EDmedblog » General Health

DEMENTIA: HELP FOR CAREGIVERS

admin — Tue, 01 Jun 2010 11:58:51 +0000

Keeping the environment predictable, buying helpful devices, and ruling out other memory-impairing conditions go only so far in reducing the strain of dealing with a person with this disease. The real effort lies in coping with a loved one turned alien, where the tools used in normal human encounters no longer apply.

Dave (who usually cared for his wife with dementia) had gone out of town the previous week and left his wife with their daughter. After [they went] to a restaurant . . . Dave’s wife refused to get in the car to go back home. . . . She began accusing her daughter of trying to hurt her and insisted on seeing Dave. They argued for some time but nothing calmed her down. Instead, she got more and more agitated until she collapsed and the paramedics were called. . . . When Dave arrived home, she continued making accusations against their daughter. Dave tried to reason with her but reported to the group that he had no success. In fact, she denied having done anything wrong and insisted that it was her daughter’s fault that she had gotten upset.

This incident, reported at a family support group session, illustrates how emotionally difficult caring for someone with dementia can be. It can take every ounce of forbearance to cope full time with a person literally “out of his mind,” as many caregivers do.

For instance, in a 1986 study of caregivers, Duke University researchers found that their subjects averaged three times as many stress symptoms as a comparison group; they were much more apt to use tranquilizers; they had low morale. Hobbies, visits with their families and friends, and especially just relaxing by themselves were all casualties to the burden of dealing with this devastating disease. The one glimmer was that physically these caregivers were holding up, no more likely to visit their doctors than the control group – people dealing with the normal stresses of daily life.

It comes as no shock that care-giving causes emotional distress. The surprise is that the severity of the patient’s illness itself is not the primary determinant of that strain. Rather than the victim’s objective symptoms, three more external aspects of the situation seem to make caring for a person with dementia feel impossibly burdensome: not having the support of family and friends; having had an unloving or ambivalent relationship with the person before the disease struck; and feeling out of control, unable to handle problems that do arise.

Having a negative legacy from the past is hard to change. But if you are caring for a victim of Alzheimer’s disease you can take action to draw on the other two resources that researchers find so critical to not feeling overwhelmed: support from family and friends and the right problem-solving tools.

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GENERAL HEALTH

ALZHEIMER’S DISEASE: STEPS TO IMPROVE SYMPTOMS, CAPACITIES AND THE QUALITY OF LIFE

admin — Tue, 01 Jun 2010 11:58:19 +0000

Eliminate illnesses compounding the problem. Although it is incurable in itself, dementia often coexists with conditions that can be treated – depression, other illnesses and memory impairment from medications. These problems exacerbate the mental confusion. When they are ferreted out and eliminated, thinking often improves.

Judiciously consider using tranquilizers. Although tranquilizers have the potential to make mental cloudiness worse, they can help with the emotional and behavioral symptoms of the disease. If a person with Alzheimer’s disease wakes up at night to wander and scream, is physically abusive, is flooded with anxiety, or hears voices that are not there, antipsychotic medications, the same type of tranquilizer used to treat severe emotional disorders such as schizophrenia, may be worth a try. If your doctor does prescribe this type of medication, monitor your relative’s symptoms carefully to see whether the net effect is genuinely better or worse.

Provide a simple, predictable environment. The environment also can have a marked effect on how well the person feels and functions. For instance, a man with Alzheimer’s disease in its early stages may find work very threatening but have no trouble handling life comfortably if he retires and his mental requirements are less. Trips or moves are likely to be hard, because being in new territory puts extra stress on a mind struggling to make sense of a life already flowing by too fast. True, the pace is more relaxed in Arizona, but Chicago is “where your wife has lived all her life. The neighborhood is too noisy, the house is too big; but the contours of each are imprinted on her brain. People with dementia function best on the most familiar ground.

My father used just the wrong approach with my mother during the years her memory was failing. He took her to every new restaurant, forced her to travel. He was trying to make her last years happy by offering her the best. He also believed that piling on more experiences was better – that it would strengthen the brain cells that remained. I wanted him to keep her life simple, not continually confront her with the terror of new things. It hurt me to see her humiliated, when she was forced to do things that were beyond her capacities, where all she could do was fail.

When a person’s memory is dulled by an unstimulating life, new experiences may be the antidote. But dementia is totally different from the type of forgetting caused by looking at four walls. The advice to search out fulfillment or do memory exercises falls flat with dementia. No memory workout can retard the brain-cell loss of Alzheimer’s disease. In fact, because it may flood the person with anxiety, forcing memory-stimulating exercises on an Alzheimer’s victim is likely to boomerang.

Use external aids. On the other hand, using external memory props can be very effective, particularly when the illness is in its earlier stages. One standard prop is notes. Fasten a note to the stove reminding your mother to turn it off; pin one to the front door reminding your husband to take his coat. People with dementia tend to be more confused in the evening, in part because in the dark less information about the world comes in (and they also may be less alert). Simple strategies such as leaving a bathroom light on can reduce the terror of waking up with a full bladder and forgetting where the toilet is. In helping more information to penetrate, be creative! Use your ingenuity to turn up the volume of those things that must be remembered.

In the middle stages of the illness other devices may be very helpful – those that make living safer and assist the person with jobs such as bathing and dressing. If you are afraid your father will wander out of the house and get lost, install double locks, the kind that must be unlocked from the inside; sew identification labels in his clothing; there is even a homing device on the market that signals a caregiver when the patient wanders off.

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GENERAL HEALTH

CHANGES IN YOUR CHILD’S LIFE: BRINGING HOME A NEW BABY

admin — Thu, 21 May 2009 06:57:11 +0000

This is a stressful transition for everyone involved, including parents (see Chapter and other siblings. There is a major disruption in routine for the whole family. Sleep is invariably disrupted as the baby’s needs are attended to, and tiredness may result in increased tension within the family. There may be increased expectations of other siblings, who will be required to take on increased responsibility and help with the new arrival, and around the house generally.

Sibling rivalry is especially common with the birth of a new sibling. An elder child will often resent the arrival at home of a new sibling. Frequently he will regress in his behaviour. Competencies he has acquired, such as being dry at night, will be lost temporarily. He may begin to suck his thumb, wet the bed at night, and will request drinks in a bottle or a nappy at night. He may resent the attention paid to the new baby and want his mother’s attention during feeding time. All of this is normal behaviour, and parents should not be overly concerned.

Sometimes the sibling rivalry may be expressed physically, with a toddler actually hitting the baby, out of anger at the intruder. After a time, this usually settles down, but may resurface again when the new baby becomes mobile at around 12 months of age. Again the new sibling’s ability to interfere with the older child’s activities may give rise to feelings of irritation and anger. This sets the scene for what often seems an ongoing battle.

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WHIPLASH – DESCRIPTION

admin — Mon, 18 May 2009 06:10:39 +0000

Whiplash injury to the neck is a phenomenon associated with the car.

The sudden acceleration and then deceleration of the head and neck when the car is struck from behind is likened to the way a whip is cracked.

On the day of injury there is a little stiffness and soreness and then over several days it tends to get worse, rather than better.

So, often, if you do see a doctor in the first week both you and he tend to treat it lightly.

By the second week it is not improving. Perhaps then an X-ray is taken. The report is usually normal.

By the third week the symptoms have worsened. As well as pain and stiffness you may be experiencing giddiness, blurred vision and a ringing in the ears.

And in view of the normal X-ray, both you and your doctor are thinking that perhaps at the worst the symptoms are due to nervous tension.

Whiplash injury to the neck is poorly treated by many doctors at the moment and poorly understood by most patients.

The pathology or underlying injury is not fully understood.

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FOOD POISONING – INTRODUCTION

admin — Fri, 15 May 2009 09:01:25 +0000

Food poisoning is the term for attacks of vomiting and diarrhoea which can happen within 24 hours of eating food contaminated with bacteria, toxins or chemicals.

However, it is also possible for the same disease to pass from person to person or, more commonly, to be spread by infected water.

The outbreak may involve many people or come from a source where many might be affected and prompt notification can lead the inspectors to investigate, find and contain the source before too many are stricken.

In recent years there was an Australia-wide outbreak of gastro-enteritis due to contaminated oysters from the St. George River in NSW and, before that, over 60 cases of typhoid occurred in Victoria from a carrier working in a takeaway food store. And infected salami caused an outbreak and temporarily closed the factory making the salami.

Typhoid and paratyphoid fevers are specific diseases due to specific germs.

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DES – GENERAL INFORMATION

admin — Fri, 15 May 2009 07:04:40 +0000

During the ’50s, diethylstilboestrol or DES, a synthetic oestrogen or female hormone, was widely used in treating cases of threatened miscarriage.

It has been shown that the daughters of women exposed to this hormone during pregnancy have an increased rate of developing cancer of the vagina although further research has shown the incidence is not as high as first supposed.

There is, however, a high incidence of genital and urinary abnormalities in the sons and daughters of women exposed to the hormone.

There does not appear to be any reduction of fertility in these individuals, although continuing research is necessary as more enter the reproductive age group.

Unfortunately, proper scientific research may be hindered by the intrusion of claims for damages in the litigation-prone U.S.

Special clinics have now been established at some of the major Australian women’s hospitals to investigate and monitor women exposed to DES.

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HEALTH, LONG LIFE AND SEXUAL VIRILITY: VITAMIN E AND WHEAT GERM OIL

admin — Fri, 08 May 2009 08:20:52 +0000

A friend of mine in Canada, Mrs. K., had seven early miscarriages during eight years of marriage. She was unimpressed by my repeated advice to try wheat germ oil and vitamin E, because her obstetrician didn’t think it was worth considering. However, when another friend, a veterinarian, told her that this was exactly the treatment he had been using successfully on horses and cows with records of miscarriage, she decided to try. Within three months she became pregnant and, after a full nine-month pregnancy, delivered a healthy boy.

The healthy functioning of the reproductive system is dependent on many factors. Both psychological and physiological causes must be considered. Nutrition is, of course, a most vital factor. Many vitamins and other nutritive substances are directly involved in a healthy sex life. But if there Was one vitamin which could be called the sex vitamin, then it would be vitamin E.

It has been established that vitamin E can prevent miscarriage and stillbirths. Vitamin E is essential for the normal production of sex hormones. It has been demonstrated in animal tests that when vitamin E is deficient, the testicles degenerate and production of hormones is diminished—both sex hormones and pituitary hormones, which stimulate sex glands.2 Vitamin E, being a natural and powerful anti-oxidant, also protects sex hormones from destruction by oxidation. Dr. Evan Shute of Canada, a pioneer in the use of vitamin E for disorders in the reproductive system, has used vitamin E extensively and successfully in the treatment of various disorders from male sterility to miscarriages and menopausal symptoms. In one study he used vitamin E in 153 pregnancies in which there were 122 threatened abortions and 87 threatened miscarriages. 60 percent of the abortions and 86 percent of the miscarriages were prevented by vitamin E treatment. Dr. Shute says that vitamin E deficiency is very common in pregnant women.

Vitamin E has also been found to relieve the symptoms of menopause, or change of life: hot flashes, dizziness, pain, etc. Doses of 150 to 300 milligrams a day are prescribed in such cases. A Hungarian doctor has found that vitamin E decreases pain in childbirth labor.

Vitamin E is, indeed, absolutely essential for the normal function of the reproductive system and a healthy sex life. The best natural source of vitamin E is wheat germ oil and wheat germ. Other good sources are cold-pressed vegetable oils, such as corn oil, soybean oil, and sunflower seed oil. Green vegetables are also good sources, particularly cauliflower, turnips, and spinach. Milk and dairy products are also good sources. You can also buy vitamin E in capsule form at health food stores or drug stores. Doses most often recommended by doctors are between 300 and 600 I.U. per day.

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HOW THE LATEST DISCOVERIES CAN HELP TO GROW HAIR: CASE HISTORIES

admin — Fri, 08 May 2009 08:14:59 +0000

Totally bald man gets full head of hair!

It happened in Stockholm. The man was totally bald for several years—I mean he had no hair whatever on the top of his head. This didn’t bother him very much, but he also suffered from hardening of the arteries and atherosclerosis, which was a greater reason for concern. The largest hospital in Sweden, Sodersjukhuset in Stockholm, tested new treatments for these diseases. Over one hundred patients participated in prolonged treatments with nicotinic acid, one of the B-vitamins, also called niacin. Our bald man was one of the patients in this test group. After three years of treatment with nicotinic acid he received a vigorous hair growth on his previously bald head and is now the proud owner of a full head of hair.

Nicotinic acid has a widening and dilating effect on blood vessels, particularly on the peripheral capillary system. It would seem that the vigorous hair growth in this case was effected by the increased blood supply through the dilated blood vessels and capillaries in the scalp.

Note: Do not confuse nicotinic acid with nicotine, which is a very dangerous poison and has no relation to nicotinic acid, a B-vitamin.

English doctor cures baldness—unintentionally!

Dr. John Kelvin reported in the British Medical Journal that he treated many patients for blood vessel disorders with the drug composition beta-pyridylkarbinol, derivative of vitamin substance pyridin-3-carbonic acid. The drug was intended to improve blood circulation in the feet and hands. The doctor noticed that some of his bald patients had new hair growth.

“I didn’t connect this new hair growth with the drug I was using until one more of my patients, who had been totally bald previously, walked into my office one morning with a beautiful and well-combed head of hair!” said the doctor.

After this incident was publicized, the English paper reported that the drug stores were stormed by a multitude of men of all ages asking for “the new tablets.”

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DISEASES OF THE LIVER AND GALL-BLADDER: LIVER-DISTURBANCES

admin — Wed, 29 Apr 2009 09:31:20 +0000

The liver, the largest detoxicating organ in the body, has its place at 37′-40′ in the sixth minor zone of the right iris. The gall-bladder, which is both anatomically and physiologically connected to the liver, has its place at approximately 39′ in the fourth minor zone, and in any case in the right iris only.

1. Liver-disturbances-Inflammatory states of the liver register as white or yellowish clouds or wisps in the specified area. In the inflamed state, the liver is swollen as the result of congestion, which is indicated by the displacement of the iris-wreath towards the pupil, and also by the inwardly depressed nerve rings if these exist. At the same location may be seen the small arteries of the sclera, which when apparent, always indicate the existence of an inflammatory disturbance of the organ in the area to which they run.

Where there are inflammation signs in the liver area, one must very carefully consider whether the white signs (clouds or wisps) are present only in the liver area, or whether they are merely part of the total sign commencing at the iris-wreath and extending over the gall ducts to the liver area. In the first case the disorder concerns the liver only, and is due to a disturbance of the detoxicating function of the liver which becomes charged with blood from the organism. In the second case the disturbance arises from a disorder of the duodenum (usually ulcerated), and because of the extending inflammation, leads to gall stasis and inflammation of the gall ducts and liver. Here, therapeutics must first be directed to the duodenal disorder.

Where there are inflammatory processes affecting the liver, and hence a lighter colour in the liver area, there will also be seen signs in the area for spleen—left iris 20′. With such liver disturbances the patient complains of severe flatulence, and signs for this will be seen in the intestinal zone.

Much more often, the sign of inflammation is seen as a darkening of the liver area, and this indicates diminished liver function, leading to more or less severe metabolic disturbances. With this sign, there is usually found a very dark neurasthenic ring, as an indication of portal congestion.

Small dark spots in the liver area are signs of sclerosis, and enable one to diagnose a commencing hepatic cirrhosis. The greater is the darkening of the liver area, the greater is the disturbance of liver function.

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VACCINES PROTECTING CHILDREN: POLIO

admin — Tue, 28 Apr 2009 10:08:04 +0000

Polio, also known as poliomyelitis or infantile paralysis, is an infection of the spinal cord that can, in 1 to 2 percent of cases, lead to paralysis or death.

Outbreaks of polio do still occur in this country, and infants should receive two or three doses of live vaccine (Sabin, containing types 1, 2, and 3). The first dose should be given at two months, with the second and third doses separated by intervals of six weeks to two months. This vaccine is given by mouth, not as an injection. A booster dose should be given at the age of four to six years. Children who were not immunized in infancy should receive a total of three or four doses, depending on their ages. The Sabin vaccine is undoubtedly safe for children.

Adults who are not immune and who plan to travel to a country where polio is uncontrolled should also be immunized. In fact, all adults should be immunized against this disease. Some medical authorities believe that the risk of an adult being exposed to polio is minimal, and therefore adult immunization is unnecessary. However, too many cases of polio have occurred in adults over the age of 30 to make this argument acceptable.

The Sabin vaccine does carry a slight risk of polio for adults. However, the Salk vaccine (which is a dead vaccine) does not. Adults who are not immune should receive an initial series of Salk vaccine to acquire temporary immunity, followed by a full series of Sabin vaccine for permanent protection.

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