Sudden onset of illness in old age, By Sylvester Ikhisemojie

Opinion

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Last week, we discussed how to maintain a moderate weight amongst middle-aged people. This week, we are exploring the spectre of sudden ill health appearing without warning in people aged 50 years and above. Some of these ailments can announce their presence painfully. One of the most common of these ailments is stroke. We have discussed various types of strokes on this page in the past and it is worthwhile to emphasise the fact that a stroke occurs when there has been a sudden reduction or complete blockage of the flow of blood to certain parts of the brain. When this happens, certain brain cells begin to die. Consequent upon this, there will be weakness in the face, hands or legs. Then there may be confusion, loss of bearings and difficulty with speaking, and after this, a person can slip into unconsciousness and even death. The refrain will be all too familiar as many people would recall after the demise of the individual that they interacted with the person hours or days before the sad news. The likelihood of a crisis like this is greatly diminished by engaging in some of the things we discussed last Sunday as being incredibly beneficial to the sustenance of good health. Basically, the advice can certainly bear repetition: keep your blood pressure in check, manage your stress with responsibility, engage in regular and moderate exercise, eat a low cholesterol meal and stop cigarette smoking.

Another common disease condition seen in this age group is the formation of gallstones. This is more common in women and there can be associated debilitating upper abdominal pain with fever and jaundice. Gallstones are hardened bits of bile, the green fluid produced and stored in the gallbladder that helps the body to get rid of some of its waste, and to digest certain types of food. These stones can vary in size, from a grain of sand to a golf ball. You are more likely to have this condition if you are obese or have diabetes or if you do not exercise. On the whole, it is far more common in women who are at least a decade younger than 50 years and are often described as fat, fertile, fair in complexion, female and forty. This problem might have been developing over several months without any indication of its presence except as an incidental finding while examining someone for an entirely different problem. In middle age, however, especially among those people who are at a high risk for developing the condition, the pain can begin quite suddenly and be followed up rapidly by fever, chills and rigors and the onset of vomiting and jaundice. It is quite possible, therefore, that one person who was seen to be in good health only the previous evening suddenly takes ill with the above sequelae of events taking place in rapid sequence. On many occasions, even a problem such as gallstones will often mask something more serious such as cancer. That is a life-changing diagnosis.

Another common problem in this age group is the impact of slipping and falling. Usually, the consequences are severe, and these range from the risk of sustaining fractures to the extreme danger of falling down and hitting the head on some hard object that can imperil or end life. At this age, the bones have lost much of their girth and mineral integrity and have weakened somewhat. Therefore, they are brittle and can easily fracture. Calcium and vitamin D supplementation in the form of pills can help slow the rate of degeneration of these bones. Therefore, there needs to be the professional expertise to rapidly fix such bones, the absence of which leads to many complications, loss of limb and even eventual loss of life. Many of these falls occur within the home, such as within bathrooms or on the staircase or on any wet floor within the house. Such falls can also occur outdoors with significant degrees of injury. While some of these people can afford the cost of their treatment, there are others who cannot afford even the cost of a consultation at a hospital, not to mention the entire range of therapies that can ensue from having an operation to physiotherapy. As it is with such bony injuries, so it is with cancer, and the diagnosis of any single type of cancer common at this age, from ovarian and cervical cancer in women to prostate and brain cancers in men, is certain to be dramatic. Other conditions like multiple myeloma, malignant melanoma, colon cancer and kidney cancer are also prevalent in this age group.

Another common condition often seen among seniors that can occur suddenly with the threat of life-changing drama is a heart attack. We have also explored this phenomenon in the last few months, and it is important to remember that some of the features of this condition are chest pain, shortness of breath and chest pain that often radiates to the back, shoulders and neck. There may also be sweating, dizziness and nausea but we now know that the likelihood of suffering from this particular problem is reduced when you maintain a healthy weight, conduct moderate and regular exercises and avoid cigarette smoking.

One of the most dramatic events that can occur among people of this age is the spectre of suffering a detached retina. The retina is that part of the eye that perceives light and transmits what it receives to the brain where these lights are processed into images. So, if it separates from the outer wall of the eyeball, it will have its oxygen supply cut off and blindness can ensue with great speed. You might see floating specks or flashes of light. This is more common in people who are short-sighted or have had cataract surgery or suffer from some other eye diseases. It is a genuine emergency for which immediate consultation with the appropriate doctor is needed, but due to a combination of ignorance, superstition and lack of healthcare facilities, a situation like this will be attributed to witchcraft in many parts of our country. This reminds one of a community with so many old people suffering from cataracts. Most of these people were emphatic that it was normal to have cataracts in old age.

One other malady that tends to be common among seniors is the development of kidney stones. This is more common in men than in women. It is made up of calcium balls that become hard and lumpy like stones. Usually, most of these are small and are passed out of the body harmlessly. Sometimes, they form into big stones that cause immense pain, block the flow of urine and cause the development of urinary infections. Some of these have jagged edges and can cause bleeding with the result that such blood appears in the urine. These stones can largely be prevented by drinking adequate water and other fluids each day.

Related to this condition in some way is gout, a condition that causes sudden pain and swelling in one of the joints of the foot, usually the big toe. This is a type of arthritis caused by the build-up of uric acid in the blood. If you take certain types of anti-hypertensive medicines or you are a frequent alcohol drinker and you eat red meat, you are at risk of developing this condition. The excessive consumption of fructose, a type of sweetener found in fruits, and a state of obesity increases a person’s risk of coming down with gout. Finally, elderly people are more likely to come down with pneumonia, especially the variant caused by bacteria. This is true because the body’s immune system is more likely to reduce in integrity with advancing age and is thus less able to fend off certain types of infections.

The threat is so real that in the United States, the Centres for Disease Control and Prevention advocates that people aged more than 65 years should take the pneumococcal vaccine, which is effective in preventing pneumococcal pneumonia. That kind of pneumonia is one which can be life-threatening.

Credit: Dr. Sylvester Ikhisemojie

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