Sadly, the dramatic changes that occur just before and after nightfall can, in some ways, be loosely compared to the words penned in folklore and fiction when “unsuspecting victims” experience unwelcomed transformations and do uncontrollable acts they normally would not do during the day. They may feel remorseful about these the next morning while others may not recall their actions at all.

Many of those who are not familiar with Sundowner’s per se simply know their loved ones have a difficult time at night and, depending on the severity, the symptoms can unfortunately prevent needed, restful sleep for the individual and their caregivers. after my husband and I began hearing about, and even witnessing, similar patterns in those we are close to, we began to research these mysterious metamorphoses and were surprised, not to mention tremendously relieved, to find this was not only recognized as a specific condition but may be, to some degree, treatable depending on the individual.

Much of our personal research suggests one should first be aware of what the sufferer is doing or eating that could be triggers for the negative behavior as well as become very familiar with their medications and their possible side effects. As it relates to treatments we learned that in addition to certain vitamins, herbs, supplements and prescribed drugs, there are some other creative activities that can be tried. one of these is keeping the person busy doing things they find enjoyable. Something as simple as folding clothes, playing games or performing repetitive tasks they may have done earlier in life can be quite beneficial to relieve stress, which is thought to be one of the possible triggers for those afflicted. Our physician’s assistant said these can also be useful diversions when the unpleasant symptoms start to surface in the evening.

Trying to keep the day-to-day activities as consistent as possible can be extremely beneficial. one certified nursing assistant we spoke with recently said that she and her patient’s wife would pack the husband’s lunch daily. then he would “go off to work” to a spot on the back porch where he would replace door knobs, taking them off and putting them back on again. He was in a safe environment, doing something he was good at and staying busy, which we were told is especially important to those who were quite productive in their younger years.

In addition, receiving proper sunlight may combat the depression that sometimes accompanies or could possibly exacerbate this condition. If natural sunlight is not an option, light boxes that mimic sunlight have been reported to be effective. these can also reset the individual’s internal clock if they have their days and nights reversed. Exercise and social activities such as visiting with friends or family can be therapeutic for some folks as well.

We read that nursing homes have experienced positive results in allowing trained animals to interact with patients, and some have found aromatherapy, music or sounds like ocean waves, singing birds and the like to be quite soothing. Hand holding or hand massage treatments have also been used to calm agitation, but these are not effective for those who show signs of anger or violence.

Of course our experience is limited to our personal research and circumstance; therefore, anyone concerned about this topic should seek the advice of their doctor and/or healthcare professional. Even though there is still much to be learned about Sundowner’s, it was comforting to realize the disorder has a name, and there are folks out there with firsthand experience to offer. the Internet and the library were also wonderful resources regarding what is known as well as how to make the best of the situation. one of the most refreshing books we found on the topic of Alzheimer’s is “Finding the Joy in Alzheimer’s: Caregivers Share the Joyful Times” by Brenda Avadian.

The role reversal of becoming a parent to one’s parent or spouse can in some ways be more daunting than being a parent to one’s actual offspring; therefore, relying on whatever support system that is at one’s disposal can be invaluable. If “it takes a village to raise a child” it will surely take a “sympathetic neighborhood” to cope with this challenge. To those who feel a sense of responsibility, trying to courageously handle the experience alone can quickly become overwhelming. Therefore, accepting assistance from trusted friends and family as well as guidance from objective, trained professionals can be so helpful. Maintaining a positive and proactive attitude in keeping with the philosophy that everything happens for a reason can transform the journey from hopelessly agonizing into a life lesson that may someday benefit others.

Even though every situation and person is different, in many ways we as individuals are still quite similar. we all want an enriched quality of life as we travel through it; and with the proper information, support, attitude and faith, hopefully the uncontrollable and the mysterious won’t prevent those affected from embracing and relishing the precious, sweet time spent together.

Jenny Waisner teaches computer classes at Davidson County Community College.

I’m not sure if this is paleo related… but here is what’s up.

Been doing Paleo for a couple of months and kept some track of the changes in my body. at first I noticed that it seemed I would get restless leg syndrome at night the first few weeks I started (never had before, went away and hasn’t returned… not sure if it is related to my paleo diet/lifestyle).

I also started the LeanGains regimen last week.

So… last week my wife gets a stomach bug… really sick for one day only, including nausea, vomiting, dizziness, etc.

A day later I feel some sour stomach symptoms but felt alright (no dizziness or nausea). Next morning, since I don’t eat breakfast, I drink some water and my stomach is on fire. after throwing up (and the dinner I had from the night before) I felt better and went to work. (Never felt that kind of heartburn/stomach-pain)

Still doing the LeanGains regimen, but the problem now that it seems any time I drink water (filtered from the tap, which I have been drinking for years, no problem) I get that same burning sensation. I have to take small sips and let the burning go away (usually after 5-10 minutes) before sipping any more.

Weird part is that I can eat food and not have the burning sensation. I can even take my multivitamin (when I would normally have burning sensations if I don’t take it with food), or my liquid fish oil supplement and have no problems at all. I’ve even chanced it and sprinkled cyan pepper and Tabasco on my eggs and felt nothing.

So what is it about the water? even if I sip water WITH my meal I’ll feel the burning sensation, but if I don’t sip water I’m good. does this have to do with going Paleo, macronutrient ratio change (body adjusting), or my LeanGains eating schedule? Or maybe it’s all still the stomach bug (assuming I caught it from my wife).

A little more info: I’ve NEVER had heartburn before… and the burning doesn’t feel like it’s in my esophagus, but more underneath my stomach… like as if the water getting released into my small intestine and the burning happens at the lower stomach sphincter.

Somebody help me hack this, please.

TV presenter Nigel Farrell tells how a bizarre exchange led to him being diagnosed with pancreatic cancer

It had been a gruelling couple of weeks filming, yomping through the ice and snow with heavy cameras and tripod in one of the remotest places in Britain  -  Barra, one of the most southerly islands of the Outer Hebrides, 60 miles off the wild north-west coast of Scotland. 

We’d been shooting for a BBC documentary series called Island Parish, and now my cameraman Aidan and I were sitting in the tiny airport terminal beside the sandy beach where the planes land from Glasgow, heading home to London for a few days’ break. 

All clear: Nigel Farrell, with partner Sally Ann, has been told all traces of cancer have disappeared

Suddenly, I noticed Aidan was leaning forward and looking at me in an odd way. ‘I hope you don’t mind me saying,’ he said awkwardly, ‘but your eyes seem to have turned slightly yellow.’

I checked in the loo mirror, but it was quite gloomy in there and I couldn’t see anything wrong. At home in my Islington flat that night, the lighting was low and my partner Sally Ann didn’t notice anything.

That all changed dramatically the next morning.

‘My God, you’ve turned completely yellow!’ Sal shouted in alarm when we awoke. it was weird staring back at my new, totally yellow self in the mirror; I had assumed I was in the peak of health, and had felt no aches or pains at all.

Things then moved incredibly rapidly  -  and never again will I curse the NHS.

‘You’ve got jaundice,’ said my GP an hour later. it was a Saturday, and they’d sent me straight in to his surgery.

‘It’s often caused by gallstones. not a huge problem, but you need attention immediately. I’ll make an appointment for you to see someone at UCLH.’

University College London Hospital is my local general hospital. this was my first big piece of luck. I didn’t know it at the time, but UCLH is a world leader in treating the liver and pancreas.

‘What, some time this week?’ I asked.

‘No,’ he said, looking at me kindly.

‘I mean now. Right now.’

A few hours later I was in the ward being examined by a surgeon. it all seemed slightly surreal. I’d never felt better in my life.

Early warning: Cameraman Aidan noticed that Nigel’s eyes had ‘turned slightly yellow’ while they were shooting a BBC documentary series called Island Parish

One of the common causes of jaundice is blockage of the bile duct, which normally carries bile from the liver to the gut. The liver extracts potential toxins from the blood, modifies them and passes them into the bile so they can reach the gut and be excreted from the body.

if they cannot escape, the toxins ‘leak’ back into the bloodstream, and one  -  bilirubin  -  produces a yellow colouration, usually visible first in the whites of the eyes, and later in the skin.

An endoscopic camera examination revealed that, in my case, the blockage was the result not of gallstones but of a tumour in the pancreas. Sal and I were horrified, well aware that it could be cancer. A quick trawl of the internet revealed that pancreatic cancer has an appalling prognosis for most people.

We passed the three-week wait for the operation in a kind of dizzy dream, heightened by the fact that still at no stage did I feel remotely ill.

As it turned out, my swift diagnosis was my second big piece of luck. Early symptoms of pancreatic cancer disguise themselves behind less alarming problems such as weight loss or diabetes, and are notoriously hard to identify. often it is simply too late by the time doctors realise what it is.

The fact that my tumour had blocked the bile duct, making its existence obvious, was a blessing in disguise. of every 100 patients diagnosed with pancreatic cancer, only ten can be operated on. I was already in the ‘lucky’ ten per cent.

The operation is called a Whipple procedure, and in my case it lasted seven hours. Led by an outstanding surgeon, Charles Imber, the team removed not just the tumour but part of my pancreas, gall bladder, and parts of the bile ducts, bowel and stomach, in an attempt to prevent any potential spread of the tumour.

I was in intensive care for a few days, then moved to the ward. The registrar broke the news from the pathology lab. ‘I’m afraid your tests reveal that the tumour was cancerous,’ he said. ‘But we have managed to cut out the whole growth.’

I suppose we had been wildly hoping against all the odds that the tumour was benign so, knowing that this form of cancer has a high chance of recurring, this was, in a way, the lowest point.

My imminent death now seemed a real possibility; most pancreatic cancer patients die within six to eight months of diagnosis. it was almost more of a worry trying to imagine how my friends and family  -  and particularly Sal  -  would take the news. In fact, whatever their private thoughts, everyone was unbelievably upbeat and supportive.

Having stared death squarely in the face, I decided to put it back in its box and focus on recovering from the operation. I’d been told it was vital to get out of bed and walking as quickly as possible  -  even though this was painful at first  -  to get the lungs working and so help stave off infection. I took a few more steps each day, eventually pounding the ward and later the stairwells.

Seeing the other patients, many of whom seemed to be in a far worse state than me, made me realise that I was, even now, lucky to be alive.

I met a man who had started to undergo the same operation as me, but the surgeons were unable to remove his tumour because of its proximity to a major blood vessel. later, I saw the delight on his face as his wife and young children arrived for a visit. he, too, looked the picture of good health.

Of the one in ten pancreatic cancer patients surgeons can operate on, in six cases they are unable to remove the entire tumour. I was now in the ‘lucky’ four per cent.

Hugely helpful was the fact that, even in the ward, I could keep working. if I was a teacher or employed in a bank, I would no doubt have been signed off for months. The offices of my TV production company are just down the road from UCLH, in Soho, so colleagues were able not just to visit, but to bring in scripts and DVDs of rough-edited programmes for me to work on in bed.

Within a month, I was back on the Outer Hebrides with Aidan, filming the main characters on our documentary series  -  Father John Paul Mackinnon, the Catholic parish priest on Barra, and his colleague in the next-door parish of South Uist, Father Roddy McCauley, who suggested celebrating my return to the islands with a wee dram, and promised to light candles and say prayers for me at Mass.

On my return, I started a six-month course of chemotherapy at a neighbouring North London hospital, the Royal Free, designed to attack any rogue, post-operative cancer cells that may still have been whizzing around my system.

I was on a trial regime; chemo pills every day for three weeks, along with a once-a-week, half-hour chemo drip, then nothing for the fourth week, to allow the body to recover.

Mercifully, there were few side effects. My hair thinned a little but not noticeably. The chemo tries to destroy cells that replicate (the principle characteristic of a cancer), so the palms of my hands and the soles of my feet (where the skin cells get worn quickly and automatically replicate themselves) suffered badly.

I had terrible blisters, which made walking difficult at times, and handshakes could be embarrassing. But I was able to function pretty much as normal, which I’m sure was a major contribution to my rapid recovery, both physically and mentally.

In late November last year, I had a CT scan, and this, along with the results of blood tests, showed that the chemo appeared to have done its job and there was now no evidence of cancer. The consultant was beaming as she gave us the results.

‘Go away and enjoy Christmas,’ she said, and we all laughed idiotically. I guess they spend a lot of time dishing out bad news in the oncology department.

‘We’ll be monitoring you every three months with a scan and blood tests. see you next February. Have fun.’

Outside the hospital, Sal and I hugged with relief. again, the next few days had a surreal quality. I had been in the hands of doctors since early February  -  nearly ten months  -  so I had handed over responsibility for my life to them. now I was on my own, feeling lost and lonely.

Talking to other ‘survivors’ helped. I had coffee with an inspirational woman called Ali Stunt, a mother of two young boys, who had surgery for pancreatic cancer three years ago, aged 41. Ali had experienced months of unexplained back pain, and was diagnosed only after a CT scan paid for by her private health insurance.

‘My surgeon said that had I waited four weeks for the scan I would probably not be here today,’ she told me. ‘Early diagnosis of this killer would help save so many lives.’

Ali went on to found a charity called Pancreatic Cancer Action to try to increase awareness among doctors and patients alike. She has become something of an expert. ‘The general population need to know about it, the symptoms and the risk factors  -  smoking, obesity and hereditary links.’

I am well aware there is a real risk of recurrence, but if you can get through the first two years, your chances of survival increase dramatically. Never has the cliche ‘take each day as it comes’ been more relevant.

It has been a joy to return to normal life. I wake each morning feeling more ambitious and vigorous than ever. And yes, those moments I used to take for granted, I now relish; the warmth of the winter sun on my hand, the sip of a fine wine, the smile of a stranger on a bus.

Has it changed my life?

No. I have a job I cherish and a family, friends and a partner whom I love. all I have ever wanted is the chance to continue as before. if I can function, I can be happy.

Has it made me appreciate life more? A hundred times. there is no past, there is no future, so the saying goes, there is only now  -  and you can either seize the moment, or not.

Island Parish is on BBC2 at 7.30pm on Fridays, starting this week.

DR ELLIE CANNON SAYS:

This is a classic, text-book case of how doctors are taught pancreatic cancer shows itself. Painless jaundice is what we call a ‘red flag’ for cancer and must be investigated immediately.

Jaundice can also be caused by gallstones, but patients normally experience pain with this.

Anyone with jaundice should see their GP straight away. if it is the weekend, you must go to A&E. Pancreatic cancer has a poor prognosis generally, but the earlier the diagnosis, the better the chances of survival.

3 weeks ago maybe 4 i cut my pinky on a fence as i was hopping it, it was like a sharp thing ontop of the fence, it cut it pretty deep. i thought i needed stiches, i showed it to my mom and she immediatly brong up tetanus. im 19, work off the books so i have no medical insurance, so i showed it to my dad and he put butterfly stitches on it and said it would be alright. ok so now about 3-4 weeks later im at my friends party and when im leaving my moron friend decides it would be funny to trip me as im running to my friends car, so i hit the ground land right ontop of my other pinky, it kinda snapped in half, and i snapped it back into place(only putting this here cause idk if you can get tetanus from crushing a bone)so the next morning i wake up extremely sick, i don't know if it was a hangover or what, but i was sick. started off just being a mild fever, and a lot of throwing up, towards the middle of the day i started getting like spasms in my stomach, had some difficulty breathing(which i get on occasion, i am heavy smoker). so that day passes and the next morning i wake up, not that sick anymore but i got a stiff neck, chest still hurts when i breathe, and the arm of which my pinky was cut felt pretty stiff. ok so that day passes, now its today, i wake up my neck wasnt as stiff as yesterday, my arm still feels stiff, and my chest is still hurting. i don't remember the last time i got a tetanus shot, maybe when i was 9 or 10? im 19 now, i didnt wanna tell all this information to my mom because she would have spazzed out, so can someone let me know whats going on am? do you think i have tetanus or am i being paranoid?

Basically i wake up and my legs feel like jelly and this sometimes spreads to my arms. Also if anyone has any tips on how to control the negative thoughts i get

Go to a doctor. this may be more than just anxiety. other medical problems can cause the jelly sensation and the negative thoughts.

I would talk with my doctor if I were you. He or she might prescribe Paxil or something. no need to be referred to a shrink, necessarily.

basically you should not try to run away from problems.Take a pen and jot down the things that are troubling you.Sleep over them and look at the list next morning , you would be surprised to know that most of the things would look ridicoulsly simple. Take a few deep breaths and then start tackling the problems one at a time,and ,wow ,there goes your anxiety down the drain