Anaesthetic Alzheimers

Anaesthetic alzheimers is a tragic development after successful surgery. Almost everyone knows someone who sadly developed what was presumed to be senile dementia, or the dreaded A, after an operation. Were they were about to develop the disease anyway? Specialists are now acknowledging that the very young and the elderly are particularly vulnerable to a general. 


Just recently a good friend and patient fell and broke his hip. The total replacement was relatively successful and he can walk fairly well, but the poor man has lost his marbles.

It's tragic seeing such a once vibrant man falling apart; worse, he knows it's happening and that he probably won't see out the year.

The mental deterioration has meant he can't grasp the need to exercise his leg, and to eat properly. He's losing weight fast and starting to fall again. He refuses to use his walker most of the time.

The end is nigh, I fear.

No one is to blame for this sorry state of affairs; a general anaesthetic more frequently that we want to acknowledge causes Alzheimers, or premature senile dementia.



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"If you do a perfect operation, and you have someone who comes out with say a perfect heart, it's just heart-wrenching if you have a neurological dysfunction."

- Dr Aubrey Galloway, Chairman of cardio-thoracic surgery: New York University School of Medicine.



The New England Journal of Medicine reports that "more than half of heart by-pass patients awake with cognitive dysfunction, ranging from a stroke to memory loss."




Anaesthetic Alzheimers

Anaesthetic Alzheimers is a medical disaster after surgery.


World Congress of Anaesthesiologists

The risk of permanent harm to neonates and the elderly from anaesthetic drugs was a hot topic at the World Congress of Anaesthesiologists in Cape Town in 2008.

Anaesthetic Alzheimers is a distinct possibility at every operation.



Professor Mike James

The University of Cape Town's medical school, department of Anaesthesia, and co-chairman of the Congress Scientific Programme, said:

“Evidence is emerging on how anaesthetic drugs might alter the functions of the brain in the very young and older patients, and that this may be permanent."


“This shows the need for more precise, better-targeted anaesthetic drugs,” said James, who is also head of the SA Society of Anaesthesiologists.

As many as 10% of older patients run the risk of permanently losing brain function after undergoing an anaesthetic and surgery.

ANAESTHETIC ALZHEIMERS. It's for real.


Professor Duncan Mitchell

Emeritus Professor Duncan Mitchell, of the University of the Witwatersrand’s Brain Function Research Group, said: “Every time you have an anaesthetic you lose neurons and since elderly people have fewer neurons, they lose proportionately more neurons.”

Typically, patients recuperate fully from the operation but sometimes their cognitive function is impaired permanently . THE OPERATION WAS A SUCCESS BUT SADLY THE PATIENT LOST HER/HIS MARBLES.


Professor Maze

“Elderly patients who go in for a hip or knee operation, for example, may be able to walk afterwards but not remember where they are walking to.”

He believes this loss in brain functioning is induced by inflammation related to the surgery rather than the anaesthetic itself. (Editor: Does it make a difference?)

An anaesthetic and surgery on patients may be the catalyst that pushes vulnerable patients over the edge into short-term memory loss or, worse still, Alzheimer's disease.


FROM THE COAL FACE

Mrs L was a favourite patient. My wife's maths teacher at high school, they had the same name, she was always one of my favourites. Now long dead, I think I can say that Jean L was one of the tartars who would accept nothing but the best from her pupils, and the number of serious mathematicians who went on to prove themselves could certainly not be easily numbered. Hundreds, perhaps thousands of accountants, actuaries and engineers.


The good wife, Jean nee Lindsay, like her guru, is a maths teacher. To this day, the best pupil at Estcourt High School receives the JL trophy, in memory of two fine mathematicians.

But I couldn't help Mrs L's knees. She had guarded the goals for the Springbok hockey team in her prime, and her patellae had taken a beating. Eventually she had a double genu replacement, done simultaneously.

Mrs L was never the same. She lost her marbles. Exactly what happened no one will ever know, but a 65 year old genius, instantly became a pathetic, sad woman who could neither remember who she was, where she lived, or who her chiropractor or even who her husband were.

We remember you with great affection, Mrs L. One of the geniuses of your generation who gave so much to so many.


Iatrogenic illness

There is no treatment that is perfectly safe. That includes Chiropractic. Any honest chiropractor will tell you that he has had patients whose sciatica got worse, were very dizzy for a few days after the treatment, and about 1/ 2 000 000 patients will have a stroke after a cervical manipulation, making it about the safest treatment for anything on the planet but, still, it can happen.

Iatrogenic illness is doctor-caused disease.

But there is nothing that we chiropractors do that comes even remotely close to the dangers of anaesthetic Alzheimers; just compare the insurance premiums.


AntiCholinergic side effects

Many drugs, and especially the ANTICHOLINERGIC SIDE EFFECTS of a full half of all medications causing mental fuzziness and forgetfulness can tip one prematurely into old age senility.

It's different to anaesthetic Alzheimers, slowly progressive as against an abrupt change, but the end result is much the same.


Alzheimers and Exercise

Even if you are genetically programmed to get Alzheimer's disease due to the APOE gene on BOTH genes, by following the rules you can be assured of being in the 60% who do not get Alzheimers disease. ALZHEIMERS AND EXERCISE and certain dietary changes are vital.

At a recent Alzheimer's Association International convention more research was presented concerning the link between waking speed and steadiness on the one hand, and cognitive decline on the other.

The question remains: will a dedicated exercise programme aimed at increasing walking speed (by treating foot pain for example) and steadiness (by quadriceps strengthening exercise, say) have a positive affect on limiting cognitive decline? We think so.

By not addressing hip arthritis, knee arthritis symptoms, ankle joint pain in the older person, are we directly contributing to early cognitive decline? It seems likely...



Chiropractic

In the last month I have been treating a 58-year old woman, moderately obese, diabetic, with right trochanteric hip pain of five years duration. Astonishingly, none of the doctors she had consulted had found the definitive loss of internal rotation, flexion and adduction of the hip, or ordered radiographs.

Instead such diagnoses as trochanteric burisitis were offered. What has this to do with anaesthetic Alzheimers?


One month into the programme she informs me that she can now walk two kilometres with some pain towards the end; flexion and internal rotation are dramatically improved with the standard Chiropractic protocol for treating arthritic hips. She no longer requires analgesics at night, and yesterday she informed that she had cut her toenails for the first time in two years.

Radiographs taken three weeks ago confirm moderately advanced hip arthritis.


What is the point of this anecdote? Has the very significant improvement in her gait also contributed to limiting early cognitive decline?

Unfortunately, lower limb pain is a double wammy for the brain. It limits walking and independence, and the frequent surgery, in ten percent of cases, contributes in 10% to permanent neurological dysfunction, or anaesthetic Alzheimers.


Brisk Walking Can Rebuild Your Brain

A study reported in the Journal of Gerontology followed a group of healthy, but sedentary 70-year olds who started a three hour per week of brisk walking programme:


After a half year, those in the walking group showed significant increases in brain volume, while those in the non-aerobic stretching and toning group did not. Those areas of the brain responsible for memory and information-processing that are especially prone to age related deterioration showed the greatest gains on MRI from aerobic exercise. It could even perhaps undo some of the effects of anaesthetic Alzheimers.


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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.



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Interesting questions from visitors

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You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

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