Features of Dementia 2

Hi everyone

We’re still on features of Dementia.

Yesterday, we discussed memory. Today we’ll look at other mental functions.

One of the common features is the inability to handle finances. Most persons with Dementia loose their money because of the memory loss. They make purchases and forget the balance. They can collect money from the bank and forget it on the counter. Some of my patients consistently lost their pension for months or years.

In addition, a time comes when they are unable to differentiate between the Currency notes.

For example, a sachet of water is 10 Naira in Nigeria. Anybody who wants to buy one sachet should pay with a 10, 20 or 50 Naira. Using a 1000 Naira note is inappropriate. Such a person does not know the purchasing power of that note. In essence, the person will most likely not ask for his balance of 990 Naira.

Hence, he looses the money if the person is not honest.

I have a patient, an entrepreneur who lost about 5million Naira in a week. His staff collected ridiculous sums for purchase of cheap items like tissue paper, plastic cans ETC. He just issued cheques without realizing he was been duped.

Another problem is in speech. They may have difficulty in naming familiar everyday objects like pen, comb, toothbrush, mirror, plates ETC. You may find them using many words to describe such an object. In some cases, they act the function of the object. In some cases, they simply stop while speaking because they are looking for the word. Some may veer off the conversation and are not able to get back to the original topic.

Location of familiar places is also a major issue. One of my patients went to a nearby market by 9Am. She came back at 5Pm exhausted having walked round for 8 hours unable to locate the market and unable to come home. Painfully, some of them may actually get missing and never find their way back home.

The person with Dementia also has difficulty with Judgment. They may leave a tap running or leave food burning. Such simple everyday decisions become overwhelming.

Note that all these features become WORSE in a NEW environment. Hence taking your mother or father who has some degree of Dementia out his or her usual home to his son or daughter’s house in the city worsens the condition.

This is because there is so much NEW information ( bedroom, bathroom, fridge, water, door, cooker, kitchen ETC) in this person who already has difficulties in Registration of new information. Hence it may take her months to locate the bathroom. She may go into the kitchen to take a bath or ease herself. This is the reason some of them are thought to be mad. Painfully some of them subjected to elder abuse, exorcism and what have you.

These are some of the main features of Dementia. Please if your father or mother has any of these, he or she needs to see a Doctor.

Thanks for reading

Features of Dementia 1

Hi everyone

Thanks for reading

Today, we’ll be looking at the clinical features of Dementia.

The mental functions that are commonly affected in persons with Dementia include:

Memory, Speech, Intellect, Judgement, Ability to find their way, Ability to plan, initiate, multi task and change plan.

Please note that ANYBODY can forget, fail to plan, have a poor sense of judgment, or mix words. This is especially so with increasing age. This does not mean that the person already has Dementia. For it to be Dementia, the problem is enough to impair everyday functions and activities as we shall see below.

Memory is usually the most important and most obvious function lost. There are many classifications of memory. One of the simplest classifications is the Classification

according to duration: long and short term memory. Long term memory ( information gathered over years) is less likely to be affected.

Recent or Short term memory is more readily affected.

Actually, the memory is like a filing system. It has three steps: Registration, Storage and Retrieval.

Registration is lost very early in Dementia. This is the reason persons with Dementia ask the same questions over and over again. It is because the information was never registered: hence it can’t be retrieved. The information especially when recent like the meal just eaten, the message received hours, days or weeks earlier is totally lost. One of my patients will ask for breakfast every 20-30 minutes. Eating that meal never registered, telling him that he has eaten never registered either.

Note that we all forget naturally, but remember once we are reminded. This is because the information registered and as such can be retrieved.

The forgetfulness starts from everyday information, misplacing personal items like tooth brush, comb, wristwatch, keys, money ETC.

On some occasions, the person may put the items in illogical positions, e.g. Palm oil in the bathroom, bathing towel in the kitchen or parlour ETC.

Often times the person may discuss an incident that occurred 20 years earlier as though it happened yesterday. An 80 year old woman may ask for her late husband or her new born baby because what she can remember is 45 years ago when she was nursing a baby with her young husband by her side. This is because the long term memory remains intact for long.

In view of the forgetfulness, the person becomes unable to function. The deterioration leads to difficulty in remembering familiar persons. They may call their children the wrong names. They are unable to cope with every day duties or keep appointments. One of my patients came out of the bathroom without rinsing off the soap: he had forgotten that step in bathing. Another woman couldn’t remember the ingredients of a dish she had cooked for more than 60 years.

Dementia gradually changes the person in many different ways.

We’ll continue tomorrow. Thanks for reading

Dementia

Hi everyone

Thanks for reading my blog. Hope you had a great weekend.

September 21st was World Alzheimer’s Day. Therefore, we’ll be looking at Dementia this week. You are WELCOME

Dementia is taken from two words de( without) and mentis( mind).

It literally means ‘ without the mind’.

It is a disease that causes severe decline in mental functions that is enough to impair everyday functions.

There are many types of Dementia.

The commonest types are Alzheimer’s Dementia and Vascular Dementia.

Risk factors of Dementia

These are factors that make one person more likely to have Dementia than another.

The commonest risk factors are as follows:

  1. Age. Dementia is a disease of the aging brain. It is therefore commoner in persons who are more than 75 years.
  2. Low level of Education. Alzheimer’s has been associated with persons who are not well educated.
  3. Females. Dementia is noted to be commoner in women.
  4. Non communicable Diseases. The second type of Dementia called vascular Dementia is seen in persons with non communicable Diseases like Hypertension, Diabetes, High Cholesterol and others. These are persons who also come down with Stroke. The stroke may be noticeable or non noticeable. The non noticeable types of Stroke arise from affectation of very small blood vessels. The deficit in the brain is negligible but numerous of such minor, negligible deficits add up and form noticeable deficits in speech, intellect, judgement ETC leading to Dementia.
  5. Excessive Alcohol intake is another risk. This is because Alcohol destroys different parts of the brain. It is also a risk factor for Stroke.
  6. Head injury. Some types of Dementia may arise from injuries to the head from road traffic accidents, assaults ETC
  7. Other brain diseases like brain tumour, chronic infections of the brain ETC
  8. Some may be genetic

There are few other risk factors. We’ll talk the symptoms tomorrow.

Have a great day

Bringing Epilepsy out of the Shadows!

Hi everyone

Thanks for reading my blog

In the past two weeks, we’ve been looking at Epilepsy.

We’ve noted the following facts:

Epilepsy is a medical disease: Not a Spiritual disease! In essence all persons with Epilepsy should carry themselves with boldness and confidence. It’s not their fault in any way.

Epilepsy is a TREATABLE disease: treated in the Hospital. Hence all persons with Epilepsy should see a medical Doctor.

Epilepsy is not contagious or transferable. You can relate or touch such a person, there’s no risk of contacting the disease.

Epilepsy is not a hereditary disease

Persons with Epilepsy should not be stigmatized in any way : in education, job opportunities, friendship, marriage and all. In fact, I have a patient with Epilepsy who comes for all his hospital appointments with his room mate from a different geopolitical zone in Nigeria. His room mate ensures that he keeps my instructions about avoiding triggers. Persons with Epilepsy are entitled to such rich, rewarding friendships and relationships.

We’ve also seen the actions you should take and not take on witnessing someone convulsing.

Finally, there are triggers that must be avoided by the person with Epilepsy to ensure better control.

I hope that I can boldly say that I’ve brought the dreaded stigmatized disease called Epilepsy OUT OF THE SHADOWS!!!

Thanks for reading

Have a great weekend.

Taking Charge in Epilepsy

Hi everyone

Good day

Thanks for being here

Still bringing Epilepsy out of the Shadows! Today, we’ll look at how to take charge of your care.

We have ascertained that Epilepsy is a condition that can be treated medically so what is the next step?

All persons with Epilepsy should see a medical Doctor. There are medications that can control the convulsions. The Doctor may also refer the person to a Neurologist for specialist care.

However, convulsions have certain triggers( not CAUSES!!)

Control and prevention of these triggers go a long way in controlling the convulsions i.e. reducing the frequency and severity.

Some of these are:

  1. Bright lights, flashing lights and screens: I’ve found a higher frequency of convulsions in persons who are always in front of screens like Tv, laptops, IPADs, smart phones ETC. Most of these become better controlled when they change these habits. I had to ask my patient who works in a TV shop to change his trade. I also stopped a young boy whose job description was online registration to stop.
  2. Music, loud speakers, loud noise: This is a new one on me. I’ve seen a lot of patients who have convulsions while singing or sitting near the choir, musical instruments, amplifiers, loud speakers or the DJ. These persons had remarkable improvement once they avoided music.
  3. Inadequate Sleep and Exertion have also been identified. Persons with Epilepsy should endeavour to sleep up to 7 hours in the night. THey should avoid night parties, frequent night vigils( Yes Night Vigils). I counsel the students to read everyday during the day and avoid TDB ( reading till day break) during examinations.
  4. Alcohol, Nicotine and Recreational drugs remain a NO- NO for anybody with convulsions.
  5. Menstruation is another trigger which cannot be avoided in a young girl. However, the stress can be reduced by taking common pain relievers two days before the period starts.

Other triggers include emotional and psychological stress, fever, pains ETC.

Please watch yourself or relative with Epilepsy. Avoid anyone of these triggers that you observe.

Thanks for reading

See you tomorrow as we conclude on Epilepsy.

Convulsions: What you should do

Hi everyone

Thanks for reading my blog

Yesterday we looked at all the wrong actions people take when witnessing a convulsion. Today, we look at the correct steps to take.

You are Welcome

Convulsions are usually dramatic and scary. They can occur anywhere: at home, in the kitchen, on the road, in the vehicle, on the staircase, near the river or swimming pool.

There are some persons with Epilepsy who may have warning signs before the convulsions. The presence of these signs enable them find a comfortable, safe and private environment: like the bedroom. However, a large number of persons with Epilepsy may not have a warning sign.

On seeing anyone having convulsions, please take the following steps:

  1. The most important step is to ensure their safety since they are usually unaware of themselves and their environment. The person can fall into the fire, fall in front of a moving vehicle, fall on a naked electric wire, sharp knives or objects, into the river ETC. They therefore get injuries: some of these injuries are severe enough to endanger life. Therefore, making the environment safe is a crucial measure. Remove all sharp objects, hot water, fire ETC
  2. It is also wise to keep other people away from anybody who is convulsing. This is because these persons may take actions that will harm the person.
  3. Do not try to hold down or stop the movements physically. This will either harm you or the person.
  4. Place the person to lie on the side: preferably the left side. This helps to keep secretions from entering the tube to the lungs.
  5. It is wise to note the duration convulsions: the Doctor will want to know.
  6. Please do not put anything in the person’s mouth as written yesterday
  7. Wait to comfort and console the person after the convulsion. Such persons wake up confused, tired and ashamed. Your empathy at such a time means a lot to him/ her.
  8. Take him/ her to the hospital or advise the person to seek medical care.

Once again, Thanks for reading

Convulsions: what shouldn’t be done

Hi everyone

Thanks for reading

I sincerely thank my colleague Obiageri for drawing my attention to a common scenario in our communities. She had witnessed a child having convulsions in the market.

So many people proffered all types of solutions including drinking the mother’s URINE!!

This is appalling and wrong: Very very WRONG!

This poor knowledge and understanding is the main reason for this blog: medical information at your finger tips.

Some of the common solutions to stop convulsions used in our communities are as follows:

  1. Putting spoon inside the mouth. This is a dangerous practice and has led to severe injuries in the mouth.
  2. Putting the feet over fire.. Fire, hot water or heat WILL NOT STOP the convulsions. Rather, they cause burns of the feet and legs. Oftentimes, the person will have to be admitted for treatment of the burns.
  3. Putting Kernel oil, kerosene, Shea butter, urine or crude oil in the mouth. The mentioned substances are considered medicinal in most African cultures. Hence these are forcefully given to persons who are convulsing. Again, these substances do not stop convulsions at all. In addition, their forceful administration is very dangerous. These substances may go the wrong way: getting into the tube to the lungs instead of the tube to the stomach. The consequences of this misdirection are disastrous including Death!!
  4. Administration of substances into the eyes. In some cases, some the substances mentioned above are applied to the eyes. Once again, these substances will not stop the convulsions. In addition, they can cause damage to the eyes.
  5. There may be some other ways people use in our communities to stop convulsions. Please desist from all these methods as most of them are dangerous, very dangerous!!!

Thanks for reading. See me tomorrow to know what to do when someone is convulsing.

God bless you

Epilepsy: What next?

Hi everyone

How was your weekend? You are welcome to a new week. Thanks for reading my blog.

Last week, I took time to debunk the common myths surrounding Epilepsy. These myths are the reason a lot of persons with Epilepsy are not properly treated.

Now that we’ve debunked most of the myths about Epilepsy.

What is the next step?

If you have Epilepsy, now you know that you have nothing to be ashamed of: it’s an ailment like many others.

If you know any one with Epilepsy, now you know that there’s no reason to avoid, stigmatized the person. The person needs care, love consideration and support just like any other ill person.

To relatives, friends, colleagues and all persons with Epilepsy, please see a Doctor near you. There are medications that can control the convulsions.

The Doctor may eventually refer such a person to the Neurologist.

The drugs should be taken everyday as prescribed. Please do not discontinue the medications on your own. It’s only a Doctor that can discontinue the medications. This is done when The person has been seizure free for two or more years.

Thanks for reading

See you tomorrow

Epilepsy: Debunking the Myths 4

Hi everyone

Thanks for reading

I’m rounding up on debunking the Myths surrounding Epilepsy.

Today, we’ll look at two other myths:

  1. Persons with Epilepsy cannot marry or have children

Persons with Epilepsy are not considered for marriage by many. In fact, in some cases, their families are stigmatized as well: making it difficult for the other members of the family to marry.

The fear is that persons with Epilepsy are abnormal as already written yesterday. Some others fear that they may not have children.

The person with Epilepsy can marry because they are normal human beings. All they need to do is take their medications regularly just like all other persons on regular medications.

Epilepsy has nothing to do with the reproductive tract. Hence they ( both the men and women) are well able to have children like all other people.

They are also capable of caring and raising the children like other parents especially when they are taking their medications.

However, persons with Epilepsy are given special care during pregnancy and delivery.

2.Epilepsy is hereditary

The belief that Epilepsy is hereditary is one of the reasons people decide not to marry persons with Epilepsy. Some others also believe that Epilepsy can be transmitted through breast milk.

Epilepsy is NOT hereditary! However, there are some hereditary diseases ( occurring in both men and women) which may cause convulsions: though this is not common.

Epilepsy cannot be transmitted through breast milk. The person with Epilepsy should breastfeed her baby. There’s no problem or risk in breastfeeding.

Do you know of other beliefs? Please let me know.

See you tomorrow.

Epilepsy: Debunking the Myths 3

Hi everyone

Thanks for reading my blog

I’m still on the numerous myths and wrong beliefs surrounding Epilepsy.

Today we’ll look at two other myths as follows:

1.People with Epilepsy are abnormal, retarded or mad!

This myth is very painful. It is the reason persons with Epilepsy ( PWEs) are badly treated and stigmatized by the society.

People with Epilepsy are not abnormal in anyway. Most of them have normal intelligence. They are not mad or sub normal in anyway.

I have many patients with Epilepsy who are graduates: Doctors, Bankers, Lawyers, teachers, business men ETC

They are all normal people with normal intelligence. In fact, one of my patients with Epilepsy was the best graduating student in her class in the University.

She used to have convulsions during examinations: she will complete the exams after the convulsions and make an A in the course. She’s currently pursuing her Masters Degree and leading the class as well. However, there are certain diseases which cause mental retardation as well as convulsions. These type of persons need further care.

2.People with Epilepsy should not go to school, work or have a normal life

Again this is wrong considering that they are normal as I’ve already written. Please do not withdraw the child from school because of Epileps. In addition, do not discriminate during employment. They have the capabilities to keep a job and excel in their chosen profession.

However, activities and jobs that may expose the person to danger are not advisable. Some of these include driving, swimming, handling fire, electricity or heavy machinery and others.

The person with Epilepsy can EXCEL like everyone else.

Thanks for reading

See you tomorrow