Dementia is an umbrella term
used to describe various conditions which damage brain cells and lead to a loss
of brain function over time. Dementia causes a progressive decline in a
person’s mental functioning. It is a broad term, which describes a loss of
memory, intellect, rationality, social skills and normal emotional reactions. The symptoms of dementia develop gradually over a
period of years. The progression of these diseases is largely unpredictable for
Facts in brief
Dementia has a life changing physical, emotional and
mental impact on the affected person and their primary carer and family. There
are more than 100 conditions that cause dementia. While the risk of dementia
increases with age, it is not a natural part of ageing. Dementia affects
approximately one in 20 of people aged over 65 years. This rises to one in five
in the 80 plus age group. While it is comparatively rare, dementia can affect
younger people. There are approximately 3,800 people under the age of 65 with
Younger Onset Dementia in the Ireland. A person with dementia will live for an
average of four to eight years, depending on their age at diagnosis. Alzheimer's
disease, the most common cause of dementia in Ireland, accounts for more than
50% of all cases; the second most common form is vascular dementia, which may
Risk Factors The risk factors for Alzheimer's
disease include increasing age being female, family history, head
injury, Parkinsons, hypothyroidism, exposure to dietary aluminium,
cardiovascular disease, smoking and high alcohol intake
Alzheimer’s disease progresses, various conditions develop that may lead to
death, such as septicemia, pneumonia and upper respiratory infections,
nutritional disorders, pressure sores, fractures, and wounds. In the early
stages of Alzheimer’s disease, health maintenance activities should be
encouraged including exercise, the control of high blood pressure and other
medical conditions, annual immunization against influenza, dental hygiene, and
the use of eyeglasses and hearing aids as needed. In later phases of the
disease, it is important to address basic requirements such as nutrition,
hydration, and skin care.
no straightforward test for Alzheimer’s Disease so diagnosis is difficult,
particularly in the early stages. Diagnosis is usually made by excluding other
causes such as infection, vitamin deficiency, thyroid problems, brain tumour,
depression and the side effects of drugs which all can produce similar
symptoms. Diagnosis involves a variety of medical assessments
and observations. Assessment usually includes a mini mental state examination
(MMSE). Specialists can only make a probable diagnosis. However, clinicians
with experience in memory loss are able to diagnose AD to within 80-90%
Medication can slow down progression of AD but is not a cure. Medication
should be used in conjunction with non-drug treatment options. For more
information on non-drug options, call into Whelehans or discuss with your GP. Four
drugs are approved for treatment of dementia in Alzheimer’s Disease (AD) in the
UK and Ireland. These are donezepil (ARICEPT®), galantamine (REMINYL®),
rivastigimine (EXELON®) and memantine (EBIXA®). The first
three are cholinesterase inhibitors and memantine is a NMDA receptor antagonist.
All of these drugs must be started under specialist care. All these drugs now
have less expensive but equally effective generic equivalents. These
treatments can help improve a person’s memory and enable the person to retain
new information for longer.The most
common side effects are nausea, vomiting, diarrhoea and anorexia. These can be
a particular problem because many people with AD loose weight. However,these
side effects wear off after a few weeks in most people.
Studies have demonstrated modest improvement in
cognitive symptoms with cholinesterase inhibitors. Some studies demonstrated a
beneficial effect for up to two years after starting treatment. There are no
studies of longer periods of medication but most patients can expect that, in
time, they will stop responding to treatment as the disease progresses. If the
effect wear off, some prescribers recommend a ‘drug holiday’, for example the
drug is stopped for six weeks and then started slowly again.
Donepezil has demonstrated in the short term (six months) a beneficial
effect on mood and behaviour.Rivastigmine is licensed to treat dementia in Parkinson’s disease. Exelon
4.6mg/24hr transdermal patch and Exelon 9.5mg/ 24hr transdermal patch have been
recently launched. The initial dose is 4.6mg/24hr for a minimum of four weeks,
and if tolerated, can be increased to 9.6mg/24hr which is considered the
recommended effective dose. The rivastigmine patch is considered to have fewer
side effects than the capsule version. Of the four drugs available memantine is the only one licensed to treat
moderate severe AD.
There are no guidelines to recommend one drug over
another. Donepezil and modified release galantamine only need to be taken once
a day which is convenient. Rivastigimine and memantine need to be taken more
often though memantine is often given as a single dose in the morning (ie) 2 x
10mg memantine tablets in the morning. There is also insufficient evidence to
support the use vitamin E in AD. Further studies are required to test the
benefits of Ginkgo biloba.
article is shortened for this Health Blog.. More detailed information and
leaflets is available in Whelehans or check www.whelehans.ie
Eamonn Brady is a pharmacist and the owner of Whelehans
Pharmacy, Pearse St, Mullingar. If you have any health questions e-mail them to
Find a balance between
exercise and rest. Swimming is an excellent activity because it
strengthens your muscles and joints without putting any strain on them.
Losing excess weight
will reduce the pressure on your joints.
Try to eat a healthy,
balanced diet and cut down on saturated fats.
A hot water bottle is
useful when joints feel stiff and painful; try an ice pack if they are hot
Natural medicines: are any effective?
pharmacist I am often asked what natural medicines are beneficial to those
living with arthritis including the likes of Osteoarthritis (the most common
type of arthritis and caused by wear and tear) and Rheumatoid Arthritis (the
most debilitating form of arthritis caused by severe inflammation of the
joints). For today’s talk, we don’t have the time for me to discuss all natural
medicines but I will discuss a few of the most popular ones. There are
thousands of natural and herbal pain relief products marketed in magazines,
newspapers, the internet, health food shops etc. and most have little or no
evidence and are gimmicks to help you part with your money (as when you are in
constant pain you will try anything to try relieve it). My main advice, before
try any alternative, natural or herbal product, check with a health
professional like your pharmacist or GP first as they will advise you if there
is any evidence of effectiveness and more importantly on any interactions with other
medicines you are taking or potential side effects.
Omega 3 Fish oils
oil is recommended for a healthy diet because it contains the omega-3
eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA), precursors to eicosanoids that reduce inflammation throughout the body.
of their anti-inflammatory effect they tend to be more beneficial to those
living with Rheumatoid arthritis rather than Osteoarthritis.
3 fatty acids are primarily found in oily fish such as salmon, fresh tuna, mackerel,
herring, sardines and pilchards. We should eat two portions of fish per week,
one of them oily.
I am often asked which
Omega 3 supplement is most effective for reducing inflammation and helping
ease arthritis type pain and swelling.
One I find good results
with is an Omega 3 product on the market called “Lyprinol®”.
It appears to
demonstrate quite a powerful anti-inflammatory effect and comes with none
of the fishy taste associated with traditional fish oils and side-effects
commonly seen with steroids or prescription anti-inflammatory medication
such as NSAIDs (eg) ibuprofen, diclofenac, naproxen
comes from the New Zealand Green Lipped Mussel, which has long been
recognised by the Maori people for its nutritional qualities. Lyprinol®
is said to be 200 to 300 times more inflammatory action than other fish
oils and flax seed. As a result, Lyprinol® has been shown in
research to be beneficial for arthritis and joint pain.
Flexiseq®- a new drug free gel for Osteoarthritis
Is it worth trying?
is new drug-free joint pain gel for osteoarthritis. Flexiseq® has
got a lot of attention due to comments from the likes of Arthritis Ireland and experts.
Flexiseq® was researched and
developed in Germany for the management of pain and joint stiffness in patients
with osteoarthritis.Flexiseq® is a gel
containing nanostructures called Sequessome™ vesicles, which are able to cross
the skin and target sites of pain when rubbed in. Once inside the joint, Sequessome
vesicles accumulate on the damaged cartilage forming a lubricating layer.
Research shows is benefits in relieving pain with comparable
efficacy to celecoxib, a leading prescription drug used for treating
osteoarthritis pain. Daily application in the morning and evening can
potentially give improvement in joint pain in as little as two days.
Medical device…not a drug
Flexiseq® is registered
as a medical device; thus Flexiseq® does
not contain any pharmaceutically active ingredients meaning it doesn't contain
any drugs that might interact with medication you may be taking for pain or any
John Church, CEO of
Arthritis Ireland said “We welcome any
new innovative approach to making life easier for the 450,000 people living
with osteoarthritis in Ireland.”
Conaghan, from the University of Leeds, and lead author of a major study
published in the British medical journal calledRheumatology said: “Many living with chronic osteoarthritis pain
can’t take or can’t tolerate current oral analgesics because of side effects. Referring to his study involving Flexiseq
he said “the new study is interesting
because it suggests that a novel topical therapy, that doesn't include a
topical anti-inflammatory drug, may help osteoarthritis pain”.
and chondroitin supplements
and chondroitin supplements have traditionally been used to provide pain relief
for osteoarthritis pain. These chemicals are found naturally in cartilage and
are thought to improve the condition of damaged cartilage in osteoarthritis.
They may also slow down thinning of the cartilage. However, there is not enough
evidence yet to prove that glucosamine and chondroitin help osteoarthritis. In
fact, NICE (National Institute of Clinical
Excellence) who advice the NHS in the UK on what medicines are effective,
cost effective safe etc., advise that glucosamine and chondroitin supplements
should not be allowed on NHS prescriptions due to little evidence of their
efficacy. The HSE has followed NICE’s advice and Glucosaminewastaken off the GMS list in 2012 (meaning it was no longer covered by the
medical card) with the HSE citing lack of evidence of effectiveness as the
reason to no longer allow.
and Flexiseq®, Glucosamine etc. are alternative therapies; they
should not replace conventional treatments prescribed by your doctor. It can
complement other arthritis treatments. Always consult your doctor.
For comprehensive and free health advice and information
call in to Whelehans, log on to www.whelehans.ie or dial 04493 34591.
word “Cancer” still strikes fear into the hearts of most people. Historically,
once diagnosed the thought was that the illness is terminal. However, through
the development of skills and knowledge, along with many campaigns focussed on
raising awareness, promoting lifestyle wellbeing, self-checking leading to
early detection, survival rates for most types of cancer are increasing.
is Breast Cancer Awareness Month
October is Breast Cancer
Awareness Month; to mark this Cancer
Support Sanctuary LARCC
in conjunction with Whelehans Pharmacy held a Cancer Information Event in
Whelehans Pharmacy on Tuesday October 13th. As part of this event, pharmacist
Eamonn Brady gave a talk on “Breast cancer prevention, care and aftercare” to a
full pharmacy. Ger Connaughton from LARCC was “delighted so many ladies called in
for a consultation with LARCC staff throughout the day and many booked in for
LARCC’s breast care and other cancer services in the coming weeks”. Bernie
McHugh from LARCC explained that “while LARCC advertise their services, many
people in Westmeath do not realise the full extent of the cancer support
services on offer from us on your doorstep (at LARCC’s premises at the Friary
in Multifarnham). As well as offering a range of call-in support services to
people diagnosed with cancer and their families, LARCC is the only residential
cancer care provider in Ireland. Most of our services are free of charge as we
cover most of the costs through the kind support of fundraising events and
donations. Events like our recent awareness event in Whelehans pharmacy are a
great way of informing people of our services.”
can save your life
Breast cancer is the
second most common cancer in women after skin cancer; every 3 hours a woman in
Ireland is diagnosed with breast cancer. One of the
main messages that came from the cancer awareness event was that if cancer is
caught early, most people survive. 80.6% of all women diagnosed with breast
cancer survive for 5 years or longer (and survival rates continue to increase
every year). Early detection is the key to survival. Eamonn Brady, pharmacist
from Whelehans Pharmacy emphasised during his cancer talk that “Self-checks for
breast cancer are vitally important; 74% of Irish women with breast cancer
discovered the lump themselves. You know your body better than any doctor does.”
Approximately 80% of breast
cancers occur in women over 50 years.
If you do notice any change in your breasts, see your GP
as soon as possible.Pain isn’t usually a sign of breast cancer.If you have pain in one or both breasts, rest assured it’s
probably due to hormonal changes, a benign cyst, a ligament strain or another
condition; however it is important to get unexplained pain checked by your GP.
More common warning signs of breast cancer include a
palpable lump, a change in the size or shape of the breast, puckering of the
skin, nipple changes (like scaling or discharge), or increased warmth. A mammogram (X-ray of the breast) is the most common way to check for
A breast prosthesis explained
removal of the full breast or part of the breasr (mastectomy or lumpectomy) is
one of the main treatment techniques for breast cancer. The surgery can leave
the breast scarred and a different shape and size than prior to surgery.A breast prosthesis is an artificial breast
which is worn after the mastectomy. It helps balance the body and allows a bra
to fit naturally on the side of the mastectomy and prevents potential problems
such as back and neck pain and shoulder sagging downwards which can lead to
aches and pains. In Westmeath, LARCC provide a specialist prosthesis and bra
fitting service for women who have undergone breast surgery; find out more by calling LARCC at
1890 719 719. LARCC have a specialist fitting room at their premises in
service provides you with access to a comprehensive range of products and
clothing through the support of qualified consultant fitters; many of the
products are covered on the medical card and by health insurers.
Manual Lymph Drainage
If lymph nodes removed as part of
the surgery or damaged during chemotherapy/radiation, lymphedema (swelling of
the hand and arm) may occur, even years after treatment.
Lymph Drainage (MLD) redirects fluid from
swollen areas to healthy lymphatic vessels, transporting it back to the normal
circulatory system. Specialist MLD therapists exerts different intensities of hand
pressure to increase activity of normal lymphatic vessels and to encourage the
fluid away from congested areas by bypassing ineffective or injured lymph
vessels. The treatment is very gentle and a typical session will involve
drainage of the neck, trunk, and the affected extremity (in that order),
lasting approximately 40 to 60 minutes. Specialist bandages and sleeves
may be recommended by the therapist. LARCC offer MLD with their highly
skilled therapists who see their clients on a pre-arranged appointment
basis. There is a waiting list for this service
advice and information on LARCC services, contact Cancer Support Sanctuary
LARCC at 1890 719 719 or checkwww.cancersupport.ie
For comprehensive and free health advice and information
call in to Whelehans, dial 04493 34591 or log on to www.whelehans.ie. You can also e-mail
queries to email@example.com.
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Wetter and colder winter weather means cases of
headlice increase we spend more time indoors in close proximity. Head lice
(Pediculus capitis) affects only humans, and cannot be passed on to, or caught
from animals. Head lice are common in schoolchildren, particularly between the
ages of 4 and 11, but anyone with hair can catch them. The lice are small wingless insects that feed
on blood obtained by biting the scalp. These
bites tend to be itchy and this itchiness is caused by an allergy to the lice. Female lice lay their eggs at the hair roots,
particularly near warm areas behind the ears and at the back of neck. These
eggs appear as white or white coloured grains and are best removed with a fine
comb while the hair is wet.
often causes itching of the scalp, but may also go unnoticed. If you suspect head lice, check the base of
hairs for eggs and comb the hair over a piece of white paper and the lice will
appear as pink or brown specks. Sometimes an infestation is marked by tiny red
spots on the scalp. Lice may be visible
in the hair behind the ears and at the nape of the neck as these are favourite
spots for infestations.
are transferred by close hair-to-hair contact. They cannot jump, fly or swim, but walk from
one hair to another. It is a
misconception that head lice infestation is as a result of dirty hair and poor
Lice can be
a persistent and recurring nuisance, so it is important to treat them quickly
and thoroughly. If one member of the family needs treatment it is important to
check the rest of the family and treat if live lice are seen.
is used to remove lice without using chemical treatments. This method is helpful because head lice are growing
increasingly resistant to insecticides used to remove them. The following steps are best to follow:
·Wash the hair as normal using an ordinary
·Apply conditioner liberally to wet hair (this
causes lice to lose their grip on hair).
·Comb the hair through with a normal comb first.
With a fine tooth nit comb (available in pharmacies), comb from the roots along
the complete length of the hair and after each stroke check the comb for lice
and wipe it clean. Work methodically
over the whole head for at least 30 minutes.
·Rinse the hair as normal.
·Repeat every three days for at least two weeks.
LOTION OR RINSE
Only use a
lotion if you find a living (moving) head louse. Apply the preparation
according to the instructions, and remove the lice and eggs with a fine-toothed
nit comb. Treatment should only be done
once and then repeated seven days later. There is no need to wash clothing, or
bedding, if they have come into contact with head lice. This is because head lice quickly die without
a host to provide warmth and food.
There is a
vast array of insect repellants available in pharmacies. In recent years easy
to use treatments such as Lyclear® Crème Rinse (contains lice comb
in pack) are proving popular as they involve only a 10 minute treatment. Lyclear®
Crème Rinse can be used on children over 6 months. Lyclear has a pleasant smell
and is suitable for asthmatics.
ELECTRONIC LICE COMB
is an example of an electronic lice comb. It detects and kills lice without the
need for chemicals. It uses an AA battery.
The best prevention
is normal hair care and checking yours and your family's hair and scalp
periodically. If your child has long
hair, tie it back as this helps to reduce the likelihood of contact between
their hair and that of an infected child. Regular combing of hair using the
“wet combing” method (see above) can help with early detection as well as
treatment. Repellants (available in pharmacies) may help to prevent head lice
but effectiveness is unclear.
For comprehensive and free health advice and information
call in to Whelehans, dial 04493 34591 or log on to www.whelehans.ie.
You can also e-mail queries to firstname.lastname@example.org. Find us on