brain . mind . body integrative health
Both brain-specific and general physical illnesses are capable of causing complications of brain or mind.
Complications can include confusional states (delirium), memory problems (dementia), attention deficits (ADD), emotional symptoms (depression/anxiety), behavioural abnormalities, or syndromes specific to certain brain areas (focal deficits).
NEUROCARE is a unique initiative offering comprehensive, coordinated care by various medical specialists based at Stellenbosch Medi-Clinic, arguably a leading Private Healthcare Establishment in South Africa.
NEUROCARE clinical services include virtual consultation (telemedicine), multi-disciplinary outpatient consultation, hospital liaison services, options for hospitalization (medical and therapeutic), legal assistance and home support.
Specialist tests available include pathological investigation (blood tests etc), brain imaging (MRI and CT scans), electrophysiology (EEG for epilepsy), muscle tests (EMG), nerve tests (NCS), various cognitive assessments (memory tests) and internet based screening and monitoring software (MEDIWEB).
NEUROCARE special programs include the Adult ADD drive, Memory Matters campaign, Dignify Dementia project, Hope for Parkinson's initiative, TBI Reclaim action (Brain Injury), Softening Stroke- and Fit Free programs.
This service is coordinated by our Clinical Director Dr Jan Swanepoel, and is supported by specialists representing the fields of Neurology, Liaison Psychiatry , Clinical/Councilling Psychology, internal Medicine, general Surgery and Neurosurgery.
Suite 109, Medi-Clinic Stellenbosch (New R44 site)
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Gail Scott: 066-4701447 (ADD, Memory, Psychiatry, MEDIWEB)
gail@neurocare.co.za
Marietjie Heath: 021-8879015 (Neurology, EEG, NEUROLAB)
marietjie@neurocare.co.za
Dr Jan Swanepoel: 082-5080744
jan@neurocare.co.za
Dr Annette Swanepoel: 082-5002588
marietjie@neurocare.co.za
Liaison Psychiatry is the sub-specialty which provides psychiatric treatment to patients attending general hospitals, whether they attend out-patient clinics, AE emergency departments or are admitted to in-patient wards. Therefore it deals with the interface between physical and psychological health.
There is now abundant evidence that medical and surgical patients have a high prevalence of psychiatric disorder which can be effectively treated with psychological or pharmacological methods. One quarter of all patients admitted to hospital with a physical illness also have a mental health condition which, in most cases, does not receive necessary treatment while the patient is in hospital.
Critical situations
Liaison Psychiatric input must be considered in the following patient groups:
Neurology situations - Patients suffering epilepsy often experience psychotic symptoms, memory problems and has a 6x increased suicide rate. Parkinson's patients often hallucinate, patients diagnosed with brain tumors need input from start to completed post-operative rehabilitation, not to mention the many needs of those who suffered brain injury or trauma, bleeds, dementia or MS.
Hematology situations - Systemic illness such as leukemia or lymphoma notoriously affect brain and mind. Memory problems, chemo-related side-effects, fatigue, depression, anxiety or suicide are common complications, whilst rehabilitation after bone-marrow transplant is vital.
Oncology situations - Cancer sufferers often need psychiatric input when battling chronic illness conditions, chemo-related complications such as memory problems, fatigue, eating problems or nausea, whilst terminal situations necessitate the care of families and loved-ones.
Rheumatology situations - Conditions such as Rheumatoid Arthritis, and many other immunological systemic illness by definition affect brains detrimentally. SLE patients often hallucinate, whilst immune suppression therapy such as steroids often cause mind symptoms such as depression, panic and memory problems.
Cardiology situations - Cardiovascular sufferers such as myocardial infarction (heart attacks) patients, those with valve lesions or irregular beats (heart flutter) often suffer serious depressive and anxiety complications, and may even end up with vascular dementia. Much can be done to improve function, prevent complications to brain or mind or assist with rehabilitation after cardiac surgery.
Gynecology situations - Hormonal conditions, female cancers or infectious STD states often require intervention psychiatrically. Post-natal depression can be treated successfully, whilst brain medication often prove successful for menopausal emotional fluctuations.
Surgery situations - Post-operative complications such as delirium (confusion), abnormal pain conditions, depression or medication addiction often necessitate brain or mind input. Multi-trauma victims (Post Traumatic Stress Disorder), those after joint replacement or with resulting weakness benefit from specialized and comprehensive rehabilitation programs.
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Attention Deficit Disorder impacts many adults and its frustrating symptoms can hinder everything from your relationships to your career development.
Once you identify your own symptoms and understand the challenges that come with ADD, you can learn to compensate for areas of weakness and take advantage of your many strengths and talents.
Understanding ADD in Adults
Attention deficit disorder is not just a problem in children. If you were diagnosed with childhood ADHD, chances are, you’ve carried at least some of the symptoms into adulthood. But even if you were never diagnosed with ADHD as a child, that doesn’t mean you can’t be affected by it as an adult.
Attention deficit disorder often goes unrecognized throughout childhood. This was especially common in the past, when very few people were aware of ADHD. Instead of recognizing your symptoms and identifying the real issue, your family, teachers, or other parents may have labeled you a dreamer, a goof-off, a slacker, a troublemaker, or just a bad student.
Alternately, you may have been able to compensate for the symptoms of ADHD when you were young, only to run into problems as your responsibilities increase. The more balls you’re trying to keep in the air—pursuing a career, raising a family, running a household—the greater the demand on your abilities to organize, focus, and remain calm.
This can be challenging for anyone, but if you have ADD, it can feel downright impossible.
That’s why a clear diagnosis of Adult ADD can be an enormous source of relief and hope. It helps you understand what you’re up against for the first time and realize that you’re not to blame.
The difficulties you’ve had are symptoms of attention deficit disorder—not the result of personal weakness or a character flaw.
Inattention is considered an important core aspect of suffering Adult Attention Deficit disorder.
If you have experienced more than 3 of the symptoms listed below, chances are that your performance is impaired by your current ability to attend or concentrate on what is important.
In such cases we strongly recommend a more detailed assessment by a professional, or at least a more detailed measurement such as offered by our measuring module.
Do you often...
It's normal to forget. We all forget. But as we grow older, the time comes when we start to forget more than we used to. However, if this starts to happen regularly, we may start to worry about whether we suffer dementia.
Dementia mainly affects older people. After the age of 65, the risk of developing it doubles every 5 years. Over the age of 80, about one in five people suffer from some degree of dementia.
Having said this, it's important to remember that four out of five people over the age of 80 are not suffering from dementia.
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There are several different causes for memory disorders, so further medical tests to establish the reason for forgetting is critically important.
Many causes are reversable, so all people (of all ages) concerned about their memory function must be examined in a specialist memory clinic.
The following symptoms are especially important to pay attention to:
There is always hope and potential improvement - but only when the exact diagnosis is made, and specialist medication prescribed.
Being forgetful may be caused by attention problems, stress, reversable medical conditions or primary memory illnesses.
If you have experienced more than 2 of the symptoms listed below, chances are that you are suffering a medical memory disorder or illness.
In such cases we strongly recommend a more detailed assessment by a professional, or at least a more detailed measurement such as offered by our measuring module.
Have you suffered...
Epilepsy can cause difficulties by way of typical epileptic fits ("seizures"), episodes of being absent ("absences"), as well as various other chemical-electrical complications.
Epilepsy patients are therefore medically vulnerable to developing dissociation ("disconnecting from themselves or the world"), attention deficit disorder (ADD), various types of forgetfullness (memory problems), clinical depression or uncontrolable anxiety.
These symptoms must be identified as they can effectively be managed in specialist treatment centres.
Unfortunitely most patients suffering Epilepsy is unaware of the medical nature of these complications, and often "blame themselves" for "not coping".
Nothing can be further away from the truth as research has shown that most Patients suffering a chronic physical illness is generally better at coping with life's challenges despite their illness.
Mistaking chemical-electrical complications which produce brain and mind symptoms is like blaming yourself for getting a chest infection...
Most first-world treatment centers for Epilepsy involve a team of experts such as a Neurologist, Neurolab Technicians (for EEG monitoring), a Liaison Psychiatrist (treating complications) and a Neuropsychologist (for memory tests etc.).
Under-estimating Epilepsy and its complications will have serious consequences, not only medically, but also in terms of professional- and interperonal function.
Focussing onEpilepsy complications, will in most instances make a big difference to quality of life in general terms.
If you have suffered any one of the following symptoms chances are that you can benefit from specialist input:
Have you ever...
Traumatic brain injury (or even "concussion") is often referred to as "TBI".
Since our brain defines who we are, the consequences of a brain injury can affect all aspects of our lives, including our personality.
No two brain injuries are alike and the consequence of two similar injuries may be very different. Symptoms may appear right away or may not be present for days or months after the injury.
Most people are unaware of the scope of TBI or its overwhelming nature.
TBI complications are common and may be missed initially when the medical team is focused on saving the individual's life.
A brain injury can be classified as "mild" if loss of consciousness or confusion and disorientation is shorter than 30 minutes. Even though this type of TBI is called "mild", the effect on the family and the injured person can be devastating.
"Severe" brain injury is associated with loss of consciousness for more than 30 minutes and memory loss after the injury or penetrating skull injury longer than 24 hours.
TBI complications
While MRI and CAT scans are often normal, the individual may struggle with significant TBI complications:
These symptoms are commonly overlooked, and can be improved or managed by specialist Neuropsychiatrists and the application of modern neurotropic medication and rehabilitation exercises.
Brain injury related complications may appear right away or may not be present for days or even months after the injury.
If you have experienced more than 2 of the symptoms listed below, chances are that you have developed complications.
In such cases we strongly recommend a more detailed assessment by a professional,
or at least a more detailed measurement such as offered by our measuring module.
Have you suffered...
Suffering a stroke may not be the end of a fullfilling life. Many Patients suffering a stroke may recover in full, whilst others may adapt to even permanent deficits to the extend that they continue to enjoy a productive, enjoyable life.
Research show that recovery from stroke is heavily dependent on managing "stroke complications", and is not simply a fucntion of regaining muscle strength.
The most common medical complications developing after stroke are depression and "unlogical sadness", anxiety and panic attack, even paranoia (suspiciousness), attention-, concentration and memory problems.
Sadly most Patients,their families and even some Doctors caring for stroke patients, ignore these complications, thereby compromising optimal recovery significantly. Not identifying them is a large part of the problem.
Immediately after suffering a stroke, Patients must be rusked of to the nearest specialist medical center where an interventional Radiologist, Cardiologist or stroke Physician may reverse the clot or treat the cause acutely.
Equally important is to manage the first 2 years after stroke well too. Stroke rehabilitation is offered at specialist clinics where Patients can access a rehabilitative Psychiatrist, a clinical Neurologist and stroke Occupational Therapists.
Such specialists will focus on regaining function that was lost, preventing and treating complications and help Patients to adjust to a life changed.
Above all, never give up hope, as many people continue to improve for years to come after stroke.
If you have suffered any one of the following symptoms chances are that you can benefit from specialist input:
Have you ever...
Parkinson's disease may affect people as young as 45 years old, and is also often overlooked in older individuals as "being tremulous" is considered "normal" in error.
Much can be done for patients with this condition, but sadly many individuals strangely feel ashamed for suffering involentary movements and often hide their symptoms i.s.o. consulting with a specialist Neurologist. Many effective medications exist that generally make the world of difference.
Parkinson's disease is perhaps the best example of all illnesses of the chemical-medical nature of Neuropsychiatric complications.
Where Parkinson's motor (muscle) symptoms is casued by a relative shortage of the brain chemical dopamine, Neuropsychiatric complications are caused by episodic excess of the same chemical (caused by over-treatment, or sometimes due to variable release by the brain).
The Neuropsychiatric complications include anxiety, unlogical paranoia, emotionality such as depression, occasionally forgetfullness (memory problems), and rarely hallucinations (such as shadows at night etc.).
Ideally Parkinson's patients should receive specialist input from a Neurologist (addressing muscle and movement symptoms), and a Neuropsychiatrist (monitoring for and treating chemical-medical complications).
Liaison Psychiatrists are medical Doctors that specialised further in the treatment of brain and mind complications of various physical illnesses such as Parkinson's, and needs to be distinguised from Psychologists.
Comprehensive management strategies involving a team of specialists will make the difference between leading a functional and enjoyable life when diagnosed with Parkinson's disease.
Parkinson's disease cause Neurological and Neuropsychiatric complications. Identifying treatable complications early is vital to effective intervention and quality of life.
If you have suffered any one of the following symptoms chancesare that you can benefit from specialist input:
Have you ever...
