Update:   14 October 2007
I.   CONTENTS: Common Ailments of Oldies simply explained on this website
II.  LINKS: Ailments of Oldies from  other websites,  only highly reputable ones
III. Medical links mainly for professionals [& a few Vet links]

I.  CONTENTS:  Common Ailments of Oldies on this website:
          Alzheimer's disease [Dementia, pre-senile & senile]: losing your mind   Update April 2007
           Arteries   Diseases of Arteries:   Coronary arteries to Heart :  Heart Attack
                                        Carotid arteries to Brain : Stroke or "Brain attack"
                                        Peripheral arteries to Legs: "Claudication";  Gangrene
             AUTOPSIES  A note on post mortem examinations: are they worth doing?
           Blood pressure   High Blood Pressure    "Hypertension"
           Bones & Joints   Osteoporosis  &  Osteoarthritis   update 25 Jun 2005
           Bowels   Older Bowels :  Constipation;  Diverticulosis    Bowel Cancer
           Brain   Losing Your Mind:   Are you getting Alzheimer's Dementia?  update 25 Jun 05
                   Stroke ["brain attack"]   Depression
           Breast cancer
           Cancer in general:  What exactly it is, types, benign & malignant, causes, who gets it
                  Breast cancer   Colon cancer   Leukaemia   Lung cancer   Myeloma   Prostate cancer Colon cancer
              Constipation  & Diverticulosis
   Death  & Dying:  Ways & Wills,   How they tell if we're dead,   How to prepare for it
    Dementia: Alzheimer's disease: losing your mind   update 25 Jun 05
    Depression
   Diabetes: what it is,  who gets it & why,  complications,  treatment
   Diabetes: a personal  account by a doctor who developed diabetes
  
       Eyes   Failing Eyesight  [link not working at present (Oct 2007)]
       Ears   Failing Hearing
       Heart   Heart Attack  [a "Coronary"]     Heart Failure     High Blood Pressure
       Leaking : Problems with your Waterworks "Incontinence"
       Leukaemia   [cancer of blood cells] in older people
       Lung cancer
   Muscles & joints    Osteoarthritis   Polymyalgia
   Myeloma  [plasmacytoma & multiple myeloma]
    Parkinson's disease: The Shakes:
   Prostate:   benign obstruction;   cancer;
   Shaking   The Shakes:  Are you getting Parkinson's disease?
    Side Effects of treatment, especially some chemotherapy  [also see Breast cancer Radiation & Hormone therapy;
         Prostate cancer Hormone therapy, & Leukaemia anti-infection therapy & Bone Marrow Transplant
   Waterworks   Leaking : Problems with your Waterworks: "Incontinence"

  

II.  LINKS: Common Ailments of Oldies on this & other websites

TOPIC         LINKS [underlined]    Articles in red are those on this website, other links in blue; links also given above

Arthritis:  (a) Osteoarthritis: Seattle:                  (b) Osteoarthritis:  Article this page, with illustrations of hip joint

Bladder leakage:  (a)  Incontinence of urine; & for bladder cancer see Cancer, (e) bladder                                 (b)  Leaking  (Incontinence of urine)

Bowel problems in oldies:  (a)   Constipation : the guts of the matter                                                (b)   Diverticulosis & Diverticulitis

Brain: Parkinson's Disease:  from the Parkinson's Institute in California               The Shakes:  are you getting Parkinson's disease                 Alzheimer's Dementia : Are you  losing your mind?

Cancer:  *What exactly cancer is, types, benign & malignant, causes, spread, who gets it                (a)  many types eg bladder, brain, breast, lung, myeloma, prostate, but not colon                (b)  many types including colon, with drawings, from American Cancer Society                (c)  many cancers from University of Pennsylvania's Cancer Center (oncolink)                (d)  from Johns Hopkins Hospital                 (e)  bladder cancer  from Cancer Info. & Support International (N.Amer)                (f)   breast cancer this website [breast ca]; breast cancer  from Cancer Info. & Support                           International breast cancer online overview  (good one, with diagrams.)                 (g)  colon cancer this website [colon ca]                (h)  leukaemia   this website  [leukaemia]                (i )  lung cancer  this website  [lung cancer]                (j)   myeloma  this website [aka multiple myeloma]                 (k)  prostate cancer this website  [prostate ca]; prostate cancer  from Cancer Info. & Support International

Deafness:   (a)  Australian directory for deafness;  Elderly hearing:   causes & cures                      (b)  hearing disorders                       (c)  hearing disability

Diabetes: (a) Canadian Diabetes Assocn.                (b) in older people       i.e. "Mature Onset Diabetes"                    (c)  U.S. link

Diet/Nutrition:  (a)  American Dietetic Association                             (b)  Mayo Clinic Nutrition Center                             (c)  US Orthopedic Assocn.,  Seattle, diet for osteoporosis

Eyesight:    (a)  Macular degeneration   by a sufferer, (Brian, with new research)  or by another sufferer (Judy)                     (b)  Conditions of Elderly Eyes  [Illustrated article this website, not working at present]                     (c)  Glaucoma & Macular degen.  [Roy. Australian College of Ophthalmologists]

Heart & Arteries:   (a)  American Heart Association                                 (b)  Canadian Learning Center for Seniors                                 (c)   Artery disease (Peripheral Vascular Disease) USA  NIH                                 (d)  Arteries: lowering cholesterol to prevent artery & heart disease                                 (e)  Article this Page:  Diseases of Arteries (the body's pipes) illustrated                                 (f)   Illustrated article on  Heart Failure

Osteoporosis: (a) Univ. of Florida                          (b)  Osteoporosis, illustrated   Article this page

Polymyalgia Rheumatica: article this website

Stroke:   (a)  this site:  stroke, illustrated to show which parts of the brain do what                (b)  from the American Heart Assocn.:                (c)  from the famous  Johns Hopkins Hospital:                (d)  a good one from  NSW Health Dept.

Waterworks: Leaking  from the Bladder ["urinary incontinence"]

III. Medical Links  mainly for Professionals [& a few Vet Links]

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Go to: Local Health Help Phone Numbers for Sydney & Eastern suburbs

Go back to Top of this Health Page    Bishy's Home Page

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ARTERIES & HEART:  Arteries [The Importance of Pipes], including
                                         Coronary arteries [block --> Heart Attack ],
                                                 Carotid & cerebral arteries to brain [block or leak --> Stroke],
                                         Femoral arteries to legs [block --> Gangrene ]
                                    High Blood Pressure,      Heart Failure

The  Importance  of  Pipes
 What  every  plumber  knows:  Of  Artery,  Pipe  &  Hose

Description of arteries, effects of arterial disease, causes, prevention, treatment & symptoms

  Main types  of Artery Problems
  Causes         "       "         "
  Prevention   "       "         "
  Treatment    "        "        "
  Symptoms    "        "        "

 I could make out a good case for your arteries being the most important structures in your body.  Without those fabulous flexible hose-pipes carrying the blood around your body, you'd be dead.  The blood transports oxygen  which keeps your cells alive, your heart pumping, your brain computing & your muscles moving.

  However you could argue that heart or lungs or brain are more important.  Without your heart to pump the blood along the arteries the oxygen would never reach its destination.  Without the lungs to take in oxygen from the air, your cells would starve.  And without your brain to think about all this and order you around you would be nothing more than a vegetable.
    Of course all these organs work together & they're all essential.

  A city has two main types of water pipes, one to supply fresh water & the other to get rid of dirty water & waste.  Similarly you have two types of blood vessels: one to transport fresh blood around the body, & the other to return the used blood to the lungs for recycling (re-charging with oxygen.)  The fresh blood is carried away from the heart by arteries, & used blood for recycling goes back to the heart via veins.  This article is just about arteries.

 The trouble with arteries, like any pipes, is that they can wear out, leak, burst, get clogged up, or become completely blocked.

    This can lead to serious problems.  The 3 main problem areas are:
1)  Coronary arteries (arteries supplying the heart muscle).  If these are blocked some of the heart muscle will die, which will result in a "heart attack".  You will get pain in the chest, & maybe down the left arm.  Your recovery will depend on the exact site & size of the blockage & how soon you are treated.
            Click underlined bit for  More details of symptoms of disease of arteries to the heart.
2)  Carotid arteries in the neck, take the blood up to the skull & continue inside the skull as cerebral arteries supplying the brain.
    [a]   If these get blocked part of the brain will die, resulting in one form of "stroke".
    [b]   Another form of stroke occurs when a cerebral artery gets weak & springs a leak, so blood spurts out like water from a hole in a garden hose.  This is a "cerebral haemorrhage".  As the brain is very soft, the consistency of baked custard, the force of spurting blood can squash & damage it.
            Click underlined bit for  More details of symptoms  of disease of arteries to the brain.
3)  The Aorta (the largest artery taking blood from the heart), femoral & popliteal arteries (taking blood to the legs & feet).  If these become narrowed so not enough blood reaches the leg muscles, you will get pain in the calves on walking ("claudication").  If not enough blood reaches the skin it will die & go black & your toes may drop off  (I'm not kidding), or even most of your foot. This is "gangrene". When I was a student (many years ago) as long as the foot wasn't infected they really did often wait for the toe to drop off, but nowadays they seldom wait, they amputate.
            Click underlined bit for  More details of symptoms  of peripheral artery disease in legs.

    There are other effects, but these 3 are the commonest.

What causes these artery problems?
   Back to the pipes.  Just as you get a build-up of black sludge on the inside of drain pipes, so you can get a build up of yellow sludge on the lining of arteries.  In human arteries the gunk is mostly fat.  The fat is mostly saturated fat, cholesterol & low density lipoproteins.  High density lipoproteins (like those in avocardos) are good for you -- they stay in the blood.  Low density lipoproteins are bigger & lighter and get swirled to the edge of the rivers of blood where they get stuck to any roughening of the pipe lining.  They come mostly from meat & dairy products.

In this diagram the large artery on the left is normal.  You can see at the top that the wall of the pipe is thin compared with the central space or "lumen" carrying red blood.  The artery in the middle is thickened by yellow fatty gunk, so that the lumen is much narrower.  This is called "atheroma" or "atherosclerosis".  Atheroma is worsened by a fatty diet.  It wouldn't take much more for this blood vessel  to become completely blocked.  The lining is now rough, & a small pink clot has got caught on a snag on the left side of the middle artery, further narrowing the lumen.
    The pipe on the right is a diagram of a small artery -- these  "arterioles"  are less than 1mm across (I have magnified it).   Its wall is relatively thick compared with the lumen.  This is what happens when you have high blood pressure ( "hypertension").  Unlike in metal pipes, in a living artery the high pressure of the blood being pumped through causes the wall to thicken  (maybe to help prevent it bursting!?)  Too much salt can make your blood pressure higher, & so can worry & stress .
    Another factor that can damage arteries is diabetes.  People with severe diabetes are much more likely to get atherosclerosis, blocked arteries, gangrene of the legs, heart attacks & strokes.  So control your diabetes.
    Another bad factor is overweight, which puts a strain on your heart, & another is nicotine, which can cause small arteries to contract & narrow, so less blood gets to the skin & muscles & organs.

So we can list 5 high causes of artery disease:
1.  High fat diet, especially saturated fats, cholesterol & low density lipoproteins
2.  High blood pressure (hypertension)
3.  High blood sugar  (diabetes)
4.  High weight (obesity)
5.  High nicotine intake  (smoking)

Prevention: What you can do about it is pretty obvious:

1. Eat less animal fat:  less fatty meat & less dairy produce, or low fat milk,  unsaturated margerine, reduced fat cheese & light yoghurt.  [Don't cut them out altogether.  You need some fat to get enough vitamins A & D.]
2.  Eat less salt.  (For goodness sake don't cut it out altogether -- you badly need salt, especially in summer or if you sweat much).
3.  Avoid stress.  Almost impossible for worriers with responsibilities for kids or at work.  But try to get away from problems regularly with some engrossing hobby.
4.  If you have diabetes, check your sugar levels.  If it is just Mature Onset Diabetes, ie it came on after  45-50 years, this should be simple.  You may be able to control it without insulin, just with diet.  Indeed it is sometimes called Non Insulin Dependent Diabetes.
5.  Give up smoking.  I know this can be terribly difficult -- the addiction is worse than with alcohol.  I kept wanting cigarettes for 3 years after stopping.
6.  Exercise for 20-30 minutes at least 3 times a week.  This is supposed to reduce stress as well as weight, but don't overdo it at first.  Exercise will certainly improve the blood supply to your heart, by gradually dilating the arteries, but it will also increase the heart's need for blood, so to be too vigorous too suddenly could be catastrophic.
7.  Have a drink [yes, an alcoholic drink] before or with dinner.  I examined thousands of bodies of patients who died in hospital, & many of them were alcoholics.  These people with shocking livers had arteries as clean as a baby's.  Maybe the alcohol disolved the fats!?  Or maybe the alcoholics just ate very little.  Whichever, a little alcohol won't hurt & may help.
    This is not just me spouting an opinion I have held for years because of a personal observation.  They suspected it 2000 years ago when Christ blessed the wine.  And now it has been confirmed by a doctor in Germany.  He studied people who had an 'angioplasty'  to widen their coronary arteries.  In those who drank no alcohol, 42%  relapsed, needing another procedure for re-narrowing of their arteries.  In those who drank some alcohol [1 bottle of wine a week worked OK] only 23% needed a 2nd procedure.  Of course Binges are bad.

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Go on to     Health Help Phone Numbers     Failing Eyesight  Failing Hearing
Osteoporosis &  Osteoarthritis    High Blood Pressure
Go back to Top of this Health Page   SeniorsA Home Page
Go to  Failing Eyesight    Failing Hearing       Osteoporosis  &  Osteoarthritis       Leaking [Waterworks problems]     Bowels
     High Blood Pressure   Heart Failure      Artery problems      Diabetes  
    The Shakes:   Parkinson's disease?    Losing Your Mind:   Alzheimer's Dementia?     Depression      Dying & Death
   Cancer  as a whole;   Breast cancer;   Prostate cancer;   Colon cancer;   Lung cancer     Leukaemia      Myeloma  
    Links  to Oldies Ailments sites

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Diagnosis: Some of the Tests that help the doctor be sure of the diagnosis
  Before he can decide on the best treatment for you, the doctor needs to know exactly where & how big the blockage is.

[1] Plain X-Rays [radiographs] are not much good for blood vessels.  They mainly showed up bones & big solid organs like liver.  You can see the shape & size of the heart, & part of the outline of the largest artery, the aorta, but not much else, & certainly not the coronary or cerebral arteries.
[2]  Angiogram was the 1st way to do this -- when I was a student it was the only way.  As most arteries don't show up on an ordinary X-Ray, they inject into your blood a dye that reflects X-Rays then take the pictures.  If you have a complete block or marked narrowing of an artery it will be well seen.  This was used for all arteries whether in the brain, heart or leg.
[3]  Ultrasound was the next development.  The ultra-sound waves bounce off materials of different consistency, so the difference between the tough wall of an artery & the fluid blood inside it can be detected on the screen & a picture taken of abnormal areas like a tube filled with solid clot instead of liquid blood.
[4]  Computerised Tomography [CT] Scans were the next advance & showed much more detail than ordinary X-rays.  They are good for demonstrating soft tissues like the brain, kidneys, & small organs like the thyroid & lymph nodes.   In the brain they will show haemorrhages of a centimetre or more where an artery has leaked, or dead areas where the blood supply has been blocked by a clot.
[5]  Nuclear Magnetic Resonance or Imaging [NMR or NMI] are even better for soft tissues, especially brain, showing up details like pictures in an anatomy textbook.  At revealing tiny abnormal areas of a few millimetres they are magic!  But still fairly recent & expensive.
[6]  Positron Emission Tomography [PET] Scans are the newest, & different in that they show up not the anatomical structure but the actual working of the brain.  Hot spots where the brain is working madly show up in one colour, & cold spots where the brain is partly resting or completely dead show up in other colours.  If a block in one of the arteries to your brain has caused a bit of brain to die, this can be detected.

Treatment: What the doctor can do about it:

1.  Prescribe medicines:
   (a)  something to stop your blood from clotting, so clots won't block the arteries.  Examples of anti-clotting agents are aspirin & warfarin.  Too much of these will make you bruise & bleed easily, & it can take some time, trial & error, to adust the dose to the individual.
   (b)  something to lower your blood pressure if it is high.  These anti-hypertensive agents also cause problems in some patients, so the first one prescribed might not suit you.  Your doctor may have to try 2 or 3 before you find the best, so have patience.
   (c)  something to decrease the fats in your blood: lipid-lowering agents.

2.  Perform surgery:

First you will have to have special X-rays: ultrasound, scan, angiograph or other "image" of your arteries [see above under Diagnosis] to find out exactly where & how badly they are clogged, to see if you are suitable for an operation.  If so they can try one of the following:

   (a)  try to stretch the artery, like stretching a shoe that is too tight.  A narrow tube with an inflatable balloon at one end is inserted through your skin, & threaded up & up till the image on the screen shows that it has reached the worst part of your artery.  When the tube reaches the narrowest part the balloon is blown up to stretch it.  This is the simplest form of angioplasty & can be done under local anaesthetic.

You may ask can the artery collapse down after the balloon is removed, or can the plaque grow again?  The answer to both questions is yes.  But there is a  device to counteract this, called a stent.  A stent can be left in the artery to prop it open, like the spokes of an umbrella prop open a brolly.  The stent, like the balloon, is not infallible, but it may give you a few extra years.

   (b)  open a slit in the artery & core it out like a plumber cleans out a pipe.  This is called endarterectomy, &  it helps some people, especially those with narrowing of the carotid arteries in the neck, taking blood up to the brain.

  
   (c)  bypass  surgery.  This means bypassing the blocked artery by putting in another pipe, either one of the patients own veins or a small artery from elsewhere which won't be missed, or a tube of some artificial fabric.  If you hear of a friend having a "triple bypass", this means they had 3 coronary arteries blocked & 3 new tubes inserted to act as a detour letting the blood through to the heart muscle.  The diagram below shows a single bypass.

 

    This has become a very common & successful operation, greatly lengthening the life of tens of thousands of Australians every year.  Most people, if they are not too ancient & don't have other serious illnesses, have 2, 3 or 4 coronary arteries done at the same operation.
    If you have any symptoms (e.g. pain in the chest or arm, pain in the legs on walking, dizziness, weakness or numbness on 1 side, breathlessness etc.)  see your doctor early before your arteries get too bad to salvage.
 

 

 

3.   Rehabilitation
        [a]     After surgery on coronary arteries.  With a big incision in your chest you won't want to move.  But you'll be given pain-killers for a couple of days, & you'll be got out of bed as soon as possible to keep you active.  The 1st couple of days it may be just sitting out of bed, then they will want you to walk, & in no time they will have you climbing steps.  When you leave hospital you will soon be expected to walk a mile a day, briskly enough to get out of breath.  All this will keep your heart pumping & stop your new arteries from blocking up.  You will be given tablets to help keep your blood from clotting.
        [b]    After a stroke.  If your parent or partner has a stroke, don't despair.  Many can be rehabilitated.  If he is unconscious for more than 18 days, he is unlikely to recover, & if he lives he may be a vegetable, unable to feed himself or communicate.  If he is unconscious for only a day or two, with intensive training he may be able to return to near normal.  You may ask: if a patch of brain cells is completely dead, how can he recover?  Do new brain cells grow in like new skin grows over a cut?  It is thought not.  But surviving brain cells can be trained to take over for those lost.
        This takes a long time, so you may need to be patient & persistent for a year or so.  It is much more difficult to teach an adult to walk than an infant.  He has further to fall & has lost all confidence, so progress may seem extremely slow.  But a good physiotherapist in a rehabilitation unit can do wonders.  Learning to speak & write again also take time, but a speech therapist can be employed, & an occupational therapist can help teach him fiddly things like feeding & dressing himself.  Doing up buttons & tying laces can be a real problem, but pull-on tops & slip on shoes may be manageable.  Even when a hand regains enough strength to hold a spoon, finding the mouth can be a great challenge if connections to the part of the brain that knew where the mouth is have been damaged.
        When I was a student, many stroke victims lay round neglected till they got pneumonia & died.  Now, with the fantastic strides in rehabilitation, most can regain an enjoyable life.
        [c]    After a leg amputation.  This has been successfully overcome for years -- at least since the 2nd World War.  But that was mostly young men.  In the last couple of decades I have seen shaky men in their seventies & eighties learn to walk down steps to the street & uphill to the shops on their artificial limb.

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Go back to  Top of this Health Page     SeniorsA Home Page
Go to  Failing Eyesight    Failing Hearing       Osteoporosis  &  Osteoarthritis       Leaking [Waterworks problems]     Bowels
     High Blood Pressure   Heart Failure      Artery problems      Diabetes  
    The Shakes:   Parkinson's disease?    Losing Your Mind:   Alzheimer's Dementia?     Depression      Dying & Death
   Cancer  as a whole;   Breast cancer;   Prostate cancer;   Colon cancer;   Lung cancer     Leukaemia      Myeloma  
    Links  to Oldies Ailments sites

 

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Symptoms of Diseases of Arteries

1.  Coronary Artery Disease:  Heart Attack

a)  Pain in the chest, sometimes spreading to neck, left shoulder or down left arm
b)  Pressure, fullness or squeezing feeling in centre of the chest
c)  Discomfort in the chest, with lightheadedness, fainting, sweating or nausea
d)  Shortness of breath or difficulty breathing, especially when lying down

If you have one of these, see your doctor immediately.  If he is not available, call an ambulance & go to a hospital emergency department.  Any one of these symptoms may be due to something else, like indigestion or a lung problem, but rule out the most serious cause at once.  Catching a heart attack early may save a life.

2. Carotid & Cerebral Artery Disease:  Stroke

The Brain & How it Works
        If you’ve seen sheep’s brains at the butchers, you’ll have an idea of what ours are like – soft and whitish like blanc mange or baked custard, with a grooved surface.  Ours are bigger & more complicated but the same consistency.  When you cut across a human brain, you see that the outer 8 millimetres or so is grey [your grey matter or “cortex”] while the rest is mostly white, with some grey patches near the centre.
        The grey matter is made up of nerve cells or “neurons.”  The white matter is made up mostly of connections between the neurons.  These fine threads are like telephone wires, conducting messages.  Like the electrical cords to toaster and jug in your kitchen, your brain wires are insulated, but not by plastic. They are encased in a fatty substance called “myelin.”  Your brain cells have innumerable connections to others in different areas.

       You see from the diagram  that different parts of the brain have entirely different functions.  There is a vertical strip down the centre of each side of the brain that controls movement which you command, like running & lifting, & at the lower end of this is a patch that controls speech.  at the back is the visual area which interprets the colour patterns from your eyes into objects you recognise like trees or friends or writing, & the front is concerned with your personality, whether you're aggressive or placid, passionate or passive.  The deepest parts in the base of the brain ["basal ganglia"] & the brainstem control involuntary movements like breathing & heart beats.
 

        If we sliced down through the middle of the brain, from ear to ear, we could see the full length of the strip which controls voluntary movement.  That on the left commands the right side of your body, and the brain on the right commands the left side.  The communicating fibres cross over in the midline, before they reach the spinal cord.  In the spinal cord they descend to the nerves supplying the muscles.  There are specific areas in the brain for each group of muscles, starting with the toes on the inner side, then moving up to knees, thighs, trunk, shoulders, arms and so on, and ending with face and mouth.
 

 Stroke
        Stroke is so called because it is sudden, laying you low at one fell swoop, at a single stroke.  It is due to a sudden destruction of part of the brain.  The two commonest causes are:

[a]  Blockage of an artery  by a clot, so life-giving oxygen can’t get to the brain cells supplied by that artery, or
[b]  Bursting of an artery, so blood spurts out with force, as from a fireman’s hose, destroying the soft brain tissue in its path.
The type & severity of the symptoms caused by these catastrophes will depend on which artery & therefore which part of the brain is damaged.

 

 

      A common place to have a blockage of the blood supply to the brain is in the middle cerebral artery.  I have drawn a diagram of this large artery with many branches to show three examples of many possible sites where a clot could obstruct the flow.  The blood is coming up from the largest part of the artery at the bottom of the diagram, & if this widest part is blocked  [labelled “3” on the diagram] the effect will be worse.  The oxygen supply to all voluntary muscle control areas will be lost, so one half of the body, leg, arm & face, will be paralysed.  Speech may also be affected.  This will depend on whether you are right or left handed, as the speech area is only on the dominant side.  Remember, the left side of the brain controls the right side of your body, so if you are right handed the left side of the brain will also control speech.  And vice versa.
        If the small branch labelled “2” on the diagram is blocked, only speech will be affected – your limbs will be OK.  If the medium sized branch labelled “1” is blocked, you won’t be able to move your arm or leg, but face & speech will be fine.  If any of these arteries are only partly blocked, so a trickle of blood can still get through, your nerves cells may not be completely killed off but just knocked out, & as the clot shrinks they may recuperate and you may recover completely.
        If you have a big haemorrhage in the middle of your brain, it can interrupt fibres coming from both sides of the grey matter, heading for the brainstem, spinal cord and nerves to the muscles, so both sides of your body may be paralysed.  Depending on the size & force of the haemorrhage, the “paralysis” may be complete loss of all ability to move muscles you wish to move, or it may be just weakness, so you can move some parts of you.  Sometimes a person who has lost all mental control of their muscles may appear to move.  This may be just an involuntary jerk, not a voluntary movement and not a hopeful sign.

 

Early warning signs: Transient Ischaemic Attack (TIA) or minor stroke:
a)  Double vision, spots in front of the eyes, sudden dimness or partial loss of vision or blindness in one eye
b)  Giddiness, spinning sensation, nausea, loss of balance, unsteadiness or falls
c)  Pins & needles, numbness or loss of feeling in 1 limb, 1 side of face or 1 side of the body
d)  Clumsiness, weakness or paralysis of 1 limb, 1 side of face, 1 side of body
e)  Hesitant, slurred or garbled speech;  difficulty talking or understanding speech
 f)  Difficulty swallowing

If you have any of these, see your doctor immediately. Even if the attack passes quickly, make an urgent appointment.  Prompt investigation & treatment may prevent a major stroke.  Most of the above symptoms may be due to something else, like giddiness due to vestibulitis (inner ear problem), but be sure to be checked for the most severe cause which is stroke.  If you or a companion suspect you may have a stroke, they should get you to a big hospital asap, as there is now a way to prevent the worst effects of stroke.  They 1st do a brain scan to see if the symptoms are due to a blockage in or a bleed from an artery, & if it is a blockage they immediately operate to get rid of the blockage.  This will avoid most of the brain damage so you will recover far more quickly & more completely.

3. Peripheral Artery Disease  (also known as Peripheral Vascular Disease or PVA)

a)  The main symptom is pain in the legs on walking, usually in the calf, but occasionally in the thigh or buttock if the artery blockage is higher up.
      At 1st the cramp-like pain only occurs when walking fast or uphill, & stops when you rest.  If the blockage gets  worse, the pain may come on even when you're walking on the flat.
      It can also be brought on by cold, or by certain medications such as some beta-blockers for high blood pressure.
b)    The blockage of an artery above the groin may also cause impotence.
c)    A severe blockage low in the leg can cause changes in the feet.
      At 1st the toes will be pale & cold,  the toenails thickened & the skin thin & dry.  If you don't do something about it, bits of skin can die, producing painful sores or ulcers, or whole toes can become discoloured bluish or black & dead -- this is gangrene.

Don't let it get to that stage.
a)  See your doctor.
b)  Look after your feet: wash daily, dry carefully & use baby oil or moisturising lotion.  Wear comfortable shoes that let in air, & loose socks or stockings with no elastic tops.

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Local  Health  Help  Phone  Numbers
Sydney &  Eastern  Suburbs

Aged  & Community Care	02-9263-3705
Aged Services Associationof NSW	02-9745-2999
Alzheimer's Association       120 Coxs Rd, North Ryde 2113	02-9805-0100
Arthritis Foundation	02-9281-1611
Asthma Foundation	02-9906-3233
Blind: Royal Blind Soc. NSW (& see Eye)       4 Mitchell St, Enfield 2136	02-9334-3333
Cancer Council of NSW       153 Darling St, Woolloomooloo 2011	02-9334-1900
Continence Foundation of Aust (NSW)	02-9840-4165
Continence Advisor: Waverley       War Memorial Hosp, Birrell St	02-9389-9800
Deaf Society of NSW (& see Hearing)       169 Macquarie St, Parramatta 2105	02-9893-8555
Diabetes Australia	02-9660-3200
Diabetes Education Centre, Randwick       Prince of Wales Hospital, Barker St	02-9382-4600
Eye Clinic NSW University (& see Sight)       Newton Bldg, Barker St, Kensington	02-9385-6424 02-9385-6426
Feet care: Thursday a.m. appointments       31-33 Spring St, Bondi Junction	02-9369-4087
Health Centre: Waverley Community      125 Birrell St	02-9389-9800
Hearing Services: Australian (& see Deaf)      175 Castlereagh St, Sydney	02-9267-8055
Hearing  " Bondi Jn: Tuesday appointments      Mill Hill Centre, 31-33 Spring St, Bondi Jn	02-9267-8055
Hearing Informatn.& Resource Centre	02-9144-7586
Heart: National Heart Foundation      Level 4, 407 Elizabeth St, Surry Hills 2010	02-9219-2444
Nurses (home visits): War Memorial Hosp                 Our Lady's Nurses of the Poor, Coogee                Nurses for the Elderly Confused	02-9389-9800 02-9665-6331 02-9389-9800
Osteoporosis Prevention Program       Prince of Wales Hospital, Randwick	02-9382-8132
Podiatry: Waverley Seniors Centre        31-33 Spring St, Bondi Junction	02-9369-4087
Sight: blind & partially sighted group (& see Eye)       31-33 Spring St, Bondi Junction	02-9369-4087
Stroke Recovery Association       RSL Club, Gray St, Bondi Junction	02-9550-0594
Stroke Support Group: Wednesday p.m.       War Memorial Hospital, Waverley	02-9387-1166

This is by no means a complete list.  More numbers will be found on the Waverley Council website under Waverley Library & Community Services published directories:  A Directory of Services for Older People.  That includes phone numbers & addresses (but no web sites) for:

Hospitals in Eastern Suburbs, public & private
Counselling Services: Bereavement & Relationships
Chronic Pain Association
Parkinson's Syndrome Society
Technical aids for disabled
Conditions not particularly related to the older age group, eg

Drug & Alcohol Counselling & Support
Mental Health & Intellectual Disability
Amputee Association
Colostomy Rehabilitation
Epilepsy Association
Kidney Foundation
Multiple Sclerosis Society
Quadriplegic Association . . .  & others (most in above table.)

Link:  http://www.euthanasia.org/
The Voluntary Euthanasia Society in UK gives an excellent example of a living will you could print out, sign & have witnessed, or alter according to your own wishes.  It makes the good point that you should acquaint your GP or other doctor & perhaps your most trusted & compatible relative, friend or neighbour with your wishes.  Before you cite their names in your living will, make sure they agree with you and are not a closet catholic or rabid “right-to-lifer”.  The site gives much information, & U.K., U.S., Jewish & other links.

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