Fibroids

Fibroids are non-cancerous tumours that grow in or around the womb (uterus). The growths are made up of muscle and fibrous tissue and vary in size. 

They are sometimes known as uterine myomas or leiomyomas.

Many women are unaware they have fibroids as they do not have any symptoms. Women who do have symptoms may experience:

         

• tummy (abdominal) or lower back pain 
• a frequent need to urinate
• Constipation 
• pain or discomfort during sex 
• Heavy or painful periods

In rare cases, fibroids can cause significant complications, such as infertility and problems during pregnancy.

symptoms, fibroids are sometimes diagnosed by chance during a routine gynaecological examination, test or scan.

However, you should see your GP if you have persistent symptoms of fibroids so they can investigate possible causes. 

If your GP thinks you may have fibroids, they will usually refer you for an ultrasound scan to confirm the diagnosis.

The exact cause of fibroids is unknown. However, they are linked to the hormone oestrogen. Oestrogen is the female reproductive hormone produced by the ovaries (the female reproductive organs). 

Fibroids usually develop during a woman's reproductive years (from approximately 16 to 50 years of age) when oestrogen levels are at their highest, and they tend to shrink when oestrogen levels are low, such as after the menopause (when a woman's monthly periods stop at around 50 years of age).

40% of women developing them at some point in their life. They most often occur in women aged 30 to 50 years.

Fibroids are thought to develop more frequently in women of African Caribbean origin. It is also thought they occur more often in overweight or obese women because being overweight increases the level of oestrogen in the body.

Women who have had children have a lower risk of developing fibroids, and the risk decreases further the more children you have.

Types of fibroids

Fibroids can grow anywhere in the womb and vary in size considerably. Some can be the size of a pea, whereas others can be the size of a melon.

The main types of fibroids are:

• intramural fibroids – the most common type of fibroid, they develop in the muscle wall of the womb 
• subserosal fibroids – fibroids that develop outside the wall of the womb into the pelvis and can become very large 
• submucosal fibroids – fibroids that develop in the muscle layer beneath the inner lining of the womb and grow into the middle of the womb 

In some cases, subserosal or submucosal fibroids are attached to the womb with a narrow stalk of tissue. These are known as pedunculated fibroids.

If fibroids do not cause symptoms, treatment is not needed. They will often shrink and disappear without any treatment over time, particularly after the menopause.

If you do have symptoms caused by fibroids, medication to help relieve the symptoms will usually be recommended first. 

If these medications are ineffective, surgery or other less invasive procedures may be recommended.

Medication to improve symptoms

The following medicines are used to treat heavy periods whatever the cause, including heavy periods that are caused by fibroids. These medicines may not work so well if your fibroids are large. However, one or more of the following may be worth a try if your periods are heavy and the fibroids are small:

• Tranexamic acid is taken 3-4 times a day, for the duration of each period. It works by reducing the breakdown of blood clots in the womb (uterus).
• Anti-inflammatory medicines such as ibuprofen and mefenamic acid. These also help to ease period pain. They are taken for a few days at the time of your period. They work by reducing the high level of a chemical (prostaglandin) in the lining of the womb. Prostaglandin seems to contribute to heavy and painful periods.
• The contraceptive pill may help you to have lighter periods and can often help with period pain too.
• Levonorgestrel intrauterine system (LNG-IUS) is similar to the coil that is used for contraception. It is inserted into the womb and slowly releases a regular small amount of progestogen hormone called levonorgestrel. It works by making the lining of the womb very thin, so bleeding is lighter. However, it can sometimes be difficult to insert into the womb in women with fibroids.

Medication to shrink fibroids 

Some women are given a gonadotrophin-releasing hormone (GnRH) analogue. This is a hormone medicine that causes you to have a very low level of oestrogen in your body. Fibroids shrink if the level of oestrogen falls. This can ease heavy periods and pressure symptoms due to fibroids. However, a low oestrogen level can cause symptoms similar to going through the menopause (hot flushes, etc). It may also increase the risk of 'thinning' of the bones (osteoporosis). Therefore, this treatment is given for a maximum of six months.

GnRH analogues, such as goserelin (for example, Zoladex®) or leuprorelin acetate (for example, Prostap® SR), are often prescribed for three to four months before having an operation. This will will make it easier to remove fibroids. Sometimes a low dose of HRT is also given to reduce the incidence of menopausal side-effects.

A new medicine called ulipristal acetate (UPA) has also been available since April 2012. It works by blocking the effects of the hormone progestogen. Progestogen is thought to play a role in fibroid development, so (by blocking progesterone) this medicine shrinks fibroids. Clinical trials have shown that this is a good treatment option, although it has not yet been recommended by the National Institute for Health and Care Excellence (NICE). It can be used for a maximum of three months for women who have moderate-to-severe problems from their fibroids.

Surgery and other operative treatments

There are several different operations available to remove and treat fibroids.

Hysterectomy: this is the traditional and most common treatment for fibroids which cause symptoms. Hysterectomy is the removal of the womb. This can be done by making a bikini scar in the lower tummy (abdomen). Or, if the fibroids are small enough, the womb can be removed through the vagina so there are no scars. A hysterectomy may be a good option for women who have completed their family.

Myomectomy: this is a possible alternative, especially in women who may wish to have children in the future. In this operation, the fibroids are removed and the womb is left. This procedure is not always possible. This operation can be done through a cut (incision) in the abdomen, via keyhole surgery (laparoscopically) or through the vagina (hysteroscopically). The type of operation depends on the size, number and position of the fibroids. Recurrence of the fibroid is fairly common after a myomectomy. There is a risk of very heavy bleeding with this operation. Your surgeon should advise you that a hysterectomy may be needed if that situation arose.

Endometrial ablation: this procedure involves removing the lining of the womb. This can be done by different methods. For example, using laser energy, a heated wire loop or by microwave heating. This method is usually only recommended for fibroids close to the inner lining of the womb.

MRI-guided focused ultrasound: this treatment sends pulses of high power ultrasound through the skin of the lower abdomen. It is targeted at the fibroid, using the MRI scanner. It is effective but there is no research yet on the long-term outcome for women trying to conceive.

Uterine artery embolisation: this procedure is done by a specially trained radiologist (X-ray doctor) rather than a surgeon. It involves putting a thin flexible tube (a catheter) into a blood vessel (artery) in the leg. It is guided, using X-ray pictures, to an artery in the womb that supplies the fibroid. Once there, a substance that blocks the artery is injected through the catheter. As the artery supplying the fibroid becomes blocked it means the fibroid loses its blood supply and so the fibroid shrinks. The complete process of fibroid shrinkage takes about 6-9 months but most women notice a marked improvement in their symptoms within three months. There is a good chance of success with this procedure but it does not work in every case.

Other techniques: MRI-guided laser ablation is a newer technique. In this procedure a small needle is put through the skin into the centre of the fibroid. The correct position of the needle is shown by the MRI scan. The laser energy is then passed down the needle, which destroys the fibroid. This technique is not suitable for all types of fibroid. There is not enough evidence currently to justify using this technique routinely.

Haemorrhoids (Piles)

Piles (haemorrhoids) often go away by themselves after a few days. However, there are many treatments that can reduce itching and discomfort.

Making simple dietary changes and not straining on the toilet are often recommended first.

If more invasive treatment is needed, the type of treatment used will depend on where your haemorrhoids are, particularly if they have developed above, on or below the dentate line. This is a line in the anal canal that separates the areas where the nerves can and can't transmit pain messages. 

Non-surgical treatments are likely to be very painful for haemorrhoids that have developed on or below the dentate line, as the nerves in this area can detect pain. In these cases, haemorrhoid surgery will normally be recommended.

Dietary changes and self-care

If constipation is thought to be the cause of your haemorrhoids, you need to keep your stools soft and regular, so that you don't strain when passing stools.

You can do this by increasing the amount of fibre in your diet. Good sources of fibre include wholegrain bread, cereal, fruit and vegetables. 

You should also drink plenty of water and avoid caffeine (found in tea, coffee and cola).

Follow the below advice when going to the toilet: 

• avoid straining to pass stools, as this may make your haemorrhoids worse 
• after passing a stool, use moist toilet paper or baby wipes to clean your bottom, rather than dry toilet paper 
• pat the area around your bottom, rather than rubbing it 

Medication

Over-the-counter topical treatments

Various creams, ointments and suppositories (which are inserted into your bottom) are available from pharmacies without a prescription. They can be used to relieve any swelling and discomfort. 

These medicines should only be used for five to seven days at a time. If you use them for longer, they may irritate the sensitive skin around your anus. Any medication should be combined with the diet and self-care advice detailed above. 

There is no evidence that one method is more effective than another. Ask your pharmacist for advice about which product is most suitable for you. Always read the patient information leaflet that comes with your medicine before using it.

Corticosteroid cream

If you have severe inflammation in and around your back passage, your GP may prescribe corticosteroid cream which contains steroids.

You should not use corticosteroid cream for more than a week at a time, as it can make the skin around your anus thinner and the irritation worse.

Painkillers

Common painkilling medication, such as paracetamol can relieve the pain of haemorrhoids. However, you should avoid codeine painkillers, as they can cause constipation.

Products that contain local anaesthetic  (painkilling medication) may also be prescribed by your GP to treat painful haemorrhoids. Like over-the-counter topical treatments, these should only be used for a few days, as they can make the skin around your back passage more sensitive. 

Laxatives

If you are constipated, your GP may prescribe a laxative. This is a type of medication that can help you empty your bowels.

Non-surgical treatments

If dietary changes and medication don't help, your GP may refer you to a specialist. They can confirm whether you have haemorrhoids and recommend appropriate treatment.

If your haemorrhoids are found to have developed above the dentate line, non-surgical procedures such as banding and sclerotherapy may be recommended.

Banding

Banding is a procedure that involves placing a very tight elastic band around the base of your haemorrhoids, to cut off their blood supply. The haemorrhoids should then fall off within about a week of having the treatment. 

Banding is usually a day procedure, without the need for an anaesthetic, and most people can return to their normal activities the next day. You may feel some pain or discomfort for a day or so. Normal painkillers are usually effective, but your GP can prescribe something stronger, if needed.

You may not realise that your haemorrhoids have fallen off, as they should pass out of your body when you go to the toilet. If you notice some mucus discharge within a week of the procedure, it usually means the haemorrhoid has fallen off. 

Directly after the procedure, you may notice blood on the toilet paper after going to the toilet. This is normal, but there should not be a lot of bleeding. If you pass a lot of bright red blood or blood clots (solid lumps of blood), go to your nearest accident & emergency (A&E) department immediately.

Ulcers (open sores) can occur at the site of the banding, although these usually heal without needing treatment. 

Injections (sclerotherapy)

A treatment called sclerotherapy may be used as an alternative to banding.

During sclerotherapy, a chemical solution is injected into the blood vessels in your back passage. This relieves pain by numbing the nerve endings at the site of the injection. It also hardens the tissue of the haemorrhoid so that a scar is formed. After about four to six weeks, the haemorrhoid should decrease in size or shrivel up. 

After the injection, avoid strenuous exercise for the rest of the day. You may experience minor pain for a while and may bleed a little. You should be able to resume normal activities, including work, the day after the procedure.

coagulation

Infrared coagulation is also sometimes used to treat haemorrhoids.

During the procedure, a special device that emits infrared light is used to burn the haemorrhoid tissue and cut off their blood supply.

A similar procedure can also be carried out using an electric current instead of infrared light. This is known as diathermy or electrotherapy.

Surgery

Although most haemorrhoids can be treated using the methods described above, around 1 in every 10 people with the condition will eventually need surgery.

Surgery is particularly useful for haemorrhoids that have developed below the dentate line because, unlike non-surgical treatments, anaesthetic is used to ensure you don’t feel any pain as they are carried out.

There are many different types of surgery that can be used for haemorrhoids, but they usually involve either removing the haemorrhoids or reducing their blood supply, causing them to shrink.

Immunodeficiency Disorder

Immunodeficiency Disorder

Immunodeficiency disorders prevent your body from being able to fight infections and diseases the way it should. An immunodeficiency disorder makes you considerably more susceptible to catching viruses and bacterial infections.

Immune disorders are oftentimes categorized as either congenital or acquired. When you’re born with a disorder, it’s sometimes called a congenital or primary disorder. Acquired disorders are sometimes called secondary disorders. Secondary disorders are more common than primary.

How Does The Immune System Work

To understand immune disorders, you need to understand the basics of how your immune system works. The immune system is made up of several organs including your spleen, tonsils, bone marrow, and lymph nodes. These organs make and release lymphocytes, which are white blood cells classified as B cells and T cells. B and T cells fight invaders called antigens. Examples of antigens are bacteria, viruses, cancer cells, or bodily fluids from a sick person. B cells release antibodies specific to the disease your body detects. T cells kill off the cells in your body that are being attacked by disease.

Types Of Immune Deficiency Disorders

Primary immunodeficiency disorders are immune disorders you are born with. Primary disorders include:

• X-linked agammaglobulinemia (XLA)
• severe combined immunodeficiency (SCID disorders)
• common variable immunodeficiency
• Alymphocytosis (“boy in a bubble” disease)

Secondary disorders happen when your body is attacked by an outside source, such as a toxic chemical or an infection. Severe burns and radiation also can cause secondary disorders. Secondary disorders include:

• AIDS
• cancers of the immune system, such as leukemia
• immune complex diseases, such as viral hepatitis
• multiple myeloma

Who Is At Risk

People who have a family history of primary disorders are at a higher-than-normal risk for them. 

Anything that weakens your immune system can lead to a secondary immunodeficiency disorder. For example, the exposure to bodily fluids such as blood and sperm from someone infected with HIV can cause AIDS. 

Removing the spleen can weaken your immune system. Spleen removal may be required in response to one of any number of diseases or injuries, including cirrhosis of the liver, sickle cell anemia, or trauma to the spleen. Aging also weakens your immune system. As you age, some of the organs that produce white blood cells shrink and produce fewer of them. 

Proteins are important to your immunity. An insufficient amount of protein in the diet can reduce the strength of your immune system. Additionally, when you sleep, your body produces proteins that help your immune system fight infection. For this reason, lack of sleep reduces your immune defenses. 

Cancers and the chemotherapy drugs used to treat them can reduce your immunity.

The following diseases and conditions are also linked to immunodeficiency disorders:

• ataxia-telangiectasia
• Chediak-Higashi syndrome
• combined immunodeficiency disease
• complement deficiencies
• DiGeorge syndrome
• hypogammaglobulinemia
• Job syndrome
• leukocyte adhesion defects
• panhypogammaglobulinemia
• Bruton’s disease
• congenital agammaglobulinemia
• selective deficiency of IgA
• Wiskott-Aldrich syndrome

How To Recognise Symptoms 

Each disorder has unique symptoms. The first indicator that something is wrong with your immune system is becoming repeatedly and chronically sick, even with minor illnesses, including pinkeye, sinus infections, or diarrhea. If these problems don’t respond to treatment or don’t completely get better over time, your doctor might test you for a disorder. Recurrent pneumonia and yeast infections could also suggest you have a disorder.

How Do You Get Diagnosed

If your doctor thinks you might have an immunodeficiency disorder, he or she will want to do a thorough medical exam including:

• medical history
• physical exam
• T cell count
• white blood cell count

Vaccines can be used to test your immune system response in what is called an antibody test. Your doctor will give you a vaccine and make an appointment in a few days or weeks to test your blood for its response to the vaccine. If you don’t have an immunodeficiency disorder, your immune system will produce antibodies to fight the organisms in the vaccine. You might have a disorder if your blood test doesn’t show antibodies.

How To Treat 

Each disorder will be treated according to the specific conditions it causes. For example, AIDS causes several different infections, including Kaposi’s sarcoma, which is treated with doxorubicin lipid complex, and cryptococcosis, which is treated with fluconazole.

Treatment for immunodeficiency disorders commonly includes antibiotics and antibody replacement. A drug called interferon is often used to treat the viral infections caused by a disorder. 

If your bone marrow is not producing enough lymphocytes, your doctor might order a bone marrow transplant.

What Is The Outlook

Most doctors agree that people with immunodeficiency disorders can lead full and productive lives. Early identification and treatment of the disorder and the problems it causes are very important.

How Can Immune Deficiency Disorders Be Prevented 

Primary disorders can be controlled and treated, but not prevented. Secondary disorders can be prevented in a number of ways. For example, it is possible to avoid AIDS by not having unprotected sex with someone who carries the virus. 

Sleep is very important to a healthy immune system. According to the Mayo Clinic, adults need about eight hours of sleep per night.

If your immune system is not working properly, it is important that you stay away from people who are sick. 

If you have a contagious immune disorder like AIDS, you can keep others healthy by practicing safe sex and not sharing bodily fluids with people who don’t have the condition.

Gammaguard Liquid (pros & cons)

GAMMAGARD LIQUID is used to treat patients with primary immunodeficiency diseases (PI). There are many forms of PI. The most common types of PI result in an inability to make a very important type of protein called antibodies, which help the body fight off infections from bacteria or viruses. GAMMAGARD LIQUID is made from human plasma that is donated by healthy people. GAMMAGARD LIQUID contains antibodies collected from these healthy people that replace the missing antibodies in PI patients.

Tell your healthcare provider if you have a history of poor kidney function or kidney failure. If so, GAMMAGARD LIQUID should be administered at the slowest intravenous infusion rate as determined by your healthcare provider.

Contact your healthcare provider or call emergency services immediately if you have reduced urination, sudden weight gain, or swelling in your legs. These could be signs of a kidney problem.

Do not use GAMMAGARD LIQUID if you have a known history of a severe allergic reaction to immune globulin or other blood products. If you have such a history, discuss this with your healthcare provider to determine if GAMMAGARD LIQUID can be given to you. Tell your healthcare provider if you have a condition called selective (or severe) immunoglobulin A (IgA) deficiency.

If any of the following problems occur after starting treatment with GAMMAGARD LIQUID, stop the infusion immediately and contact your healthcare provider or call emergency services. These could be signs of a serious problem.

• Hives, swelling in the mouth or throat, itching, trouble breathing, wheezing, fainting or dizziness. These could be signs of a serious allergic reaction.
• Bad headache with nausea, vomiting, stiff neck, fever, and sensitivity to light. These could be signs of irritation of the lining around your brain.
• Reduced urination, sudden weight gain, or swelling in your legs. These could be signs of a kidney problem.
• Pain, swelling, warmth, redness, or a lump in your legs or arms. These could be signs of a blood clot. 
• Brown or red urine, fast heart rate, yellow skin or eyes. These could be signs of a liver problem or a blood problem.
• Chest pain or trouble breathing, blue lips or extremities. These could be signs of a serious heart or lung problem.
• Fever over 100°F. This could be a sign of an infection. 

These are not all of the possible side effects with GAMMAGARD LIQUID. You can ask your healthcare provider for physician’s information leaflet.

If you or someone you love is living with primary immunodeficiency  (PI) disease, you are probably already aware that regular medical treatments are necessary to help prevent getting frequent infections and secondary complications. But there are also many non-medical activities you can do on a daily basis to help maintain good physical and mental health. Below are common-sense tips to guide everyday living for PI patients. 

• Nutrition—Eat a balanced diet to help fight off diseases and infection. This is especially important for children, who are growing and developing.
• Hygiene—Wash your hands frequently, especially before meals and after using the bathroom. Viruses, including the common cold, are most often spread by unwashed hands.
• Wound care—Clean cuts or scrapes with antiseptic to help avoid infection.
• Dental care—Brush your teeth and floss daily, and visit your dentist on a regular basis. People with primary immunodeficiency are more likely to experience tooth decay and gum disease.
• Regular exercise—Exercise regularly to keep your body strong and your mind active.
• Stress—Avoid stress as much as possible, as stress can negatively affect how the immune system operates.
• Sleep—Get consistent and sufficient sleep every day. Not getting enough sleep can make you feel “run down” and can affect your immune system.
• Illness—Avoid people who are ill as much as possible, as they can spread infections, to which PI patients are particularly vulnerable.
• Interacting with others—Talk with your spouse, friends, family members, and healthcare team about anything you’re going through. Many people find joining a support group to be extremely helpful and reassuring. Ask your healthcare team if there are support groups in your area.
• Educating yourself—Learn all you can about your condition. Knowing the facts can go a long way in alleviating any uncertainty or fear you might be feeling.

Taking good care of yourself can also mean treating the signs and symptoms of infections and illnesses as they occur. Talk with your doctor before taking any medications. Besides antibiotics as prescribed by your doctor, this could include over-the-counter medications, such as:

• Aspirin or ibuprofen for pain and fever relief
• Decongestants for sinus congestion relief
• Expectorants to clear airways

Living With Amnesia

It’s normal to become a bit forgetful as you get older. However, memory loss could be a symptom of something more serious and should be checked by a GP.

Memory loss, also called amnesia, occurs when a person loses the ability to remember events and information they would normally be able to recall. This could be something that happened only seconds or minutes ago, or a memorable event that happened in the past. The memory loss may have started suddenly or may have been getting worse over the last year or so.

Memory loss can be distressing, for the person affected as well as for their family. Relatives may fear the worst and assume it's caused by dementia but this often isn't the case.

The following information will tell you:

• what to do if you're worried about memory loss 
• how to tell if it could be caused by dementia 
• the most common causes of memory loss (but don't rely on this to self-diagnose a condition) 
• how to cope with a poor memory 

What to do if you're worried about memory loss

If you're worried because you or someone you care for has lost their memory, see your GP. They'll do an initial assessment and ask questions about symptoms, family history and lifestyle. They may also order a blood test

Memory loss has a wide range of possible causes, depending on the type of memory loss.

Doctors classify memories as either:

• Immediate memories, such as sounds, which are only stored for a few seconds. 
• Short-term or recent memories, such as telephone numbers, which stay in your memory for 15-20 seconds. The brain can store about seven chunks of short-term information at any time. 
• Long-term or remote memories - more permanent memories, which have been reinforced because you've repeatedly gone over them in your mind. 

If your GP thinks that you or your relative needs an assessment for dementia or that there may be another more serious underlying condition, such as brain damage, they'll refer you to a specialist.

Could it be dementia?

If you're reading this because you think your memory problems may be a sign of dementia, rest assured that they probably aren't. A person with dementia will not usually be aware of their memory loss or may deny it.

Your memory loss is likely to be caused by something a lot more common and treatable, such as depression. 

You may be worried that someone you care for has dementia. However, bear in mind that around 40% of people aged over 65 have some kind of memory difficulty, and only 15% will develop dementia each year. 

If your instincts are correct, their denial or lack of awareness of their memory loss can make it hard to convince them to see a GP. 

Signs that someone has dementia

As a general guide:

• Dementia usually occurs in people over the age of 65. 
• Someone with dementia will struggle to remember immediate or recent events, but can still recall events that happened a long time ago. Therefore, if their long-term memory is affected, it probably isn't dementia. 
• The memory loss doesn't happen suddenly but gets gradually worse over time. 

Common causes of memory loss

Generally, GPs find that patients who see them about memory loss are most likely to have: 

• Stress
• Depression
• Anxiety 

Their memory loss is due to poor concentration and not noticing things in the first place because of a lack of interest. Sleeping problems make the memory loss worse.

Your GP may suggest trying antidepressant tablets, If their assumption is correct, these should improve the memory problems as the depression lifts.

An elderly person with memory loss is likely to have depression if they also experience changes in behaviour, such as hoarding or being bad tempered.

Other common causes of memory loss are:

• a head injury, for example after a car accident 
• a stroke that cuts off some of the blood supply to the brain and causes brain tissue to die 

These will cause sudden memory loss, where you either forget events that happened before the trauma (retrograde amnesia), or you forget everything that happened after the trauma (anterograde amnesia). 

Less common causes of memory loss

Less commonly, memory loss can be caused by:

• an underactive thyroid, which means your thyroid gland (found in the neck) does not produce enough hormones 
• certain types of medication, such as sedatives and some treatments for Parkinson's disease 
• long-term alcohol misuse 
• bleeding in the brain, known as subarachnoid haemorrhag
• Vitamin B1 deficiency 
• problems with blood flow to part of the brain, which cause sudden episodes of memory loss that a person cannot recall afterwards (known as transient global amnesia)  
• a stressful or traumatic event that causes someone to block out the memory, leaving them unable to remember important information (known as psychogenic amnesia) 
• a brain tumour. 

Living with amnesia focuses on building habits to follow rather than relying on medical remedies. To cope with his extreme amnesia, Clive Wearing began keeping a journal after the onset of illness in 1985. Since his memory lasts only a few seconds, writing allowed him to retain some record of the past, although he never explicitly remembers doing it. Most entries are brief, guided by his implicit, or habitual, memory of how to write and instinctual awareness of keeping the journal.

Although Wearing's knowledge of specific facts and recent events is nonexistent, his IQ has stayed close its pre-amnesia levels, as with other amnesia patients. For instance, if you ask Wearing for directions to the kitchen, he wouldn't be able to tell you. But if you ask him to make you a cup of tea,  he can walk to the kitchen and do it independently. Because the implicit and semantic memories, which control performance and motor skills, reside in different areas of the brain from episodic memory, intelligence isn't severely affected.

Unfortunately, there is no magic pill or surgery that can fully restore the lost memories of someone with persistent amnesia. Since neurotransmitters play a large role in memory creation, researchers are investigating the potential of isolating them for treatments. With amnesia caused by alcoholism, (Korsakoff's syndrome), vitamin B1 supplements can help stop brain deterioration. Psychotherapy can also aid people with dissociative amnesia by working through the traumatic event. However, most persistent amnesia cases that deal with disease or injury-related brain damage depend on coping, not cures.

Since the bulk of amnesia cases involve anterograde amnesia, treatment focuses on ways to retain new information and build habits through your implicit memory, as we see with Wearing. In this way, you can think of memories as expiring coupons -- either use them or lose them. By integrating memory tools into everyday life, amnesia patients can recall memories as often as possible to try to strengthen them. Amnesiacs manage to remember to use these memory tools by creating habits, or implicit memories, so they instinctively know to check their calendar in the morning for appointments, for instance.

Pocket calendars or PDA's, such as PalmPilots, Blackberries and iPhones, can be helpful since people with amnesia can program reminders, store large amounts of information and take it everywhere. Having simple data like this on hand can increase the patient's sense of independence and lighten the burden on caretakers. In addition, establishing patterns of living are integral for amnesia patients to get on with daily life.

What can I do to improve my memory?

Here are some simple techniques to enhance your memory:

• Give yourself time and keep calm.
• 
  
• Keep to a routine. Place everyday items such as car keys, money in the same place and do try to do things in the same order.
• 
  
• Write information down as possible, keep paper and pencil or stick it notes near the telephone.
• 
  
• If you need to remember to take something with you to an appointment or when you go out leave it somewhere obvious e.g., by the door, or write yourself a big note to remind you and leave it on the door.
• 
  
• Get organised. Although most people are used to keep a diary at work, you might find it helpful to have a diary at home to remind you to do something.
• 
  
• Use an alarm to help you to remember to do something in the future, for example to take something cooking out of the oven or to make a phone call.
• 
  
• Repeat back to someone important information that you need to remember. Not only will this check that you have heard the information correctly, it was also increase the chance that you will be able to recall it later.

Memory and aging: What's normal, what's not

Forgetfulness is a common complaint among older adults. You start to talk about a movie you saw recently when you realize you can’t remember the title. You’re giving directions to your house when you suddenly blank on a familiar street name. You find yourself standing in the middle of the kitchen wondering what you went in there for.

Memory lapses can be frustrating, but most of the time they aren’t cause for concern. Age-related memory changes are not the same thing as dementia.

As we grow older, we experience physiological changes that can cause glitches in brain functions we’ve always taken for granted. It takes longer to learn and recall information. We’re not as quick as we used to be. In fact, we often mistake this slowing of our mental processes for true memory loss. But in most cases, if we give ourselves time, the information will come to mind.

Memory loss is not an inevitable part of the aging process

The brain is capable of producing new brain cells at any age, so significant memory loss is notan inevitable result of aging. But just as it is with muscle strength, you have to use it or lose it. Your lifestyle, health habits, and daily activities have a huge impact on the health of your brain. Whatever your age, there are many ways you can improve your cognitive skills, prevent memory loss, and protect your grey matter.

Furthermore, many mental abilities are largely unaffected by normal aging, such as:

• Your ability to do the things you’ve always done and continue to do often
• The wisdom and knowledge you’ve acquired from life experience
• Your innate common sense
• Your ability to form reasonable arguments and judgments

Normal forgetfulness vs. dementia

For most people, occasional lapses in memory are a normal part of the aging process, not a warning sign of serious mental deterioration or the onset of dementia.

Normal age-related forgetfulness

The following types of memory lapses are normal among older adults and generally are notconsidered warning signs of dementia:

• Ocassionally forgetting where you left things you use regularly, such as glasses or keys.
• Forgetting names of acquaintances or blocking one memory with a similar one, such as calling a grandson by your son’s name.
• Occasionally forgetting an appointment.
• Having trouble remembering what you’ve just read, or the details of a conversation.
• Walking into a room and forgetting why you entered.
• Becoming easily distracted.
• Not quite being able to retrieve information you have “on the tip of your tongue.”

Does your memory loss affect your ability to function?

The primary difference between age-related memory loss and dementia is that the former isn’t disabling. The memory lapses have little impact on your daily performance and ability to do what you want to do.

When memory loss becomes so pervasive and severe that it disrupts your work, hobbies, social activities, and family relationships, you may be experiencing the warning signs of Alzheimer’s disease, or another disorder that causes dementia, or a condition that mimics dementia.

Normal Forgetfulness vs Mild Cognitive Impairment (MCI)

Mild cognitive impairment (MCI) is an intermediate stage between normal age-related cognitive changes and the more serious symptoms that indicate dementia. MCI can involve problems with memory, language, thinking, and judgment that are greater than normal age-related changes, but the line between MCI and normal memory problems is not always a clear one. The difference is often one of degrees. For example, it’s normal as you age to have some problems remembering the names of people. However, it’s not normal to forget the names of your close family and friends and then still be unable to recall them after a period of time.

If you have mild cognitive impairment, you and your family or close friends will likely be aware of the decline in your memory or mental function. But, unlike people with full-blown dementia, you are still able to function in your daily life without relying on others.

While many people with MCI eventually develop Alzheimer's disease or another type of dementia, that doesn’t mean it’s inevitable. Some people with MCI plateau at a relatively mild stage of decline while others even return to normal. The course is difficult to predict, but in general, the greater the degree of memory impairment, especially when accompanied by trouble moving your legs and feet, the greater your risk of developing dementia some time in the future.

Symptoms of mild cognitive impairment (MCI) include:

• Frequently losing or misplacing things
• Frequently forgetting conversations, appointments, or events
• Difficulty remembering the names of new acquaintances
• Difficulty following the flow of a conversation

The same practices that contribute to healthy aging and physical vitality also contribute toa healthy memory

Exercise regularly. Regular exercise boosts brain growth factors and encourages the development of new brain cells. Exercise also reduces the risk for disorders that lead to memory loss, such as diabetes and cardiovascular disease. Exercise also makes a huge difference in managing stress and alleviating anxiety and depression—all of which leads to a healthier brain.

• Stay social. People who don’t have social contact with family and friends are at higher risk for memory problems than people who have strong social ties. Social interaction helps brain function in several ways: it often involves activities that challenge the mind, and it helps ward off stress and depression. So join a book club, reconnect with old friends, or visit the local senior center. Being with other people will help keep you sharp
• Watch what you eat. Eat plenty of fruits and vegetables and drink green tea as these foods contain antioxidants in abundance, which can keep your brain cells from “rusting.” Foods rich in omega-3 fats (such as salmon, tuna, trout, walnuts, and flaxseed) are particularly good for your brain and memory. Eating too many calories, though, can increase your risk of developing memory loss or cognitive impairment.
• Manage stress. Cortisol, the stress hormone, damages the brain over time and can lead to memory problems. But even before that happens, stress or anxiety can cause memory difficulties in the moment. When you’re stressed out or anxious, you’re more likely to suffer memory lapses and have trouble learning or concentrating.
• Get plenty of sleep. Sleep is necessary for memory consolidation, the process of forming and storing new memories so you can retrieve them later. Sleep deprivation reduces the growth of new neurons in the hippocampus and causes problems with memory, concentration, and decision-making. It can even lead to depression—another memory killer.
• Don’t smoke. Smoking heightens the risk of vascular disorders that can cause stroke and constrict arteries that deliver oxygen to the brain.