Memory loss: What do I do?
View(s):I have a problem to discuss with you. Please let me know how to consult you early.
If you wish to see a psychiatrist (or any other specialist) in the private sector the easiest is to go to the website www.echannelling .com and make your appointment. Most major private hospitals and specialists in the country are now available for booking through this site. If you wish to save the booking fee look up availability on the website and book your appointment directly at the hospital of your choice.
When seeing a psychiatrist ensure that you are seeing a fully qualified specialist. Such a doctor should have the MD in Psychiatry and Board Certification as a Specialist in Psychiatry as minimum qualifications. Otherwise you will be paying a specialists fee to see a partially qualified doctor.
To see a psychiatrist in a government hospital most teaching and general hospitals conduct psychiatry clinics, and appointments could be obtained through the respective outpatient departments. In the National Hospital of Sri Lanka you may obtain appointments to see a consultant in the University Psychiatry Unit from the reception in ward 59 on any weekday or Saturday morning. A letter of referral from your family doctor is preferred but not essential. The waiting time is usually less than two weeks. The clinics are on Monday, Wednesday and Saturday mornings.
There are special clinics for alcohol, tobacco and other substance use problems on Monday afternoons and for adolescent problems on Friday afternoons. Due to security reasons there is no direct access to the ward from Ward Place but you need to enter through the main gate on Regent Street opposite the Norris Canal Road. Outside visiting hours the letter from your family doctor would be useful to gain entry to the hospital.
n A retired government servant writes: “I am 81 years old. I have gradual loss of memory for the past 15 years. I remember many things that happened during my childhood and adolescent years but have difficulty recalling incidents that happened yesterday. I misplace things and I find it difficult to locate them. I fail to recognise people at times. I have had no head injuries but I have had mild black outs and was disoriented for a few seconds. I am in general good health. I walk a kilometre or two 3 to 4 times a week. Seven months ago I underwent a coronary by-pass surgery and recovered”.
For a complete evaluation of your memory problem you will need to consult a psychiatrist. Your history suggests that you have some form of dementia. You have the typical sign of being unable to remember recent events (short term memory loss) and but being able to recall childhood incidents reasonably well (long term memory).
There are two main causes of dementia. The leading cause is Alzheimer’s disease where there is accelerated death of brain cells due to as yet uncertain causes and vascular dementia, where there is damage to the brain cells due to impairment of blood supply to the brain. In your case I feel it is more likely to be vascular dementia. The duration is long where as in Alzheimer’s dementia the deterioration is more rapid.
You have also had several blackouts indicating lack of blood supply to the brain. The fact that you have had a cardiac by pass operation indicates that your blood vessels elsewhere probably have some degree of blockage.
There are no specific drugs to treat and reverse the damage caused by dementia but a few drugs that may help to slow the progress of the disease are available. In the case of vascular dementia it is important to prevent if possible, further blockage to blood vessels that supply the brain. No doubt in your case, since you are after a bypass, all these measures are in place. This would include control of blood pressure and blood glucose and reduction of cholesterol.
I would like to take this opportunity to bring to our readers attention an important article published in the September volume of the journal Aging which has generated much interest. The full article is available free of charge on the web. The title of the article is “Reversal of cognitive decline: A novel therapeutic programme”. The authors describe a multimodal programme designed to enhance metabolism to generate new nerve cells in the brain. Ten patients with memory loss and significant work impairment were recruited for the programme. Remarkably nine improved and were able to go back to work or continue work with improved performance. There were nearly 30 interventions prescribed but all patients did not follow every aspect of the programme.
Here is a typical programme followed by one of the participants. He was a 69-year-old businessman with 11 years of progressive memory loss diagnosed as having Alzheimer’s dementia by a special scan. He fasted for a minimum of three hours between dinner and bedtime and for a minimum of 12 hours between dinner and breakfast. He stopped taking simple carbohydrates (sugars) and increased the consumption of vegetables and fruit and reduced the consumption of meat. He took probiotics (organisms such as bacteria and yeast available in supplements and food) and coconut oil a teaspoon twice a day (probably not necessary in our country where we anyway consume coconut oil in our food). He tried to sleep at least eight hours a day. He exercised strenuously swimming 3 to 4 times a week, cycling twice a week and running once a week. He took capsules of the herbs Bacopamonniera (known as brahmi, it is a creeping succulent herb), Ashwagandha (also known as Indian ginseng is a small plant belonging to the nightshade family) and curcumin (a substance found in turmeric). These substances have been in use in Ayurveda for centuries to treat various ailments including memory loss. He took a combination of vitamins, minerals and supplements including Vitamin C, Vitamin E, Zinc and Omega 3 oils.
Six months later he had lost 10 pounds. He recognised faces at work unlike before and functioned without difficulty. His ability to add numbers rapidly in his head returned. Most strikingly his accelerated decline in the past two years halted completely. Some participants found it difficult to maintain the life style changes prescribed in the programme. We do not know what changes or supplements are the most important in the programme. Larger studies will give the answers in the future. Meanwhile at least there is something we can do about a condition that was previously thought to be untreatable.