Dr. Thompson's Blog

Long-Term and Nursing Home Care

With all the recent corona virus deaths in nursing homes, this would be a  difficult time to decide what to do if a parent or elderly relative can no longer live at home. If someone is able to stay in their own home with a live-in caretaker that would be the best. However, finding the right  individual can be very difficult. When my father had a stroke after my mother died, my brother and I looked at several options for his care. He did not want someone living in the house to care for him, so we found the best nursing home we could. It was close to Pomona College where he had been a professor, so old colleagues and friends could visit him. We also paid extra for him to have a private room. He probably got better medical care than most of the  patients, because my brother was a hospital administrator and as a physician, the on-calI doctors knew I checked every two weeks on his care. I was working in Northern California and my brother was in Arizona, so we took turns visiting as often as we could.There are two sources for help if you need to find good long-term care. One is the Medicare website at www.medicare.com that has a nursing home comparison site. The Assisted living Federation is at www.alfa.org or 1-703-691-8100. it is important to ask about what  medical care is available and if possible speak to some of the patients.

I have always paid for my own long term care insurance because long-term care can be very expensive. By checking and re-checking on a parent or  relative's medical care and  also speaking with the medical personnel, your relative should get the best care possible. 

 

 

Fear and the Corona Virus

This is a very hard time for many families, particularly if they have lost a loved member of their family from the terrible Corona Virus. Having gone through the polio epidemic as an intern at Children's Hospital in San Francisco, I saw what a disease can do to families.  I learned long ago that you have to make yourself go just one day at a time. I was impressed that Governor Andrew Como of New York had assembled a mental health group where people could call a special number and speak to one of the professionals. Older people who remember the depression, the various wars the country has had or lost someone have learned to value each day. My much loved daughter died nine years ago this Saturday from breast cancer after receiving terrible medical care in Santa Fe at a so-called Cancer Center. I miss her greatly but am glad she had a rich, full life doing wonderful art and running a business. I keep in touch with her husband and two step-children, who now are married and have babies. By reaching out to other people, we can help them and ourselves  I hope that when we have a new president we will all have learned lessons which can bring us together as Republicans and Democrats, so we take better care of each other. Helping someone does make the days go more quickly I have found and there are many lost, lonely people who greatly need our help. 

Benign Hypotonia is not a Diagnosis

Neuromuscular disorders are frequently misdiagnosed in the U.S. because there are few neuromuscular specialists in this country. I have found that even some medical textbooks list Benign Hypotonia or Congenial Hypotonia as specific diagnoses. Even with all the genetic studies that neurologists usually order the correct diagnosis may not be made. In the last weeks, I have had e-mails from parents in Ethiopia, London, the east coast in the U.S. and Australia asking for help in finding a neuromuscular specialist. Fortunately , Professor Sewry and Professor Dubowitz in London always respond to my requests for names of  specialists. They have been good friends  from the times I spent working in Hammersmith Hospital in London, where they were formerly based. 

If an accurate diagnosis is not made, there can be no true genetic counseling and if there is new medication, as in the case of spinal  muscular  atrophy, a baby or child can not be given the medicine. 

I realize there is a great deal for medical students to learn these days and neurological training is not popular because neurologists do not make the money that specialists like plastic surgeons etc. make. 

If as a parent you have a baby or child with muscle weakness, you want to see a neuromuscular specialist, not a general neurologist. A large series of genetic tests are usually not necessary and certainly should never be the first thing that is done, A muscle biopsy using a local anesthetic and a CPK  or CK (outside the US) may be the only tests that are needed to make a diagnosis. 

Preventing Parasites in Pets from infecting your Children

Veterinarians can make a big difference if they are sure the parents of children who have dogs or  cats for playmates understand about the parasites that animals can transmit. The principal parasites are roundworms, tapeworms, and hookworms. Little children who  play in a yard barefoot are at risk for picking up parasites. If they play with their pets and then put  hands in their mouth, this can be a source of contamination. Some kids eat soil, grass or other areas contaminated by  parasites' eggs. 

One way to prevent infection is to have your pet or pets routinely dewormed. It is important to know that hookworm larvae can penetrate the skin. One study showed that 80% of parents had no idea that parasites were a problems with their children's pets. People who have pets spend billions of dollars on their animal which is far more money than is spent on children in the U.S.

One important fact is if pets are kept free from fleas, this can help prevent tapeworm infection. Also litter boxes need to be cleaned regularly  and hands washed afterwards.