If you have a discharge from your eye that does not resemble normal watering and it’s accompanied by redness and itching, you probably have a common condition known as conjunctivitis, also called pinkeye. In addition to the redness and discharge, your eye may feel as though there’s grit in it. Although conjunctivitis is uncomfortable and the appearance of a reddened eye may make you want to stay inside until it clears up, pinkeye usually presents no threat to your permanent vision.

Conjunctivitis is easy to spot, but it’s also easy to catch. Young children are extremely prone to conjunctivitis because of their still-developing immune systems and their tendency to share toys that have been contaminated by germs. But adults frequently get pinkeye as well.

Conjunctivitis can be caused by either a bacterial or a viral infection. When a bacterial infection is the culprit, both eyes are usually affected, and there will be a lot of discharge. The discharge will often form a crust while you sleep. A viral infection will cause less discharge, and only one eye tends to be affected.

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If you think a person is having an epileptic seizure, you should call 911 or his doctor, if you know who it is. Don’t fight the person, and make sure he has an adequate airway. Hold his tongue down with your fingers so that he is unable to swallow it. This is important, since during an epileptic seizure the tongue loses its muscle tone and can fall back toward the throat and block the airway.

If you don’t know the person, check for a medical ID bracelet. Instead of epilepsy, his seizure may be due to low blood sugar.

If you or a family member has experienced seizure for the first time, you must see your physician, who will do a complete medical history and physical exam in addition to a CAT scan of the brain and and an electroencephalogram (EEG), which is used to detect abnormal electrical activity in the brain. The patterns the neurologist will detect in the brain-wave activity will help him select the best possible treatment. Though during most of the test you will be lying still with your eyes closed with electrodes attached to your scalp, your neurologist may choose to stimulate seizure activity in the brain with flashing strobe lights. This explains why flashing lights at a nightclub or rock concert, or even a light that flashes through tree branches as you drive under them in a car, can trigger a seizure in people who are prone to them.

Magnetic resonance imaging, frequently referred to as MRI, is a technique that allows your doctor to get a very detailed X ray of your brain-wave activity on a computer; an MRI may also be done with secondary epilepsy to find the exact location of a tumor that may be responsible for altering the brain waves. The doctor’s main task is to find the underlying cause of the seizure, which will lead to proper treatment.

Phenobarbital and phenytoin are two medications commonly used to treat secondary epilepsy; other antiepileptic medications include primidone, carbamazepine, and valproate. The dosage for each medication will depend on your sex, age, and weight. Once you begin taking the medication, your doctor will monitor you regularly to make sure you receive the correct dosage.

Since antiepileptic medications can produce a number of side effects, you will need to visit your doctor regularly. For instance, when the drug Dilantin (phenytoin) accumulates in the bloodstream, you may have walking disturbances and lethargy. That’s why it’s important for your doctor to closely monitor your blood level as well as your health.

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Description and Possible Medical Problems

If an elderly relative shows any of the above symptoms, it’s likely that she has Parkinson’s disease, which is a relatively rare condition that usually affects people in their late 60s or older. Typical characteristics of the disease include a tremor in the hands that occurs primarily during periods of inactivity; the tremor will usually cease during even slight physical movement. This tremor—called a resting tremor—usually looks as though a person is rolling a pill between her fingers, over and over again.

Another sign of Parkinson’s disease is that the muscles become rigid; a third is that the facial muscles will also become rigid and fixed, resulting in a masklike expression. A fourth common symptom of Parkinson’s is that when the person starts to walk, she has to start slowly because of her inflexible muscles, and she has to take small, shuffling steps; her torso is also probably bent forward.

The first thing to say about Parkinson’s is that we don’t know what causes it. Although a virus that caused an influenza epidemic in the early 1900s is sometimes identified as the cause of Parkinson’s disease, not everyone who has the disease today had that particular flu. In some cases, medication that is prescribed to treat psychiatric problems can cause symptoms that mimic Parkinson’s disease, especially antipsychotic medications like Haldol, which is commonly used in nursing homes. In some advanced cases of the disease, dementia can develop; however, some of my Parkinson’s patients who are in their 90s have no change in their mental state at all.

Treatment

If you suspect that an elderly relative has Parkinson’s, the physician will do a complete medical history and physical exam and run some routine tests to check for thyroid disease, liver abnormalities, and a blood count to make sure that she can tolerate any medications she is taking. First, he will check to see if medication is causing the symptoms. Once he rules that out, treatment for Parkinson’s will begin.

Medications that are commonly prescribed to treat Parkinson’s dis¬ease not only control the tremors of the illness but also slow down its disability. Sinemet is a drug commonly used to treat the disease. Your relative may find support groups helpful, but the truth is that most Parkinson’s patients can successfully manage their households for many years without additional help.

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Preventive medicine will also be practiced more widely. This will be a boon to the consumer as well as helping to keep medical costs manageable. Preventive medicine not only helps a health care provider detect and treat an illness in its early stages, it also involves established ongoing patient education programs, which gets the patient more involved in his health care and therefore more likely to follow the instructions of his health care provider.

To give you an example, consider one of my female patients, who is at risk for developing diabetes, since her mother was diabetic. She schedules regular checkups with me during which we monitor her blood sugar level and I provide nutritional counseling so she can prevent the disease from developing. If she did have the disease, we would then continue to keep tabs on her condition on a regular basis in order to prevent some of the more severe complications of the disease from developing.

For instance, if she had diabetes, not only would she be seen by her primary care physician, we would recommend she have routine eye care and checkups done by an ophthalmologist in our HMO. She’d also visit with a nutritional counselor, who could advise her about diet and exercise methods that would help keep her disease from progressing. We might also want her to regularly check in with a nurse practitioner, who could help her with her medications and answer any questions she might have. All these health care providers will be part of a local health care network in which they’ll be integrated between outpatient care and the hospital. Clearly, patients will benefit greatly from this new system of total care.

Again, I want to reassure you that even though the way medical care is provided will change under ongoing health reform plans, it will result in better, more focused care for everybody. Of course, you may no longer be able to see a physician for a routine complaint, but you will receive better-quality, more coordinated treatment when a more serious illness or condition strikes. That’s where Body Signals comes in. By showing you how to recognize your body’s classic symptoms of distress, you’ll be in a strong position to work within this new system, discern when professional attention is required, and convey this need to those in charge of your health care.

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Health care provider: This is any person who provides care to a patient, from a physician to a bedside aide. In the eyes of an insurance company, a health care provider can also be an institution, like an HMO or a hospital.

HMO: This is the acronym for “health maintenance organization.” An HMO is a group that provides health care under the definition of managed care. An HMO can consist of doctors in their own private practices who are spread out over a city or region, or it can be one general office where all the health care providers are in one location. The HMO can be owned and operated by an insurance company, hospital, union, private corporation, or other group.

Managed care: This is a system in which the people and companies that pay for health care—the patients and the insurance companies—and the providers of health care—doctors, nurses, and the hospital—cooperate to provide quality care while working to keep medical costs down.

Point of service (POS): This is any service that’s provided in a physician’s private office.

Preferred physician organization (PPO): This is a group of private physicians who agree to participate with a given insurance company. They are usually on a fee-for-service basis. A PPO is frequently established by a hospital to link its entire staff of physicians with one insurance carrier.

Primary care physician (PCP): A primary care physician can be a generalist, internist, family practitioner, pediatrician, and, in some cases, an OB/GYN. In other words, a primary care physician is a health care provider who is the first person a patient will see before being referred to a specialist.

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