FACT OR MYTH- ABOUT BACK PAIN

Back pain is the number one disability for those under age 45. And it runs second, after the common cold, as the top reason for visiting a healthcare provider in the United States.

There is nothing really wrong with you. Myth! Chronic pain sufferers report that doctors generally tell this to about 90 percent of them and it is incorrect. In reality, the majority of low back pain cases or some 90 percent generally come from an unknown cause, like an infection or a particular injury. And the duration of the pain runs generally from four to six weeks.

“People dont die from chronic back pain.” Wrong! The pain combined with depression and anxiety in long-term cases places sufferers at risk for suicide, which does happen from time to time.

Namenda and Other Medications

Another medicine, called Namenda, has recently been approved for use in the U.S. This medication has a different action than the acetylcholinesterase inhibitors and the two types of drugs may be used together, at the same time. This may increase the effectiveness of therapy.

All of the FDA-approved treatments now available only provide relief of cognitive symptoms; they do not attack underlying disease. A recent study found that patients with mild Alzheimer’s disease who take a drug called Flurizan were able to slow the disease-related decline in their activities of daily living (such as eating and dressing) by about 67 percent when compared with people on placebo.

Flurizan is the first of a new class of drugs known as selective amyloid beta-owering agents, which are intended to affect the suspected underlying cause of the disease, a build-up of beta-amyloid protein.

The cholinesterase inhibitor, Cognex, is rarely used anymore due to serious liver side effects and the need for frequent blood testing.

In a trial involving eight people with mild to moderate Alzheimer’s, researchers at Weill Medical College of Cornell University are trying to harness the body’s immune system to fight Alzheimer’s. In this trial, intravenous immunoglobulin (IVIg) seemed to increase the levels of anti-beta-amyloid antibodies in the blood to a greater degree than seen before resulting in an average 45 percent decrease of amyloid. Six of the eight patients experienced improvement in cognitive function and none of the patients had declining function.

Acetylcholinesterase Inhibitors

Alzheimer’s causes the destruction of neurons (brain cells). It also destroys the important chemical messenger acetylcholine, which is responsible for memory and other cognitive skills. While no drug has yet been shown to completely protect the brain against the effects of Alzheimer’s, drugs that protect acetylcholine from destruction appear to hold the symptoms at bay for a while longer. These medications are known as acetylcholinesterase inhibitors (AChE inhibitors) and include :

    Aricept,
    Exelon, and,
    Reminyl.

For the acetylcholinesterase inhibitor drugs, the dose of medication is started low and gradually increased to the recommended level. Tolerance (the drug no longer provides the same benefit) may occur. It is also important to know that these medications are expensive, averaging in the neighborhood of $130 per month. Your insurance or health cover may or may not cover the costs of this drug.

Reminyl Warning: in April 2005, Reminyl’s label was changed to include information about the deaths of 13 elderly patients who were taking the drug during a study. The deaths were due to various causes, including heart attack and stroke.

Alzheimer’s Drugs and Medication

Modern drugs can help sooth agitation, anxiety, depression, and sleeplessness, and may also help boost participation in daily activities. Newer medications are also becoming available that can improve or preserve thinking skills, at least temporarily.

Please note: Regular reassessment is required while you are on any of these medications. This helps doctors determine if the medicines are being tolerated without troublesome side effects. These regular visits are also to make sure the patient is responding to the medication appropriately.

It is important to note that consumption of some nutritional supplements or medications can have serious side effects or interfere with other prescribed medications. Please consult with your doctor before using any nutritional supplements or medications.

Alzheimers and Aspirin

Treatment for Alzheimer’s Disease

By reducing or eliminating as many of the risk factors as possible, it should be possible to greatly reduce your chances of developing Alzheimer’s and other dementias. Studies on the results of various treatments have been mixed and more research is needed. It is important to talk to your doctor before starting any new treatment for Alzheimer’s (even for over-the-counter treatments), as some of these may even be harmful in certain circumstances.
When diagnosed and treated for Alzheimer’s, you will need to have regular follow-up visits with your health care team.

Alzheimer’s – Driving a Car

Alzheimer’s can affect driving ability in a number of ways including:

    Finding your way around
    Remembering which way to turn
    Judging distance from other cars and objects
    Judging speed of other cars
    Reaction time
    Hand-eye coordination

The issues of driving ability and safety can be very difficult ones, both practically and emotionally, for people diagnosed with Alzheimer’s, and their families. A diagnosis of Alzheimer’s does not necessarily mean that a person must cease driving immediately. However, any changes in a person’s ability to drive will indicate a need for this to be considered.

Most of us are unaware of just how complicated a process driving is. We simply take the activity for granted. Alzheimer’s can cause loss of memory, limited concentration, loss of sight, and a range of other problems. This will eventually affect a person’s ability to drive safely. Some people may recognize their declining abilities, others may not. Doctors will often recommend that a person should stop driving or they may refuse to approve a driver’s license renewal, particularly if they have been alerted to any problems.

The Impact of Alzheimer’s Disease

Many, but not all, people facing the onset of Alzheimer’s are aware that something is wrong. The diagnosis of dementia or Alzheimer’s can come as somewhat of a relief, as they now know what is causing the problem. Alzheimer’s affects people in different ways and each person will find their own approach to managing with the changes which occur.

There are some good reasons to tell the person with dementia about the diagnosis: Early intervention can enhance quality of life. Knowing about the condition can allow for planning for the future. Access to information, support and new treatments are helped when the person knows about their condition. Knowing about the condition allows for an honest and open discussion of the experience of dementia between family and friends.

Being diagnosed with dementia means that there are a number of matters to consider in planning for the future. If you are still working you will need to consider how dementia affects your working life and start thinking about future changes which may be needed. You may have already noticed the effects of dementia on your work. Some of the changes might include:

Genetic Testing for Alzheimer’s Disease

While most cases of Alzheimer’s Disease are not directly caused by a gene, there are some identified genetic links. For a fuller discussion of the genetics of Alzheimer’s disease, see the risk factors pages. There are genetic tests for these genes, but they are typically only necessary in cases where there is a family history of younger onset dementia.

Younger onset Alzheimer’s disease (onset before age 65) is known to be caused by at least three genes:

APP (amyloid precursor protein) gene
Presenilin 1 gene
Presenilin 2 gene

There are genetic tests for these genes, but they are typically only necessary in cases where there is a family history of younger onset dementia. The E4 sub-type of the apolipoprotein E (ApoE) gene increases the risk of developing late onset Alzheimer’s disease, but does not cause the disease. It is important to emphasize that while the ApoE4 variant may increase risk of developing late onset Alzheimer’s disease, having the ApoE4 gene does not mean that a person will develop the disease.