T he ageing endure all sorts of rites of passage. the hitherto lusty and hydraulically independent man pops his first Viagra (surely there should be some small, funereal ritual for this occasion, with a celebrant reading something profound and the singing of an appropriately sad hymn). the golfer, her hips and knees not what they were, takes delivery of her first golf buggy and knows she will never walk 18 holes again. the cricket legend is tapped on the shoulder and told his reflexes no longer qualify him to play at the highest level. the enfeebled suburban gardener who for 50 years has thought of himself as the Tarzan in the jungle of his garden, is at last faced with a job that needs muscles bigger and younger than his own, and brings in, for $35 an hour, the young man who has put up a notice at the local shops advertising that for garden jobs he has ”no expertise but just lots of brute strength”.

Until now I have been the one true brute in my garden. it has been my territory and I have guarded it as jealously as a male rhinoceros guards his territory, keeping other males at bay. but, as one of the rites of this passage of enfeeblement, I hired this young brute and he came around and did in three brutish hours what would now have taken me three days and then would have required a fortnight’s convalescence as my outraged little biceps recovered. In this I am the tragic Ricky Ponting and my Young Brute is a $35-an-hour Dan Christian, usurping me.

Where do they go, a man’s biceps? it seems like only yesterday mine were the size and shape of Australian Rules footballs but today as I shrivel they are back to what they were when I was a pre-pubescent and when my mother, chortling, used to compare them to a sparrow’s kneecaps.

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Mention, above, of Viagra, coincides with news about older people and sexually transmitted diseases. [Warning: do not read further if mental pictures of old people having sexual intercourse cause distress.] I read that: ”Baby boomers in the leading three English-speaking economies, the USA, UK and Canada, are being diagnosed at progressively higher rates of sexually transmitted diseases (STDs), according to a report written by researchers from King’s College London, and Thomas’ Hospital London, in the Student British Medical Journal.

The authors explain that a significant number of older adults appear not to be practising safe sex. the authors explain that when a 56-year-old male has ‘waterworks’ problems, or a 61-year-old female experiences lower abdominal pain, they do not usually expect these to be symptoms of an STD; but more often today they are. In their study, the researchers found that over four-fifths of 50- to 90-year-olds are sexually active in the UK, the USA and Canada. the number of reported cases of STDs in this age group has more than doubled since the beginning of the millennium.”

These boffins say that it’s too early to be sure what the reasons for these sudden increases in STD infections among baby boomers might be but they strongly suspect it has something to do with more older people being sexually active now that there are magic medications that, like a magician producing a rabbit from a hitherto empty hat, can produce erections out of thin air, as it were.

The highly amusing William Ian Miller has been saying scathing things about Viagra lately while promoting his new book Losing it: the lament of an aging professor. Professor Miller is (like this columnist) 66 now and what’s refreshing about his book and his interviews and his occasional online essay (you can Google one of the latter at ”Losing it: the Lament of an Aging Professor”) is that he really does write about ageing as a thing to lament. Most popular writing and gibbering about growing old is full of false pep about these being the best, leotard-wearing, gymnasium-going, tango-dancing, new language learning, sexually adventurous years of our lives, but Professor Miller takes the refreshing view that growing old is a tragedy, albeit an inevitable one which we may as well accept with as many laughs as we can squeeze out of our plight.

He’s very funny on the subject of Viagra, saying among other things that its only virtue is to enable ”old fools” to go on being old fools for much longer than they otherwise would if they’d only embrace what the pharmaceutical companies call ”sexual dysfunction” as not a dysfunction at all but a kind of gift from God, liberating men from the tyranny of lust.

It won’t have occurred to big Pharma but what would be more useful, I think, would be a kind of gardener’s Viagra that pepped an ageing gardener up for long enough to be able to perform as a brute in his garden when there are manly feats of heavy work to be done. the drug would somehow circumvent the nether regions (because its hopeless trying to garden with an erection, and one’s witty wife and witty female neighbours say smart-arse things like ”Is that a pair of secateurs in your pocket or are you just pleased to see me?”) but flow to the biceps, pumping them up to be like Aussie Rules footballs.

Change of weather, in particular the contrast between day and night may have an impact on people with asthma, a condition mainly caused by the constriction of muscles around the airways that then become inflamed, narrow and fill with mucus.

“In fact extreme weather can be an asthma trigger in people who are sensitive to not only cold but also hot climate,” said Dr Saipin Littikote, a pediatrician at Mahasarakham Hospital. “A change in temperature _ up or down _ can set off a bronchial spasm, which can become bronchitis that can lead to such symptoms as wheezing, coughing, feeling tight in the chest that make it difficult to breath.”

Asthma symptoms often strike at night during sleep.

In severe cases, asthma attacks can be life-threatening in the absence of timely and proper treatment. but Dr Watchara Boonsawat, president of Easy Asthma and COPD (chronic obstructive pulmonary disease) Clinic Network said that asthma is usually not considered a deadly condition because preventative treatment options are readily available.

“Now standard practice for asthma treatment in Thailand is much better than in the past _ both controllers and relievers,” said Dr Watchara. “It’s unfortunate that some attacks occur as a result of the refusal of patients to accept their asthmatic condition and their poor compliance. while most cases of severe asthma attacks occur in people who don’t have an appropriate treatment and don’t take their medication correctly.”

Today, asthma treatment can be easily accessible. According to Dr Watchara, there are now over 900 hospitals nationwide which develop easy asthma clinics that are able to provide standard treatment for asthma attacks including quick assessment of lung function, inhaler and educational programme on how to well cope with the condition and exercise for asthmatics.

“We believe that the activities can help patients with asthma to this end have improved quality of life,” Dr Watchara said.

Developed since 2009, Easy Asthma Clinic programme is a collaboration between Easy Asthma and COPD Clinic Network and the National Health Security Office. by following the group’s standard treatment guidelines, Dr Watchara said it’s found that the number of patients with acute asthma attack have decreased to less than 50 per 100,000 population. the number of patients who have been treated with steroid medication increased, while the number of patients needing admission decreased.

“All clinics, even in some rural areas, are now able to provide standard practice for asthma treatment so that they provide convenience for patients who don’t need to visit a provincial hospital,” said Dr Watchara.

To keep asthma attack at bay, nothing is important than the classic self-care measure of taking good care of oneself. to achieve this, asthmatics should eat well-balanced meals that include different food groups and regularly exercise.

“Asthmatics should drink enough fluids every day, as well,” said Dr Saipin, who is also president of Holistic Asthma Care Model of Mahasarakam Hospital that won the first prize at the EACC Excellence Award 2011, given to hospitals that have an outstanding record for asthma treatment.

Another key element of asthma attacks, control and prevention, Dr Saipin said, is to avoid triggers, pollen, airborne allergens. Dusty bedroom particularly can exacerbate asthma. the doctor drew attention to bedding, pillows, rugs and carpets where dust and invisible dust mites may be present and can accumulate.

“Hanging blankets in the sun may not be enough,” said Dr Saipin. “Better wash the sheets and blankets every week in hot water for more than 30 minutes to kill dust mites. and make sure that water is hotter than 55-60 Celsius.”

Patients with asthma, Dr Saipin said, are recommended to have a peak flow metre, a tool that is used to monitor asthma symptoms, at home. It’s a simple device that asthmatics can use to measure how well their lungs are working so that they can decide if they need to take action in order to keep asthma exacerbation under control.

“On top of that, asthmatics should have a thorough knowledge of their illnesses that can be varied with season, and record their illnesses that can help them monitor and manage symptoms effectively. Also strictly follow medication and treatment plan as prescribed by a doctor,” Dr Saipin said.

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i have been very sick for a year, now my epiglottis is sticking up out of my throat, could this be a symptom of pancreatitis? also heart palps and tight chest back muscles after eating, and pain under left side of collar bone? please help as the doctor will not help me

This is what I read from pdf.org/en/symptoms , and it describes exactly what is going on with me for the past few weeks now.

Resting Tremor: about 70 percent of people with Parkinson’s experience a slight tremor in the early stage of the disease – either in the hand or foot on one side of the body, or less commonly in the jaw or face. The tremor appears as a "beating" or oscillating movement. Because the Parkinson's tremor usually appears when a person's muscles are relaxed, it is called "resting tremor." This means that the affected body part trembles when it is not doing work, and it usually subsides when a person begins an action. The tremor often spreads to the other side of the body as the disease progresses, but remains most apparent on the original side of occurrence.

Is it possible for me the have developed this disease? I AM ONLY 21 YEARS OLD

I researched and found no correlation with sleeping pills and accutane but just incase you might know something, I have been on 1 1/2 courses of accutane and been using OTC sleeping pills every night for like 2 years, but recently quit like 2 weeks ago.

resting tremor and mild tremor may stated' Parkinson's'. take physiotherapy and pshycho

Painful symptoms are very common for Multiple Sclerosis patients. They can be mild to debilitating, and sometimes it is hard to get doctors and family members to understand just how frustrating it is to cope without extra help. here are a few ways you can take your pain into your own hands by managing the way you live.1. Keep your joints and muscles young and flexible.

Whether you are 25 or 105, it is important that you maintain a light exercise routine to help make life as manageable as possible. This does not mean you have to become a body builder; however, pain should not keep you from being active. If you can, just take walks to keep the blood flowing to your muscles and brain. It is better to avoid going out in very cold weather, which will make pain worse, or hot weather, which triggers tingling symptoms in some individuals. Invest in an exercise bike or a treadmill, and avoid putting heavy stress on the knees. If you are in a wheelchair, see about attending physical therapy sessions or do some stretches at home.

2. get the right medication.

When you are feeling as though you can not live your life due to excess pain, do not be afraid to call your doctor for an appointment to increase or change your medication. Some sufferers of Multiple Sclerosis feel as though pain is just part of living with the disease, but you have the right to be comfortable. Make sure to use drugs safely, and only go to one pharmacist. If you have many doctors, they might not know what else you are taking. A single pharmacist will know every drug you are taking, so they will be able to tell you if one might interfere with the potency of another, or even cause unsafe side effects.

3. Accommodate yourself.

Keeping track of what daily activities cause the most pain and discomfort will help you learn to avoid what troubles you. there is a solution for just about everything these days. A simple wire tool with a handle can help you fasten buttons. Attach rubber grips or modeling clay to toothbrushes, silverware, and cup handles to make them easier to hold without straining the joints. Supportive shoes and sneakers can be fashionable and help to relieve strain and fatigue that can be caused by walking or standing in poorly fitted shoes.

Living with Multiple Sclerosis pain, numbness and fatigue can be managed to make your life easier. there are always new ways to help treat the symptoms of MS, and researchers are becoming ever closer every day to a cure. The best thing to do is to take good care of yourself for a long and healthy life, and never lose hope. Stay in the know about treatments that can help you feel better.

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I have noticed over the past 10 years I have developed many of problems that could be diagnosed as dyslexia in a child. can dyslexia develope in adults or get worse in an adult? I suspect that I may have had it all my life but awareness has icreased. I also have MS has anyone heard of any association with MS and dyslexia symptoms.

As far as I'm aware, dyslexia is only diagnosed in children as this is the age that people are generally learning to read. if you are experiencing similar symptoms, it may be related to your MS, if the sensitive eye co-ordination muscles are being affected by your MS.

Hello, I should think that having MS does not exclude the possiblity of having dyslexia. I'm sure you might notice dyslexia more as an adult if it hasnt been worked with by professionals. However, could it be a symptom of your MS (I dont know if MS would affect your brain in any way?) Or could it be a sid-effect of any medication that you might be on?

How about doing a search for dyslexia on wikipedia?

Many children go undiagnosed with dyslexia, and people do find out that they are dyslexic when they are adults.

MS damages both myelin and the nerve cells within the brain, thereby compromising a variety of functions handled by the brain.In MS a symptom is an impairment in visual perception and constructional abilities. So therefore, it could be possible that your ability to perceive information that you read and your abilty to write in what we see in a constructed way which is correct may be altered. Hope this helps.

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Q I have reached my 79th birthday and have been diagnosed with pelvic prolapse, affecting mostly my bladder. however, my OB-GYN describes it as bladder, bowel and cervix.

Owing to my heart skipping occasionally, I went through an EKG and all stress tests and blood testing preparing me for surgery.

I was given approval for the surgery until my OB-GYN told me that she would not perform the necessary surgery as it would be a long procedure and she didn’t want to put my body through that much stress.

A pessary was ruled out because it did not work for me. so, for the time being, I have decided to live with the situation but am now asking your advice on whether I should get a second opinion or do nothing? what problems do you think I would encounter later on?

A Pelvic prolapse is a weakening of the muscles and ligaments of the pelvic organs with the end result being that the organs slip downward out of their normal position.

This is a rather common condition that affects almost 50 percent of all women who have had children.

Symptoms include loss of bladder and bowel control, an increased sensation of urgency to urinate with a sensation of being unable to fully empty the bladder, repeat infections and excessive vaginal discharge.

To document the diagnosis, there are bladder-function tests plus pelvic floor strength tests, ultrasound, MRI or cystoscopy.

Because there are several types of prolapse, I will explain them briefly. If the anterior vaginal wall and bladder fall, the condition is known as a cystocele.

If the posterior vaginal wall and rectum fall, the condition is known as a rectocele. If the uterus falls, a person has uterine prolapse. Small bowel protrusion through an area between the vagina and rectum is an enterocele.

Initial treatment might begin with medication. For example, menopause causes a decrease in estrogen levels in a woman’s body that results in a weakening of vaginal muscles.

Estrogen-replacement therapy can restrengthen those muscles; however, this therapy is not appropriate for all women. that decision must be left to each patient’s primary-care physician or gynecologist.

The next step might be physical therapy to include either biofeedback or electrical stimulation — then surgery. the procedure depends on what specific type of prolapse a person has.

I don’t know your full medical history and can only suggest you return to your surgeon with a list of questions.

Ask why the doctor has chosen not to perform the procedure after all your testing. Perhaps she found something in the test results that she failed to share with you.

Then, if you remain dissatisfied, ask for a referral to another specialist for a second opinion. Bring all your test results when you go.

Write to Peter Gott, c/o United Media, 200 Madison Ave., Fourth Floor, New York, NY 10016.

Imagine that for years you’ve lived with a body that is in constant, uncontrollable, motion: your hands tremble, your head bobs, you walk in short, shuffling steps, and muscles all over your body spasm so strongly it’s painful. Everyday activities, like going to the bathroom, are incredibly difficult and time consuming. you may look at others who walk, talk, and go to the bathroom with an ease that is impossible for you to imagine and think, that’s “them,” not me.

This description is close to what life is like for many of the estimated 7 to 10 million people worldwide who have Parkinson’s disease. but a recent study may offer hope that a change for the better could very well arrive in their near future. Neurologix, inc., a biotech company based in Fort Lee, new Jersey, successfully used cutting edge gene therapy to improve tremors, rigidity and other motor control problems in a group of Parkinson’s disease patients, and with minimal side effects. If the therapy makes it to the market, it will be the first of its kind to do so.

For the uninitiated, gene therapy is a procedure in which a group of cells within the body are upgraded with one or more new genes to modify their behavior. the targeted cells are literally reprogrammed to exhibit new behaviors and abilities. A modified virus, called a vector, is used to safely infiltrate the targeted cells and inject them with the new genes. the viruses are mutated in a way to prevent their replicating out of control or causing any harm to the patient.

In the treatment being tested by Neurologix, gene therapy is used to modify neurons within the substantia nigra, an area in the back of the brain responsible for motor control. the gene therapy is aimed at increasing the expression of the GAD gene within the targeted neurons. GAD is used within neurons to make GABA, an inhibitory neurotransmitter which is decreased in the Parkinsonian substantia nigra, resulting in overactive neuron firing. In theory, with increased GAD production, GABA production will also increase, putting a “break” on the overactive neurons in Parkinson’s patients.

Injecting a virus into a specific part of the brain is no small feat. to inject the GAD gene, the experimental half of the patients (22) had, under local anesthesia, holes drilled into their skulls into which catheters were inserted. they then went to a recovery room where the GAD gene was injected into the catheter. the remaining control patients (23) underwent sham “surgeries” in which researchers imitated the sounds of the procedure and pretended to drill a hole in the skull and insert a catheter. Six months following surgery, the motor skills of both patient groups were assessed. the placebo group showed an improvement of 11 percent. the group that received GAD improved their motor scores by 23 percent with all but two showing improvement.

The current study was the second trial that Neurologix has subjected their GAD gene therapy to. Phase 1 took place in 2007 and included 22 patients. the study showed similar improvements but did not include a control group. Now that the therapy has passed phase 2 Neurologix is trying to raise the $30 to $40 million it will cost to conduct a phase 3 trial which requires 1,000 to 3,000 test subjects. after phase 3 is completed it is then up to the FDA to decide whether or not the therapy is safe enough to be sold.

The millions of people across the world with Parkinson’s disease and their families will be watching closely.

If it does make it to market, Neurologix’s GAD gene will be a significant advancement in the treatment of Parkinson’s disease. at present the best treatment for Parkinson’s disease is levodopa. you might recall levodopa—also called L-dopa—bringing comatose patients to life in the movie “Awakenings” based on the book by Oliver Sacks. Like the GAD gene therapy, giving patients levodopa does not help prevent or reverse the actual disease but improves quality of life by alleviating symptoms. unfortunately, as we saw in “Awakenings,” levodopa must be taken continually and its effectiveness typically wears off over time.

The Promise of Gene Therapy

To give cells back that which they have lost—as in returning Parkinsonian substantia nigra neurons to normal levels of dopamine or GABA production—is the ultimate hope in gene therapy. you permanently correct the cell itself rather than continually feeding it what it lacks. Making gene therapy ever more attractive is our increasing ability to identify the abnormal genes associated with inherited disease like Alzheimer’s disease, manic-depression, intestinal cancer, heart disease, diabetes, and many others.

But the road for gene therapy has been a rocky one. A four-year old girl with a severe combined immunodeficiency (SCID)—known to most as “bubble boy disease” from the famous story of David Vetter who was forced to live in a sterile bubble—became the first person to receive gene therapy in 1990. she got better, but whether or not it was due to the therapy or something else has since been a matter of debate. much effort since then has been aimed at developing safe and effective gene therapies, but the fact is no gene therapy has yet been approved by the FDA.

Gene therapy is further complicated by the fact that diseases are, well, complicated. the advances in genetics that so enticingly point us to potential targets for gene therapy also reveal that many common disorders such as arthritis, diabetes, Alzheimer’s disease, and heart disease are brought on by the combined effects of multiple genes.

But a string of successes in the past few years clearly shows that gene therapy is marching forward:  in 2008, vision was restored to patients with blindness brought on by a defective gene; in 2009, 8 of 10 patients were cured of a form of bubble boy disease; in 2010, a man was cured of a kind of blood disease called beta-thalassaemia. each of these success stories were the result of targeting single genes. the wait may be longer for gene therapies to tackle the more complicated, multi-gene diseases, but its evident that some diseases are amenable to a single gene approach. I think we can expect exciting results in the near future. Research is currently underway to develop gene therapies for Huntington’s disease, blood disorders, various forms of cancer, Sickle cell anemia, cystic fibrosis and deafness.

To be clear, both the GAD gene and levodopa treat the symptoms, not the underlying causes of Parkinson’s disease. Until we know exactly why the neurons of the substantia nigra become impaired we won’t be able to develop a cure. For now we’ll have to be okay with that. And if Neurologix one day soon delivers a gene that improves quality of life for millions of the world’s people with Parkinson’s disease, I think they’ll be okay with that too.

[image credits: wearingoff.org, new York Presbyterian/Weill Cornell Medical College via the Dana Foundation]

Cervical spine arthritis is also known as spondylosis, a condition that affects the upper spine. Arthritis is generally caused by the wearing and tearing of cartilage in the joints, which results from injuries or aging.

Cervical spine arthritis is caused by degeneration of the cervical vertebrae caused by wearing-off of the cartilages in between them. this degeneration slowly narrows the nerve root spaces (foramen) between the vertebras and compresses the nerves in the spinal cord. when this happens, the nerves are inflamed bringing pain that extends to the arms.

Cervical spine arthritis is most common in people between 40 to 60 years old and is considered a normal part of the wear-and-tear as one gets old. However, cervical spine arthritis may develop early in some people perhaps as a result of injury or trauma to the back.

Cervical spine arthritis is more common in men than women with symptoms that are similar to the symptoms of rheumatoid arthritis and osteoporosis, which are frequently experienced by women.

Symptoms of cervical spine arthritis:

- Chronic neck pain especially when moving- Numbness in the neck, arms and hands- Weak muscles- Tenderness or stiffening of the neck- Headaches- Difficulty in maintaining balance

Different tests are conducted to diagnose cervical spine arthritis. These are the following:

• X-rays – this is a very effective way to determine the level of degeneration in the spine.• Myelogram or CT scan – this type of test provides a detailed spinal bone structure.• MRI (Magnetic Resonance Imaging) scan- this test is performed to get a clearer picture of structures aside from the spine.

If these tests show that your cervical spine arthritis is severe, your physician may refer you to an orthopedic surgeon for further assessment.

Most cases of cervical spine arthritis respond well to different conservative treatments depending on the individual’s condition. Basically, neck rest is the first thing step of treatment. To help you with this, you need to consider proper body posture, the pillows that you use and the activities that you perform.

Anti-inflammatory drugs like aspirin, ibuprofen, acetaminophen or painkillers are also recommended by doctors to treat cervical spine arthritis. These medicines are known to lessen the swelling and the pain. for severe pain, doctor-prescribed oral sedatives can also be taken but as much as possible they should be avoided.

Non-surgical treatments such as hot and cold compress as well as a massage can help alleviate pain. for some cases physical therapy is advised as well as exercises.

If all conservative methods failed, the last option in treating severe cervical spine arthritis is surgery. Some surgeries involve the removal of a portion of a bone to relieve spinal cord pressure. Other such surgeries involve bone fusion, removal of a damage disc or creating a space in the nerve roots. Patients should talk to their doctor about what type of surgery will work for them.

Distended Stomach Acute Pancreatitis: how to Deal with Severe Pain Felt By Pregnant Women

The best way to establish whether or not you are suffering from distended stomach acute pancreatitis is to look for common symptoms such as tenderness, pain as well as rigidity of the muscles in the abdominal region – all of which in fact, often requires treatment in the form of emergency surgeries. In the case of pregnant women, distended stomach acute pancreatitis can lead to severe pain though this pain is also very much like what is experienced by patients that are not pregnant.

Psychological Changes

Nevertheless, there are psychological changes that are commonly associated with distended stomach acute pancreatitis in a pregnant woman and this need to be understood and interpreted in order to discover an appropriate treatment method.

Doctors will need to study the history of the patient including knows when the distended stomach acute pancreatitis symptoms began, their intensity as well as the nature of pain suffered. It is also necessary to establish the gestational age as early as possible in order to make correct evaluation of the problem.

Some of the questions that need to be answered in regard to finding out what is causing the distended stomach acute pancreatitis symptoms include knowing how the pain began – whether suddenly or did the pain grow in its intensity. It is also necessary to learn whether the pain was steady or just crampy or dull or sharp as well as stabbing.

Doctors will also need to establish whether the pain from distended stomach acute pancreatitis began immediately before taking a meal or just after consumption of a meal. was the pain localized or has the location of the pain changed and is there any vomiting and nauseous feelings experienced and if so when did these begin – before feeling the pain or after. Finally, it is necessary to learn what if anything causes the pain to worsen or even makes the patient feel better.

Doctors will need to conduct a physical examination of the patient. this will help in differentiating between, for example, extrauterine tenderness and uterine tenderness. Furthermore, a lab test may also be required to find the exact cause of the distended stomach acute pancreatitis pain.

Treatment can depend on the specific causes and surgery obviously is only required if the condition is very severe and serious. As soon as the diagnosis has been made, and if the symptoms are severe enough, surgery should be begun as soon as possible to prevent further complications and to also nip the trouble in the bud, so to speak.

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