Wednesday, September 29, 2010

email from Bernie

Dear Veera/JB
most of our school/college contacts are past late 60's and their 70's.
we should all be grateful for the more recent confirmation that neuronal replication, was not a myth,but a fact,as many noticed,
but were unable to explain how an old dog ,learns new tricks.
retiring from professions or vocations, forced at age 50-55 was a well known harbinger of death or brain death. Learning to use the less dominant hemisphere, not only taps a vast unused resource,
but also prepares one ,in the event of some neuronal damage,post embolic or other stroke related events. We forget the impact of old injuries,including mild cerebral trauma, manifesting decades later.
The impact of depression, anxiety,panic states mood changes
and other common disorders, including hostility,anger,jealousy,that occur ,but not fully recognized ,diagnosed or treated. They do lead to mental status dysfunction, and most are likely to respond to treatment, early recognition,and when less subject to denial.like I am fine,but I know you are worse, or related attitudes. Early recognition of MCI[minimum cognitive impairment] impacted the care of millions, but is only freely available to a very small minority. Ignorance and resistance,to consider the possibility of impairment,is a great obstacle. Also like in Sri Lanka, the availability of treatment,is a major factor, for the vast majority. Training the brain,will make it better,as JB has explained, but is ignore, we are functionally better ,much better, in most areas of cerebral and intellectual performance. In some areas we are less efficient, like in running,cannot swim 100 fast laps, or lift heavy weights. But we can read ,retain recollect,much more and would surprise some of our old teachers. I used to discuss this with Dr Anthonis,DJ,Daphne[latter 2 my uncle and aunt, and were embarrassed,when addressed them as such,especially after my wife Sheila started the conversation] we recalled so many incidents,
even some variations with Appendectomy procedures[even though I branched out to Psychiatry/neuro psych/forensic psych,many decades ago] most of the conversations were in non medical areas.
remembering old names numbers was one item. We have vast resources now, that we couldn't imagine before the pre Arthur Clark era. We can speak to a computer and or I phone and get the dumb contraption,to talk back and give us the information. We can write or type with errors,and receive auto correction, and the list is endless
future potential ,not even contained by our imagination.We recognized that our genes are immortal after all, and only the physical body is the transient,limiting factor.
Then who cares? Other latent clinical features,emerge,as we grow older, and we do not know how to include these,in our discussions or diagnosis. If we diagnose ,for instance ,with 6 symptoms and signs, what happens if we have only 5 or 5.99 confirmed.Are we allowed to diagnose with conviction? We may have 95% of the symptoms of MCI but remain undiagnosed,untreated,neglected?/
That is the question.
Bernard de Silva
Cincinnati/MT lavinia

email from Dawood

Lee Kuan Yew on aging ......

'Stay Interested in the World, Take on a Challenge'
by Singapore Minister Mentor Lee Kuan Yew
(This story was first published on Jan 12, 2008)

MY CONCERN today is, what is it I can tell you which can add to your knowledge about ageing and what ageing societies can do. You know more about this subject than I do. A lot of it is out in the media, Internet and books. So I thought the best way would be to take a personal standpoint and tell you how I approach this question of ageing.

If I cast my mind back, I can see turning points in my physical and
mental health. You know, when you're young, I didn't bother, I assumed
good health was God-given and would always be there. When it was about
1957 - I was about 34, we were competing in elections, and I was really fond of drinking beer and smoking. And after the election campaign, in Victoria Memorial Hall - we had just won the election, the City Council election - I couldn't thank the voters because I had lost my voice. I'd been smoking furiously.

I'd take a packet of 10 to deceive myself, but I'd run through the
packet just sitting on the stage, watching the crowd, getting the feeling, the mood before I speak. In other words, there were three speeches a night. Three speeches a night, 30 cigarettes, a lot of beer after that, and the voice was gone.

I remember I had a case in Kuching, Sarawak. So I took the flight and
I felt awful. I had to make up my mind whether I was going to be an
effective campaigner and a lawyer, in which case I cannot destroy my
voice, and I can't go on. So I stopped smoking.

It was a tremendous deprivation because I was addicted to it. And I
used to wake up dreaming...the nightmare was I resumed smoking.. But I
made a choice and said, if I continue this, I will not be able to do my job. I didn't know anything about cancer of the throat or oesophagus or the lungs, etc. But it turned out it had many other deleterious effects.

Strangely enough after that, I became very allergic, hyper-allergic to smoking, so much so that I would plead with my Cabinet ministers not to smoke in the Cabinet room. If you want to smoke, please go out, because I am allergic.

Then one day I was at the home of my colleague, Mr Rajaratnam, meeting foreign correspondents including some from the London Times and they took a picture of me and I had a big belly like that (puts his hands in front of his belly), a beer belly. I felt no, no, this will not do.

So I started playing more golf, hit hundreds of balls on the practice
tee. But this didn't bring down my waist size. There was only one way it could go down: consume less, burn up more.

Another turning point came when - this was 1976, after the general
election - I was feeling tired. I was breathing deeply at the Istana,
on the lawns. My daughter, who at that time just graduating as a doctor, said: 'What are you trying to do?' I said: 'I feel an effort to breathe in more oxygen..' She said: 'Don't play golf.. Run. Aerobics.'

So she gave me a book, quite a famous book and, then, very current in
America on how you score aerobic points swimming, running, whatever
including cycling. I looked at it sceptically. I wasn't very keen on running. I was keen on golf. So I said, 'Let's try'. So in-between golf shots while playing on my own, sometimes nine holes at the Istana, I would try and walk fast between shots.. Then I began to run between shots. And I felt better. After a while, I said: 'Okay, after my golf, I run.' And after a few years, I said: 'Golf takes so long. The running takes 15 minutes. Let's cut out the golf and let's run.'

I think the most important thing in ageing is you got to understand
yourself. And the knowledge now is all there. When I was growing up,
the knowledge wasn't there.. I had to get the knowledge from friends,
from doctors.

But perhaps the most important bit of knowledge that the doctor gave
me was one day, when I said: 'Look, I'm feeling slower and sluggish.'So he gave me a medical encyclopaedia and he turned the pages to ageing. I read it up and it was illuminating. A lot of it was difficult jargon but I just skimmed through to get the gist of it. As you grow, you reach 20, 21, 22, 23, 24, 25 and then, thereafter, you are on a gradual slope down physically.. Mentally, you carry on and on and on until I don't know what age, but mathematicians will tell you that they know their best output is when they're in their 20s and 30s when your mental energy is powerful and you haven't lost many neurons.

That's what they tell me. So, as you acquire more knowledge, you then
craft a programme for yourself to maximise what you have. It's just common sense. I never planned to live till 85 or 84. I just didn't think about it. I said: 'Well, my mother died when she was 74, she had a stroke. My father died when he was 94.' But I saw him, and he lived a long life, well,
maybe it was his DNA. But more than that, he swam every day and he kept
himself busy. He was working forthe Shell company. He was in charge, he
was a superintendent of an oil depot.

When he retired, he started becoming a salesman. So people used to tell me: 'Your father is selling watches at BP de Silva.' My father was then living with me. But it kept him busy. He had that routine: He meets people, he sells watches, he buys and sells all kinds of semi-precious stones, he circulates coins. And he keeps going. But at 87, 88, he fell, going down the steps from his room to the dining room, broke his arm, three months incapacitated. Thereafter, he couldn't go back to swimming.

Then he became wheelchair-bound. Then it became a problem because my
house was not constructed that way. So my brother - who's a doctor and had a flat (one-level) house - took him in. And he lived on till 94. But towards the end, he had gradual loss of mental powers.

So by my calculations, I'm somewhere between 74 and 94. And I've reached
the halfway point now. But have I? Well, in 1996 when I was 73, I was
cycling and I felt tightening on the neck. Oh, I must retire today. So
I stopped. Next day, I returned to the bicycle. After five minutes it
became worse. So I said, no, no, this is something serious, it's got
to do with the blood vessels. Rung up my doctor, who said, 'Come
tomorrow'. Went the day after, he checked me, and said: 'Come back
tomorrow for an angiogram.' I said: 'What's that?' He said: 'We'll pump
something in and we'll see whether the coronary arteries are clear
or blocked.'

I was going to go home. But an MP who was a cardiologist happened to
be around, so he came in and said: 'What are you doing here?' I said:
'I've got this.' He said:'Don't go home. You stay here tonight. I've
sent patients home and they never came back. Just stay here. They'll
put you on the monitor. They'll watch your heart. And if anything, an
emergency arises, they will take you straight to the theatre. You go
home. You've got no such monitor. You may never come back.'

So I stayed there. They pumped in the dye, yes it was blocked, the left circumflex, not the critical, lead one. So that's lucky for me. Two weeks later, I was walking around, I felt it's coming back. Yes it has come back, it had occluded. So this time they said: 'We'll put in a stent.' I'm one of the first few in Singapore to have the stent, so it was a brand new operation. Fortunately, the man who invented the stent was out here selling his stent. He was from San Jose, La Jolla something or the other. So my doctor got hold of him and he supervised the operation. He said put the stent in. My doctor did the operation, he just watched it all and then that's that. That was before all this problem about lining the stent to make sure that it doesn't occlude and create a disturbance. So at each stage, I learnt something more about myself and I stored that. I said: 'Oh,
this is now a danger point.'

So all right, cut out fats, change diet, went to see a specialist in Boston, Massachusetts General Hospital. He said: 'Take statins..' I said: 'What's that?' He said: '(They) help to reduce your cholesterol. ' >
My doctors were concerned. They said: 'You don't need it. Your cholesterol levels are okay.' Two years later, more medical evidence came out. So the doctors said: 'Take statins.' Had there been no angioplasty, had I not known that something was up and I cycled on, I might have been gone at 74 like my mother. So I missed that deadline.

So next deadline: my father's fall at 87. I'm very careful now because sometimes when I turn around too fast, I feel as if I'm going to get off balance. So my daughter, a neurologist, she took me to the NNI,
there's this nerve conduction test, put electrodes here and there. The
transmission of the messages between the feet and the brain has
slowed down.

So all even with all the exercise, everything, effort put in, I'm fit, I swim, I cycle. But I can't prevent this losing of conductivity of the nerves and this transmission.

So just go slow. So when I climb up the steps, I have no problem. When I go down the steps, I need to be sure that I've got something I can hang on to, just in case. So it's a constant process of adjustment.

But I think the most important single lesson I learnt in life was that if you isolate yourself, you're done for. The human being is a social animal - he needs stimuli, he needs to meet people, to catch up with the world.

I don't much like travel but I travel very frequently despite the jet
lag, because I get to meet people of great interest to me, who will
help me in my work as chairman of our GIC. So I know, I'm on several boards of banks, international advisory boards of banks, of oil companies and so on. And I meet them and I get to understand what's happening in the world, what has changed since I was here one month ago, one year ago. I go to India, I go to China.

And that stimuli brings me to the world of today. I'm not living in the world, when I was active, more active 20, 30 years ago, so that's what I tell my wife. She woke up late today. I said: 'Never mind, you come along by 12 o'clock. I go first.'

If you sit back - part of the ending part of the encyclopaedia which I read was very depressing - as you get old, you withdraw from everything and then all you will have is your bedroom and the photographs and the
furniture that you know, and that's your world. So if you've got to go to hospital, the doctor advises you to bring some photographs so that you'll know you're not lost in a different world, that this is like your bedroom.

I'm determined that I will not, as long as I can, to be reduced to that,
to have my horizons closed on me like that. It is the stimuli, it is the constant interaction with people across the world that keeps me aware and alive to what's going on and what we can do to adjust to this different world.

In other words, you must have an interest in life. If you believe that at 55, you're retiring, you're going to read books, play golf and drink wine, then I think you're done for. So statistically they will show you that of all the people who retire and lead sedentary lives, the pensioners, die off very quickly.

So we now have a social problem with medical sciences, new procedures, new drugs, many more people are going to live long lives. If the mindset is that when I reach retirement age 62, I'm old, I can't work anymore, I don't have to work, I just sit back, now is the time I'll enjoy life, I think you're making the biggest mistake of your life. After one month, or after two months, even if you go traveling with nothing to do, with no purpose in life, you will just degrade, you'll go to seed.

The human being needs a challenge, and my advice to every person in
Singapore and elsewhere: Keep yourself interested, have a challenge.
If you're not interested in the world and the world is not interested in you, the biggest punishment a man can receive is total isolation in a dungeon, black and complete withdrawal of all stimuli, that's real torture.

So when I read that people believe, Singaporeans say: 'Oh, 62 I'm
retiring.' I say to them: 'You really want to die quickly?' If you
want to see sunrise tomorrow or sunset, you must have a reason, you
must have the stimuli to keep going.'

Tuesday, September 28, 2010

You and your memory - Dr. JB Peiris

Keep your brain ticking

Senior Consultant Neurologist Dr. J.B. Peiris suggests some simple ways to keep your mental faculties healthy.;
A few days ago a friend of mine asked me how best to remember names. Having faced the problem myself (possibly, a familial trait) I could not think of a suitable answer immediately. So, I did some thinking, reading and surfing and here are some interesting facts, myths and food for thought.

By the time you are 65 years, your brain isn't what it used to be- you will start to notice the signs: you forget people's names and you cannot remember where you left your keys or mobile phone. Clearly not everyone ages in the same way.
Reaction time is slower and it takes us longer to learn new information. Sometimes it takes longer to retrieve information, resulting in that tip-of-the-tongue phenomenon — where you almost have that word or that thought. That's typical of the middle-age brain.

There is a good reason why our memories start to let us down. At this stage of life we are steadily losing brain cells in critical areas such as the hippocampus - the area where memories are processed. This is not too much of a problem at first; even in old age the brain is flexible enough to compensate.

At some point though, losses start to make themselves felt. It's true that by midlife our brains can show some fraying. Brain processing speed slows down. Faced with new information, we often cannot master it as quickly as our younger peers. And there's little question that our short-term memories suffer.

There are, however, some brain functions which improve with age. We actually grow smarter in key areas in middle age which, with longer life spans, now stretches from our mid 40s to our mid to late 60s. In areas as diverse as vocabulary and inductive reasoning, our brains function better than they did in our 20s. As we age, we more easily get the "gist" of arguments. Even our judgment of others improves. Often, we simply "know'' if someone — or some idea — is to be trusted. We also get better at knowing what to ignore and when to hold our tongues.

Fresh thinking about the brain
An old myth in neuroscience is that once a brain cell dies off you can't replace it. But many studies have now shown, that
there is, in fact, brain cell growth throughout life. It continues to develop, and even continues to grow new brain cells. So the brain can continue to learn throughout the middle age years and beyond.

Plasticity of the brain
The brain can be changed or moulded to suit the needs – the concept of "Plasticity" which relates to changes by
adding or removing connections, or adding cells. Research has shown that in fact the brain never stops changing through learning.

In a recent study referred to as "your brain on Google," healthy, middle-aged volunteers, all novices on the computer, were taught how to do a Google search. They were told then to practise doing online searches for an hour a day, for seven days. After the week's practice, the volunteers came back into the lab and had their brains scanned while doing a Google search. The scans revealed significant increases in brain activity in the areas that control memory and decision-making.
The area of the brain that showed the increases was the frontal lobe, the thinking brain, especially in areas that control decision making and working memory.

With practice, a middle-age brain can very quickly alter its neuron-circuitry; can strengthen the neuron circuits that control short-term memory and decision making.

It is also known that other areas of the brain also increase in size with usage. For example, the finger area in the motor cortex in Braille readers and professional string instrument players is more extensive than in a normal individual.
The ability of the brain to change with learning is what is known as Neuro-plasticity.

Remembering names and numbers
Let me now try to answer the question I posed at the beginning – how to remember names and numbers.
Repeat it 7 seconds later
Train your mind frequently by repeating to yourself anything you need to remember as quickly as you learn it. This is very useful especially when remembering phone numbers and dates. Repetition is a simple system on how to improve memory power, but it works even for long term memory. Recall it after 7 seconds to store it in memory.
Write it down
Let the paper remember for you. The point is to have use of the information later, and if that's more easily done by way of an "external memory device" like pen and paper, why not take advantage of these tools? Also, writing things down is another way to more strongly "fix" something in our minds.
Imagine the future use
If you think about how you will use information, you're more likely to remember it. For example if after learning a new algorithm in a math class you imagine using it during a test, you'll probably remember it better - particularly when taking a test.

How to improve ‘brain fitness’
Consider the brain a muscle.
Variety and curiosity is the basis. When anything you do becomes second nature, you need to make a change. If you can do the crossword puzzle in your sleep, it's time for you to move on to a new challenge in order to get the best workout for your brain.

Brain aerobics
What exactly constitutes a brain aerobic exercise? To qualify as a brain aerobic exercise, the activity

Needs to engage your attention

  • Must involve two or more of your senses
  • Must break a routine activity in an unexpected, nontrivial way

Play games
Sudoku, crosswords, playing chess or bridge, dancing regularly and electronic games can all improve your brain's speed and memory. These games rely on logic, word skills, math and more. These games are also fun. You'll get benefit more by doing these games a little bit every day -- spend 15 minutes or so, not hours.
Meditation
Daily meditation is perhaps the single greatest thing you can do for your mind/body health. Meditation not only relaxes you, it gives your brain a workout. By creating a different mental state, you engage your brain in new and interesting ways while increasing your brain fitness.

Turn off your television
Television can stand in the way of relationships, life and more. Turn off your TV and spend more time living and exercising your mind and body.

Exercise your body to exercise your brain
Physical exercise is great brain exercise too. By moving your body, your brain has to learn new muscle skills, estimate distance and practise balance. Choose a variety of exercises to challenge your brain.

Read something different
Branch out from familiar reading topics. If you usually read history books, try a contemporary novel. Read foreign authors, the classics and random books.

Learn a new skill
Learning a new skill works multiple areas of the brain.
Your memory comes into play, you learn new movements and you associate things differently. Learning a new language or becoming computer literate is equally good. Reading Shakespeare, learning to cook and building an airplane out of toothpicks all will challenge your brain and give you something to think about.

Make simple changes
We love our routines. We have hobbies and pastimes that we could do for hours on end. To really help your brain stay young, challenge it.

Change routes to your destinations, use your opposite hand to open doors, and eat dessert, shave, and brush teeth, texting, using the computer mouse. Writing with the other hand is a useful way of using the non dominant hemisphere to do a component associated with speech – usually located in the dominant hemisphere.
The brain is an organ like no other. You can ‘exercise’ it in many different ways and this is the best way to make the best use of it.
Use it or lose it, is true of the brain; importantly you can use it in many different ways.

email from Dawood

Hi Phillip,

This is an Important EYE TEST.
Please pass it on!!

Rgds
Dawood

Subject:
Fw: Fwd: Fw: Japanese Eye Test

Japanese Eye Test

THIS IS BRILLIANT!!!



If you cannot decipher anything, then try pulling the
corner of your eyes as if you were Japanese. Keep
pulling until your eyes are almost closed...It works.

Too FUNNY not to pass on!

Monday, September 27, 2010

The man with the shotgun

The man with the gun

It was a felicitation meeting in the village Town Hall. An official was retiring after fifty years of dedicated service. A guest speaker was invited, to give the farewell speech. He started on his speech and described the services done by the official. Then he started reminiscing about the events in his – the speaker’s - personal life, drawing parallels with the officials. The allotted time for the guest speaker was one hour. The speaker got carried away, relating experiences in his own life, that the speech was nearing two hours. Then the speaker saw a man with a shotgun entering the hall. He walked across in the space between the speaker and the large audience. The speaker stopped his eulogy and asked the man with the shotgun why he came carrying a gun. The man carrying the gun replied ‘Do not worry. Please carry on with your speech’. The speaker was nonplussed and asked the man carrying the gun ‘Why are you carrying a gun?’ The gun-carrier replied ‘I am looking for the man who made arrangements, for you to be the guest speaker in this occasion. Please carry on’.