Question: One of my parents seems to be becoming forgetful and confused.  How does one tell if this is Alzheimer’s disease?

The first step is to see if the patient has the correct symptoms.  The second step is to see if the patient is in the proper age group.  Alzheimer’s disease is almost exclusively a disease of the elderly and on very rare occasions a disease of the middle aged.  It virtually never affects younger people.  Beyond this, the diagnosis is made by ruling out other potential causes for the symptoms.  This is very important since some of the other conditions which might cause similar symptoms are completely curable.  The medical evaluation for Alzheimer’s disease, therefore, consists largely of an evaluation to rule out other things which might be masquerading as Alzheimer’s disease.  If nothing else is found, and the patient has the proper symptoms and is in the proper age group, then Alzheimer’s disease is the diagnosis.  This simple approach is really very accurate.

You can find Dr. Wright at  Semmes-Murphey Neurologic & Spine Institute, online at www.semmes-murphey.com or by calling  901.522.4949

Question: Are there any pills that can prevent breast cancer?

Answer: Breast cancer prevention is best directed against women who are at increased risk of developing cancer. Genetic forms of breast cancer predisposition are largely managed surgically as well as medically. When postmenopausal women who take estrogens stop, their risk of cancer declines quite rapidly.

The P-01 study of tamoxifen (an oral anti-estrogen pill) for 5 years found that women with a Gail-model risk of 1.66-fold or higher than the general population of developing breast cancer resulted in a 49% reduction in the development of invasive breast cancer and an even higher reduction in the development of precancerous lesions. There was a slight increase in the risk of blood clots and uterus cancer, but there was no increase or reduction in deaths from any cause. Patients who were at significantly higher risk benefited more. The drug raloxifen proved to be equally effective to tamoxifen in the STAR trial. The Royal Marsden and the Italian studies of tamoxifen did not show this benefit, but were not as well designed as trials.

These anti-estrogen drugs are probably worthwhile in the patient at higher risk of breast cancer, and should probably only be prescribed by a breast cancer specialist who can accurately determine one’s risk of this disease.*

Dr. Donald S. Gravenor - Dr. Gravenor joined the Family Cancer Center in 2000 as Physician and Principal Investigator. He brings to the group a strong background in medical research. He has served as the principal investigator in over 20 Phase 3 clinical trials.  He is also an active member of the American Society of Clinical Oncology and is on two national committees. He is Board Certified in Internal Medicine, Medical Oncology, and Hematology. Learn more at www.familycancercenter.com.

**This answer is not intended as and does not substitute for medical advice.

Question: What does it mean when I get a report from my doctor on my routine laboratory studies that my liver tests are up?

Answer: Liver enzymes (ALT and AST) are enzymes that are formed in the liver and may indicate inflammation in the liver or problems with other major organs.  Occasionally, alkaline phosphate and GCT will show to be elevated.  These elevations are associated with drainage of bile, gallstones, tumor blockage, alcoholic liver disease or drug-induced (herbal of prescription) disorders.  Again, a specific diagnosis should be pursued.  Another elevation that sometimes presents itself is bilirubin.  This is the main bile pigment that sometimes produces a yellow discoloration in the skin and eyes.

Albumin and Prothrombin are the only true liver tests for determining disorders and other specific problems in the liver relating to protein levels and blood clotting.

If you get an elevated liver test, your physician will explain what type of elevation it is and what needs to be done, if anything.

Important Facts to Remember:

• No correlation between degree of liver test elevation and severity of disease.
• Please tell you doctor about ALL medications especially over the counter or herbal medications.
• The tests should be followed until normal or a firm diagnosis is made.

Dr. Michael J. Levinson – Dr. Levinson graduated with a Bachelor’s degree from the University of Florida and with honors from UT Medical School. He is a Fellow of the American College of Physicians and a Fellow of the American College of Gastroenterology. He serves as an Associate Professor at the UT College of Medicine and as Chief of the GI Teaching Service at Baptist Memorial Hospital where he has received the Outstanding Teacher Award many times. Dr. Levinson is part of Memphis Gastroenterology Group and can be reached at 901.747.3630 or memphisgastro.com.

**This answer is not intended as and does not substitute for medical advice.

Question: What causes tooth loss?

Answer:

The majority of tooth loss, which is suffered by 9 out of 10 people, is caused  by bone loss from unchecked gum disease.  Bacteria from gum disease can cause the attachment between the tooth and bone to weaken and form an empty pocket.  Without professional cleaning every 3 months, this pocket quickly becomes deeper than you can clean with regular methods, such as flossing and brushing.  Then, quietly and painlessly the disease can progress to the root of the tooth without any visible signs, until the pocket gets so deep that the infection is trapped. When this happens, pus from the infection cannot drain, your gum swells deep below the gumline and a painful gum boil is the result.

While this is going on untreated, you are at ten times the risk of heart attack or stroke, more likely to get chronic kidney failure, cancer, arthritis, and less likely to control diabetes. This is because periodontal disease is a chronic infection that is seeping into your circulatory system and literally changing the lining of your vessels.  It can become a constant challenge to your immune system to battle such an infection.

Bad breath, an unattractive smile and failing health need to be met head on with a thorough periodontal exam and complete set of x-rays. Prevention and maintenance are the first step to the way back to good oral health and a beautiful, confident smile.

Dr. Kitsie Hendrix - Kitsie Hendrix, D.D.S. graduated from Emory University School of Dentistry, subsequently earning certification in periodontology from the University of Pennsylvania. A periodontist, Hendrix specializes in gum and dental implant surgery and has practiced for over 27 years. Visit her online at perio-implantdentistry.com .

**This answer is not intended as and does not substitute for medical advice.