Category Archives: Medical

Staving off Alzheimer’s disease.

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It may be too much to expect that major degenerative diseases such as Alzheimer’s and Parkinson’s diseases can be prevented just by mental exercises. However there can be no excuse for ignoring  the problem, and not doing all we can to research the benefits of brain exercises.
Please read this article carefully, and think about what you can do to stay alert and “with it” as you age.
http://www.abc.net.au/news/2014-02-28/brain-exercise-vital-for-healthy-ageing/5290348?section=sa

Brain exercise vital: Use it or lose it, visiting expert Dr Michael Merzenich warns Australians

By Mike Sexton

Updated Fri 28 Feb 2014, 2:34pm AEDT

Dr Michael Merzenich
Photo: Dr Michael Merzenich says it is possible to have good brain function deep into old age
Video: Chronic pain (7.30 South Australia)
Map: SA

A neuroscientist is warning people need regular brain exercise to help ward off health risks such as senility as they age.

Australians generally are living longer, healthier lives than ever before but visiting American neuroscientist Michael Merzenich warns work is needed to maintain functioning into old age.

Dr Merzenich, emeritus professor of neuroscience at the University of California, says the burden of rising demands on the health system could become economically and socially unsupportable.

“By the time you reach your 85th birthday about half of us will need continuous care, [so] have to think about maintaining our abilities and capacities,” he said.

I think it is possible to keep most people in good stead from brain health to the point where their brain span can equal their life span

Dr Michael Merzenich

On a visit to South Australia, Dr Merzenich warned medical advances of the past century had dramatically increased the average life span but had largely ignored brain function.

His research has found people who frequently exercise both physically and mentally can maintain healthy functions deep into retirement.

“We are in the middle of a grand experiment,” he said of the ageing population.

“I think it is possible to keep most people in good stead from brain health to the point where their brain span can equal their life span.”

Dr Merzenich has pointed to his Australian friend Rex Lipman, now in his 90s and still working.

Rex Lipman Photo: Now in his 90s, Rex Lipman does regular puzzles

To keep physically fit, Mr Lipman plays tennis but twice per day he also takes time to exercise his brain, doing online puzzles and problem-solving.

“It exercises the neurons of the brain, making them move,” Dr Merzenich said.

“Loss of cognitive response is caused by neurons that are no longer healthy and growing and instead of being plastic and soft like when we were young, they get hard and stiff and we don’t hear as well, see as well or taste as well.”

Dr Merzenich says Mr Lipman is “an Australian treasure” and has applauded his friend’s zeal for preaching the value of regular brain exercise.

Link: Dr Michael Merzenich was on Todd Sampson’s ABC series Redesign My Brain last year

In recent days in Adelaide, the pair have been taking their message to high school students, staff and students of the University of Adelaide and a gathering the science hub, RiAus, the Royal Institution of Australia.

Too old to Drive?

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South Australia tightens the licence requirements for elderly drivers

http://www.adelaidenow.com.au/news/south-australia/south-australian-elderly-drivers-to-face-tougher-tests-to-prove-competence-behind-wheels/story-fni6uo1m-1226710949266

An article in Adelaide’s The Advertiser on September 4, 2013, written by Police Reporter Ben Hyde, stimulated much debate all-day on talk-back radio station 5AA.

South Australian Motorists over the age of 70 must pass an annual medical and eyesight examination, and receive a certificate of fitness to drive.  Of particular concern to the Department of Planning, Transport and Infrastructure (DPTI) of the SA government, are medical conditions that might adversely affect competence to drive safely.

Examples include diminished visual acuity, sleep disorders, attention deficit disorder and other psychiatric problems, degenerative neurological disorders e.g. Alzheimer’s and Parkinson’s diseases, epilepsy, diabetes, drug dependency, and heart disease.

All drivers, whatever their age, have a duty to report any condition that might affect their fitness to drive. Because of the increased incidence of medical disorders with age, an annual medical examination is appropriate for those over 70.

The New Certificate of Fitness Assessment Form

There has been a concern with the standard of medical information provided by some doctors completing the current assessment forms. This has prompted, according to the Road Safety Minister Michael O’Brien, the design of a more detailed document with a comprehensive patient questionnaire and examination report, to be completed by the driver and the medical examiner.

The new form complies with national guidelines in assessing fitness to drive. It is not aimed at increasing driver suspensions which have increased from 1416 in 2010/11, to 1541 in 2011/12, and now in 2012/13 to 2016, a jump of 30%. There are 117,000 licence holders in South Australia who are 70 or older.

In addition to those loosing their licence, an extra 816 drivers had restrictions placed on their licence. This was up from 645 in 2011/12 and 381 in 2010/11. This rapid increase is in part due to ageing of the population, but may also be a function of improved reporting.

The intention of the government is to reduce the high incidence of over 70-year-old drivers involved in fatal collisions. This year 17 of 74 road deaths have been in this age group. This statistic does not differentiate between the age group of the drivers mostly responsible for the accident.

By drawing attention to driving competency from medical causes, and placing restrictions when appropriate, the measures may in fact prolong driving longevity for the elderly.

The Victorian Approach

http://www.heraldsun.com.au/news/opinion/keeping-older-drivers-on-the-road-is-the-test/story-fni0ffsx-1226680985609

This article by Judith Charlton in the Herald Sun on July 18, 2013  puts the entirely different perspective of the Victorian State government to mandatory licence testing of older drivers. Annual medical examinations do not alter the road toll. Although older drivers may have more medical issues, their vision and hearing be less acute, and their reflexes slower, they are more likely to change their driving habits, and to drive within their limitations.

They are less likely to speed,  more likely to be cautious. They are less likely to weave in and out of traffic, cutting into the path of other cars. They often stop driving at night,  and avoid peak hour city traffic. They often pick less frequented roads. Many just use their car to do the shopping, to attend church, entertainment and sporting fixtures, and to visit friends. They are less likely to engage in such hazardous activities as talking on a mobile phone, or texting messages. They are mostly experienced drivers with good driving records.

Sure they may be annoyingly slow for impatient drivers behind them. They may miss opportunities to enter and leave streams of traffic. Because of this they are often honked impatiently and sometimes subject to road rage. A little more consideration would help prevent them from becoming flustered. Because of their frailty they are more likely to be severely injured in motor vehicle accidents.

Victoria claims the lowest older driver (over75) crash rate per number of licenses issued, according to an Australian study, quoted by Associate Professor Judith Charlton. She is an associate director of the Monash University Accident Research Centre, and has been a lead researcher in an Australian, Canadian, and New Zealand study of more than 1000 drivers over 75.

Pop-Star’s experience

Living in South Australia, an annual medical examination was necessary when he turned 70. This has not been onerous. He advised the Transport Department of health issues when they arose.  The first was an irregularity of his heart rate. Later he needed to wear glasses when driving.

Subsequently, he developed sleep apnoea, but this was a problem controlled by a CPAP machine, or a dental splint at night. His doctor had no hesitation in recommending his licence be approved each year. In 2002 he was diagnosed as having Parkinson’s disease, but the symptoms were not severe, and medication helped. More recently he developed an oesophageal diverticulum (pouch) causing regurgitation of undigested food especially at night when lying flat.

With such disturbed sleep he became increasingly sleepy during the day to the point that Mrs Pop-Star stopped him from driving for longer distances, for fear of him sleeping at the wheel, and causing an accident. Pop-Star did not mind at all being chauffeured by his dear wife.

When his next medical examination fell due, his doctor was unsure whether she should again endorse his licence. For this reason she requested a driving test. Pop-Star had no difficulty in passing this test easily , and has since increased his driving without problem.

Pop-Star’s Attitude

There are some elderly who stubbornly refuse to acknowledge when they are no longer safe to be driving. For this reason Pop-Star regards compulsory medical examinations as appropriate. In his opinion however it is not fair to place all responsibility on either doctors’ reports, or even on practical driving tests. Driving is a privilege, not a right. It is important for the elderly to listen to their family, and be proactive in restricting their own driving when necessary. From his own experience, cessation of driving need not be permanent. Driving with restrictions may be a welcome alternative.

The day will come when he can no longer drive. Pop-Star, faced with this possibility, tries to be positive about the prospect.  Being a passenger can be enjoyable, observing the scenery, back-seat driving, and getting to talk to his wife! To his disgrace he often tends to snooze, or occasionally use his great little smart phone for all sorts of uses, from Googling to answer his wife’s questions, to checking the stock-market, and playing chess. With less car expenses, occasional taxi rides is an affordable alternative. Staying at home has its advantages too.

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Learn to listen to your heart!

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English: Coronary circulation, with coronary a...

English: Coronary circulation, with coronary arteries labeled in red text and other landmarks in blue text. This vector graphics image was originally created with Adobe Illustrator, and modified with Inkscape. 32px|alt=W3C|link=http://validator.w3.org/✓ The source code of this SVG is valid. Category:Valid SVG (Photo credit: Wikipedia)

Wayne’s Story

Mrs Pop-Star’s cousin Wayne was a family favourite. Like many Aussie blokes he was chatty, easy-going, and genial. His physical presence was imposing; tall and a little overweight, like his father. He enjoyed a beer, but did not drink to excess, nor did he smoke.

It was surprising perhaps, but despite having girl-friends over the years, he had never married. He lived in a bachelor pad at prestigious seaside resort suburb Glenelg, working as a printer at Adelaide’s Griffin Press, before a career change to an Insurance salesperson.

When his father died, he shifted back to live with his adoring mother Dawn, to keep her company in the spacious family home. “Wayney” as Dawn like to call him, was 39, and provided her with the company and support she needed.

It was a cool but sunny spring morning in early September 1990. Breakfast over she went outside into their leafy garden to tend the ferns in the shade-house, and under the canopy of stately mature trees.

When she was finished, she came inside to tidy the kitchen. Entering the hallway, to her horror, there sprawled on the floor in his bedroom doorway was the motionless form of her precious son. There had been no cry of pain that she had heard. Oh why had she been outside when he needed her! It all came without premonition or warning of which she was aware.  She was desolate. To lose a child is the most excruciatingly painful event that can befall any parent.

It was not until later that Gastrogel, and antacid tablets were found in the glove-box of his car, that we made sense of his recent medical appointment.

Don’t ignore symptoms such as chest pain, even if you are still young. 

Medicos then regarded Ischaemic Heart Disease (IHD) also known as Coronary Artery Disease (CHD) as a condition to be considered in those who were over 40 years of age.

Reflux, and peptic ulcers of both the stomach and duodenum at that time were the commonest cause of pain in the chest and upper abdomen in patients under 40. This was in the days before Adelaide trained bacteriologist Robin Warren co-discovered that peptic ulcers, considered a surgical disease, were caused by the bacterium Helicobacter pylori, and could be treated medically with antibiotics. For this discovery he received a Nobel Prize in Medicine.

Not always does a heart attack present with agonizing chest pain. Such pain suggests a massive heart attack which could prove fatal.

Frequently before this the patient will have had symptoms that may not have been severe, indeed quite mild, and have perhaps been ignored. With CHD occurring increasingly in younger age groups, it is important that any unexplained chest pain is properly investigated. Remember too that CHD is a common cause of death in women, as well as in men.

This story illustrates how important it is to not ignore one’s symptoms and to seek prompt treatment, particularly now that there are so many interventions available to clear the blockages. Hopefully some readers will take note and visit the website for the Heart Foundation, to become familiar with the symptoms, prevention and management of Coronary Artery Disease.

http://www.heartfoundation.org.au/Pages/default.aspx

A little information about the Coronary Arteries

There are two coronary arteries, right and left, that lie on the surface of the heart, sending branches deeply into the heart muscle. Although the four heart chambers are full of blood to be pumped to the rest of the body, none of this is available to nourish the muscle of the heart itself. Instead, these two arteries arise where the main artery, the aorta, starts at the outlet of the left ventricle.

For superb illustrations of coronary artery anatomy please click on the link:

http://www.radiologyassistant.nl/en/p48275120e2ed5

There is little overlap of the circulation between the two arteries.  Blockage occurs when atheroma deposits of cholesterol form in the artery wall, distorting blood flow, and initiating the formation of blood clots. The heart muscle, starved of blood will die and be replaced with scar tissue that weakens the pumping action of the heart.

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Pop-Star’s Shingles.

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As the first rash appeared,on the oleft side of the chest.

As the rash first appeared,on the left side of the chest.

Early stage of shingles on back and side

Early stage of shingles
on back and side

Herpes zoster is commonly known Shingles, the name being derived from the Latin word Cingulum meaning a girdle or band reflecting the band like distribution of the painful rash which encircles one side of the body.
It is caused by the varicella-zoster virus which earlier in life causes chicken-pox, but may lie dormant in some nerve roots of the spinal cord for years before being activated when disease, stress or old age lower the body’s immunity.
Pop-Star had chicken-pox when he was 12.  “Monoclonal B cell lymphocytosis“, an early asymptomatic form of chronic lymphocytic leukaemia may have affected his immunity.
Since the virus spreads along the nerves damaging them, it causes constant painful sensations which range from a constant ache, sharp stabbing pains, creepy crawly feelings, a painful itch, at times  hot boring pain, and intense sensitivity.

 
Since it is not often life-endangering, it is a condition that is not particularly news-worthy; but it can plague the lives of the elderly for a long time, at a time when their health is already compromised.
In the early stages of the rash when little vesicles or blisters are forming, the patient may pass on the virus to others, but surprisingly, if infected chicken-pox not shingles is the outcome.

 

Shingles can involve almost any region of the body, but most commonly the chest or the abdomen. Less commonly the trigeminal nerve of the face can be involved. The characteristic features of the condition are that the rash is painful and always confined to just one side of the body.

Fully developed rash on the back

Fully developed area on the back

Fully blown rash left chest

Fully blown rash left chest

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THE POP-STARS GOLD ANNIVERSARY

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50 years of marriage! Fancy the old couple still being around together in their mid-seventies, into their second decade of retirement; a decade when the quality of life is increasingly impacted by losses!
Losses such as the big five f’s: friends and family, finances, figure and fitness; not to mention health and memory; but not necessarily their libido and enjoyment of life.
There are some great advantages is still being together at this age, although so often this is not possible e.g.
• Companionship in sharing life’s experiences when many friends have died and other friendships have waned.
• Someone to share love and passion, when safe and intimate relationships are hard or impossible to form.
• Someone with whom one can seek and give support and assistance.
• Someone who understands how one feels, and compensates for one’s own inadequacies.

The wedding vow “In sickness and in health” had real significance for Pop-Star as their anniversary approached.
Just before going to bed ten days before the big event, Pop-Star had an ache in the front of his chest. It was not severe but was still there in the morning. With a prior history of coronary artery disease Pop-Star thought he should be checked out as he might be having a heart attack.
Mrs. Pop-Star took him to hospital where he was admitted for tests. A heart attack was ruled out but it wasn’t until two nights after discharge back home that the diagnosis became evident.
Overnight the pain was worse and an exquisitely sensitive rash in a band three inches wide appeared on only the left side of his chest, just below his left nipple.
A diagnosis of shingles was obvious and he was started on the anti-viral drug (Famcyclovir) and medication for the pain.
Although relieved that it was not a heart attack, he was to find out it is an incredibly painful affliction with neuralgia that can linger for months or even years after the rash disappears in 1-2 months.

 

The Gold Anniversary that proved to be a Non-event


Mrs. Pop-Star also has medical issues. Foremost is painful disabling osteoarthritis of both knees. Indeed she was booked for knee replacement surgery three days before the Anniversary. It was the earliest appointment she could get with her Orthopaedic Surgeon. Her attitude was “what better present could I have for the occasion than a new knee”?
Disappointingly the Anniversary was a non-event apart from the promised extended cuddle. They were just grateful to still be alive and together.
Selflessly MPS postponed her surgery for the present to look after him.

The new Royal Adelaide Hospital we had to have! Time to have a check-up on what is planned!

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East Wing.

East Wing. (Photo credit: Wikipedia)

http://www.adelaidenow.com.au/news/south-australia/state-government-has-no-budget-to-demolish-royal-adelaide-hospital/story-e6frea83-1226594980271

A political, not a medical agenda

It is hard to escape the conclusion that the New Royal Adelaide Hospital now under construction is more a big-noting political statement than a necessary expansion of the State’s medical program.

The promotional video boasts a world-class hospital but suggests it will be more of a commercial precinct than an acute hospital. Promised are gymnasium, crèche, cafes and shops with parks and recreational areas; all accommodation is in private rooms, something even private hospitals can not yet emulate. A gymnasium may be great for staff, but is scarcely appropriate for an acute hospital where the average stay is only a few days.

The Royal Adelaide medical staff opposed the building of a new hospital on the chosen site, so their views have never been sought on how to make it work. It is becoming increasingly clear that it will just not be possible to dispense with the old RAH in 2016, and that it will necessary to use the two facilities in tandem, at least for some time.

Is it justified to demolish the present Royal Adelaide Hospital?

For 173 years the present hospital has been remodelled, and refitted as required to maintain and upgrade the facilities and equipment of a world-renowned and respected teaching hospital.

Despite the freezing of funds for new constructions on the present site the last few years, the hospital is far from being derelict and in need of demolition. Far from it. Even the now dated East Wing appears to visitors to provide excellent clean, well maintained accommodation, admittedly in six bed bays and not the expensive private rooms planned for the new hospital.

The Casualty and Emergency Department where the hospital interacts with the community is well planned, in excellent condition, and works efficiently. The specialty departments are less on view to public scrutiny, but provide state of art care for those who need it.

The Radiology and Radiotherapy Departments house some horrendously expensive diagnostic and therapeutic equipment; some it might not  be possible to shift.

It has to be questionable whether the new hospital site will be adequate to accommodate all the Departments of the present hospital.

Back to the ” drawing board!”

It is incredible that with construction of the new hospital well underway, it would seem that there has been insufficient medical input, nor has the move with equipment, and subsequent demolition work been properly costed. There is not even a plan for future use of the discarded site.

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The day Mrs Pop-Star Said Yes! Jan 26, 1963

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English: View from the lookout at the town of ...

English: View from the lookout at the town of Meekatharra, Western Australia. (Photo credit: Wikipedia)

English: The Kumarina Roadhouse on the Great N...

English: The Kumarina Roadhouse on the Great Northern Highway, between Meekatharra and Newman, Western Australia. (Photo credit: Wikipedia)

Locator map for this town within Western Austr...

Locator map for this town within Western Australia, showing position relative to the state’s capital city, Perth. (Photo credit: Wikipedia)

Anniversaries of life’s main events, for those concerned, are like public holidays minus the holiday unfortunately. They trigger memories, and remind us what is important; they are an opportunity to revive our love, our fidelity, our friendships.

Mrs Pop-Star or MPS wasn’t her real name then. That will be confidential. Pop-Star thinks the initials MPS appropriate even back in those good old days. He thinks they stand for “My Personal Secretary”. Certainly she has been all of that for him. Then too it could be said that the abbreviation is “My Partner for Sex”. The less said about that the better, the children think. Mrs Pop-Star is inclined to think her husband treats her like he thinks it stands for “My Personal Slave”. There is more than an element of truth in this.

It is rather remarkable that the day MPS said yes was Australia Day, just 50 years ago. “Australians all let us rejoice for we are young and free”, ‘Pop-Star asked me, and married we will be’! We didn’t get to the fifth stanza, but for the record “Advance Australia Fair” has been Australia‘s National Anthem since 1984.

http://www.imagesaustralia.com/australiannationalanthem.htm

Pop-Star had actually popped the question to MPS two years earlier. He thought she would be a pretty good catch. Good looking. Smart and intelligent. A top nursing graduate. Industrious like her mother. Enjoyed a joke like her father, but told better ones. Convivial. She would compensate for all that Pop-Star was not.

MPS didn’t say yes then, but then she didn’t say no either. She just decided to take a position as nurse, cook, bottle- washer, ‘jill’ of all trades, at a school for indiginous Australians at Karalundi, near Meekatharra in the remote outback of Western Australia. Letters were exchanged during the year, which she duly read to the school-kids. They were quite impressed with Pop-Star’s literary skills, but enjoyed the bits at the end most.

MPS must have thought that the suggestion he had made back then was worth accepting before he changed his mind after a 2 year wait. She decided Australia Day was the perfect auspicious occasion for the announcement. Forever afterwards all Australians would join in our celebration January 26.

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