NPH and Dementia

I’m glad many have enjoyed the pics of the flowers and afghans.

I came across some information this morning on normal pressure hydrocephalus. It reminded me of my neurology rotations. Although it is fairly rare, I was able to see several cases of it. And, yes, it truly did manifest itself as dementia in all of the 5 cases which I saw. And it was one of the questions on my medical licensing exam. Fortunately I won’t forget the symptoms after seeing them in real life. But I feel badly that many physicians frequently misdiagnose this disorder. Hopefully, the Dr. will order a consultation from a neurologist to appropriately diagnose it.

Normal pressure hydrocephalus (NPH) is an abnormal increase of cerebrospinal fluid (CSF) in the brain’s ventricles, or cavities. It occurs if the normal flow of CSF throughout the brain and spinal cord is blocked in some way. This causes the ventricles to enlarge, putting pressure on the brain. Normal pressure hydrocephalus can occur in people of any age, but it is most common in the elderly population. It may result from a subarachnoid hemorrhage, head trauma, infection, tumor, or complications of surgery. However, many people develop NPH even when none of these factors are present. In these cases the cause of the disorder is unknown.

Symptoms of NPH include progressive mental impairment and dementia, problems with walking, and impaired bladder control leading to urinary frequency and/or incontinence. The person also may have a general slowing of movements or may complain that his or her feet feel "stuck." Because these symptoms are similar to those of other disorders such as Alzheimer’s disease, Parkinson’s disease, and Creutzfeldt-Jakob disease, the disorder is often misdiagnosed. Many cases go unrecognized and are never properly treated.

 

Raquel says …"But I had never seen that entrelac type. How do you knit it as not to show the yarn overlapping on the wrong side? Can you tell me the secret?"

Some people like the texture of the overlap on the wrong side. However, if you want to eliminate it, when picking up the stitches on each rectangle just pick up only the outer loop—not both loops. Or, don’t slip each stitch on every row. There are some other technique variations which can make the front and the back of entrelac lay flat.

 

Imogene says…1. "David, a warm hello this morning! I love your Afghans. I would certainly ask you to make one for me if I felt it wasn’t too much. But, everyone else would ask for one also, and so, that would be too much." 2. "The Androderm Patch sounds like a winner to me. I have often thought my husband was low in testosterone. I am going to ask his Doctor if he can try the patch. How long did you use it before you saw results?"

The patch releases testosterone into the blood system immediately. However, it make take some time for it to actually see visible results.

You bring up a good topic about making projects for people. Pam and I have made handmade projects over the years as gifts, etc. Later, we’d find that the projects made of wool were tossed in a corner or had not been laundered correctly resulting in severe shrinkage. Some afghans made of good material were discovered on the floor for the pets, etc. We’ve also discovered that it’s difficult to phathom the cost of handmade items. And rightly so. Just walk into Walmart, Kohl’s, Sears, etc. The mass produced sweaters, throws, hats, socks are quite cheap. The yarn can get pricey especially if you make sweaters and scarves with yarn other than the brands which are sold in Walmart. Some handmade scarves are worth $75.00-$100.00 just in the yarn alone. Not to mention the time and work involved it making them. We’ve learned to use only the Red Heart and similar brands to use for regular afghans, kid’s blankets, sweaters and whatnot. They can easily be laundered and last for years even if they end up being a pet’s blanket. We’ve also tailored down our gifts using expensive yarns to only friends and family members who really appreciate the work involved and are willing to properly care for them.

The yarns used for the afghans I posted here cost almost $35.00 for each one and they were inexpensive yarns. I see some of their equivalents going for $50.00+ on Ebay. Actually I’m going to put these 2 scarves up for sale…….probably on Ebay or to someone with the best offer………I can always make more if I need something for a gift.

Warmly……….David

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3 Responses

  1. My father had NPH. After his dementia symptoms had progressed to the moderate stage, he did have a neuro evaluation with head MRI. And even though his neurologist did indicate in his notes that NPH was one of the differential diagnoses, he told the family that it was Alzheimer’s, that his brain had atrophied, and nothing could be done. 2 years later, my father had a consultation with a different neurologist to investigate possible Parkinson’s and was finally diagnosed as having NPH. His dementia was too far gone to be reversed then (started 7 years previously, apparently triggered by a fall from a ladder while pruning trees). But a shunt placed in his brain did help his walking and awareness considerably. And he had bowel incontinence in addition to urinary incontinence.

    The dementia of NPH has some subtle differences from Alzheimer’s. While my father had significant memory deficits, anything he said was true. As opposed to my Alzheimer’s/MTBI husband, who confabulates, and you can’t trust anything he says. The NPH gait is distinctive, and so is the difficulty in starting to use the legs because they are “stuck”.

    The hopeful and significant aspect of NPH is that if detected early enough, especially before memory loss gets significant, the dementia of NPH is reversible. I have read that something like 10% of patients diagnosed with Alzheimer’s and Parkinson’s actually have NPH. The tragedy is that doctors are not catching it early enough when the dementia is still reversible. If only that first neurologist had recommended further investigation. Once a patient is over 80, I think many doctors fail to diagnose thoroughly.

  2. Hi David,

    Thanks for talking about entralac. Since I don’t knit, I had never heard of it. I am going to ask my daughter if she is aware of it. She knits all sorts of things too. Her work is perfection.

    I too had a hobby once. I painted pictures. I sold a few, but like you, I couldn’t determine the cost. Time and effort alone was humongous. Not to mention the cost of paints, brushes, canvas, and other supplies. If I could have, I would have charged thousands.

    Loved visiting with you,
    Imogene

  3. David – glad to see you blogging again – and to read what you have written.

    You (and your readers) might be interested in an experiment that the BBC have just set up in the UK to test brain training – see http://www.bbc.co.uk/labuk/experiments/braintestbritain/articles/about

    I hope the link works even if the experiment is UK only.

    I plan to take part – but am leaving the benchmarking till tomorrow morning so as to give it my best shot!

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