MedFriendly Message Board: The Largest in the World

Loss of self-care/incontinence and Korsakoff's

JamesBryan — Fri, 11 Sep 2009 18:06:28 GMT

I have an eval going w/ 68 yo fellow 9th grade ed, no employment hx, dependent on family lifelong, no medical/clinical/or education records. Poor historian, no good collateral info. No other clinical hx.

He cites old hx of heavy drinking w/ Rx for Antabuse at one point, has had 3 DUIIS and license permanently suspended. Denies etoh in 3 yrs.

He comes in just a mess, malodorous, grossly neglected grooming/hygiene/attire, mucous running from nose, comes back from restroom break w/ sweatpants soaked.

No indication of malingering. Npsych testing indicates dementia, not of Alzheimer's nature. Main question -- how likely is this self-neglect to be associated w/ possible Korsakoff's? I'm thinking it is. Thanks Jim

Forum: Cognitive impairment and dementia

SSRI anticholinergic effects?

JamesBryan — Fri, 11 Sep 2009 02:56:32 GMT

Hi Dominic et al, Revisiting this topic, to what extent might SSRIs be contra-indicated in dementia cases due to anti-cholinergic effects -- if any? My understanding is that the effect is mild, compared to tricyclics. Jim

Forum: Antidepressants

Controlling social phobia

trishtrash — Sat, 22 Aug 2009 08:42:21 GMT

I'm looking to talk to anyone who suffers, or has completely recovered from social phobia. I have suffered random attacks for over 10 years now, & have still to learn how to recognise or control these attacks. They are crippling my life, to the point that I no longer speak to family & have only 1 friend I trust. I seem unable to move forward & change.

Forum: Phobias - social

Manic episodes

helen39on — Mon, 10 Aug 2009 04:17:55 GMT

My daughter is in the throes of a manic episode at present. Her doctor told her husband that the last time she had blood work done (a week before she took off for the 'big' city) the levels of divalproex were within acceptable limits so why the manic episode?

Forum: Bipolar I disorder

Stuttering and Asperger's--and connections?

Mainelyneuropsych — Wed, 17 Jun 2009 21:20:12 GMT

I've just seen someone who has Asperger's Disorder and also severe stuttering. They seem to think these can be linked. First I've heard of this. Can anyone point me to sources of informaiton on this topic?

Forum: Stuttering

Sexless marriages sometimes OK?

Mainelyneuropsych — Fri, 05 Jun 2009 16:36:40 GMT

http://well.blogs.nytimes.com/2009/06/03/when-sex-leaves-the-marriage/

"Married people under 30 have sex about 111 times a year. And its estimated that about 15 percent of married couples have not had sex with their spouse in the last six months to one year..."

Forum: General

Medical bills & bankruptcy in MS

Mainelyneuropsych — Fri, 05 Jun 2009 16:34:13 GMT

http://well.blogs.nytimes.com/2009/06/04/medical-bills-cause-most-bankruptcies/

"The health problems that left patients with the highest out-of-pocket expenses were ranked as follows:
Neurologic (i.e., multiple sclerosis): $34,167..."

"Among families who were bankrupted by illness, those with private insurance reported average medical bills of $17,749 compared to those who were uninsured, who faced an average of $26,971 in medical costs. Those who had health insurance but lost it in the course of their illness reported average medical bills of $22,568..."

Forum: General

Republica pledge to keep fighting universal healthcare

Mainelyneuropsych — Fri, 05 Jun 2009 16:30:50 GMT

http://www.nytimes.com/2009/06/05/us/politics/05health.html?hpw

If Obama doesn't cooperate, they warn, Republicans will fight to the death against health insurance for all Americans--"you saw what happened on Hillarycare, and this will be just as bad, exclaimed Warren Hatch.

Forum: Universal health care

Sunburned = doomed to cancer??

Mainelyneuropsych — Fri, 05 Jun 2009 16:19:31 GMT

http://consults.blogs.nytimes.com/2009/06/05/sunburned-as-children-doomed-as-adults/?hp

Dr. Steven Wang addresses this question.
"Severe sunburns as a child certainly increase an individuals risk for developing skin cancer. However..."

He is director of Dermatologic Surgery and Dermatology and Memorial Sloan-Kettering Cancer Center in Basking Ridge, N.J.

Forum: Prevention

Should Health Insurance Be Mandatory?

Mainelyneuropsych — Fri, 05 Jun 2009 16:15:23 GMT

http://roomfordebate.blogs.nytimes.com/2009/06/04/should-health-insurance-be-mandatory/

"President Barack Obama said this week (June 4 2009) that he is now open to Congressional proposals that would make every American responsible for getting health care insurance. In a letter to Senators Edward Kennedy and Max Baucus, he wrote that employers would have to share in the cost and that there would have to be a hardship waiver for those who could not afford insurance.

"During the campaign last year, he opposed such a broad individual mandate, which Hillary Rodham Clinton supported. At that time, he argued for a more incremental approach, requiring that children be covered first.

"Is a broad mandate that Americans have medical insurance a workable way to begin health care reform? Would taking a bolder step be more efficient or more disruptive?"

Follow the link to some rather divergent views on this heated topic.

Forum: General

The Distractable Kind.

phyxius — Sun, 31 May 2009 17:21:17 GMT

That is the type I have. It makes it really hard to get stuff done. Anyone have any suggestions on ways to get motivated?

Forum: Treatment - behavioral

A Higher Power

phyxius — Sun, 31 May 2009 17:19:37 GMT

I tried the 12 step thing when I wanted to stop drinking. Around here A Higher Power means Jesus and Only Jesus. It kind of turned me off. Plus the people at the meetings were ones I wouldn't have associated with even as a drinking buddy. I did try Rational Recovery. That kind of worked. For awhile.

Forum: 12-step approach

Stupic Psychiatrist?

Mainelyneuropsych — Sun, 31 May 2009 12:07:00 GMT

http://www.boston.com/bostonglobe/editorial_opinion/oped/articles/2009/05/31/when_all_we_need_is_a_listener

This is an Elissa Ely column from the Boston Globe:

"Fifteen minutes into the first meeting, I knew that this doctor would not be able to help me. Her questions were too simple, her expression was too even; nothing she said penetrated to my secret core. To be ruthlessly honest (as trainees always think they must), she did not strike me as all that bright. If I wanted help, I would have to find someone else..."

Forum: Adult psychiatry

Growing Old with Autism (article)

Mainelyneuropsych — Sun, 31 May 2009 11:45:23 GMT

http://www.nytimes.com/2009/05/24/opinion/24greenfeld.html

"As I spoke with the experts, I began to see that the focus on children had influenced not only the marketing of autism, but also research and treatment. It seemed the majority were interested in children only, the younger the better...

"If the current C.D.C. estimation of prevalence is correct, then there will be an awful lot of adult autistics who need lifetime support and care. Noahs life has been a grim study in how scarce those resources are. Without them, his behavior has regressed. "

Forum: Parents

Services for adults with autism are minimal

Mainelyneuropsych — Sun, 31 May 2009 11:38:49 GMT

Not that this is news to parents of autistic sons or daughters who are aging out of the education system...

http://www.nytimes.com/2009/05/31/opinion/l31autism.html?hpw

"I was greatly moved by Growing Old With Autism, by Karl Taro Greenfeld (Op-Ed, May 24), and I, too, wonder how people with autistic spectrum disorders and their families will evolve as their numbers grow..."

Forum: Financial issues