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CHRONIC CONFUSION: ALCOHOL

September 15th, 2010
As many people have learnt to their cost, the effects of acute alcohol consumption can be both seen and felt. The elderly are no different in this, though their tolerance to alcohol may be diminished. Initial feelings of well-being give way to increasing loss of social inhibitions, unsteadiness, slurred speech, difficulty concentrating, then to aggressive tendencies, nausea and vomiting, and finally to falls and unconsciousness. All of the above can occur even faster if alcohol is mixed with medication. Thus alcohol abuse should be considered in all cases of acute confusional states as well as chronic ones.
Some elderly people have carried their alcohol abuse along with them for years. These are probably in a minority, for the effects of severe alcohol abuse are not compatible with a long life. However these chronic abusers may show the effects of the alcohol on every body organ. The liver may be cirrhotic (severely scarred and fibrotic) and after heavy drinking bouts they may become yellow (due to a form of hepatitis – inflammation of the liver). General nutrition is often poor and the person looks malnourished, being thin, with a poor complexion, bad teeth and skin, a tendency to bruise easily and prone to chest infections, etc. This poor nutrition can be general or more specific if vitamins are missing. Alcoholics can be deficient in the vitamin thiamine and then present fairly acutely with falls, due to an inability to walk properly (ataxia – not the acute effects of alcohol), eye problems and an acute confusional state (Korsakoff’s psychosis), the whole brain condition being called Wernicke’s encephalopathy. The response to being given thiamine is usually dramatic.
If the supply of alcohol is suddenly withdrawn from a chronic abuser (admission to hospital or old people’s home) then it can produce the DT’s (delirium tremens). This is a very dangerous condition, with a craving for alcohol and then confusion, accompanied by hallucinations. It can be fatal, especially in the more frail elderly alcohol abuser. The long-term effects of alcohol on the brain are equally as bad. Alcohol is a well recognized cause of chronic confusion or dementia. The memory loss is accompanied by a deterioration of the personality. The emotional trauma to carers is very great indeed – having to cope with a dementing person made regularly worse by bouts of heavy drinking.
Some people only turn to alcohol in late life. It may be possible to find a precipitating cause such as bereavement, depression or a chronic painful medical condition. These people usually present with frequent falls or frequent bouts of confusion that disappear after 24 hours in hospital. They have not been drinking long enough for the physical signs to show and their bodies are not dependent on the alcohol so that they rarely get the DTs. Alcohol may be smelt on the breath or found in the blood in someone who is unconscious. More commonly, empty bottles are found in the bedside cabinet during an assessment visit to an old lady who is falling over a lot, and someone has requested her admission to an institution.
Long-term dependence on alcohol is as hard to treat in elderly people as it is in the younger age groups. A commitment to stop and keep off alcohol under difficult circumstances has to be present. There are many organizations that can help but few centers for rehabilitation of alcohol abusers will consider elderly people. The late onset drinker has a better prognosis, for it may be possible to identify the cause of the drinking and treat it. There are a few people who appear to develop a drinking habit detrimental to their health after they have started to become confused with a dementing illness such as Alzheimer’s disease, and these few can be particularly hard to help.
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EYE CARE: VISITING OPTOMETRISTS

September 15th, 2010
Another eye care professional using refractive corrections with lenses, the optometrist (pronounce (op/TOM/e/trist), has an O.D. degree which represents him or   her as a doctor of optometry.   The O.D. provides vita primary health care services.   For   instance,   the optometrist examines,   diagnoses,   and   prescribes   specific   treatment for conditions of the vision system.
Optometrists examine eyes   and   related structures   to determine the presence of vision   problems, diseases or other   abnormalities.   They   utilize   drugs   for   diagnostic purposes   when permitted   by state   laws (which are changing throughout   the   country).   By   thoroughly   evaluating   the internal and external structure  of the  eyes,  optometrists  can detect systemic  and  eye  diseases  that  require  referral of thee patient to other health care practitioners.
The  optometrist   treats   by  prescribing  and  adapting spectacle  lenses,  contact  lenses,  or  other  optical  aids  and uses  visual  training/vision  therapy  to  preserve  or  restore maximum efficiency of vision.
Education  of  the  optometrist   includes   two  to  four   years of college pre pre-optometric   training  and   four  additional   years of  specialized   professional   training  at  an   accredited   college of optometry.
In contrast to the other two eye care professionals, the optician (pronounced OP/ti/cian) is not degreed as a doctor. An optician is the technical part of the lens-servicing team. He or she may also be known as a dispensing optician or an ophthalmic dispenser. The optician could be both or either of these designated types of specialists. The dispensing optician makes and fits eyeglasses and/or contact lenses. He or she designs, verifies, and delivers lenses, frames, and other specially fabricated optical devices upon prescription to the intended wearer.
The ophthalmic dispenser both tests people for eyeglasses and also makes and fits them. The ophthalmic dispenser’s functions include, but are not limited to, prescription analysis and interpretation, the taking of measurements to determine the size, shape, and specifications of the lenses, frames, contact lenses, or lens forms best suited to the wearer’s needs; the preparation and delivery of work orders to laboratory technicians engaged in grinding lenses and fabricating eyewear; the verification of the quality of finished ophthalmic products; the adjustment of lenses or frames to the intended wearer’s face or eyes; and the adjustment, replacement, repair and reproduction of previously prepared ophthalmic lenses, frames, or other specially fabricated ophthalmic devices.
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HEALTH CARE FOR OLDER PEOPLE: PATIENT’S CONTRIBUTION TO POOR CARE

June 01st, 2010
Unfortunately, in spite of this new focus on geriatrics, there is unhappy evidence that many doctors today still may be giving their older patients less attention. In a 1987 study, when researchers videotaped the doctor/patient interviews of five typical private-practice physicians, they discovered that with older people doctors tended to focus on physical symptoms alone. Conversations about the effects of the illness – whether the patient was having trouble getting around and was worried or depressed – were much more likely to take place with younger adults.
However, the patients seemed as much at fault as the doctors. During their visits, elderly people brought up only their dizziness, or pain, or blood pressure. Younger patients tended to raise a broader set of questions, focusing both on their symptoms and on how their illness was affecting their lives.
So when older people are given less attention, they themselves may be partly to blame. Being trained in the idea that the doctor is an authority figure, they may be less aggressive in bringing up their concerns. Because they demand less from their doctors, they get less.
Sociologist Marie Haug of Case Western Reserve University, who has done extensive research on elderly patient/physician relationships, finds older people are also guilty of therapeutic pessimism and are just as prone to self-diagnose treatable conditions as old age. Because not feeling well is supposed to be “normal” at age seventy or eighty, many people are reluctant to call their doctors when a symptom appears. Their attitude is, “At my age what can any doctor do?”
My hand has begun shaking uncontrollably, and my wife tells me I should give the doctor a call. I’m reluctant. After all, I’m seventy-eight. It’s not like the shaking is so bad. I can walk. I can play golf. My life is not in danger. When I look around, I see how bad things could be. I don’t need to be in a nursing home. I don’t have heart trouble. I’m better off than most men my age. Why should a person in the pink of health waste the doctor’s time?
This reasoning condemns people to live with what they have; they lose the race by default, neglecting to put in a bet. When this man was badgered into making an appointment, his doctor prescribed a far from painful remedy – a drink of Scotch a day. He now takes his “medicine” each evening, and his shaking is gone.
Many symptoms that seem to be old age are treatable. Even real age-related disabilities – such as problems in walking or dressing – often can improve. When gerontologists at Ohio State University traced the course of disabilities like these in several thousand older men over a fifteen-year period from 1966 to 1981, they found that more of us do develop infirmities as the years advance, but disabilities also go away. Many men who had trouble reaching, lifting, or walking in 1976 did not have the same problems five years later in 1981. What looks like the permanent physical ravages of aging can be surprisingly temporary.
Furthermore, a 1986 report shows that rehabilitation can work wonders. When 190 severely disabled older people were treated at a special geriatric rehabilitation center, the changes were dramatic. The number who could function on their own (at least partially) increased from 87 to 173. Those able to walk independently rose from 42 to 127.
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GENERAL HEALTH

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DOCTORS AND HEALTH CARE FOR OLDER PEOPLE: SOME INFORMATION PROVIDED BY GERIATRICS COURSES

June 01st, 2010
Doctors are becoming aware of their attitudes. They are now being trained that we are not powerless in dealing with disabling chronic disease. Within the past fifteen years the number of medical schools offering courses in geriatrics has grown from a handful to a majority. By 1995 experts estimate that every medical school will offer at least some training in this exciting new field. Here is some of the information that geriatrics courses provide.
Diseases can produce different symptoms in older people than they do in the young.
An interesting example is a heart attack. In younger people its wrenching pain is impossible to miss. But by our seventies the only sign of a heart attack may be mental confusion or indigestion. Earlier, doctors might often have sent an elderly heart attack victim home with antacids. Today’s more geriatrically aware physicians are less likely to make this fatal mistake.
Age does not equal illness.
In geriatrics courses doctors learn that not all older people are sick. In fact, as we grow older we differ more and more from one another physically. Students are taught to view their older patients as individuals, not as bodies aged eighty or ninety-five.
What physical changes are normal and what are pathological.
Geriatric training makes doctors sensitive about labeling the many things that can be helped as just “old age.” They are less likely to over-treat too, reading illness into normal changes or pushing drugs excessively. By learning about studies such as the Baltimore study sponsored by the National Institute on Aging, they get a better sense of when to treat their patients and when not to intervene.
To restore function.
They are also trained in the orientation toward disability I just described: improving eighty-year-old Mrs. Jones’s ability to get around can be as worthwhile a goal as curing her disease. If she can get to the store, she may not have to move. She can continue to live with her husband and will not have the heartbreak of going to a nursing home. Reaching these goals may mean arranging for a physical therapist to come to her home to increase her mobility and strength; knowing about the many gadgets that can make life easier for the disabled; treating the depression that is compounding her physical problems; working with her family; knowing what community services are available to keep people out of nursing homes.
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GENERAL HEALTH

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YOUR CHILD’S HEALTH CARE: MINIMIZING THE EFFECTS OF DIVORCE ON CHILDREN

May 21st, 2009

Parents must remember that even though their relationship has ended, they are still the joint parents of their children, and always will be. As bitter and tense as many marriage breakups seem to be, it is possible to act in a way which will minimise the damaging effects on the children. Here are some things that are worth remembering:

• Always try to be open and honest with your children.

• Try to diminish the involvement of children in disputes. In particular, it is important not to use the children as a way of getting back at one’s former partner. Avoid having children caught in the middle.

• There will inevitably be disagreements about aspects of parenting, such as choice of schools, health care, discipline, and so on. If there are differences that need to be resolved, consider discussions by phone, or in person when the children are not around.

• Avoid ‘bribing’ children during custodial visits. Parents often compete with each other to gain favour with their children.

• Negotiate access visits that are reliable yet flexible. Nothing is worse for a young child than the disappointment of a suddenly cancelled visit to a parent, or a planned phone call that doesn’t eventuate.

• Consider counselling for yourselves as a couple, after the separation as well as before it. Post-separation counselling is often extremely helpful in resolving issues between the parents, and thus making things easier for the children.

• Consider counselling and therapy for your child if there continue to be concerns about him after the separation. Family therapy is often very helpful. Your doctor or nurse will be able to recommend an appropriate professional.

• There are a number of good books that have been written about divorce and blended families. Check with your local library or bookstore.

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BITES AND STINGS – GENERAL INFORMATION

May 18th, 2009

Hamilton Laboratories have released a product, Stingose, which is claimed to be of value in treating the bites and stings of insects, spiders, bees, marine creatures and plants.

It contains aluminium sulphate and this chemical denatures or destroys the protein venom of animals and the complex starches of plant venoms.

The quicker it is applied, the quicker it goes to work, neutralising the poison and relieving the pain and discomfort. It also relieves the inflammation and so there are fewer long-term effects.

For those who are allergic to bee stings, the immediate application of Stingose may be life-saving.

In northern waters at certain times of the year, the bluebottle (physalia) and the box jellyfish (chironex) may cause painful and, sometimes, fatal stings. The trouble is, these jellyfish have long trailing tentacles which wrap themselves around the body and with myriad of tiny stinging cells on the tentacles, may keep firing off and discharging venom. Attempting to brush off or wipe away the tentacles may cause further discharge of venom.

Alcohol has been recommended to kill the poison cells, dry the tentacles and make removal easier. There is some recent evidence that methylated spirits and other alcohols may fire off more venom cells. Vinegar has been shown to inactivate them but does not stop the pain or inactivate venom already in the skin. Stingose does.

The Surf Lifesaving Association in Queensland now recommends application of vinegar to inactivate the stinging cells of jellyfish tentacles and then to apply Stingose or a cooling lotion.

Vinegar is not a total treatment. Once the stinging cells have been inactivated by vinegar they should be removed with the finger tips.

Any sign of distress symptoms requires immediate medical assistance.

So, if you want a good weekend, you should not only pack the insect repellent but the best first aid treatment for bites and stings from both insects and plants.

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GALLSTONES – DESCRIPTION

May 15th, 2009

Gallstones affect both sexes and all ages but seem to be more common in the overweight and in women who have had repeated pregnancies.

The condition tends to run in familes but whether because of heredity or common environment factors, such as diet, is not yet certain.

What are these stones which are so common and cause so much concern?

The gallbladder is pear shaped, about 10 cm long, and lies tucked under the liver. It acts as a reservoir of bile and concentrates it.

Bile is formed in the liver and contains the acids necessary for the digestion of fats and also bile pigments, which are breakdown products of the red blood cells.

Diet may be the most important cause but, again, the mechanism is not proven. Diets high in refined sugar, those lacking in fibre and those high in polyunsaturated fats predispose to the formation of stones.

Although most stones contain cholesterol and some consist only of this substance, a diet high in cholesterol does not seem to lead to stones.

*370/71/1*


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EXCESSIVE BODY HAIR – INTRODUCTION

May 15th, 2009

Nature isn’t fair. Just when a man is losing the hair on his head, a woman may be gaining a crop of unwanted hair elsewhere.

But the middle years of the menopause are not the only time an excess of hair can worry women — the problem may start in the teens.

The amount and distribution of body hair is often determined by our genes and varies with the race or ethnic group to which we belong.

For most women, fine hair on the trunk, the limbs, the face and around the nipple is normal and accepted, But when the hairs are dark and coarse like a man’s, concern is felt and expressed.

Hirsutism, or excess of body or facial hair, is usually caused by an increase of the amount of androgen or male hormone in the female.

Women produce male hormones both from the ovaries and the adrenal glands, which lie above the kidneys and produce the “stress” hormones, adrenalin and cortisone. Some chemicals, which have this androgenic activity on the hairs, may be produced in the skin.

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RECIPES AND DIRECTIONS FOR SPECIAL EUROPEAN HEALTH AND LONGEVITY FOODS

May 08th, 2009

BIRCHER-BENNER APPLE MCESLI

2 tbsp. old-fashioned rolled oats (not the quick-cooking kind)

2 medium-sized apples

2 tbsp. wheat germ

2 tbsp. condensed milk or ordinary milk, fortified with 1 tbsp. skim milk powder

2 tbsp. honey

1/2 lemon

2 tbsp. chopped hazel nuts or almonds

Soak oatmeal overnight in four tablespoons of water. In the morning, add lemon juice and milk; mix well. Shred apples, un-peeled but well washed, into the mixture. Add honey, wheat germ and nuts, and stir. Serve at once, as it will lose in taste and food value if apples darken (oxidize). This dish is a favorite at the famous Bircher-Benner biological clinic in Switzerland and is also very popular in health food restaurants in Europe.

FRUIT SALAD A LA AIROLA

1 bowl fresh fruits, organically grown if possible

1 handful raw nuts and/or sunflower seeds

3-4 soaked prunes or handful of raisins, unsulphured

3 tbsp. cottage cheese, preferably homemade, unsalted

1 tbsp. raw wheat germ

tsp. wheat germ oil

3 tbsp. yogurt

tsp. natural, unpasteurized honey

1 tsp. fresh lemon juice

Wash all fruits carefully and dry. Use any available fruits and berries, but try to get at least three or four different kinds. Peaches, grapes, pears, papaya, bananas, and fresh pineapple are particularly good for producing a delightful bouquet of rich, penetrating flavors. A variety of colors will make the salad festive and attractive to the eye.

Chop or slice bigger fruits, but leave grapes and berries whole. Place them in a large bowl and add prunes and nuts (nuts and sunflower seeds could be crushed). Make a dressing with one teaspoon of honey (or more if most of the fruits used are sour), one teaspoon of lemon juice, and two tablespoons of water. Pour over the fruit, add wheat germ, and toss well. Mix cottage cheese, yogurt, wheat germ oil, and one teaspoon of honey in a separate cup until it is fairly smooth in texture and pour it on top of the salad. Sprinkle with nuts and sunflower seeds. Serve at once.

This is not only a most delicious dish but it is the most nutritious and perfectly balanced meal I know. It is a storehouse of high-grade proteins and all the essential vitamins, minerals, and enzymes you need for optimum health. This salad should be a daily must for the beauty-conscious and health-conscious alike.

WAERLAND FIVE-GRAIN KRUSKA (for 4 persons)

1 tbsp, whole wheat

1 tbsp. whole rye

1 tbsp. whole oats

1 tbsp. whole barley

tbsp. whole millet

tbsp. wheat bran

2 tbsp. unsulphured raisins

Take five grains and grind them coarsely on your own grinder. Place in a pot with one to one and a half cups of water and add bran and raisins. Boil for five to ten minutes, then wrap the pot in a blanket or newspapers and let it stand for a few hours. Experiment with the amount of water used—kruska must not be mushy, but should have the consistency of a very thick porridge. Serve hot with sweet milk and homemade applesauce or stewed fruits.

Kruska is an extremely nutritious dish and should be taken as a meal in itself.

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FACTORS TO PROMOTE HAIR GROWTH

May 08th, 2009

All minerals are important for the health of the hair, especially calcium, magnesium, potassium, phosphorus, iron, copper, and iodine. Vitamin D (cod liver oil) is important for the proper assimilation of the minerals in the intestines. (Remember: you are not what you eat, but what you assimilate.)

Iodine is a trace mineral which is found in foods and water in extremely small quantities. It is needed by the thyroid for its healthy functioning. It has been observed that iodine deficiency in the diet causes dryness, thinness and poor growth of hair. Iodine has a direct action on the activity of the thyroid gland. When the thyroid gland is functioning to its fullest capacity, the general metabolism is speeded up, which has a favorable effect on the quality and growth of the hair. It is also believed that iodine has something to do with keeping hair from turning gray.

The best natural source of iodine is kelp. Kelp is a dried and powdered seaweed, and can be obtained from health food stores in tablet or powder form. One or two kelp tablets usually contain a minimum daily requirement of iodine.

Remember that the diets of people known for their healthy, thick hair—the Chinese, Italians, Japanese, Eskimos, etc.—are rich in iodine, which is procured from sea foods and seaweed. Seaweed is a staple food in many countries, notably in Japan.

A few years ago sheep farmers in the Great Lakes region complained that they were having trouble growing wool on their sheep. Iodine is lacking in the soils of this area, as in many other inland regions of the United States. When the farmers added iodine to the sheep’s rations, the quality and quantity of wool improved immediately.

Kelp is also rich in many other minerals necessary for healthy hair growth, such as calcium, magnesium, phosphorus, and potassium. One or two kelp tablets with each meal is a good protective dosage.

Lecithin is very rich in choline, inositol, and phosphorus—all acknowledged hair-growth stimulants. Lecithin is a modern wonder food, indeed, and much scientific research is available which shows that it is essential for many vital functions of the body. It is extremely important for the health of the nerves. It is vital for the brain—28 percent of the brain is lecithin. It is credited with the ability to break up fat and prevent fatty deposits in the arteries—one of the plagues of modern man. It rejuvenates the endocrinal glands which are involved in the growth of hair.

Commercial lecithin, available at health food stores, is made from soybeans. It comes in granular, liquid, or tablet form. Take two to three teaspoons, or the equivalent in tablets, each day.

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