Monday, June 14, 2010

Medical Mondays: Smells like Alzheimers, but...


Happy Monday! This week's question is from Anne (Piedmont Writer).

Is there any other kind of disease that could be misconstrued as Alzheimer's? And if there is such a disease, is there a magic pill that will take care of it? My character has the signs of Alzheimer's but I don't really want her to have it, I want her to be curable.

Great question Anne! There are a few classic problems that can easily be mistaken for Alzheimers, and (usually) do have a magic pill.

B-12 Deficiency
B-12 (or cobalamin) deficiency is a cause of symptoms that mimic dementia. A patient with such a deficiency might be elderly, pale "lemon" colored from anemia and bilirubin (pigments from broken down, abnormal red blood cells), have a shiny tongue and be mentally sluggish. They might also have a wide, shuffling gait, personality changes and numbness of the hands and feet.

The treatment? B-12 pills. Or, if they cannot absorb B-12 orally (due to stomach surgery, pernicious anemia, or low acid in the stomach from being elderly) then a shot of B-12 in the arm will start fixing things. Usually these patients need B-12 supplement for life (by monthly shots or pills).

Hypothyroidism
The textbook hypothyroid patient has a metabolism that has seriously slowed down. They are sluggish, tired, slow-thinking, slow-talking, and often have weight gain. They might appear depressed and can't remember things well. Their hair will be coarse, their skin cool and clammy, and their limbs appear puffy.

The cure is giving thyroid hormones via pills. Levothyroxine (trade name Synthroid, among others) is given and titrated over several weeks to until blood tests and symptoms normalize. This is also usually a lifetime medication.

Depression
Okay, there is no blood test for this unlike the other diseases discussed today, but depression in the elderly can easily be mistaken for dementia, especially when symptoms appear as sluggishness and mental slowing, poor appetite and difficulty concentrating. Usually a good evaluation (along with screening for the above problems) can help diagnose this. And there are different antidepressants that really are modern miracle pills to help this condition.

Syphilis
A very late manifestation of untreated syphilis is called "late neurosyphilis". Syphilis is really not around in the post-antibiotic era, but it definitely pops up once in a while. The symptoms are progressive dementia over a few years, and sometimes psychiatric symptoms like depression, anxiety and psychosis. They may have tremors in their face and hands, and slurred speech.

A blood test can pick this up, the definitive diagnostic test is a lumbar puncture (spinal tap).

Okay, Anne! Have fun picking your diagnosis! And let us know which one you choose!

Please keep in mind this post is for writing purposes only and is not to be construed as medical advice!

If you've got a medical question, let me know! Post below or email me at


All I ask in return is that you become a follower of my blog and post a link on your blog when I post. Easy peasy.

Also, don't forget to check out Mental Health Mondays at Laura's Blog!

44 comments:

Vicki Rocho said...

Fascinating! I love these posts!

Piedmont Writer said...

Lydia, I can't thank you enough for this. I've been stalled in one part of my book because I couldn't get any answers anywhere on what could possibly be the problem. You are the BEST!

Stina Lindenblatt said...

I love these posts! I was thinking about you, Lydia, when I was doing research on comas, pulmonary contusion, and pneumo/haemothorax this weekend. :D

Erinn said...

This is such a great idea for a post. Thank you so much.

Jaydee Morgan said...

Loved, loved, loved the information here! I always learn so much from a visit to your blog on Mondays :)

Aubrie said...

Very interesting. I had no idea some of those things caused the same symptoms.

Joanne said...

Very intriguing. What great information that can be worked into a storyline, giving the story an unexpected twist when the patient resumes their faculties!

JustineDell said...

OMG!!! This is perfect...PERFECT I TELL YOU for my current WIP!!!! I diagnosed a character with dementia earlier in the book (because I needed those symptoms) but I needed her to get better. I was like, stuck. But this will cure all!!!! THANK YOU!!!!

~JD

Melissa said...

I am so in love with medical mondays. I keep book marking these posts so I have an easy reference for them later. It's all so fascinating.

~Nicole Ducleroir~ said...

OMG! I know Anne's story lines and this information is sure to spark new ideas for her character. You rock, doc!!

:D Have a fab week!

lbdiamond said...

Nice topic!!! Great post!!! Gosh, I always look forward to Mondays because of this. ;)

Zoe C. Courtman said...

I love this series! The questions and answers are always intriguingly helpful :D Thanks!!

Jen said...

Awesome post Lydia! This one was great and I think Anne has some great advice to run with now! Get that inspiration flowing again for sure!!!

I love the thought of a magic pill though!

Carol Kilgore said...

This is wonderful. As a writer, we never know (at least I never know) when things like this will come in handy. I'm so glad I discovered your blog!

JEM said...

Fascinating! I didn't know a B12 deficiency could develop to such extremes.

Heather said...

This was fascinating! Thank you so much for this insight. I've used my own field expertise (which field shall remain unnamed!) in my writing but I never thought to use that of my friends. A wealth of knowledge surrounds me and I didn't think to use it! *smacks forehead*

Jennifer Shirk said...

Oh, very interesting! If I have a question like that, I'm coming HERE!!

Tahereh said...

WOW. so interesting!!

Saumya said...

This is soo awesome and informative! You make me really excited for medical school :) I know I've already said this, but I think it's amazing that you've balanced both of those interests and weave them together so effortlessly.

Sandy Shin said...

This is so, so fascinating -- and has the potential for so many great plot lines. Thank you for sharing these with us!

Southpaw said...

Wow, I'd heard of the B-12 one but not the others.

Maria Zannini said...

Ref: B-12 (or cobalamin) deficiency is a cause of symptoms that mimic dementia.

Oh, noes! That explains a lot about me. LOL.

Excellent list! And thanks for stopping by my blog. I'm so glad I found you.

Lindsay (a.k.a Isabella) said...

Great post. I'm storing all this information in my brain in case I need it for future wip. :)

Diane said...

I have specifically seen B12 misdiagnosed for Alz... :O)

notesfromnadir said...

Lydia,
That is so interesting -- how 1 symptom can have so many possibilities.

Somehow I don't think Anne will go w/ your last option of syphilis. If she did, that would probably be a different kind of book she would write! :)

Deb Salisbury said...

Wow, what a list! I wasn't expecting so many possibilities. Very cool.

WritingNut said...

Lydia,

Every time I visit your blog, I learn something new :). You are a treasure chest of information!

Sharon K. Mayhew said...

Great post! I wrote a begining chapter book about a grandmother with Alzheimer's Disease. I got distracted by other new shiny ideas and put it on the shelf...Perhaps I'll pull her out and have another look.

Have a great week Lydia!

Kelly said...

Lydia, these Monday posts are so informative and interesting!!

Warren Baldwin said...

Neat blog, Lydia. And this was a very interesting post. Thanks for visiting Family Fountain and the nice comment.

WB

Shannon O'Donnell said...

This is the coolest weekly meme out there! I absolutely love reading these posts, Lydia! :-)

MBW aka Olleymae said...

Wow - that's fascinating. Thanks so much for sharing your expertise!!

Renae said...

Awesome post as usual! Check out my blog tomorrow, I'm giving you an award for being such a great blogger!

Talli Roland said...

Interesting - great question, Anne. And thanks Lydia for the answer!

Theresa Milstein said...

What an interesting question and illuminating answers!

What about those girls that started the Salem Witch hysteria? They were supposed to have eaten eaten wheat that had been tainted or had gotten a virus. Would that work?

Lola Sharp said...

I LOVE your MD Monday posts! I learn something every single Monday.

How you do all you do is beyond me, Lydia.

Love,
Lola

Phoenix said...

This is all so fascinating... my grandmother suffered from Alzheimer's so it's sort of a taboo subject in my family.

Very informative post. Well done!

Nicole MacDonald said...

Hi Lydia! I've actually linked my latest post through to your site (a previous post not this one)
hope that's okay!

Angela Ackerman said...

I saw that pic and thought that you had a magic pill for my plot problems and got all excited but then realized such a thing doesn't exist and I should have known that but now I know where to come for my med questions!

*pants*

I don't know why but that just had to come out as a run on. It wanted to!

This is great! Thanks!

Angela @ The Bookshelf Muse

Callie Forester said...

This is so cool! I thought I knew most of the writer sites, but I just stumbled across you. Love the idea of "medical Mondays." Really interesting post.

By the way, my name is Callie. I just wanted to introduce myself and say that you'd gained a new follower. :)

great blog!

Lydia Kang said...

Hi Callie! Nice to meet you! I jumped over to your blog to follow too!

Angela, sorry about the lack of true miracle plot pills. I want one too. Badly.

Nicole--thanks for the linkage!

Phoenix--thanks for coming by and I'm glad you found it helpful!

Hi Lola, thanks for stopping by. I alway love seeing those shoes of yours!

Hey Theresa. INTERESTING question about the Salem Witch trials. In fact, I may use it on an upcoming post. It's actually ergot, and it grows on rye. I'll be back on this later. It's a super cool topic (geeking out here). And it's used in modern medicine too.

Stephanie Thornton said...

Great post- medical posts are super helpful! I'll probably have some questions to ask soon- I've got some characters I need to murder soon.

Mwahahaha!

Rachna Chhabria said...

Ah..love the idea of a Magic Pill. Great post Lydia, very informative for non medicos like me.

prashant said...

I always learn so much from a visit to your blog on Mondays.
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