Author Archives: Paula.KGS

Crippling Diseases

Despite the advances in the medical sciences, there are still many crippling diseases that affect people. These can be inherited, occur after birth due to mutations or anomalies within the body, contracted through activities in our daily lives or as a result of medical treatments gone wrong. They can also be physical or mental. Although many are rare, it affect persons or ages in rare circumstances or may be gender specific if not more prevalent in one than the other, in general they are impartial. Some like heart and lung diseases, many forms of cancer (some of which are untreatable), spinal abnormalities, liver, kidney and degenerative brain diseases can be fatal.

A crippling disease is not necessarily one that directly affects the physical legs but any disease with the ability to drastically affect one’s life. Conditions can range from those that render the legs or lower parts of the body useless, to those that affect the spine (causing severe pain, curvatures, shrinking/degeneration or sometimes even death) or those that make walking too painful.

Causes of Crippling Diseases

Diseases of the body that do not directly affect the legs or lower extremities but cause so much pain that they render sufferers immobile or limit their day to day activities are also very common; autoimmune diseases in whatever form are good examples. Many bone diseases characterized by the depletion or wearing done of ligaments or cartilages; like arthritis, affect both adults and children and where as some are mild, some lead to deformities of the body part affected bringing life to a grinding halt.

Mental diseases like depression, bipolar disorders, genetic disorders (like autism), Alzheimer’s and many others can disrupt daily life if left untreated. Unfortunately, many persons pay more attention to physical diseases than they do mental disorders especially when some; like depression, occur in children and teens which can make the daily symptoms harder to cope with. All mental disorders and conditions that seem common like depression or migraines should be taken seriously since they can be life-threatening. A migraine attack while driving or carrying out any other such activity can have devastating results.

Disorders that affect the mood or emotions can not only make persons unsuited for interaction with others but lead to violent behaviors including homicides and/or suicides. A child suffering from a mental disorder can develop a learning disability directly linked to the disorder or as a result of it being ignore or untreated. Antisocial behavior at home and school can arise from feeling ‘misunderstood’.

Dealing with Crippling Diseases

When dealing with anyone diagnosed with a crippling disease; whether physical or mental, it is best to understand the underlying cause, the symptoms, the effect these symptoms will have on the patient’s daily life, how it affects you and where you fit in. Taking into consideration the nature of the disease and how you are expected to contribute to the patient’s treatment can greatly improve your ability to ease some of the burden being felt.

Multiple crippling diseases that do not developed during pregnancy can develop without signs while many will show symptoms that can be linked to common conditions. Any symptom being experienced that persists or worsens especially if being treated at home for the maximum recommend time should be brought to a doctor’s attention. Unusual behavior especially in children, teens and the elderly should never be ignored. Also, the body uses pain, nausea and infections (all from no apparent source) as warnings so heed them, if you think something is wrong then see a doctor.

Home Interior Decorating

The best way to get an objective view of your home’s interior condition is to imagine that it is up for sale and to view it in the role of a prospective purchaser. The aim of the exercise is not to give rise to a severe bout of depression on your part, but to determine what exists in the home and what could be done to change or improve it.

Start at the front door, and step into the hallway. Is it bright and well lit, or gloomy and unwelcoming? A lighter Colour scheme could make a narrow area appear more spacious, and better lighting would make it seem more inviting. Decorating the wall opposite the front door would make a long hall appear shorter, while changing the way the staircase is decorated could make it a less or more dominant feature.

Is the staircase well lit, for safety’s sake as well as for looks? Opening up the space beneath the stairs could get rid of what is typically an untidy glory hole (storage room), taking up space without saving any. Lastly, are the wall and floor coverings practical? The hall floor is bound to be well-trodden, and needs to be durable and easy to clean as well as looking attractive.

Choose an integrated decorating scheme for the hallway, stairs and landing -area. Bring down the apparent ceiling height using a dado (chair) rail or decorative border. The living room has to be light and airy during the day, yet cozy and comfortable in the evening. The fireplace and a central table provide the main focal points here.

Now move into the main living room. This is always the most difficult room in the house to decorate and furnish successfully because of its dual purpose. It is used both for daily life and to entertain visitors. It must be fresh and lively by day, yet cozy and peaceful in the evening. One of the chief keys to success is flexible lighting that can be altered to suit the room’s different uses, but the decorations and furnishings all have their part to play too.

Look at the color scheme. How well does it blend in with the furnishings, the curtains and drapes, and the floor covering? Are there any interesting features such as a fireplace, an alcove, an archway into another room, even an ornate cornice (crown molding) around the ceiling? Some of these features might benefit from being highlighted with special lighting, for instance, while other less attractive ones would be better disguised.

Next, examine how the room works. Are ‘traffic routes’ congested? Are the seating arrangements flexible? Are there surfaces on which things can easily be put down? Does any storage or display provision look good and work well? Can everyone who is seated see the television? Does everyone want to? Assessing the room in this way reveals its successes and failures, and shows how to eliminate the latter.

Continue the guided tour with the dining room, or dining area. This is often the least used room in the house, so its design tends to be neglected. As it is generally used for just one purpose, eating and it needs to be decorated in a way that avoids visual indigestion. Warm, welcoming color schemes and flexible lighting work best in this location; strident patterns and harsh colors are to be avoided.

Now turn to the kitchen. Whatever type of room this is, the most important consideration is that it should be hygienic, for obvious reasons. Are the various surfaces in the room easy to keep clean, and to redecorate when necessary? Are there dust and grease traps? Is the lighting over the hob (burners) and counter tops adequate? Is the floor covering a practical choice? As the kitchen is often the hub of family life, it needs to be functional but adaptable, and also pleasant to be in so that the cook does not mind the time spent slaving over a hot stove.

Bathrooms have their own special requirements, mainly revolving around combining comfort with a degree of waterproofing, especially if there are young children in the family. Are the decorations and floor covering suitable? How well do they complement the bathroom suite? What about the space available within the room? Could congestion be relieved by moving things around, or by moving them out altogether? Having a shower instead of a bath, for example, could create kits of extra space. Could a second bathroom be created elsewhere in the house? Otherwise, putting washbasins in some of the bedrooms could take the pressure off the family bathroom during the morning rush hour.

Lastly, we come to the bedrooms. The bed is the focal point of the room, so the way it is dressed will be the main influence on the room’s appearance. The color scheme also has its part to play in making a bedroom look comfortable and relaxing. Remember that the room’s occupant will see it from two viewpoints on entering, and from the bed, so take this into account when making your assessment. What about the ceiling? In the one room where people actually spend some time staring at it, does it deserve something a little more adventurous than white paint? Is the floor covering warm to the touch of bare feet? In a child’s room, is it also capable of withstanding the occasional rough and tumble or a disaster with the finger paints? Lastly, is the lighting adequate for all requirements? Most bedrooms need a combination of subdued general lighting and brighter local task lighting for occupations such as reading in bed, putting on make-up or tackling school homework. Some changes here may make the room function much more satisfactorily.

Once your tour around the house is complete, you should have a clear picture of its condition and how well it works, and some ideas as to how it might be improved. All you will have viewed is as a whole, not just as a series of individual rooms. That is the first step towards creating an attractive, stylish and practical home.

Purpura

What is Purpura?

Purpura means there is a tendency for the skin to bruise. It’s more likely in children under the age of six years, and often there may have been a tendency to bruise easily with simple knocks. A large number of purpuras exist, and they have a strange variety of names. Basically, the cause is a fault with the clotting mechanism of the blood. This usually involves tiny particles called platelets, which are part of the solid phase of the blood. There may be too few, or the place where they are produced, in the bone marrow, may be diseased.

Sometimes the condition follows a few weeks after a simple infection, often a viral one, or germs collecting in the urinary tract or teeth. There may be bleeding into the skin causing bruising. It may come from the nose, gums or urinary system these are the most common areas. Sometimes bleeding may occur into the bowel or pints or even into the nervous system, hit these are more unlikely. The child may run a fever, appear pale, but this varies. When the blood is examined, there is usually a reduced number of platelets.

Purpura Treatment

It can be a worrying time, and treatment may be needed for many months, often up to six or eight. Blood transfusions are given to restore the platelet count to normal, and these may be repeated depending on the child’s reaction.

Any infection is treated. The child is given a nutritious diet, probably with added vitamins, and the steroid drugs are sometimes used. Every effort is made to avoid injuring the body, for this will aggravate the bruising and bleeding. Certain of the newer drugs may also be used. It depends on the case, and the opinion of the doctors treating it. In continuing cases despite treatment (probably after six to twelve months of active therapy), the spleen, the large organ in the upper abdomen is sometimes surgically removed.

In most cases the results are favourable often with or without treatment, the vast majority of people recover within six months, but some may take longer and cases have continued for three years or more. Occasionally a purpura is fatal, but usually not.

Renal Dialysis

Two types of machines are available, and they are set with alarms that sound loudly if faults develop. Ideally, efforts are made so as to make the lifestyle as near to normal as possible. Some dialysers may be used at night when the patient is asleep; three 10-hour spells weekly being adequate. Other types are more powerful, and require shorter sessions.

The artificial kidney, as it is often called, is far less efficient than the real one, and many patients exist in a mild state of chronic renal failure. For this reason eating habits may be restricted, the diet may be low in protein, sodium and potassium, and the patient may be allowed only 600 ml of fluid daily.

Initially the patient may be treated in hospital in a dialysis unit. However, many are taught to run their own units, and can manage well at home. This, of course, throws added burdens on the marital partner, for supervision is always necessary and the whole system can alter the usual lifestyle in a home.

Various medical problems are inevitable with a system interfering so markedly with the normal operation of the body.

Access must be gained to the blood circulation. This is often at the wrist or ankle. Various devices are used. A so called arteriovenous teflon silastic shunt is popular. This basically consists of a tube connecting the artery and vein at the wrist. It is made of silastic and consists of two halves connected when not in use.

When dialysis is about to be carried out, the halves are separated and hooked to the machine. In some types, normal heart action is sufficient to pump the blood through the dialyser, but in others a blood pump is necessary. Blood comes from the artery through the dialyser where the unwanted metabolites of the body are filtered off, and then returned to the vein to re-enter the body’s circulation.

Dialysis vs Transplant

There is a continual question as to which form of treatment is best. There is no doubt that having a functioning organ, if possible is far preferable to having to rely on regular treatment with a machine. However, surgery carries with it the usual risks that go with an operation – possibly of the patient’s own life. Most patients are happy to accept the risk.

The main problem at present is not the acceptance of the concept by the patient, but the availability of suitable kidneys for transplant. At any given time there are probably 2000 to 3000 persons on the waiting list, anxious to undergo surgery, and hoping that a suitable opportunity (a suitable matching kidney) will become available. With greater public awareness and education, it is to be hoped that more supplies will become available. Many Western countries have taken the initiative in public educational programs, and have altered legislation making the total enterprise simpler, and notification easier. In the next few years one would expect to see a major step forward in this rewarding and lifesaving field.

Polyneuritis

What is Polyneuritis?

This striking and fairly common disorder means the nerve fibres degenerate from the periphery inwards. It may be due to chemical poisons and drugs, to toxins from bacteria in the body, or as a result of disorders of metabolism.

Not nearly so common today, although it still does occur, is alcoholic neuritis. Although this was often associated with a vitamin B deficiency, it probably produced a metabolic disturbance that in turn gave rise to symptoms. Certain industrially used chemicals may cause it, such as arsenic and mercury, often used in agricultural sprays (although the exact relationship is often disputed).

Drugs used in treatment may be a cause. It may occur in diabetics (diabetic neuritis) due to metabolic disturbances that take place with this disease. Unfortunately, even when the diabetes is brought under good control, the neuritis frequently persists. It seems most likely that the ingested toxin is absorbed by the bloodstream and affects the local nerves immediately, rather than producing symptoms from some central (brain) cause.

Polyneuritis Symptoms

Often the first symptom is a “foot-drop” in each lower limb. Muscle weakness, numbness, pain, paraesthesia (altered sensations) or anaesthesia (loss of feeling) may occur. This may also take place in the hands. If left untreated, it may intensify, and spread (“glove and stocking” distribution, suggesting that the skin areas normally covered by such garments are the parts affected with sensory alterations).

There may be alterations in the sweat secretions, ageing alterations in the skin, nails and other tissues. The disorders occur in a symmetrical fashion (eg in both lower, then upper limbs), and they tend to occur at more distant parts then spread toward the body itself. Weakness, muscle wasting, the tendency to muscular contraction, loss of normal reflex function, are all typical. The doctor can usually make a rapid diagnosis, for the picture is generally uniform.

Polyneuritis Treatment

This is purely symptomatic. The doctor will try to find the cause, if one exists, and endeavour to correct this. For example, if it seems to be due to association of a chemical poison, or drug therapy, or alcoholism, then efforts to eliminate these must be made. A search will be made to eliminate diabetes as a cause (often this can be done simply by finding glucose in the urine, now readily indicated by dip sticks in a few seconds).

Vitamin B preparations are often used in abundance. However, although these may improve the general feeling of the patient, unless there is a specific need for them, they are of no proven value. In vitamin B deficiency due to alcoholism (and resulting beri-beri), it can assist considerably. However, psychologically the use of this product can help.

General nutrition must be given attention. Relief of pain by suitable analgesics and physiotherapy in certain cases, especially where there is a risk of muscle contracture, may help considerably. Some forms of relapsing neuritis are assisted by cortisone products. Recovery often takes place, but residual aftermath involving neurotic pain, muscle contractures and wasting may present long term problems.

Calluses

What is Calluses?

Also called Callosity, a Callus is a piece of skin that has hardened due to repeated friction, contact, pressure or any irritation suffered by the area that becomes toughened. In humans, the condition commonly affects the feet because the source of irritation must be constant and often times the only thing on the human body that can facilitate this environment are shoes.

For friction that is excessively forceful or frequent, blisters are more likely to be formed. Generally, calluses are harmless causing only discomfort especially if the condition that fostered their development does not change (for example, continuing to wear the shoes that resulted in them). However, it is possible for them to lead to problems like infections and skin ulcerations. Often the term is paired with the word “Corn” because they tend to be yellow or of a yellowish color.

It is possible to develop calluses in the palms due to excessive use of instruments that squeeze or rub against them repeatedly. Persons in some professions are prone to calluses of the hands; musicians, athletes, chefs, cooks and persons who do excessive manual labor fall on that list. Calluses can appear anywhere on the body as long as the friction needed to thicken the skin is present.

Incorrect sizing of footwear as well as footwear made from hard material are the most common causes of calluses to the feet while tight or rough clothing can cause calluses on the body. Choosing the right footwear for daily activities and clothes that fit well and are not abrasive to the skin are key to avoiding these lesions.

Even when harmless, the condition can cause excruciating pain and discomfort. Also, ones daily life could be disrupted since difficulty walking or holding things may result from extreme cases. Besides pain, a burning sensation may be experienced.

Removing Calluses

To remove calluses, pare away the hardened layers (many people use razors), be careful when doing so since these can still bleed. It is recommended that calluses are soaked in warm water before paring to make the process easier and safer. Cuts to calluses can result in infections worsening both the condition and discomfort.

There are solutions made to soften or remove calluses that work to varying degrees (some do not work). Keratolytic Therapy can be used as well. These treatments thin the hardened skin and work best when applied both on and around the area. The outer layer then sheds as it loosens. Salicylic Acid is commonly used. As a home remedy, try 4 parts acetone with (up to) 15 parts collodion. Apply solution nightly and cover with an adhesive strip. Continue until callus disappears.

For a more organic approach, thoroughly wash then soak areas in warm water with 3 to 4 tablespoons of baking soda. After 30 minutes the dead skin should be removed or dissolved. Areas should be dried completely. Apply cornstarch to the area to keep it uninfected as well as dry. Tape a piece of vinegar-soaked cloth around the area before bed. Any dead skin present in the morning can be removed with a pumice stone.

Risk Factors of Heart Disease

If there are other diseases present, this may have a very pronounced effect in increasing the risk of subsequent premature heart disease. The two most widely incriminated diseases are diabetes and high blood pressure (referred to as “hypertension” by doctors).

(i) Diabetes. Diabetes is a complex metabolic disease that basically involves the pancreas. Here certain cells fail to carry out their normal job, and this has an effect on insulin production and the storage of blood sugars.

In turn, this leads to an increased risk of atherosclerosis, the blood-vessel disease that predisposes to plaque and thrombus formation in the arteries, with the risk of heart attack.

For this reason, there is an increased likelihood of blood-vessel disease, particularly stroke and heart attack, in diabetics. The sex difference in the incidence of atherosclerosis and heart disease (with a male preponderance) does not occur among diabetics. (The words arteriosclerosis and atherosclerosis are used synonymously.) (ii) Increased Blood Pressure (hypertension). In recent years, the major importance of an increased blood pressure has been realised.

When the heart muscle contracts, blood surges out into the aorta to be distributed to the arterial system of the body. The pressure at this point is termed the systolic blood pressure. Between this instant and the next beat, a period of cardiac relaxation occurs. The pressure falls in the arteries momentarily, and this is referred to as the diastolic pressure. Therefore, the doctor always records two figures, the systolic followed by the diastolic.

The upper levels of normal are 140/90. (Pressures are recorded in millimetres of mercury on an instrument called a sphygmomanometer.) It is now well recognised that the lower diastolic pressure is the one of major importance. If this is perpetually raised, it means the heart is always working against a positive pressure. This increases its workload, and also this in some way increases the risk factors.

It seems that about 10 – 15 per cent of the total adult population in Western lands have a diastolic pressure of 110 mm or more. In some areas this proportion is more, in some places it is less. But it is a significant feature. Many heart specialists believe that there is an increased risk if the diastolic blood pressure is persistently above 95 mm. Of those adults in the 50- 59-years age group, as many as 40 per cent may then come into this category, which indicates the widespread nature of the risk factor.

The key point, of course, is to recognise if the blood pressure is elevated. If it is, then a reduction will prolong life and lessen the risk of premature heart attack.

Headaches

Headaches also called Cephalalgias, are pains situated in areas of the neck or head. In short, they are caused when the cerebral articles dilate, by drug reactions as well as muscle contractions. Headaches can present themselves as symptoms of several conditions (most of which are temporary and innocuous) hence are often not isolated. Since the brain lacks nociceptors it cannot sense pain, for that reason headaches do not originate in the brain but in several structures around the neck and head that are pain-sensitive.

These structures can be found both within and outside of the cranium. The structures inside the cranium are the cranial nerves, blood vessels and meninges while situated outside of the cranium are arteries and veins, subcutaneous tissues, eyes, sinuses and mucous membranes, muscles, ears, nerves and the periosteum of the skull.

Headaches can be intermittent, transient, frequent, ill-frequent, mild, moderate and severe with some even having debilitating effects. Most, like tension headaches, can be treated with simple over the counter (OTC) drugs however, recurring pains should immediately be brought to the attention of a certified medical doctor for analysis and proper diagnoses in order to eliminate the problem or keep it under control.

There are many substances made to deal with headaches. Some types are only available on prescription while others can easily be accessed by anyone. Understanding and following the recommended dosages is important to avoid prolonging, worsening or aggravating the condition. Adhering to guidelines not only improves effectiveness, it also prevents overdoses.

Treating headaches is in no way limited to traditional medicines. Alternative means are constantly surfacing while some can be avoided or eliminated by removing the stimuli or irritant.

Common causes of headaches include:

Simple Infections- upper respiratory infections are the main culprits however, most infections will result in headaches. This is as a result of the invasion of viral and bacterial agents invading the body producing toxins that get distributed throughout the body via the bloodstream as they grow or multiply. Aches and pains then present themselves, mainly in large muscles areas and the joints.

Elevated temperature-these headaches tend to be localized pains, occurring in certain parts of the head. These can often by treated with home remedies or OTC drugs. Consult your physician if 12 to 24 hours of home remedies or OTC maximum dosage does not eliminate the issue.

Severe Infections-meningeal irritation can result in severe headaches. This means the tissue that covers the brain (the meninges) has been exposed to an irritant. Conditions such as encephalitis and meningitis are two such examples. Treatment for these are prescribed and done under doctor’s supervision from the onset since mild drugs are insufficient and these can be life-threatening illnesses.

Brain Tumors-these have several symptoms however, headaches tend to present themselves first. The term ‘tumor’ refers to the growth of abnormal cells and can be benign (non-cancerous) or cancerous. Brain tumors are therefore the growth of abnormal cells within the brain.

There are also stress factors, poor dieting, fatigue, exposure to excess noise, bright lights and prolonged use of the eyes.

Lawn Weed Control

The only place where weeds are acceptable is in a wildlife corner, although some people find daisies in the lawn a very attractive feature. Generally, however, weeds have to be controlled.
Any perennials that arise from small pieces of root left in the soil should be dug out, as should any suckers, and any seedlings should be hoed off.

It is inevitable that there will be some annual weeds appearing from time to time around plants, such as climbers, but, if these are removed before they set their seed, their numbers will gradually drop as the reserve of seed in the soil is used up.

There are two main weapons if you want to cut down on weeding: mulching, which uses no chemicals, and herbicides.

Killing weeds in beds and borders

Although there are herbicides that will kill some problem grasses growing among broad-leaved plants, generally you can’t use selective weed killers in beds and borders. Most herbicides will kill or damage whatever they come into contact with, but there are ways in which you can use herbicides around ornamental plants to minimize the amount of hand weeding necessary.

You may be able to treat areas in a shrub border with a watered-on weed-killer simply by shielding the cultivated plants. If deep-rooted perennials are not a problem you can use a contact weed killer that will act rather like a chemical hoe (a real hoe may be an easier alternative to mixing and applying a weed-killer if the area is small enough).

Deep-rooted perennial ‘problem’ weeds, such as bindweed, are best treated by painting on a trans-located weed-killer such as one based on glyphosate. Ordinary contact weed-killers may not kill all the roots, but this chemical is moved by the plant to all parts. Even so, you may have to treat really difficult weeds a number of times for long term eradication. Use a gel formulation to paint on where watering on the weed-killers may cause damage to adjacent ornamentals.

Mulching

Once the soil is clean, applying a mulch will do a great deal to help to keep weeds under control. It will not prevent perennial weeds that are already established from coming up but it will prevent any further germination from the seed in the soil. It will also reduce the amount of moisture lost to evaporation. A wide variety of materials can be used.
The main advantages of loose organic mulches are that they look attractive, can often be homemade (and are therefore inexpensive), and are gradually incorporated into the soil by the activity of worms, adding to the organic-matter content. It is important to top them up every year if they are to remain effective.

Inorganic mulches, such as black plastic and woven membranes, are less pleasing to the eye but provide a much more effective barrier against weeds. They are most useful in shrub beds that can be left undisturbed for some years, and are best used when the bed or border is newly planted. When using inorganic mulches, always prepare the ground as thoroughly as you would if not using a mulching sheet.
It is possible to use a combination of both types of mulch. Lay the artificial material, then cover it with an even layer of bark or gravel. This creates the best of both worlds, providing good protection against weeds and a pleasing appearance in the garden.

Weeds in lawns are best controlled by a selective hormone weed-killer, ideally applied in mid- or late spring. These are usually applied as a liquid, using a dribble bar attached to a watering-can. To ensure even application you should mark out lines with string, spacing them the width of the dribble bar apart.

Always mix and apply the weed-killer as recommended by the manufacturer. There are a number of different plant hormones used in those products, some killing certain weeds better than others, so always check that it is recommended for the weeds you most want to control. If your lawn also needs feeding, you can save time by using a combined weed and feed. The most efficient way to apply these — which are likely to be granular rather than liquid— is with a fertilizer spreader. Check with your local nursery, if unsure.
If you have just a few troublesome weeds in a small area, it is a waste of time and money treating the whole lawn. For this job, a spot weeder that you dab or wipe onto the offending weed will work well.

Mulching with grass cuttings

Grass cuttings are readily available in most gardens. They are not the most attractive form of mulch but can be used effectively at the back of borders, where they are not easily seen. Do not heap them on thicker than 5 cm/2 in or they may heat up too much as they decompose, harming the plant. Do not use cuttings from lawns that have recently been treated with a lawn herbicide which might harm the plant

WEEDING BY HAND

  1. The advantage of hand-weeding is that you can thoroughly check which weeds are present and can take more rigorous action if perennials are spotted. At the same time, it also enables you to spot any seedlings produced by plants that you may want to transplant or pot up.
  2. Hoeing is quicker than hand weeding and allows you to get round more frequently. It is very effective against annual weeds but chopping the top off a perennial does not kill it and it will soon re-emerge. Do not dig too deeply with the hoe or you may disturb the plant’s roots.

USING A LOOSE MULCH

First, prepare the ground thoroughly, digging it over and working in plenty of organic material such as rotted manure or garden compost if the soil is impoverished. Dig up deep-rooted perennial weeds, otherwise they could grow through.

Then water the ground thoroughly. Do not apply a mulch to dry ground. Finally, spread the mulch, such as the hark mulch shown here, thickly over the ground.

INSTALLING A SHEET MULCH

  1. Make a slit around the edge of the bed with a spade, and push the sheet into this. For a vegetable plot you can use special plastic pegs, but these are too conspicuous for an ornamental position.
  2. Make cross-shaped planting slits in the sheet with a knife or scissors. If planting a shrub you will probably have to make slits large enough to take a spade for planting. This won’t matter as the sheet can be folded back into place.
  3. Small plants can be planted with a trowel, but for shrubs you will need to use a spade. Provided the ground has been well prepared before the sheet was laid, it should be easy to dig out the planting hole.
  4. Although most of the sheer mulch will be hidden as the plants grow, it will be very conspicuous initially. A layer of a decorative mulch such as chipped-bark or gravel will make it much more acceptable.

Stroke

An enormous number of blood vessel disorders regularly occur in the brain. Just as the heart and coronary blood flow may be adversely affected by the nature of the walls of the blood vessels, so the brain may be similarly affected. However, the cardiac picture is repeated and extended in the brain, for the circumstances are somewhat different.

Almost all cases of serious brain damage (many of which lead to sudden death) are associated with damage to the blood vessel walls, and nearly always there is associated elevated blood pressure. Sudden disasters affecting the brain are usually referred to as “cerebrovascular accidents” (CVA for short). This means accidents in the blood-vessel system of the brain.

These often involve a series of events, which may be separate or occur in combination. Nearly always the vessel walls are adversely affected by atheroma. With the increased content of blood fats (essentially cholesterol and triglycerides), this material is laid down in the walls of the vessels. This leads to their thickening and hardening. Other elements are also laid down, and together these produce atheroma, or hardening of the walls. Collectively this is called arteriosclerosis, or atherosclerosis. It can occur slowly, over a period of many years, and gradually affect the blood vessel system throughout the whole body. But the vessels of the heart and the brain seem to be particularly susceptible to these pathological changes.

As this advances, and it is very common in the second half of life when the risks increase with advancing years, the blood flow through the cerebral system is impeded. The vessel becomes narrowed as its walls thicken. Certain parts may become narrower than others, impeding still further blood supplies (and food and iffproxygenation) to particular areas, ultimately causing damage there.

Atheromatous plaques form on the walls, and these may become craggy outposts in the central vessel bloodstream. Blood clots may commence at these points. Later on, part of the clot, or the entire mass, may break off and become part of the cerebral circulation. Suddenly, this may block a major or minor vessel, and an abrupt cessation of blood to a given area will ensue. Depending on the area this nerve centre supplies, symptoms will follow. Embolus formation, as it is called, and its subsequent blocking of a vital area is common.

Smaller arteries may steadily narrow, and these may gradually become filled with clot. This is termed a thrombosis. Again, brain areas affected by clot formation may soften and undergo liquidation. Often the vessels around them are weakened by atheroma. If the patient also suffers from an increased blood pressure, the combination may lead to a sudden breakdown in the arterial walls. Blood spurts out into the surrounding tissues. As it enters the vascular brain substance, inevitably more and more vessels are exposed and broken, so that a small rupture may become a major one. Of course, it may be a large vessel that originally ruptures, destroying a large area of brain tissue.

Brain hemorrhages of this nature are usually of major impact. Often death occurs, usually not instantly (as with the dramatic heart attacks), but generally within hours. The cerebral hemorrhage is often referred to as an “apoplexy of sudden onset,” and usually the outlook in these cases is grave. The brain is a very vascular organ. If smaller vessels are interfered with over a period of time, blood will be channeled from other areas through the so called “collateral circulation” to provide nutritional elements to the part involved.

In recent years, with more investigation of the brain possible with newer forms of scrutiny (particularly with angiography, cerebral scans and more recently with the computerized tomogram, MRI and PET), information is accumulating about these forms of brain disorder. Although certain disorders occur in the brain itself, others may be located in the blood vessels supplying it. For example, they may have become pathologically narrowed by disease, preventing adequate blood from reaching the nerve cells. In some cases, this may be helped by surgery.

Stroke Symptoms

The symptoms of a stroke (as these conditions are collectively referred to) vary with the site of the lesion. A common outcome is for one half of the body to be involved. A paralysis of that half can occur rapidly. This is called Hemiplegia. There may also be loss of speech. The essential feature is weakness and complete looseness of the muscles on the affected side of the body.

Hemiplegia is the most common sequel to vascular accidents of the brain. After the initial cerebral ischemic (lack of blood to the part) attacks, if death does not follow (and this may take anything from hours to days following the stroke), then restoration of function may take place. If this does occur, it is usually in a particular fashion. The deviation of the tongue to one side and the lack of facial symmetry clear up first. Then the lower limb begins to recover. Finally (and often very incompletely) the upper limb movements improves. The joints recover first proximally (i.e. the ones closest to the trunk). The result is that the patient can often stand after a period, but is not able to walk properly, for the feet may not be able to function adequately.

However, often the patient suddenly develops a coma with a CVA. If this is deep, with the patient showing no response to stimulation, and with respiratory irregularity, the outlook is increasingly poor. Often a sudden rise in temperature will herald death.

Stroke Treatment

Almost invariably the patient has other underlying disorders precipitating the onset of the CVA. However, there has often been no treatment beforehand, and the patient merely presents in a coma, the accident already having taken place. Treatment is minimal at this stage, and supportive therapy in hospital is all that can be given in the hope that the patient will regain consciousness and be amenable to recovery to some degree.

If a patient is seen for the first time in a coma, the best form of therapy that can be instituted by an onlooker is to place the patient in a supine position (on the back) and endeavor to make certain the airway is clear, then check for cardiac and respiratory function. If these are not present, artificial respiration (mouth to mouth resuscitation) and external cardiac massage may assist in restoring these vital functions until either expert medical attention arrives or the patient can be transported to the emergency unit of a hospital.

Anticoagulants have been tried by doctors, but this is currently not favored as being helpful in these cases. If the patient shows signs of improving, the doctors might carry out investigations (e.g. angiography, CT scan, MRI) to see if the patient is a suitable candidate for neurosurgery. Sometimes narrowing is discovered in the arteries in the neck or thorax that may be assisted by surgery. Whatever line of action is taken, often the hemiplegia is not greatly assisted by such measures. Many patients do not improve significantly.

The best advice that can be given for preventing heart attacks include the regular check ups. There are devices that can show if the blood-vessel system is likely to be affected by disease. Elevated blood fat levels (cholesterol and triglycerides) are a measurable entity. If they are raised, efforts to reduce them must be made as early as practical. This has been clearly outlined in the section on the heart, and reference to this is recommended. If the blood pressure is raised, this too must be reduced to acceptable levels. Cigarette smoking and alcohol intake must be curtailed or stopped. Taking sensible measures before it is too late is the wisest approach to what may be a sudden and lethal disease.