Sunday Gazette-Mail from Charleston, West Virginia on June 29, 1975 · Page 121
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June 29, 1975

Sunday Gazette-Mail from Charleston, West Virginia · Page 121

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Charleston, West Virginia
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Sunday, June 29, 1975
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Page 121
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W hen he was admitted to a New York hospital recently at the age of 66, a once-prominent judge was believed to be hopelessly senile. For two years, he had deteriorated rapidly, becoming confused and disoriented, experiencing large memory deficiencies* and developing suspicions that people were falsely accusing him of crimes. Several doctors had only shrugged: "At his age ... senility. .. from hardening of brain arteries . . . nothing much to be done." His family had come to believe it--almost. Yet, in the hospital, thorough diagnostic studies showed that the problem wasn't brain.artery hardening at all but rather hydrocephalus--"water on the brain/' Forty-eight hours after an operation to .correct the hydrocephalus, the ex-judge was alert, cheerful, oriented, functioning normally. Treatable conditions There should be many others like this .fortunate patient. Although many fam-~ ilies---and many physicians as well-do not realize it, new developments in medical research have revealed that "senility" isrtoo often no real diagnosis at all but only a disposal category, and that treatable conditions often masquerade as "aiteriosclerptic: senility." They ve shown that even when arteriosclerosis is present, much still can be done. Many physicians not-content to ,be merely "clinical undertakers" for the elderly have'been demonstrating that often even serious debilitating and crippling physical ills can be treated effectively if only the" effort is made--^ . using ^exactly the same methods that would be used to treat similar problems .in. younger people. ~ " The discovery of hydrocephalus in older people js recent. Although, easy to detect in -infants whose still-soft skulls enlarge with excess cerebrpspinal fluid, the condition isn't obvious at all in the rigid skull of an adult. Sophisticated diagnostic techniques now are revealing that it is surprisingly common in older people. ,jube in brain ; So effective is its correction by much the same, surgical procedure used for hydrocephalic infants--inserting a tube in the brain to carry the cerebrospinal fluid around the blockage--that Dr. A; J.; Luessenhop, chief of neurological surgery at Georgetown University, says: · "For the first time, we. can look over those patients who have been abandoned to a life of dependency and pluck them back from oblivion." Hydrocephalus isn't the only correctable cause, of seeming senility! Poor nutrition for the brain--with or without artery hardening--is another. An older person may have a heart too weak to pump enough blood to- the brain or may be suffering from an undiagnosed anemia.,' Sometimes, both conditions are present. When the by Lawrence Gallon New medical treatments enable the elderly--even those once regarded as incurable--to overcome ailments and regain former alertness^ Here a patient recovering from an illness ta/fcs to a nurse at Montefiore Hospital in New'York. pumping action of the heart is strengthened by a drug like digitalis and the anemia corrected (with iron, a vitamin, or other measures), dramatic improvement may follow. Recently, Dr. Arthur C Walsh, professor of psychiatry at the University of Pittsburgh, has treated patients with otherwise unyielding senile dementia with dicumarol, a drug to thin the blood. With such thinning, morejilood may get through narrowed brain arteries to deprived brain areas. Almost wherever physicians with a will to help the elderly look, they find ways to do so. At the University o f ' North Carolina, investigators-have been showing that thyroid gland disturbances, often readily correctable, can produce many senility-like symptoms. . At other centers, a discovery has been made that should have been obvious long ago: that mental, depression, common in the young, is also very common in the elderly, and can contribute to seeming senility. In Wheeling, W. Va., a 78-year-old woman had become increasingly withdrawn and apathetic She spent most of her time sitting and staring, had to be told to eat and to go to bed. Her children were almost certain she was suffering from progressive artery hardening--until finally an alert physician recognized that she was, in fact, severely depressed. A series of electroshock treatments led to a dramatic change within a few weeks. Less radical treatment in-such cases includes drugs and brief psychiatric sessions.-; Given a vigorous diagnostic effort, some seemingly baffling physical pror lems of older people can be solved. At the Virginia Mason Clinic in Seattle, physicians realized they were seeing a substantial number of older patients who had the same mysterious symptoms: crippling muscular pain, weakness, and low-grade fever. All shared just one detectable abnormality: routine blood tests revealed high blood sedimentation rates. That suggested inflammation somewhere. ./·'. It occurred to the physicians^that they might be dealing with something that had already received attention in Europe--giant cell arteritis, an inflammation affecting arteries. When predni- sone, a drug'to combat inflammation, was tried, one patient within 48 hours -reported feeling "perfectly well"; within three days, another was out of a wheelchair; on average, all were free of symptoms and bade at regular activities within one" or two months. Falls are halted In Chicago, a 73-year-old woman began to suffer from falls--while waiting for a bus, while standing in her kitchen, at other times. Doctors at Michael Reese and Rush Presbyterian SL Luke's Medical Centers reported the solution for her and for a who|e series of patients like her. they found that all had Parkinsdnism (shaking palsy) but none had been so diagnosed before because they had none of the classical signs such as stooped, shuffling gait, shaking of hands, pill-rolling motion of fingers. In every one, the falls stopped promptly on treatment with one or the other of two drugs, L-dopa and amantadine, regularly used for Parkinsonism. Vigorous treatment for such problems of the elderly as crippling, ar- v thritis and heart disease has also produced gratifying results. Recently, at medical centers in Texas, California and, elsewhere, patients If), 80 and* older with crippling heart disease unresponsive to medication have been treated surgically. They've come through the operation and benefited virtually as much as the younger patients--despite a common notion, even among many medical men, that advanced age makes surgery too risky. Successful operations When almost any kind of surgery is indicated for an older person, the outlook often is excellent. At Henry Ford Hospital in Detroit, in hernia operations on 200 patients 70 years and older, including one who was 92 and one 93, successful repair was achieved in 98 per cent In a Louisiana community, of 131 elderly persons Undergoing surgery for gallbladder disease arid in some cases requiring multiple procedures, 98 per cent experienced marked improvement or complete recovery. But-such cases are still too exceptional. What stands in the way? In the course of several-years of research for my new book for Crown Publishers, Don't Give Up on an Aging Parent, I talked to many physicians who go all-out to help the elderly.' They recognize that too many physicians have had the wrong attitude toward dealing with the aged. "We often act as though the passing of a 65th birthday automatically relegates a person to a mothball existence." Among the reasons: great gaps in the education _of physicians about treatment of the elderly; a feeling of many doctors that it is not rewarding to treat the elderly who have conditions that don't yield to quick cures even though they may be controllable. '·'* Doctors involved But there are bright spots in the picture. A Congressional committee survey a few years ago found no mention whatever of medical care for the elderly in the catalogs of 51 out of 99 medical schools and only 15 of more than 20,000 faculty members identified primarily with the field of aging. Today, . medical curricula are being changed. More and: more physicians are ents- ing the field-of geriatrics. A National Advisory Council on Geriatric Medical Programs has been organized to stimulate special training. Many medical centers are establishing geriatric departments. Hardly less important is the need for awareness by the elderly, their concerned families, and in fact all of us who some day will be elderly ourselves. Effective treatment for the aged is possible if people insistpn getting it

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