Reduced sense of taste and smell

While everyone else is enjoying their meal, you’re the only one asking for a multitude of condiments to be passed. Or you notice that the foods that you’ve always loved don’t excite you anymore. Ageing may reduce your sensitivity to taste, because as you age, the number of taste buds on the tongue decreases. Also, your sense of smell plays a role in how you taste your food. The aroma of the food sends a signal to your taste buds to secrete more saliva. If this is not happening, your mouth produces less saliva and this causes dry mouth, which in turn can affect your sense of taste.

People who experience diminished taste and smell often get depressed, as food no longer has the joy it once held. The most appetising foods seem unappealing; and if you add excessive salt or sugar to compensate for the loss of taste it may wreak havoc with your blood sugar levels and blood pressure too [if you have hypertension]. Loss of taste can also cause a nutrition deficiency as you no longer have the desire to eat. Besides, you become unable to detect if the food has gone bad.

How you can beat it

• Get regular flu shots to keeps respiratory infections away
• Your medication might be altering your sense of taste; have your doctor adjust the dose or substitute it with something else
• Avoid allergens like pet dander, grass, dust and others
• Stopping or reducing smoking can significantly restore your sense of taste
• Instead of adding more salt or sugar, use herbs and natural sweeteners to add more flavour to your food
• Certain foods taste better when they are eaten either hot or cold; have your food warmer or cooler for enhanced taste
• Maintain impeccable oral hygiene and give immediate attention to any dental problems.

Emotional problems

It is fairly common for older people to have emotional problems [which can often be mistaken for dementia]. As people gear up to face retirement, some of them believe that their remaining years will be an unending saga of gloom and doom. They may get upset, melancholic, lonely or bored. Also, as their children move to other cities or the grandchildren get busier with their school and college schedules, seniors may get a feeling of being redundant or may experience the empty nest syndrome.

Depression is worse still for people who are grieving over the loss of a loved one or who have been given a serious medical diagnosis.

How you can beat it

• Stay social; emotional problems can be eased by the support of the people around you. If possible, live close to your family
• Visit friends regularly
• Join a book club or dance class. Many communities have a senior-citizens group, which organises weekly events, classes and other activities for seniors
• Get professional help from a doctor or counsellor if you feel the need

Slow reflexes, reduced alertness and dullness of memory

As we age, we find it difficult to articulate our thoughts and might say “toasted peanuts” when we mean “roasted peanuts”. But if you say “purple curtains” when you really mean “roasted peanuts”, then that is a sign to watch out for, as it can indicate memory decline at best or a stroke at worst.

The recall ability in old age is affected because of the decreased blood flow to the brain. Also our bodies become less efficient at absorbing brain-enhancing nutrients, which leads to changes in cognitive skills. You may notice that you’re dropping things more often while working in the kitchen or that driving has become a problem for you.

How you can beat it

• Challenge your brain with crosswords, Sudoku or other puzzles
• Play games like chess, Jenga, scrabble or others that involve strategy
• Learn a new language, an instrument, driving route or recipe
• Read books, newspapers and magazines
• Work on projects that require you to plan and design them. Quilting, knitting clothes, starting a terrace garden are just a few ideas for you.

Urinary incontinence

This is a fairly common but very embarrassing problem for both men and women. Incontinence can range in severity from passing urine when sneezing, coughing or laughing to getting the urge to urinate so badly that you can’t get to a toilet in time. Most underlying causes are simple and easily treatable.

How you can beat it

• You can learn to re-train your bladder: Make a note of the timings when you urinate and when you leak and see if there’s a pattern. Accordingly you ‘train’ your bladder by emptying it before an incident can occur
• Do Kegel exercises to strengthen your pelvic floor
• Your doctor might prescribe a device called a pessary to reposition the urethra
• Injections, medication and surgery are some of the other ways to rectify this.

Loss of balance/dizziness

Our sense of balance is something that we take for granted. Constant falling is often due to a loss of balance, which is brought about by lack of co-ordination between eye-sight and hearing. Light-headedness, dizziness and a mild to violent spinning sensation [vertigo] are some of the symptoms you need to look out for.

Loss of balance can have a variety of causes: inner ear disorders, central nervous system disorders, low blood sugar, side effects of medication, infection, cardiac problems [including low or high blood pressure], or a poorly balanced diet. If you have difficulty walking or standing on soft or uneven surfaces, it could be the result of age-related, weakened inner ear function. Falling should not be dismissed as just another effect of ageing, but should be looked into as it can be cured.

How you can beat it

• Practise balancing exercises like yoga and T’ai Chi
• Regular walks are also beneficial to maintain balance
• Ensure that the floors of your house are free of clutter
• Put in a good lighting system and fit handrails around the house
• Place anti-skid mats in your bathroom and keep it as dry as possible
• While getting up from a lying down position, avoid doing so with a jerk or with haste.

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It is more common among middle-aged women than men. Among women, it is specifically found in those who have never conceived, or those who have given birth recently.

Since it affects people in the age group of 35 – 40, the repercussions are seen in all areas of life: work, personal, family, social.  In women, it may also affect their decision to have children.

Symptoms

The symptoms of the disease develop over weeks or months. Occasionally, they may be acute in nature.

• The joints are swollen, painful and stiff on waking up. The stiffness lasts for more than 30 minutes. The spine is not involved except for the neck area.
• Frequent fever, fatigue and weakness.
• Skin becomes red, dry and flaky. Nails also get discoloured and break easily.
• Muscles around the joints begin to shrink, thereby leading to difficulty in movement. Swelling and inflammation
  in the muscle and joint area further reduces movement.
• Haemoglobin levels take a dip, resulting in spells of dizziness and fainting.
• Swelling and dryness of the eyes is also common.
• One of the strongest signs of rheumatoid arthritis [RA] going out of control is the development of digestive problems.
• Diagnosis

It is sometimes difficult to be detected in its early stages because there is no single test for the disease. In addition, symptoms differ from person to person and can be more severe in some people than in others. The Rheumatoid factor test, which is done commonly for the diagnosis of RA, is not always accurate. There are many patients with rheumatoid factor negative but still develop RA. On the other hand, the rheumatoid factor test can be positive in a normal person who shows no symptoms of the disease. Hence, it is best to consult a rheumatologist for the correct diagnosis and treatment.

Causes

Family history:  Members of families that have human leukocyte antigen [HLA] gene have a higher risk of developing RA. However, it is not necessary that everyone with HLA will get the condition.

Age-related: Ageing is a natural cause, due to which there is weakening of the bones.

Overweight and obesity: Excess body weight puts too much pressure on joints, thereby increasing the risk of developing RA. Also, once the disease develops, the medication is less effective in those who are overweight.

Repeated injury to joints: Frequent injury to joints weakens them over time. This can hamper strength and mobility. It is important to use cushioning pads while doing any activity that may cause pressure on joints, like exercising or playing sports.

Lack of exercise: An immobile and lethargic body is an open invitation to rheumatoid arthritis. Your body is like a machine that needs to be constantly kept running in order to function smoothly and keep itself free of problems.

Unhealthy eating habits: Excess intake of protein, fat, calcium, alcohol or junk food should be avoided in order to keep rheumatoid arthritis at bay.

There is no one form of treatment for RA that can be prescribed to everyone. Patients need to consult a rheumatologist to find the right combination of drugs best suited to them. The treatment needs to be monitored and taken on a regular and continuous basis. Although there is no cure for RA, the disease can be well controlled, and the patient can lead a pain-free life.

This was first published in the November 2013 issue of Complete Wellbeing.

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8 symptoms that warrant a visit to your doctor

1. Pain on left side of chest

Pain or heaviness on the left side of your chest should not be taken lightly. Especially if it is accompanied with breathlessness and heavy sweating. Agreed, that it may be due to increased acidity…but it could even indicate a cardiac condition. At times, the pain may even be in the centre of the chest and radiate towards the left arm or the back. In either case, seek a medical opinion to rule out doubts. Don’t hesitate if the doctor recommends an ECG or a stress test.

2. Breathlessness

A sudden difficulty in breathing or breathlessness when lying down is a warning sign of asthma or heart disorders. Even a slight tightness around the chest that gets relieved by leaning forward or sitting upright hints a respiratory condition.

3. Fever

Body temperature over 102 degree Celsius should be reported to your doctor. Fever associated with bleeding [from anywhere in the body], rash, breathlessness, a wound that’s taking too long to heal, decreased urination, jaundice, irrelevant talk or incessant vomiting, means serious illness and should be looked into immediately. Even if the fever isn’t high but has been recurring [especially in the evenings], visit a doctor.

4. Headache

Headaches of considerable intensity that are fairly recurrent aren’t normal. If the throbbing feels like ‘the worst headache of your life’ or if it wakes you up from sleep, it could be a symptom of haemorrhage or a tumour. If the headache is accompanied by vomiting, dizziness or fainting spells, waste no time in getting medical attention.

5. Weakness of limbs, slurring of speech or temporary blindness in any eye

These are ominous signs of a stroke. Symptoms disappear within minutes leading you to think that it’s nothing serious. Dizziness and confusion could also indicate a stroke, which can be prevented with early intervention.

6. Change in bowel habits

If the colour, consistency or frequency of your stools has changed, consult your physician. A dull pain in the abdomen or a sudden increase in the abdominal girth, could indicate a tumour or an intestinal disease.

7. Persistent cough

Cough [whether dry or with discharge] that lasts longer than a month and does not respond to regular medication should be investigated to rule out tuberculosis. Similarly, presence of blood in cough should be immediately treated. The blood could be from a chest infection or even from the stomach.

8. Swelling in the feet or hands

Regular swelling of hands, feet or fingers in the morning could be due to a heart or a kidney disorder.

This was first published in the July 2012 issue of Complete Wellbeing magazine.

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You know it’s malaria if you have…

• Fever with shivering that comes in a cyclical pattern.
• Shaking chills and fever, followed by sweating lasting for 4–6 hours is a classical sign of malaria. It occurs either every two days or three days depending on the parasite involved.
• Severe joint pain and backache
• Vomiting
• Drop in haemoglobin
• Heamoglobinuria [Blood in urine]
• Cough
• Headache.

Pfalciparum malaria can give rise to bleeding problems, shock, liver or kidney failure, central nervous system problems and coma. Its complications can be fatal. Cerebral malaria [coma, altered mental status or seizures] can also occur if the P falciparum infection is severe. Pregnant women and young children are at a higher risk than the rest of the population.

Diagnosis

The period between the mosquito bite and the onset of the malarial illness is usually 7–21 days. Since symptoms of other diseases are similar to malaria, doctors need to conduct special tests to diagnose malaria. Usually, a blood test called as peripheral smear is done to check for presence of the parasites.

Managing malaria

Prompt diagnosis and correct treatment is extremely important. There are three main factors that determine the course of malaria treatment; the type of infecting parasite, the age and general health of the patient, and the drug-susceptibility of the infecting parasites. Drug treatment usually lasts for about 7 days.

Prevention

The best way to prevent malaria is to keep mosquitoes away. If you can, sleep in a room with mosquito-preventing screens on the windows and doors or use a mosquito net over your bed. Mosquito nets particularly help when you are travelling.

During the evening, wear light-coloured pants and shirts with long sleeves. Avoid going outdoors without protection in the evening as that is the time when mosquitoes are most active. Using a mosquito repellent cream also helps.

According to the World Health Organization [WHO], an estimated 30,000 international travellers get malaria every year. If you are travelling to a destination where malaria is prevalent, take preventive medicine. Consult your doctor to decide the exact course of medicines.

Another often ignored aspect in prevention is education. Research shows that education in recognising the symptoms of malaria has reduced the number of cases by 20 per cent in some areas of the developing world. Identifying the disease in the early stages can also stop its progress.

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Women are diagnosed with CFS far more often than men. However, it’s unclear whether chronic fatigue syndrome affects women more frequently or if women report it more often than men. CFS is most common in people in their 40s and 50s, but it can affect people of all ages.

It has several other names like vapours, neurasthenia, effort syndrome, multiple chemical sensitivity syndrome, chronic monodies and post viral fatigue syndrome.

Symptoms

It is characterised by:

• Fatigue
• Difficulty in concentrating
• Headache
• Sore throat
• Swelling of the tender lymph node
• Muscle and joint pain
• Feverishness
• Difficulty sleeping
• Psychiatric problems
• Allergies
• Abdominal cramps
• Weight loss
• Chest pain, weight gain, rash, night sweats [rare symptoms].

Causes

Of all chronic illnesses, chronic fatigue syndrome is one of the most mysterious. Unlike definite infections, it has no clear cause. Several possible causes have been proposed, including:

• Depression
• Iron deficiency anaemia
• Low blood sugar [hypoglycaemia]
• History of allergies
• Virus infection, such as Epstein-Barr virus or human herpes virus 6
• Dysfunction of the immune system
• Changes in the levels of hormones produced in the hypothalamus, pituitary glands or adrenal glands
• Mild, chronic low blood pressure [hypotension]

Medical intervention

Fatigue can be a symptom of many illnesses, such as infections or psychological disorders. In general, see your doctor if you have persistent or excessive fatigue.

Severe fatigue that prevents you from fully participating in activities at home, work or school may be a symptom of an underlying medical problem.

Complications

Possible complications of CFS are:

• Depression, related both to symptoms and lack of diagnosis
• Side-effects and adverse reactions related to medication treatments
• Side-effects and adverse reactions associated with lack of activity [de-conditioning]
• Social isolation caused by fatigue
• Lifestyle restrictions
• Missing work.

Treatment

There is no specific for CFS and treatment generally aims to relieve symptoms.

1. Slow down and avoid excessive physical and psychological stress. Your goal should be to maintain a moderate level of daily activity and gently increase your stamina over time.
2. Through cognitive behaviour therapy, a mental health professional helps identify negative beliefs and behaviours that might be delaying your recovery and replace them with healthy, positive ones.
3. Anti-inflammatory drugs alleviate headache, diffuse pain and feverishness.
4. Anti-allergic and decongestant take care of allergic [cold] rhinitis and sinusitis.
   Thus, a comprehensive approach to physical, psychological and social aspects of wellbeing is most useful.

This was first published in the February 2009 issue of Complete Wellbeing.

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