Archive for the 'nerves' Category

One Ounce That Does a Lot

The thyroid gland is about two inches long and about one inch wide. It sits at the base of the neck, straddling the windpipe. It weighs about an ounce. When your healthcare provider encircles your neck with her hands and asks you to swallow, she is checking the size of your thyroid.

The thyroid’s main job is to control metabolism by secreting hormones.  If you, an adult, have too much thyroid hormone (hyperthyroidism) you will lose weight. If you have too little (hypothyroidism), you will gain weight. But that’s not all. Thyroid hormones have a strong influence on the nervous system, which influences everything. In turn, a change in the nervous system affects the thyroid.  Together, the thyroid and the pituitary in your brain function like the heating/cooling system in your home. For example, if the temperature in your home falls below a preset minimum on your thermostat, the furnace will start and send heat around your house until the preset temperature is reached. Then, once again responding to the temperature on the thermostat, the furnace will stop sending heat. What does all this mean for the way you feel and behave?

If your thyroid gland isn’t functioning properly it will not respond to the pituitary. The level of thyroid hormone in your blood stream will remain the same or drop further.  You may feel tired or not mentally sharp. If this persists, you may feel depressed or moody. You may have difficulty sleeping, in spite of feeling tired and sleepy. Physically, you may begin gaining weight, no matter how little you eat or how much you exercise. Meanwhile, your pituitary is frantically sending out thyroid stimulating hormone (TSH).  If this goes on long enough – the pituitary in overdrive – it may result in enlargement of the pituitary. But most people never reach this stage.  They generally feel sick enough to consult a healthcare provider.

On the other hand, if your thyroid keeps sending out thyroid hormone no matter how little TSH there is in your blood, your symptoms will be different. Emotionally you may feel anxious for no reason or more anxious for the reasons you do have. There’s some evidence that prolonged stress increases your risk for hyperthyroidism. You may be irritable or have difficulty concentrating. You may have difficulty sleeping, just as with low thyroid.  Physically you will begin to lose weight, no matter how many carbs you pile on. You might notice your heart racing, often greater than 100 beats per minute. Your hands may tremble. Eventually your thyroid will enlarge and you will feel or see the enlargement at the base of your neck. But, once again, most people have consulted a healthcare provider before this occurs.

Bottom line? That little gland in your neck is powerful. It can cause both physical and emotional/mental symptoms. The mind and the body are connected. They are both part of us. It may be only one that is causing your symptoms. But always suspect both, not just one, when you aren’t feeling well.


Another Thing To Think About

Yesterday I blogged about falls. In that blog I mentioned a little known condition of the elderly, normal pressure hydrocephalus. I thought I’d follow-up on that today.


Normal pressure hydrocephalus is a neurological condition that affects the brain. Hydrocephalus means water on the brain. It would be more accurate to say water in the brain. In this case, too much water – the water being cerebrospinal fluid.


Cerebrospinal fluid (CSF) is a straw colored fluid that surrounds the brain and spinal cord. It is filtered from blood that circulates through very small blood vessels within four spaces in the brain. The spaces are called ventricles. The CSF flows from the ventricles into the subarachnoid space which surrounds the spinal cord and the brain. It is eventually re-absorbed. This process is the CSF circulation.


Hydrocephalus occurs when the normal flow of the CSF is blocked so that there is a back up of CSF in the ventricles. This causes the ventricles to enlarge and exert pressure on the brain from the inside. Hydrocephalus can occur from an obstruction to the circulation of CSF, from overproduction of CSF or from poor re-absorption of CSF. Sometimes the cause of normal pressure hydrocephalus is unknown.


Abnormal pressure on the brain results in symptoms that can vary greatly. Some of these symptoms may be related to changes in walking: weakness in the legs, sudden unexplained falls or unsteadiness when walking. As the pressure on the brain continues the symptoms become more severe and may include: memory loss, difficulty with speech, lack of interest in surroundings and episodes of urine or bowel incontinence. Normal pressure hydrocephalus may accounts for 5% of all dementias.


The treatment for hydrocephalus is surgery to shunt the excess CSF from the ventricles to another part of the body where it can be re-absorbed. The extent of recovery depends on the cause of the hydrocephalus and how much damage it has done to the brain.


Normal pressure hydrocephalus is another thing to think about when someone, especially someone over 65, has unexplained falls or changes in behavior.



Your Brain And You

Brain injury. What does that call to mind? A devastating injury that leaves you paralyzed and speechless? How about blindness or a loss of the sense of smell? How about loss of the ability to recognize your loved ones or the inability to remember what happened an hour ago?


How about all of the above or none of the above?


That’s what a brain injury is – all, some, or none of the above. And, with between 10 and 20% of the approximately 1.8 million men and women serving in Iraq and Afghanistan sustaining brain injuries, that means between 180,000 and 360,000 young people may return to this country with injuries severe enough to prevent them from supporting themselves or, possibly, even caring for their basic needs.


To the above numbers you can add the civilians who sustain brain injuries as the result of accidents, sports, neurological disease, birth trauma or prematurity. Some of these individuals will need assistance – from family, from healthcare and from government. And they will need this assistance for years to come.


Brain injury can run the gamut from mild concussions that have only transitory effects (unless too many are sustained) to penetrating wounds that result in the actual result of brain tissue. Since the brain controls all physical and mental functions, it’s evident that
brain “injury” can have a variable presentation – the all or none above. Furthermore, the location of the injury is just as significant as the extent of the injury.


Brain injury, whether traumatic or disease related, is a growing problem. The military is aware of it LINK. Now the general public –  parents, coaches, adult children of elderly parents and schools – have to become aware of it.


Even if you are not your brain, your brain is your link to the world. Protect it.


March is National Brain Injury Awareness Month.


For more information on brain injury click:


National Institute of Neurological Disorders and Stroke

Brain Injury Association of America 

NOT A Death Sentence

Saturday’s NY Times had an article about an English woman who has multiple sclerosis (MS). Multiple Sclerosis was not the focus of the article. Assisted suicide was the focus. LINK  But the article reminded me that March 2 – 8, 2009 is National Multiple Sclerosis Awareness Week. So I thought I’d spend some time writing about MS.


Multiple Sclerosis is a disease that affects the nervous system: the brain, spinal cord and the nerves that come from them. The nervous system is covered by the myelin sheath, which acts as a protection for the nerves and also speeds the conduction of electrical impulses. The nervous system sends messages from the brain to the muscles and organs and back again by using low level electrical impulses.


MS damages the myelin sheath. This causes the electrical impulses to move slower or to move in an abnormal way. The result may be symptoms such as


  • Visual disturbances.
  • Muscle weakness.
  • Trouble with coordination and balance.
  • Sensations such as numbness, prickling, or “pins and needles”.
  • Thinking and memory problems.


Multiple Sclerosis generally begins in young adulthood, between 20 and 40. Women are more often affected than men. The cause of MS is unknown, but many researchers suspect that it is an auto-immune disease. An auto-immune disease is a disease in which the body, for an unknown reason, begins attacking itself.


Some people with MS experience only mild symptoms, while others have very severe symptoms.


There are four “types” of MS:

  • Relapsing-Remitting MS – symptoms come and go, sometimes leaving residual effects, sometime not. About 85% of people with MS have this type.
  • Primary Progressive MS – disability is progressive without remission. About 10% of people with MS have this type.
  • Secondary Progressive MS – at first symptoms come and go but then the course of the disease become progressive without real remissions.
  • Progressive Relapsing MS – disability progresses without remissions, but there are episodes of acute symptom increase. This is the least common type of MS.



There is no cure for multiple sclerosis. However, MS IS manageable. It is not a death sentence.

YouTube videos:

     The Face of MS

     Famous People Who Have MS



To find out more about MS see:



National Multiple Sclerosis Society

Did You Have Chickenpox?

If you did, you are at risk for shingles.


Shingles is a painful skin condition caused by the same virus, herpes zoster, that causes chickenpox. When you are first infected by the virus, you get chickenpox, the nasty “childhood” illness that causes itchy blisters that eventually scab and fall off. Once you are over chickenpox, the virus does not go away. It retreats to your nerves where it lies dormant for years or decades. However, under certain conditions (such as advancing age or illness), it can be reactivated. The reactivated virus will then cause shingles.


Since the virus has been reactivated on your nervous system, the first symptoms are often vague – numbness, tingling or a burning sensation. However, the first symptoms can also be far from vague. The first symptom can be extreme pain. Depending on which nerve was the site of the reactivation, the pain may mimic the pain of appendicitis, kidney stones or even a heart attack. Shingles is finally diagnoses when the virus, which has traveled along the nerve, finally reaching the skin. At that point the characteristic chickenpox-like rash erupts. However, there is one difference from the chickenpox rash. The rash of shingles is painful. As with chickenpox, the rash should not be scratched or touched because this can lead to infection and can leave scars.


Shingles itself is not contagious. You can not get shingles from someone who has it. Shingles starts within a person’s own body. However, someone who has shingles can “give” chickenpox to someone, if that person has never had chickenpox.


Shingles generally lasts four to five weeks from the time the rash appears. People who are in general good health recover, though the course of the illness is not pleasant. However, people with a weakened immune system can get various complications. As we age our immune system weakens. That’s why over 50% of shingles cases occur in people over 60. Most people get shingles only once, but it can re-occur.


Treatment for shingles can include anti-viral medication. However, this medication must be given within 48 hours of the beginning of symptoms. Other treatment focuses on pain control while the illness runs its course.


Pain. Rash. Migrating virus. What’s the good news? The good news is that since 1995 there has been a vaccine against chickenpox. That means fewer cases of chickenpox and, eventually, fewer cases of shingles. Also, since 2006 there has been a vaccine against shingles. This vaccine is available to people 60 and older. LINK


The moral? If you are over 60, get vaccinated. If you have young children, have them vaccinated.


Health – it’s about prevention.


For more information on shingles visit

Diabetes: Part IV – Nerves

Your nervous system controls all of your body’s functions, including thinking and emotions. Your nervous system has two parts:

  • The central nervous system – the brain and the spinal cord
  • The peripheral nervous system – the nerves that come out of the spinal cord and affect both voluntary functions, for example, walking and involuntary functioning, for example, breathing.

There is a feedback system in the nervous system. This works something like a thermostat. The thermostat monitors the temperature in the home. When it senses the need for heat, it sends that message to the furnace. The furnace kicks on and sends heat throughout the home. The thermostat continues to monitor the temperature. When the temperature is at a predetermined level, the thermostat sends that message to the furnace and the furnace turns off.


So, in order for the nervous system to function properly, both parts must be functioning well.


Diabetes affects the nervous system in two possible ways:

  • A direct effect by bombarding the nerves with too much glucose (sugar) and causing damage
  • An indirect effect by narrowing blood vessels and depriving the nerves of needed food and oxygen.

Good control of blood sugar levels is crucial for avoiding the nervous system complications of diabetes!


Some of these nervous system complications include:

  • Numbness in fingers and toes
  • Tingling or pain in fingers and toes
  • Damage to the feedback system in the feet, causing difficulty walking
  • Erectile dysfunction (difficulty getting or keeping an erection)
  • Diminished sensation in the genitals leading to an inability to have an orgasm (women and men)
  • Poor mental functioning and possibly dementia.

How can you avoid or at least minimize the nervous system complications of diabetes?

  • Keep your blood sugar under control – diet and exercise
  • Do not smoke! Smoking narrows blood vessels.
  • Follow your healthcare provider’s advice regarding medicine.

Diabetes, both Type 1 and Type 2, is a chronic, lifelong condition. But you can do something about it. Take control of your diabetes, manage it and live a full life.


Mary Lou Bernardo, PhD, MSN


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