Tag Archives: Neurological Disorders

The Other Side of 40 – The Cerebrovascular System (Your Brain) – Changes, Challenges, Solutions

brain-alive

Last but not least, in the last part of this series, let’s talk about your brain. But first a summary comment. Life after 40 poses both opportunity and obstacles. 35 to 40 is either the age when your lifestyle begins to catch up with you, or the work you’ve put in begins to pay off. For those who’ve lived life smartly and healthily, 40 really is the new 30. For those who’ve lived life less diligently, 40 may as well be 60, and your health probably reflects that. It’s really not that difficult. Diet, exercise, don’t smoke and alcohol in moderation keeps a body strong. Now to your brain…

Changes: As you age, cholesterol based blockages (plaque formation) inside the arteries and hardening of the arteries in the blood vessels that supply the brain is called cerebrovascular disease, and it causes strokes. These changes begin in earnest at about age 35. Prior to the complete blockage of the blood vessels, the brain is deprived of adequate blood flow (and oxygen) resulting in less than optimal brain functioning, such as confusion, disorientation, memory loss and ‘mini-strokes’ (TIAs). Strokes may result in paralysis, speech disorder, and sensory deprivation in varying degrees.
brainaging
Challenges: Unlike many of the other systems I’ve discussed, the effects of these changes on our brain health status can be drastic, ranging from slight discomfort to death, and they involve major physical as well as social components. The social implications of these effects can be just as severe as the physical, as those suffering become less functional both mentally and physically. Unfortunately, in varying degrees stroke survivors become or perceive themselves to be a burden to others. Social interactions are doubly inhibited: internally, the patient is less able to interact; and externally, family, friends, and others may be less interested in interacting with them. This is sad, but true (think about the lives of the stroke survivors you may know…).
Solutions: The alternatives are twofold: after the fact, education is essential by a loved one’s support group and community, otherwise a stroke becomes a different type of life sentence. Physical and occupational therapy save lives and the quality of lives. Continuing to value and show value to your loved ones can make all the difference in the world. Before the fact, again, it’s preventive measures such as diet and exercise that have been shown to decrease or even prevent strokes. I cannot overemphasize how vital diet, exercise and the avoidance of toxins are to your long-term health.

Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following SNC! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Medical Complications and Medication Treatment of Alcoholism

liver-cirrhosis

 
There are interesting commonalities of certain drugs like alcohol and cigarettes. One is users that really enjoy them are able to do so for a long time while being oblivious to the growing danger those activities pose. Another commonality is even more so than mentally, when things go wrong physiologically, they really go very wrong.
Possible Complications
Alcoholism and alcohol abuse pose threats to many aspects of your health, including the following.

Symptoms in alcoholic liver disease copy

  • Birth defects (fetal alcohol syndrome)
  • Bleeding throughout your digestive tract, including the esophagus (up to and including rupture), gastritis (inflammation of the stomach) and ulcer disease.
  • Brain cell damage
  • Brain disorder called Wernicke-Korsakoff syndrome (includes dementia, mental status changes)
  • Cancer of the esophagus, liver, colon, and other areas
  • Changes in the menstrual cycle (period)
  • Delirium tremens (DT’s)
  • Dementia and memory loss
  • Depression and suicide

Liver-Damage

  • Erectile dysfunction
  • Heart damage
  • High blood pressure
  • Increased risks for behavioral disorders including depression and suicide
  • Increased risks for sexually transmitted infections (STIs)
  • Increased risks for trauma, including motor vehicle collisions, violence and head injuries with intracranial bleeding
  • Inflammation of the pancreas (pancreatitis)
  • Insomnia
  • Liver disease, including alcoholic hepatitis, cirrhosis and cancer
  • Nerve damage
  • Nutritional deficiencies

Treatment
alcoholism_treatment
Medical goals and patient goals are often different and seem to depend on the extent of perceptible injury that has occurred at the time of the decision to quit drinking. Often, patients will want to reduce drinking instead of stopping completely. Continued drinking in moderation is only as viable an option as the patient’s level of alcohol-related level of disease and the patient’s ability to stay limited in consumption and focused toward that goal.
Ideally, abstinence (the complete stopping of alcohol intake) is the goal, and it needs to be the goal if and when the desire to stop drinking is coupled with the presence of significant alcohol-related disease.
As everyone knows, the management of alcoholism requires multiple simultaneous approaches, including family and social networks.  It is often the family network that helps the alcoholic come to the understanding that alcohol intake has disrupted his or her ability to function normally. It is a most unfortunate occurrence when this has not occurred prior to the development of significant medical disease. Individuals with alcohol problems are more likely to take the steps necessary to successfully withdraw from alcohol use.
Regarding the medical aspects of alcohol cessation, withdrawal is a very important consideration and is best done in a controlled manner. Components of effective withdrawal address the various medical and mental health considerations reviewed earlier and medical avoidance treatment.
Medical avoidance treatment includes medicine that prevent relapse via various methods, and they include the following:

  • Antabuse (generic name: disulfiram) is a well-known and commonly used medicine that works by producing very unpleasant side effects with virtually any alcohol intake within two weeks of taking the medicine.
  • Naltrexone (brand name: Vivitrol) is an injectable medicine that works to decrease alcohol cravings.
  • Acamprosate is a drug that has been shown to lower relapse rates in those who are dependent on alcohol.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Life Begins (To End) at 40 (Unless It Doesn’t) – The Cerebrovascular System (Your Brain)

brain-alive

Last but not least, in the last part of this series, let’s talk about your brain. But first a summary comment. Life after 40 poses both opportunity and obstacles. 35 to 40 is either the age when your lifestyle begins to catch up with you, or the work you’ve put in begins to pay off. For those who’ve lived life smartly and healthily, 40 really is the new 30. For those who’ve lived life less diligently, 40 may as well be 60, and your health probably reflects that. It’s really not that difficult. Diet, exercise, don’t smoke and alcohol in moderation keeps a body strong. Now to your brain…

Changes: As you age, cholesterol based blockages (plaque formation) inside the arteries and hardening of the arteries in the blood vessels that supply the brain is called cerebrovascular disease, and it causes strokes. These changes begin in earnest at about age 35. Prior to the complete blockage of the blood vessels, the brain is deprived of adequate blood flow (and oxygen) resulting in less than optimal brain functioning, such as confusion, disorientation, memory loss and ‘mini-strokes’ (TIAs). Strokes may result in paralysis, speech disorder, and sensory deprivation in varying degrees.
brainaging
Challenges: Unlike many of the other systems I’ve discussed, the effects of these changes on our brain health status can be drastic, ranging from slight discomfort to death, and they involve major physical as well as social components. The social implications of these effects can be just as severe as the physical, as those suffering become less functional both mentally and physically. Unfortunately, in varying degrees stroke survivors become or perceive themselves to be a burden to others. Social interactions are doubly inhibited: internally, the patient is less able to interact; and externally, family, friends, and others may be less interested in interacting with them. This is sad, but true (think about the lives of the stroke survivors you may know…).
Solutions: The alternatives are twofold: after the fact, education is essential by a loved one’s support group and community, otherwise a stroke becomes a different type of life sentence. Physical and occupational therapy save lives and the quality of lives. Continuing to value and show value to your loved ones can make all the difference in the world. Before the fact, again, it’s preventive measures such as diet and exercise that have been shown to decrease or even prevent strokes. I cannot overemphasize how vital diet, exercise and the avoidance of toxins are to your long-term health.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Life Begins (To End) at 40 (Unless It Doesn’t) – The Cerebrovascular System (Your Brain)

brain-alive

Last but not least, in the first part of this series, let’s talk about your brain. But first a summary comment. Life after 40 poses both opportunity and obstacles. 35 to 40 is either the age when your lifestyle begins to catch up with you, or the work you’ve put in begins to pay off. For those who’ve lived life smartly and healthily, 40 really is the new 30. For those who’ve lived life less diligently, 40 may as well be 60, and your health probably reflects that. It’s really not that difficult. Diet, exercise, don’t smoke and alcohol in moderation keeps a body strong. Now to your brain…

Changes: As you age, cholesterol based blockages (plaque formation) inside the arteries and hardening of the arteries in the blood vessels that supply the brain is called cerebrovascular disease, and it causes strokes. These changes begin in earnest at about age 35. Prior to the complete blockage of the blood vessels, the brain is deprived of adequate blood flow (and oxygen) resulting in less than optimal brain functioning, such as confusion, disorientation, memory loss and ‘mini-strokes’ (TIAs). Strokes may result in paralysis, speech disorder, and sensory deprivation in varying degrees.
brainaging
Challenges: Unlike many of the other systems I’ve discussed, the effects of these changes on our brain health status can be drastic, ranging from slight discomfort to death, and they involve major physical as well as social components. The social implications of these effects can be just as severe as the physical, as those suffering become less functional both mentally and physically. Unfortunately, in varying degrees stroke survivors become or perceive themselves to be a burden to others. Social interactions are doubly inhibited: internally, the patient is less able to interact; and externally, family, friends, and others may be less interested in interacting with them. This is sad, but true (think about the lives of the stroke survivors you may know…).
Solutions: The alternatives are twofold: after the fact, education is essential by a loved one’s support group and community, otherwise a stroke becomes a different type of life sentence. Physical and occupational therapy save lives and the quality of lives. Continuing to value and show value to your loved ones can make all the difference in the world. Before the fact, again, it’s preventive measures such as diet and exercise that have been shown to decrease or even prevent strokes. I cannot overemphasize how vital diet, exercise and the avoidance of toxins are to your long-term health.
Feel free to ask any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Life Begins (To End) at 40 (Unless It Doesn’t) – The Cerebrovascular System (Your Brain)

brain-alive

Last but not least, in the first part of this series, let’s talk about your brain. But first a summary comment. Life after 40 poses both opportunity and obstacles. 35 to 40 is either the age when your lifestyle begins to catch up with you, or the work you’ve put in begins to pay off. For those who’ve lived life smartly and healthily, 40 really is the new 30. For those who’ve lived life less diligently, 40 may as well be 60, and your health probably reflects that. It’s really not that difficult. Diet, exercise, don’t smoke and alcohol in moderation keeps a body strong. Now to your brain…

Changes: As you age, cholesterol based blockages (plaque formation) inside the arteries and hardening of the arteries in the blood vessels that supply the brain is called cerebrovascular disease, and it causes strokes. These changes begin in earnest at about age 35. Prior to the complete blockage of the blood vessels, the brain is deprived of adequate blood flow (and oxygen) resulting in less than optimal brain functioning, such as confusion, disorientation, memory loss and ‘mini-strokes’ (TIAs). Strokes may result in paralysis, speech disorder, and sensory deprivation in varying degrees.
brainaging
Challenges: Unlike many of the other systems I’ve discussed, the effects of these changes on our brain health status can be drastic, ranging from slight discomfort to death, and they involve major physical as well as social components. The social implications of these effects can be just as severe as the physical, as those suffering become less functional both mentally and physically. Unfortunately, in varying degrees stroke survivors become or perceive themselves to be a burden to others. Social interactions are doubly inhibited: internally, the patient is less able to interact; and externally, family, friends, and others may be less interested in interacting with them. This is sad, but true (think about the lives of the stroke survivors you may know…).
Solutions: The alternatives are twofold: after the fact, education is essential by a loved one’s support group and community, otherwise a stroke becomes a different type of life sentence. Physical and occupational therapy save lives and the quality of lives. Continuing to value and show value to your loved ones can make all the difference in the world. Before the fact, again, it’s preventive measures such as diet and exercise that have been shown to decrease or even prevent strokes. I cannot overemphasize how vital diet, exercise and the avoidance of toxins are to your long-term health.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, AmazonBarnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright, Sterling Initiatives, LLC. 2013-2015

Straight, No Chaser: Life Begins (To End) at 40 (Unless It Doesn’t) – The Cerebrovascular System (Your Brain)

brainaging

Last but not least, in the first part of this series, let’s talk about your brain. But first a summary comment. Life after 40 poses both opportunity and obstacles. 35 to 40 is either the age when your lifestyle begins to catch up with you, or the work you’ve put in begins to pay off. For those who’ve lived life smartly and healthily, 40 really is the new 30. For those who’ve lived life less diligently, 40 may as well be 60, and your health probably reflects that. It’s really not that difficult. Diet, exercise, don’t smoke and alcohol in moderation keeps a body strong. Now to your brain…

Changes: As you age, cholesterol based blockages (plaque formation) inside the arteries and hardening of the arteries in the blood vessels that supply the brain is called cerebrovascular disease, and it causes strokes. These changes begin in earnest at about age 35. Prior to the complete blockage of the blood vessels, the brain is deprived of adequate blood flow (and oxygen) resulting in less than optimal brain functioning, such as confusion, disorientation, memory loss and ‘mini-strokes’ (TIAs). Strokes may result in paralysis, speech disorder, and sensory deprivation in varying degrees.
Challenges: Unlike many of the other systems I’ve discussed, the effects of these changes on our brain health status can be drastic, ranging from slight discomfort to death, and they involve major physical as well as social components. The social implications of these effects can be just as severe as the physical, as those suffering become less functional both mentally and physically. Unfortunately, in varying degrees stroke survivors become or perceive themselves to be a burden to others. Social interactions are doubly inhibited: internally, the patient is less able to interact; and externally, family, friends, and others may be less interested in interacting with them. This is sad, but true (think about the lives of the stroke survivors you may know…).
Solutions: The alternatives are twofold: after the fact, education is essential by a loved one’s support group and community, otherwise a stroke becomes a different type of life sentence. Physical and occupational therapy save lives and the quality of lives. Continuing to value and show value to your loved ones can make all the difference in the world. Before the fact, again, it’s preventive measures such as diet and exercise that have been shown to decrease or even prevent strokes. I cannot overemphasize how vital diet, exercise and the avoidance of toxins are to your long-term health.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: When That Headache is More Serious Than a Migraine

Brain-Aneurysm-Prognosis-Factors
All headaches are not created equal.  Earlier we discussed migraines, but there’s a lot more to headaches than those.  In fact, when you come to an emergency room with a history of migraines and tell us you’re having a migraine, we still aren’t thinking about migraines as the first consideration.  It’s all about the life-threats.  The lead picture suggests items to avoid if you’d like to improve your prognosis for headaches in general and especially certain ones like brain aneurysms.
Secondary headaches are those related to some other illness or condition that produces headaches as a symptom.  These are much more common causes of headaches than migraines.  They’re even more important because they could represent life-threatening conditions.  So we’ll put aside the headaches caused by things like panic attacks and hyperventilation, influenza, dental pain, sinusitis, ear infections, eye strain, dehydration, hangovers, hunger and ‘brain-freeze’ (Yes, ‘ice-cream headaches’ really are a thing!), and point you to some conditions about which you should be concerned (I’m intentionally leaving out many especially uncommon and otherwise esoteric conditions.  I wouldn’t want to encourage any hypochondriacs out there.).

 unruptured-aneurysm

  • Brain tumor
  • Carbon monoxide poisoning
  • Encephalitis/Meningitis: inflammation and/or infection of different components of your brain
  • Subarachnoid hemorrhage: and other intracranial hemorrhages

Aneurysmal_Subarachnoid_Hemorrhage-1

  • Stroke
  • Temporal arteritis: inflammation of an important forehead artery with potentially devastating consequences to your sight.

Given that I’ve blogged on several of these already (you can always enter the term in the search box on the right for more details), I’m going to focus on the symptoms you may have that may suggest your headache is different enough to get evaluated for a possible life-threat.

Consider this a ‘headache plus this symptom = go to the emergency room’ list

  • Altered mental status
  • Confusion
  • Difficulty standing or walking (different from baseline)
  • Fainting after a headache
  • High fever, greater than 102 F to 104 F (39 C to 40 C)
  • Nausea or vomiting that’s not hangover related
  • Numbness, weakness or paralysis on one side of your body
  • Slurred speech
  • Stiff neck
  • Vision disturbances (blurred or inability to see)

Straight No Chaser: Myth Busters Edition – Migraine Headaches Fact vs. Fiction

headache

There are 30 million migraine sufferers in the U.S. alone.  Women are thrice as likely to have them, but both sexes have to address the issues raised by them.  Here are some important facts regarding migraines and myths surrounding them, based on questions I’ve actually been asked.  And yes, regarding the lead picture, I refuse to say she’s lion.

Myth #1: I can’t help if I get migraines.  They’re hereditary, right?

There are a few things about being predisposed to having migraines I want you to know.

  • If you have one parent with migraines, there’s a 50% chance you’ll have them.
  • If both your parents have migraines, there’s a 75% chance you also will.
  • 4 of 5 migraine sufferers have a relative with migraines.

These facts represent a predisposition.  In order to have migraines, you must have triggers that will set off the migraine.  That’s a vital consideration in your effort to prevent, reduce and effectively treat your migraines.

Myth #2: This is a woman’s disease.  They stress out more and are more emotional.  That’s why they get headaches.

It is true that there is a strong hormonal component to migraines, particularly regarding estrogen and progesterone.  In fact, the incidence of migraines between the sexes is pretty equal until puberty.  Migraines are increased during pre-menstruation, when hormone levels are high.  Menopause may ease migraines.    All of this said, men still get migraines as well because of the presence of other triggers.  It certainly does not appear to be true that women suffer stress at a disproportionate rate sufficient to claim it as more of a trigger in women than in men.  Both sexes’ stress responses include release of substances that expands blood vessels, causing migraines.

Myth #3: My migraines won’t get any easier as I get older.

Along the same lines as Myth #2, diminished hormone production that accompanies aging may help explain how most migraine sufferers have less frequent and less intense migraines after age 40.  Because of hormonal fluctuations during perimenopause, this reduction may not be seen.

  • Most people who get migraines have fewer headaches and their headaches aren’t as strong once they hit 40. However, this may not be the case for women going through perimenopause. If hormones are a trigger for a woman’s migraines, then she could have more headaches during the period around menopause.

Myth #4: Once I’m diagnosed with migraines, only narcotics will help.

First of all, trigger identification and prevention is vital.  Migraine trigger management and treatment is a topic unto itself, but I’d like to point out a few important considerations.

  • Think triggers first and last.  The list of triggers includes foods (think chocolate, alcohol, aged cheese and caffeine; results vary with the individual), cold, stress, smoking and certain medications.  Alterations in mealtimes, exercise and sleep patterns must be monitored as well, these tend to exacerbate migraines.  Migraine sufferers are advised to maintain a headache log to identify triggers as things occur.
  • A special comment about caffeine: It helps some people, but for others it’s a migraine trigger, particularly if you’re a heavy user.  If you don’t drink many caffeinated beverages, one may help if you’re having a less than severe migraine.  If you’re taking enough in to create a caffeine dependency, overnight withdrawal may be enough to trigger a morning migraine.

Patients must become their own experts on how and when you use different medications.

  • I hope you and your primary care physician have discussed and have you focusing on your abortive medications.  These medicines can stop further progression of migraines if used early enough at the first sign of a migraine.
  • Painkillers have consequences.  As tolerance to and dependence on narcotics develop, withdrawal symptoms become more prominent.  Rebound headaches are a major component of these symptoms.  That’s a vicious cycle that doesn’t have a happy ending.  It’s important to note that your health care professionals do appreciate there is a difference between being drug seeking and drug dependent.

Myth #5: Migraines really don’t cause problems beyond the headaches, right?

Wrong.  If you have migraines, take special care to ensure you have a healthy heart and a low risk for strokes.  Refer to the Straight, No Chaser archives (or just type in the search engine to the right) for information on stroke recognition and heart attack recognition.  If you’re a female and have migraines with aura (certain warning symptoms that precede you migraine like nausea, dizziness, light sensitivity, and seeing zig-zag lines), your heart attack risk climbs by over 90% and your stroke risk more than doubles (increases by up to 108%).  The presence of migraines without aura also raises the risk of heart attack and stroke but by lesser amounts.

As per routine at Straight, No Chaser, the message is simple, but execution is key. Prevention is protection, and knowledge is power.  Check back this afternoon for life threatening causes of headaches, and feel free to send questions and comments.  Take good care.

Straight, No Chaser: Concussions Post-Script – A Neurologist's Thoughts

I’d like to welcome and thank my good friend and noted UCLA Neurologist, Dr. Charles Flippen, II to Straight, No Chaser as a contributor to this topic.
His words:
“Everyone should understand the need for both physical and cognitive rest following concussion to allow full recovery (no symptoms, no meds). That may include postponing tests and/or reduced academic workload with graduated “return to play”. Regarding post-concussion syndrome, most patients will recover, never as fast as they would wish. It will usually be stepwise with headache as usually among the last symptoms to resolve.”