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Trying to provide the best environment for someone with dementia in the present crisis: the three ‘Ss’

Dementia

It’s a difficult time for all of us – and particularly so for anyone with dementia. We are all being urged to stay at home and people in care homes are no longer allowed even to see visitors. How can those of us caring for people with dementia provide an environment that gives them the best experience in these circumstances?

First, it is important that the environment is supportive. Life does not always run smoothly and those of us who still have plentiful cognitive reserves learn to cope with that fact. We can acknowledge the need to limit our social contacts and our outings in the present circumstances. We can accept that we may feel anxious, bored and annoyed and we all hope to ‘come out the other side’ when life resumes its normal path.. Someone who has little cognitive reserve, for whom even following a routine is difficult, will find any change or complication doubly difficult. People with dementia need support. They need support from those around them and it is doubly important that those they rely on for support continue to give calm and consistent care.

As much as possible carers should keep to the habitual routine. There is no need to force the person with dementia to stay indoors, for example. If the rest of us are allowed outdoor exercise then so are they. ‘Social distancing’ can easily be maintained simply by walking in quieter areas or gently directing the person you care for in the right direction.

Secondly, the environment should feel safe. Note that I am not saying here that the environment should be safe but that it should feel safe to the person with dementia. Naturally, we should aim for a clean home environment – but becoming over-protective about touching surfaces or cleaning areas is not going to help someone with dementia to feel more safe and secure. It is more likely to cause extra stress as they cannot understand the need for such precautions. And bear in mind that most people with dementia confronted with a person wearing a mask and gloves are likely to feel terrified rather than safe.

Thirdly, the preferred environment for people with dementia should be stimulating to the senses and provide an opportunity for social interaction. Now that day centres and dementia cafes have been forced to close many carers are finding it quite challenging to provide activities for people with dementia and even more challenging to provide social interaction.

The fact is that without stimulation any of us may become bored and doze off. How often has this happened to you whilst watching a boring TV programme? People with dementia are frequently bored because many of the occupations with which they passed the time previously are now closed to them. Boredom can lead to difficult behaviour and restlessness, but often it just results in sleepiness. Simple tasks can be enjoyed – think sorting books by size, pairing socks, ‘tidying’ shelves, dusting and polishing. And remember that an impaired memory can be an advantage. If you ask someone to dust a piece of furniture more than once they are unlikely to remember that they have just completed the task. Outdoor jobs like watering plants, raking up leaves, and carrying trimmings to the compost heap combine fresh air and exercise as well as passing the time and ‘tidying the shed’ can occupy a good few hours even if the result doesn’t live up to the job description! Watching visitors to a bird table can be absorbing and this can be done through a window if the weather is not so good.

Providing social interaction is more challenging. Today we are being urged to use technology and social media to keep in touch with others but this is not an acceptable alternative for people with dementia who progressively lose the ability to work even simple devices such as a remote control. Many people with a cognitive difficulty will also be unable to associate screen pictures with the ‘real thing’ and may even find them frightening.

Telephone calls are often still acceptable as this is a method of communication that is still familiar so ask your relatives and friends to use the telephone to make contact.

You can also talk to neighbours ‘over the fence’ or whilst keeping an acceptable distance on a walk. Carers from care agencies are still allowed to visit to provide personal care or companionship if this is necessary so don’t cancel your regular care and remember to give them tips about chatting to the one you care for.

Blog post written by Mary Jordan, author of The Essential Carer’s Guide to Dementia

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Exercise in Lockdown for Osteoarthritis

Knee

We are all facing the very real threats of Coronavirus and many of us are self-isolating now, especially the over 70s. Life as we knew it has completely evaporated.  For anyone with osteoarthritis, there are plenty of things that you can do to help the condition and keep yourself generally healthy in the face of such a threat.

What better way to spend all our cooped up time than doing some exercise, at whatever level you can manage?  It helps to have an exercise slot during your very long day so that you remember to do it and it gives you something positive to do.

If you have an exercise bike, now is the time to build up the muscles around the knee which protect arthritic joints and make legs stronger.  Just 10 minutes a day can make your legs feel good and strengthen the knee area.

There are also specific exercises for  osteoarthritis in the knees,  hips and hands.

  • For arthritic fingers: try some gentle stretching/splaying of the fingers, or make a fist with your hand and then completely relax it.
  • For knees: sit well back in the chair with good posture. Straighten and raise one leg. Hold for a slow count up to 10, then slowly lower your leg. Similar exercises can be done lying down or standing. If you are unsteady on your feet hold on to a firm surface and do a few squats bending your knees so that they are over your feet, making sure you only do as much as you can.

Knee squats

  • For hips: Hold onto a work surface and march slowly on the spot bringing your knees up towards your chest alternately. Don’t raise your thigh above 90 degrees. Also, holding on to a surface, bend each knee in turn, putting your heel up towards your bottom with the kneecap pointing towards the floor.

Heel to butt

There are more diagrams (courtesy of Versus Arthritis) in One Step Ahead of Osteoarthritis with helpful instructions.

So with all this time on our hands, do something helpful for your fitness, to keep your joints working well and avoid getting bored.  Above all, stay safe.

Blog post written by Frances Ive, author of One Step Ahead of Osteoarthritis.

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Artemesia annua and the Treatment of Viruses

Artemesia annua

The outbreak of COVID-19 has advanced through the human population at an accelerated rate with devasting effects not only on our health, but by bringing fear and uncertainty in its wake.

Originating in China, it has now spread worldwide, and whole regions have been locked down in order to try to contain the advancement of this virus.

Any scientific research data on the effects of  therapeutic strategies is scarce at this time, but the FDA in the US have recently approved the use of some existing drugs in the battle to contain and treat this virus, including the anti-malarial drug, hydroxychloroquine, which is showing encouraging results.

In my book,  Irritable Bowel Syndrome & Giardia, I explain how to use Artemesia annua (Sweet Wormwood) which is widely used to treat malaria, but is also very effective in treating Giardia, a parasite which can cause very debilitating bowel and digestive disturbances.   Artemisinin, the active principle of Artemesia annua, has been shown to have anti-viral properties.

Therefore, it would be well worth considering taking Artemesia annua as detailed in the book, Irritable Bowel Syndrome & Giardia, for the treatment of viruses. I have also created, as another part of my treatment strategy for viral infections, Optimal Support #1, a holistic herbal spray that offers energetic support to the mind and body. Both myself and my clients have found it very useful. This is fast becoming a best seller for Herbal Energetix. Due to the high demand, please sign up to our newsletter where details of how to obtain these products will be shown shortly.

I would also recommend the vegetable juice recipe, featured in the book, is taken daily to boost the immune system, together with three organic oranges or one grapefruit to help boost the vitamin C intake

For more information and copies of Susan Koten’s book and sprays, please  go here or visit our online shop at www.herbalenergetix.co.uk

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Coping with loneliness and depression if someone has to self-isolate

Lonliness

The word ‘isolation’ can also be described as ‘the condition of being alone’, so it is no surprise that many of us are struggling with being lonely, low mood and depression. This is especially worrying for those who are over 70. In the younger generation, the term ‘self-isolate’ means staying at home with family, for those who are older, they may already live on their own, and their only human connection is when they go out and visit friends.

If you have an elderly loved one, or neighbor who is self-isolating, check up on them as often as you can, it need only be a short phone call, but you may be the only person they have spoken to that day. If you are the person who is struggling with the loneliness whilst having to self-isolate, there are many help lines who can offer support and a friendly voice when in times of need, such as The Silver Line, who offer a confidential, free helpline or telephone friendship for the elderly; call them on 0800 470 80 90.

Encourage your loved one or neighbor to limit their intake of the news. The more you hear, the more you buy into the panic. This only adds to the current anxiety. Instead, encourage them to watch a lighthearted TV programme or film.  You can even watch it alongside them whilst chatting on the phone so it gives them the feeling of company.

Encourage them to stay in touch with the outside world via Skype, WhatsApp or other messaging apps. Many of the elderly now have smartphones and will be aware of these forms of contact, even though it might not be their instinct to use them.

I hope some of these tips will help to keep our loved ones and neighbours in a positive state of mental wellbeing, after all…..self-isolation does not have to mean mental isolation.

Blog post written by Hammersmith author, Lynn Crilly, author of Hope with Depression, Hope with OCD and Hope with Eating Disorders

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Coping with anxiety in this time of crisis

anxiety in a time of crisis

As we are all already aware, this is a very distressing and unsteady time for many. I would like to offer some hope to those who are suffering from anxiety and anxious feelings, whether you are  or have been a sufferer of anxiety in the past, or whether the unsteadiness of this current time has caused the feelings of anxiousness and unease, I hope some of the strategies below will be able to help you cope.

  1. If you have read any of my ‘Hope’ books, you will be very aware that I am a great advocate for positive exercise and mental well-being. Many of us would leave the house on a regular basis, whether it was walking to work, or walking to drop the children at school, or a regular member of the gym, we are finding ourselves suddenly cooped up with our regular activities on hold. Making sure you are still getting regular exercise is paramount to our mental health, there are so many exercise videos on YouTube and online from beginner HIT sessions to yoga and Pilates. If you are able to leave the house, taking a brisk walk whilst getting fresh air will be invaluable. A good nights sleep and eating a balanced diet also complement exercise for their benefits on the mind.
  2. Onto my next topic….the media….whilst it is extremely important that we are all keeping up to date with the current situation, it is also important that we take our minds off it for our own sanity. Having a ‘media free’ or ‘tech free’ time each day will help us to focus on other topics and calm our minds. I love doing puzzles and find them very therapeutic. Other activities could include, reading a book, or even cooking a nice dinner.
  3. Spending more time at home is probably on most people’s wish lists, however, when it is suddenly thrown on us, we don’t know what to do with ourselves. The risk of not being able to socialize as we usually would could lead to a low mood slowly setting in. Getting up each day and giving yourselves a little self-care will go a long way to keep our minds positive and fresh.Wash your hair, shower regularly, put on fresh clothes, and you will feel ready to face the day.

Blog post written by Hammersmith author, Lynn Crilly, author of Hope with Depression, Hope with OCD and Hope with Eating Disorders

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Coronavirus – what you need to know

coronavirus

By Dr Sarah Myhill

Introduction

It now seems inevitable that sooner or later we will all be exposed to coronavirus. This is because people can be carriers of this new virus without showing any symptoms. The strategy to slow and treat therefore is FIRST slow the rate at which the epidemic grows so that medical services are better able to cope. SECOND, reduce the loading dose of infection so that the viral numbers take longer to build up in the body and so not overwhelm the immune defences. THIRD, start to improve the body’s immune defences now before you are exposed to the virus. FOURTH, kill the virus directly with vitamin C (well known for its antimicrobial actions as it is used widely as a food preservative) and iodine (a disinfectant with long pedigree)

We know that coronavirus, like the flu virus, will kill some people. However, the vast majority will live – survival is determined by good immune defences. So:

  • Act NOW to improve the body’s immune defences (our standing army)
  • STOCK UP NOW with ascorbic acid 500 grams (at least), Lugol’s Iodine 15% (30 ml) and salt pipe

Before you show any signs or symptoms of illness

The severity of any infection partly depends on the loading dose of infection. Take action to keep this loading dose low so that it takes longer for the numbers of viral particles to build up in the body. This gives the immune system time to generate an effective immune response. At this stage do not suppress symptoms with medication since this inhibits inflammation – the very tool the immune system needs to fight infection.

Make sure you have this package in place:

What Why
Eat a low carbohydrate diet, ideally paleo-ketogenic High blood sugar encourages all infections (diabetics are especially susceptible to infection)
Take a good multivitamin/mineral supplement The immune system cannot function without raw materials
Vitamin D at least 5,000 iu, ideally 10,000iu daily We get more infections in winter because we are at our most deficient then
Vitamin C at least 5 grams daily This vitamin contact-kills all viruses – the key is the dose – you have to take heaps!

For more detail see– ‘Groundhog basic’ in my book The Infection Game: life is an arms race

If there is any hint of possible exposure, keep the infectious load down with:

  • Good hygiene – wash hands regularly. After washing rub iodine oil into your hands. You can make an iodine oil yourself using 10 parts of coconut oil to 1 part of Lugol’s iodine 15%. Iodine contact-kills all microbes, as I have said; it is the best disinfectant – ask any surgeon – this is what is used before surgical incision and to prevent post-operative wound infections. Yes, your hands will be stained slightly yellow but then you will know the iodine is there.
  • Sniff and inhale Lugol’s iodine 15% 2-3 times a day using a salt pipe. I suggest 2 drops in a salt pipe sniffed up into the nose and inhaled 15-20 times. Iodine is an effective topical disinfectant. It is also volatile so when inhaled kills or substantially reduces the numbers of all microbes threatening to enter the airways.
  • And/or …possibly use a face mask, drizzle 2-4 drops of Lugol’s iodine 15% on to the lining. for the same reasons as above. Re-apply Lugol’s three times a day.
  • And/or …smear iodine oil (made as above) round the nose and upper lip three times a day. Yes, it does stain the skin yellow temporarily but it slowly evaporates from the skin to generate a disinfectant cloud of iodine. This is good for kids who may not be able to use a salt pipe or tolerate a mask.

For much more detail see my book The Infection Game: life is an arms race

At the first sign of any infection (runny nose, sore throat, cough… you know!):

Strike early and strike hard with…

What Why
Take 10 grams of vitamin C (as ascorbic acid powder) in 500 ml of water every hour until you get diarrhoea – this is called ‘bowel tolerance’ This is of proven benefit – see references below.

You must take enough vitamin C – you can only fail by under-dosing. Vitamin C is completely safe and you can do no harm with it. As one of my comic patients put it ‘Premature crapping is preferable to premature croaking.’

Inhale Lugol’s iodine every two hours. I suggest 2 drops in a salt pipe sniffed up into the nose and inhaled – this may slightly stain the inside of your nose – but then you know the iodine is present. You will know the iodine is in the right place because you can smell it. Iodine is non-toxic to humans and all mammals (but if you are allergic to iodine then you should not use it)
Good nursing care – go to bed, wrap up warm and allow the body to run a fever Heat kills all microbes
Tell everyone that you are ill so that… …they can put in place all the above to reduce their loading dose and deal effectively with the virus
To quote the poet Dylan Thomas ‘Do not go gentle into that good night….’ Fight hard and stay alive!

For more detail, see ‘Groundhog acute’ in my book The Infection Game: life is an arms race

Advice for children

  • The principles are exactly the same.
  • And no-one has ever had serious side effects from vitamin C – perhaps use 5 grams every hour to bowel tolerance – or less depending on size.
  • Use vitamin D at proportionate body weight – use the 10,000 iu but perhaps every other day or every third day – the capsule can be chewed in the mouth.
  • Really important to use topical iodine oil over the nose and upper lip as this reduces the infectious load when inhaling and exhaling
  • What is interesting is that the Chinese babies whose mothers have had coronavirus have survived fine. I suspect this is about the immune system – with very high viral loads, the immune system over-reacts and it is this over-reaction that kills. It is called a cytokine storm. This is why the very sick patients are treated with anti-inflammatory drugs such as paracetamol, NSAIs and steroids (which you would think counterintuitive. There is a place for these drugs but not with mild symptoms). My guess is these Chinese babies do not have the immune reserves for a cytokine storm and so have survived well.

Very sick patients

Very sick patients will of course need hospital treatment with anti-inflammatories (for the cytokine storm), oxygen and respiratory support (for respiratory failure). The Chinese doctors are currently treating severe cases of covid-19 with additional intravenous vitamin C and seeing excellent results.

Support for the use of high doses of vitamin C

Follow the links below for more information about the science and clinical experience behind using high-dose vitamin C:

From 1943 through 1947, Dr Klenner reported successful treatment of 42 cases of viral pneumonia using therapeutic doses of vitamin C. This was administered by mouth, intravenously and intramuscularly. See:

And there is lots more good science and practical detail at Ascorbate Web

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Using Pro-Resolution Nutrition To Control the Coronavirus

Virus

This post originally appeared on DrSears.com. It is written by Hammersmith Health Books author, Dr Barry Sears, author of The Mediterranean Zone

Viruses and bacteria were here long before we were and will definitely outlast us. So, when a new pathogen crosses from its natural animal reservoir to infect humans, what are you going to do? One choice is the ancient approach to quarantine infected individuals until the disease runs its course. That method was used in fighting the Black Death that started in 1348. Actually, the first appearance of the Black Death occurred about 800 years earlier when it was known as Justinian’s Plague and is estimated to have killed between 30 to 50 million in the Roman Empire. When it re-emerged in the fourteenth century it killed about half the population in Europe or approximately 75 million people. However, it didn’t immediately disappear as it continually reappeared in Europe until about 1660. The most effective interventions against the Black Death were draconian measures ranging from closing the borders, use of quarantines in both international trade (i.e., preventing ships from entering ports) and in domestic travel, and finally in keeping citizens confined to their towns to await their fate.

Newly emerging viruses can even be worse. According to the Centers for Disease Control (CDC), the first appearance of the influenza virus in 1918 infected about 1/3 of the world’s population, killed between 20 to 50 million worldwide including 675,000 in the U.S. between 1918 and 1920 (1). There were no vaccines, no antibiotics to treat secondary infections at this time, just quarantines and good personal hygiene.

Today, the modern way to treat pandemics of bacterial or viral infection is to simply surrender to the power of pathogens and use vaccines and antibiotics and modern medical care (i.e., ventilators, etc.) for the infected until the patient either survives or dies. According to the CDC, we are still not doing a good job in the U.S. as in the 2018-2019 flu season, it is estimated that more than 35 million Americans were infected (about 9 percent of the total population) with the flu, and 34,000 Americans died even though we had vaccines and antibiotics (2). While those numbers are definitely better than they were in 1920, but don’t bode well for future new viruses.

So, how are we handling the current coronavirus since we have no vaccine? The Chinese are using the ancient method of strict quarantines. It is highly unlikely that type of iron-fisted population control will work in the United States and Europe. And without a vaccine, the spread of this virus into an immunologically naïve population can rapidly expand. Is there another approach?

I believe the answer to that question is a definite yes. I call this the immuno-nutrition approach. The body has a powerful internal system to fight viral and bacterial infections. It’s a combination of both the innate and adaptive immune systems. The innate system is ancient and primitive as it reacts quickly to chemical structures. It works as our first responder to any type of microbial invasion. The adaptive immune system is more sophisticated in that it uses immune cells that digest the microbial invader and hopefully remember its structure when it might return. The adaptive immune system is slow to response (especially to a new biological invader) because it needs the innate immune system to prime it. However, unlike the adaptive immune system, the innate immune system is under strong dietary control and that’s where immuno-nutrition comes into play.

Immuno-nutrition is not simple advice to eat a healthy diet, but requires following a highly defined nutritional program to optimize the innate immune system to make the adaptive immune system more responsive to all microbial invaders. The key feature is your ability to optimize the Resolution Response™. The Resolution Response is your body’s internal healing response. It is composed of three distinct dietary interventions to reduce, resolve, and repair the damage caused by an injury including those caused by microbial (i.e., viral and bacterial) infections such as the coronavirus (3)

Without going into great detail in this blog, any injury causes an initial inflammatory response to alert your immune system that you are under attack. The more inflammation you have in your body, the less likely you can optimally activate your immune system to respond to this microbial challenge. This is why your first goal is to reduce excess inflammation in the body, not by taking an anti-inflammatory drugs (which are also anti-resolution drugs that inhibit the next step of the Resolution Response), but by following an anti-inflammatory diet such as the Zone diet (4-6). That is only the first step. Next you have to resolve the inflammation induced by the microbe by increasing the production of a group of hormones known as resolvins (7,8). This can only be done by consuming high levels of omega-3 fatty acids in the diet to maintain a low AA/EPA ratio in the blood. What is the right dose of omega-3 fatty acids? Your blood will tell you. If your AA/EPA ratio is between 1.5 and 3, then you are taking enough (3). Most Americans will require at least 5 grams of EPA and DHA per day to reach that ideal AA/EPA range since the average AA/EPA ratio for most Americans is about 20. Finally, you have to optimize the innate immune system using high-dose polyphenols that are water-soluble so they get into the blood to activate the gene transcription factor known as AMPK. How many polyphenols? Enough to keep your levels of glycosylated hemoglobin (HbA1c) between 4.9 and 5.1 per cent. This will take about 1 gram of water-soluble polyphenols per day with delphinidins being the best choice (9).

Of course, the more closely you follow the Zone diet, the fewer water-soluble polyphenols or omega-3 fatty acids you will need to optimize your internal Resolution Response (3). Such water-soluble delphinidins that can activate AMPK are found in low levels in blueberries or in far higher concentrations in delphinidin extracts. Once AMPK is activated by these water-soluble polyphenols, then it begins to orchestrate your immune system to attack and neutralize the microbe. This is definitely a team approach. If any one of the three steps (reduce, resolve, and repair) is not working at optimal efficiency, your ability to control the outcome of the microbial infection (in this case the coronavirus) will be inhibited.

This could mean the difference of either having runny nose or being on a ventilator because the likelihood you will be exposed to the coronavirus is great due to globalization. The choice of the outcome of that coronavirus exposure is yours.

References

https://www.cdc.gov/flu/pandemic-resources/1918-pandemic-h1n1.html
https://www.cdc.gov/flu/about/burden/2018-2019.html
Sears B. The Resolution Zone. Zone Press. Palm City, FL (2019)
Sears B. The Zone. Regan Books. New York, NY (1995)
Bell SJ and Sears B. “The Zone diet: An anti-inflammatory, low glycemic-load diet.” Metabol Synd and Related Disord 2:24-38 (2004)
Hotamisligil GS. “Inflammation, metaflammation, and immunometabolic disorders.” Nature. 542: 177-185 (2017)
Serhan CN. “Pro-resolving lipid mediators are leads for resolution physiology.” Nature 510: 92-101 (2014)
Morita M et al. The lipid mediator protectin D1 inhibits influenza virus replication and improves severe influenza. Cell 153(1):112-125 (2013)
Jin X et al. “Delphinidin-3-glucoside protects human umbilical vein endothelial cells against oxidized low-density lipoprotein-induced injury by autophagy upregulation via the AMPK/SIRT1 signaling pathway.” Mol Nutr Food Res 58: 1941-1951 (2014)