anaesthetic and so a general anaesthetic may be necessary.

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FEET – GENERAL INFORMATION

admin — Fri, 15 May 2009 09:00:29 +0000

Placing a wedge of rubber between the first and second toes may help but this needs a wide shoe to accommodate it.

At operation, the bunion is removed, the bony overgrowths are shaved off and the joint is realigned. The toe becomes straight again and the joint is either fixed or floppy but this doesn’t seem to interfere with function.

It takes some time before the foot is comfortable in a shoe but almost all who have the operation are pleased with the result.

Hammer toe is a condition which affects the second, third and fourth toes. It is usually due to overcrowding or to one of these toes, usually the second, being too long.

The toe becomes bent and the flexed joint sits up and, by rubbing against the shoe, develops a painful corn on the top. Operation to fillet the toe, taking out some bone, and shortening it so that it fits the shoe, gives a good result.

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CYSTITIS – TREATMENT

admin — Fri, 15 May 2009 07:03:36 +0000

Once the sample is collected, treatment can be started. Potassium citrate is used to render the urine alkaline. This can be given as Citralka, or as one of the newer tablets or powders that dissolve in water to form a pleasant fizzy drink. Like the old-fashioned barley water, these relieve the symptoms but do not cure the complaint.

Antibiotics are always necessary. The doctor will usually choose that which he thinks is the most suitable and await the results of the culture to see if he is right.

Antibiotics should always be taken for a full course of from five to seven days to deal with the bacteria completely. Patients should not stop the treatment just because they feel better. This applies to any infection when antibiotics are prescribed.

If the culture and sensitivity tests show that the bacteria causing the infection are insensitive to the antibiotic the doctor has chosen, it can be changed to a more appropriate one.

During pregnancy, the doctor must choose the antibiotic with care. Some antibiotics can affect the foetus and should be avoided.

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HOW MAJOR IMPROVEMENTS IN CHEMOTHERAPY HAVE COME ABOUT – DRAMATIC AND OBVIOUS IMPROVEMENTS IN TREATMENT

admin — Fri, 15 May 2009 06:34:20 +0000

Unfortunately, dramatic and obvious improvements in treatment like these are rare. After the results in Hodgkin’s disease were published, the principle of using high dose combinations was applied to other types of cancer. A few types showed a similarly dramatic improvement in results but for many it was much less spectacular or nonexistent. For example, about one in three people with extensive breast cancer gain a remission with single chemotherapy drug treatment and their average length of life is about nine months. About two in three people get remissions with combination chemotherapy and their average length of life is about twenty-one months, none are completely cured. In cancer of the large bowel and most types of lung cancer, no combinations of drugs results in people living any longer, on average, than those who have no anti-cancer treatment at all. Combinations using the drug cis-platinum are far less effective against other types of cancer than they are against testicular cancer.

How have cancer specialists reacted to the fact that dramatic breakthroughs in treatment are rare and usually only apply to a few particular types of cancer? They have reacted by spending a lot of their own time and energy and a lot more of their patients much more precious time, energy, and comfort trying to prove very small differences between treatments. They look for differences that are ‘statistically significant’, that is, unlikely to be due to chance. ‘Statistically significant’ does not mean significant for people, as you will soon see.

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THE G.I. FACTOR: ANSWERED QUESTIONS

admin — Fri, 08 May 2009 13:49:15 +0000

Has the G.I. factor been tested in long-term studies?

At least twelve studies to date have looked at the G.L factor in the diet in relation to long-term diabetes control. Some of these studies have been five weeks long, others, including ours, up to three months. All but one showed a clear benefit in improving blood sugar levels. People with high blood lipids (cholesterol, triglycerides) showed improvements in this area as well.

The insulin response is important and the G.L factor does not tell us anything about this. Is there a correlation?

In general, studies have found an excellent correlation between the G.L factor of a food and its insulin response. Sometimes the insulin response is higher or lower than expected. The presence of more protein will increase the insulin response proportionately. A large amount of fat may reduce the glycaemic response but not the insulin response. But we should be avoiding large amounts of fat.

Why do different groups around the world come up with different values for the same food?

For the most part, we see very reproducible G.L factors for the same foods from standardised tests around the world. Apples and oranges, for example, have been tested a great deal and give similar G.L factors.

Packaged foods like cornflakes also give very consistent values.

Rice is one food which is very variable because its amylose content varies from variety to variety. Oats and porridge vary, too. To date we are not sure of the reasons for this. Potatoes vary with the variety and method of cooking. New or cocktail potatoes have lower G.L values.

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FAT LOSS: FIXED FACTORS

admin — Fri, 08 May 2009 13:12:42 +0000

Genetics. Where there is good reason to suspect a genetic influence on obesity, it is reasonable to suspect that the fat loss response to exercise will be blunted in comparison with the non-obese. Generic influences probably mean a reduced level of fat utilisation at a given exercise intensity meaning that a greater total amount, and greater attention to the type of energy intake, is required.

Race. Although not yet widely studied, differences in body fat distribution, muscle fibre type, and fat oxidation rates between different ethnic and racial groups could be expected to have an impact on exercise effects between groups. For example, the higher level of glycolytic fast twitch’ muscle fibre in negroid people and American Indians, which is known to be associated with higher levels of body fatness, could influence the exercise parameters required for optimal fat loss in these racial groups, although the most appropriate approaches are not yet known. Until more research confirms these proposals, the general principle of increased energy expenditure for fat loss is all that can be recommended.

Myth-information. It is often assumed that mates and females should lose fat at the same rate through physical activity. This is not so. Exercise appears to be not as effective for fat loss in most women as it is in men.

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