There are various definitions of Alzheimer ’s disease including: – “The slow onset of memory loss leading to a gradual progression to a loss of judgement and changes in behaviour and temperament.” – “A living death” – “The global impairment of higher functions, including memory, the capacity to solve problems of day to day living, the performance of learned percepto-motor skills (for example tasks like washing, dressing and eating), and the control of emotional reactions in the absence of gross clouding of consciousness.” Memory Loss Memory loss occurs in all cases of Alzheimer’s disease. The most recent memories are the first to be affected, the things we’ve done in the last few hours or days. Later, as the disease progresses, the past memory also deteriorates. The fact that memory loss is such an important feature of Alzheimer’s, the testing of a person’s memory is an easy and cheap method of diagnosing the condition. Questions asked should be extremely basic, for example: – What day is it today? – How old are you? – Where are we now? – What year is it? – What month? – Count backwards from 20 to 1. These questions will test a person’s short term memory, and also orientation; disorientation being another problem experienced by Alzheimer’s suffers. Disorientation Disorientation, or not knowing who or where you are, is closely connected to memory loss. Typically, an Alzheimer’s sufferer will forget birthdays, become unsure of what day it is, and even forgets their own name. You can understand why Alzheimer’s has been called ‘a living death’. Because it is the short-term memory that goes first, suffers who go out alone have often returned to a house they lived in years ago, thinking they have come home. Disorientation inside the home can become a problem too but not until the disease is in its later stages. It is important that nothing is moved or changed in the home to preserve continuity. If their environment and routine remains unchanged, an Alzheimer’s sufferer will remain more content and confident; change the environment however and their confusion and disorientation becomes readily apparent. This is why treatment at home rather than in hospital is preferred and transfer to hospital should be a last resort. Personality Change One of the cruellest aspects of Alzheimer’s disease is the change in personality many people experience. Often, the general behaviour and personality of Alzheimers suffers in the later stages will be in complete contrast to their usual behaviour they exhibited in earlier life. Mood swings, from being ecstatically happy to extremely sad, verbal and sometimes physical aggression, and extreme anxiety and nervousness often affect the Alzheimers sufferer and, of course, the carer who can help best by offering continuous reassurance and patience. Personal Hygiene Personal hygiene often becomes a major issue with the sufferer forgetting to wash and bathe. Body odour, and stained and soiled clothing and hands can be a cause of great stress and result in a cruel loss of dignity. Communication During the early stages understanding simple speech remains unaffected, but finding the correct words can be a problem and the Alzheimers sufferer will often leave sentences unfinished. The taking of messages particularly over the telephone can be difficult and this is often one of the first signs of dementia. As the disease worsens communication will become more difficult as comprehension skills decrease. Eventually their whole speech can become gibberish until eventually the Alzheimer sufferer will cease to talk altogether and will withdraw into his or her small world. Sleep Although the amount of sleep required by an Alzheimers sufferer is unlikely to change, their sleep cycle may do. So, instead of wanting to sleep at night and be awake during the day, this could become reversed. This isn’t a problem of itself except for the carer who will have his or her nights disrupted. The carer is advised to keep the patient active and awake during the day as much as possible, even though it is tempting to seize an opportunity to do some chores and enjoy some peace and quiet should the sufferer fall asleep. A warm drink at bedtime may help, although any problems with incontinence should be considered. Ensure there are no other reasons for the restless nights, such as joint pain or night cramps. In the event the latter are a problem, administer mild painkillers. In the worst case scenario, many people use a night sitting service to ensure the sufferer is closely supervised while the carer gets a few nights of undisturbed sleep. Malnutrition Eating and drinking can be a problem with Alzheimer suffers. More accurately the lack of food and drink and the resulting malnutrition is the problem. A sufferer may develop an irrational fear of the food you are providing, or they may simply forget or refuse to eat. Two likely causes of the latter are ill-fitting dentures, especially if the sufferer has lost weight; and constipation. A well balanced diet with plenty of roughage and a high fluid intake will help prevent constipation. General Advice For Carers It is difficult to judge who has the worse time, the Alzheimers sufferer or the carer. In the early stages of the disease it is probably the sufferer, in the latter stages it is undoubtedly the carer. Help minimise disorientation by not moving anything in the home. To do so will make their confusion worse. Admit an Alzheimers suffer to hospital as a last resort. Once you do so disorientation and confusion will increase markedly. Do not let a sufferer out alone, they may have difficulty finding the way back home. Do all you can to help the sufferer maintain dignity. – A warm drink or a tot of their favourite alcoholic drink may aid sleep at night. – Try to keep the patient active and awake during the day. – Keep a cold drink nearby to remind the sufferer to take fluids. – Keep disruption to routine to a minimum to prolong the Alzheimers sufferer’s independence as long as possible. Closely supervise medication. It is very easy for the Alzheimers sufferer to forget they have taken their medication, and take it repeatedly. Alzheimer’s disease is progressive and incurable, although there are drugs that can slow the progression. It is one of the saddest diseases in that it is difficult to care for or regularly visit someone who no longer knows your name or recognises you.

Does this sound familiar to you? My dentist and hygienist mentioned that I had irritated gums as they cleaned my teeth. This is a symptom of gingivitis. Gingivitis can be a stepping stone to major problems in the mouth and gum line. It can lead to periodontal disease, which is a much more serious problem with the potential for actual bone loss. Halitosis (bad breath) could be related to a gingivitis infection as both are caused by bacteria. Red, swollen and/or bleeding gums characterize gingivitis. These symptoms are most evident upon flossing and sometimes from brushing. Bacteria cause gingivitis. And bacteria are considered to be responsible for bad breath. Sometimes, I could even see the bloodstains that the hygienist quietly wiped away with a towel. It was embarrassing enough to know that I wasn’t controlling my gingivitis problem, but to know that she was actually trying not to make a big deal out of it was troubling. I knew my dentist was concerned because she gave me a bottle of alcohol based mouthwash to try and mentioned that she wanted to see how I looked next time. I don’t like using it; there is too much alcohol and the taste is not very pleasant. Alcohol may also dry the mucous membranes in the mouth. The Problem Bacteria can stick to your teeth and secrete acid onto them contributing to cavity formation. They can also infect the gums, particularly around the gum line, causing gingivitis. This can manifest initially as bleeding and irritated gums. Having a lot of uncontrolled bacteria multiplying in the mouth may also lead to bad breath, but there is a natural and normal amount of bacteria in the mouth, and you will never completely get rid of them all, nor would you want to. Theory has it that it is actually the anaerobic bacteria that live in the tongue and throat that produce sulfur that in turn produce hard to get rid of bad breath. These anaerobes create VSCs or volatile sulfur compounds. One type is the familiar rotten egg smell. There are other odors coming from VSCs as well. These sulfur-producing bacteria may feed on certain foods, like coffee, alcohol and meats. A gingivitis problem can offer a way for bacteria to easily enter your blood stream and that can lead to additional problems. Systemic infections could come from this. Gingivitis can be something that makes your gums bleed easily in a mild case or it can be the root of deep gum recession, leading to bone loss in the worse case scenarios. (Periodontal disease) Loss of gum line can be discouraging. A friend of mind once described the process as, “getting long in the tooth». Sometimes, people experience this problem by brushing too hard. TIP: Using a soft bristled toothbrush with the type of motion that your hygienist recommends may help prevent eroded gum lines. Treatment and Prevention Had you ever heard of under-the-gum cleanings? This could be part of the protocol your dentist might invoke, should you develop periodontal disease. If you know people that have had an under-the-gum cleaning; they may tell you that it is not very pleasant. Your dentist can deal with this problem in a variety of ways. However, prevention probably is the best option. Include good flossing and brushing habits – see your dentist for details. And you could add a non-alcohol based mouthwash alternative to your regimen. I’m currently using a special toothbrush that uses vibration to clean the teeth. This device does a better job than a regular toothbrush in keeping my teeth clean. It does take a little while to get used to because of the vibration. It makes many, many vibrations per second. This helps to give it such wonderful cleaning abilities. Don’t feel sad if you have excellent oral health habits but you still have bad breath. This is common and many people experience this same situation. Oral health products that don’t contain sodium lauryl sulfates or artificial flavors that can still kill the bacteria that cause bad breath without using harsh alcohol or tough chemicals may be helpful. I am not a dentist. This article is for information purposes only. This article is not meant for diagnosis, treatment or prevention nor is it meant to give advice. If you have or suspect you have gingivitis, periodontal disease or any other dental problems, visit your dentist for a consultation.

For most people, the diagnosis of genital herpes (Herpes Simplex Virus 2 or HSV2) is a shock. For others, the diagnosis maybe a confirmation of suspicions they have had about their own health or their partner’s behavior. Seeking to answer the question of how the patient contracted the condition often leads to a search for blame and then self-recrimination. Living with herpes is something that initially may take some psychological adjustment for some patients. It need not mean the end of your sex life or that you will need to remain celibate for the rest of your life. Firstly HSV2 and HSV1, better known as the cold sore virus, are just two of a related group of seven viruses that are known to infect humans. Others include the Varicella-Zoster virus, commonly known as chicken pox and shingles. Diagnosis of infection with either HSV1 or 2 can be established with a blood test known as the Western Blot test; the upside of this test is that a patient who does not have active lesions may be diagnosed through the presence of antibodies to either strain. Accuracy of this test is only 90-95% depending on the lab involved. Some instances have occurred where patients were diagnosed with either a false positive or a false negative. The most accurate diagnosis is with a physician taking the top off a fresh lesion, obtaining a swab from the base of the lesion and a lab growing a viral culture from it. Extracting a viable swab from the lesion can be quite painful for the patient. HSV2 traditionally involved infections in genital areas, with the virus lying dormant in the sacral nerve at the base of the spine during periods when the patient is not experiencing lesions. HSV1 traditionally involves infections around the mouth and nose and lies dormant in the trigeminal nerve in the neck during non-active phases of the disease. Current epidemiology studies across the Western World indicate the incidence of HSV2 to be around one in eight people, or 12% of the population. Only one in five of those with antibodies have been diagnosed. In real terms, in a room containing forty people, five have HSV2 but only one knows they have it. A further three of the five may have had an isolated symptom once or twice. This would have appeared so insignificant that they mistook it for a pimple, infected hair follicle or a boil. The final one in five is someone who has never had a symptom and may never do so. For this patient, and the other three undiagnosed patients, accusations of infection (generally followed by accusations of infidelity) from a partner are often met with counter accusations and disbelief. A conservative estimate of the world population with HSV1 antibodies and the ability to infect others is around 90%. Of these, roughly 45% are symptomatic. If you have been diagnosed with either infection, it is very possible you contracted it from someone who has no idea they have it themselves. People have received the messages about safe sex and changed some of their practices, believing that only penetrative sex requires safe sex. Sexual health specialists now report that half the new HSV diagnoses in clinics have been microbiologically confirmed as HSV1 on the genitals, in the general community it is now estimated that 20% of all herpes infections in the genitals are in fact HSV1. On the plus side for the infected patient, when the HSV virus is not living in its ideal host environment (i.e. HSV1 infection of genitals, oral HSV2 infection) infections have been generally documented to be less severe and happen less frequently. Another mistake many patients make, is assuming that they are not infectious during a dormant or asymptomatic phase of their disease. Studies have shown that even when a couple who are clinically discordant (i.e. one is positive and the other is negative) use what is recognized as gold standard treatment for reduction of risk to partners, the rate of transmission in a 12-month period is still 10%. This management of infection control involves the use of condoms during all sexual encounters and complete abstinence from sex during the positive partner’s symptomatic phases. Interestingly, sexual health experts report that if one partner has remained negative for 10 years in a clinically discordant partnership, it is very unlikely that they will contract the disease after this time. It is speculated that they have some immunity/protection either natural or acquired that science has not yet managed to identify. A true primary infection of HSV2 can last for up to ten days, it involves a systemic response, where all the glands in the body are swollen, much as if the patient has influenza, as well as the obvious genital burning, itching, pain with urination or complete inability to urinate. Many patients think they are presenting with a primary infection, but, severity of symptoms indicates to the physician, this is in fact a recurrence. In these cases the patient’s primary infection would have been asymptomatic, but, for some reason, they have become run down and their immune system is not responding as it did when they were first infected. These and subsequent recurrences of HSV2 are usually around five days in duration, unless there is a serious immune system deficiency. In this case, the treating physician should refer the patient for further testing. Because HSV transmission requires skin-to-skin contact and viral shedding to occur, typically an infection of HSV2 is specifically confined to the genitals. Affected areas include the vulva and labia in women and penis and scrotum in men, due to penetrative intercourse being quite localized. Where a patient has been infected with HSV1 on the genitals, the area is usually larger and vesicle distribution more extensive due to oral sex skin-to-skin contact covering a more extensive surface area of the genitals. Both viruses may be treated effectively with anti-viral drugs. As stated earlier, each virus has its ideal host environment. For the patient infected with HSV1 on the genitals, this means subsequent infections are usually less virulent, and in some cases may only ever recur once or twice in their lifetime. For the patient infected with HSV2 on the genitals, the incidence of recurrence can vary greatly. Recurrences are related to the health of the immune system. Triggers may include stress, poor diet, lack of sleep, sunburn and in some women, their menstrual cycle. During the first year of infection, the number of recurrences may range from one to twelve, with an average being four to five. During subsequent years the immune system responds better, the patient learns what will trigger a recurrence and usually tries to avoid it. Eventually most patients can experience as few as one to two recurrences per year. Also, as the patient learns to better recognize the symptoms of an impending recurrence, they are able to administer anti-viral drugs earlier. This can minimize the length and duration of the attack, and possibly prevent lesions altogether. It is important for the patient to remember that despite avoiding a recurrence, they are still shedding the virus and they are still potentially infectious to their partner. Maintenance doses of anti-virals may be taken daily to reduce the number of recurrences. Up to 50% of patients on these therapies report an absence of recurrences in a 12-month period. Where this therapy is discontinued, patients almost certainly will experience a recurrence within three weeks. This is generally followed by a reduction in the number of annual recurrences. There are a small number of female patients who have required this maintenance therapy with anti-viral drugs continuously since they first became available, over 15 years ago, in earlier forms. As recurrences reduce in frequency and severity, most patients eventually come to terms with their diagnosis. For some, this is never the case, sexual health physicians report that they need to refer between 10-20% of their patients for further psychological counseling. This is in spite the fact that they are very experienced with the disease counseling required for this diagnosis. What is importa
nt, regardless of how well patients appear to cope with the initial diagnosis, is ensuring access to information. This can be obtained readily and anonymously from www.herpes.com, www.herpeshelp.com or www.genitalherpes.com these sites contain up to date facts and also links to other sites. These provide names and contact details of support groups, local clinics and sexual health specialists. Although HSV2 is a lifelong infection, with the right management and care it is not necessarily symptomatic, nor should it impede the patient from enjoying a loving and long-lasting, secure relationship.

Diabetes sneaks up on a person slowly – one grain of sugar at a time – one pound at a time — until all of a sudden the pancreas and other systems of the body don’t cooperate and function together. Insulin activity dwindles, fat and protein metabolism switches gears, and soon the circulation to the eye blood vessels and kidneys isn’t behaving itself. Like the old song, “foot bone connected to the ankle bone, ankle bone connected to the knee bone,” anything that goes wrong in one part of the body affects all the other parts. In diabetes the effects are life-threatening. In the United States alone there are over 18 million people with diabetes, (almost 7% of the population) and most of them aren’t aware of it yet. People with diabetes cover a wide range of ages, from babies up to the senior citizens. Finding out how to handle the problem and following all the advice given to them consumes their lives. Ultimately the challenge requires creating a balance of diet, exercise and insulin. Balance, balance, balance! This becomes the controlling word in a diabetics life. Diet remains the biggest task of these challenges because of the addictive nature of the body’s longing for sweets. Milder forms of diabetes can be controlled by the diet alone, rather than having to resort to added insulin. The diet for each individual needs to be balanced to individual needs, and the ingredients for all seem to be a balance of carbohydrates, proteins, and fats. Keeping a balance between the acid and PH levels in the body also needs to be considered. Yet, it just isn’t that easy to give up those bottles of Pepsi that seem to make you feel stable. ‘White foods’ are almost always a no-no for a diabetic, and those fresh vegetables are a life-sustaining necessity. Diabetics often have unique personalities. They tend to be part of the most creative section of the population. They think in terms of wholeness rather than in details, which means they often love to start a project but have a hard time finishing it. Their creativity also can express in ways that others might call disorganized. The Ugly Duckling story portrays the hidden life of the diabetic, and they often don’t have enough self-respect or self-esteem because they feel they are different. From the brilliance of their thinking (which is often hid from the rest of the world) to the tag of ‘erratic’ that is sometimes applied to them, the diabetic is who you want around in a time of crisis. When the house is on fire they will excel because they are only dealing with one situation at a time. However, should the car not start in the morning there are too many options available. A diabetic is as apt to call the suicide help line as to call a mechanic. Living as a diabetic, or living with one, means acknowledging that there is a major difference in how the wholeness of the personality functions. Reinforce the positives and learn to live with a little disorder. Respect the bodies intelligence that knows when it needs to rest. The non-diabetic hasn’t always learned this beautiful lesson on how to make the most of a human life. The diabetics are the way-showers!