Sense of smell and Alzheimer´s – Dr. David Hepburn

According to Alzheimer´s society of Canada the number of people with dementia has increased considerably in recent years. Currently there are a little over half a million Canadians with dementia and around 46 million in the world suffer from Alzheimer. As we can see, it is one of the most important challenges for public health in near future specially if we considering that there is no cure for this disease at the moment and the average age of the world population is getting higher.

In consequence early detection can be very helpful. For this reason Dr. David Hepburn and Dr. Robert Sealey give you a very important advice to detect Alzheimer’s with anticipation and can be treated properly.

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According to Dr. Sealey an important research has suggested that loss sense of smell probably would be the first indication that a person could have Alzheimer’s. Conforming to scientists of this research the amyloid plaques which are responsible for the cognitive decline in dementia initially begin to accumulate in the part of the brain responsible for the sense of smell. As consequence, to note a loss of sense of smell should be the warning to see a doctor

Consequently Dr. David Hepburn comment that thanks to this discovery now we have an inexpensive alternative that can be done through the sense of smell, replacing brain scans in order to determine if early Alzheimer’s is setting in.

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Therefore it is very important to be aware of our sense of smell as Dr. David Hepburn said because the early detection of Alzheimer’s can make a difference not only in the treatment to be followed but in the quality of life, once the disease is diagnosed.


Tips to live longer Dr. David Hepburn

“Die young at an old age…” Dr. David Frederick Hepburn.

The majority of people want to live more years and the most important thing is to live them well. That’s why Dr. Robert Sealey and Dr. David Hepburn give you the following recommendations so that you can live longer and better.

  1. Exercise

The first recommendation is basic, exercise!. Although you do not need to lose weight, exercising is very important. As mentioned by Dr. David Hepburn: Exercising allows your body to release good chemicals for you, which help to you to feel better

  1. Sleep

The second recommendation is about restoring your body. Sleep, you must sleep enough for your body to recover. Sleeping well helps you to lose weight, to your memory and even to overcome of depression

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      3. Stop Smoking

One of the best things you can do to your health is stop smoking. In fact Dr. Hepburn recommends not only leave the cigarette but any substance harmful to your health such as excessive alcohol or heroin.

     4. Smile

As simple as it sounds smile can contribute to your health. Smiling helps to lower your cholesterol levels and your blood pressure levels.

     5. Drink Red Wine

There are several studies that show that drinking red wine in moderation, (which means  one or two drinks a day) provide antioxidants that reduce cholesterol and prevent heart attacks, even help prevent colds

     6. Eat Chocolate

Dr. Hepburn and Dr. Sealey point out that another recommendation is to eat chocolate. It is important to mention that the darker the better. This reduces the risk of cancer

     7. Lose Weight

Finally the last recommendation made by Dr. David Frederick Hepburn. Lose Weight (only if you need it).

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Bladder Matters Dr. David Frederick Hepburn

Dr. Hepburn and Dr. Sealey In their well-known program, Wisequacks talked about the importance of taking care of urinary incontinence.

First at all Dr. David Hepburn begun saying that “Urinary incontinence is an under-diagnosed and under-reported medical condition that affects whopping a number of you but it takes about six to nine years for the average person with urinary incontinence to come to a doctor” Dr. Hepburn emphasize that for some reasons and social stigmas a lot of people do not visit doctors for this problem.

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Dr. Sealey accentuate that one main problem is the syndrome called “overactive bladder where I get this twitchy sort of contraction of the muscles and it makes me feel like I have to go quite frequently and urgently sometimes over eight times a day” This syndrome indicates Dr. Hepburn and Dr. Sealey affects about 1 in 6 adults

Dr. David Frederick Hepburn mention that if you have this problem is a pathology and it is very important to see a Physician which helps you with this and actually there are a lot of things that you can do to treat this syndrome. On the other hand Dr. Hepburn commented that there is another type of incontinence called “stress incontinence” Dr. David Hepburn defines this kind of incontinence as one that is caused by the stress.

Another important incontinence is the one that “where if you laugh or a cough or sneeze you may actually leak a little bit” this happens a lot to the women “who have a weak pelvic floor from giving birth to say children or locomotive or a man who’s had a prostatectomy prostate”. The important thing as mentioned by Dr. Hepburn is that there are many ways to treat the syndrome and why you should not suffer from incontinence

Dr. David Frederick Hepburn

In the words of Dr. David Frederick Hepburn himself “there’s somethings that can be done don’t suffer for six to nine years with stress incontinence or overactive bladder syndromes there are lots of things that can be done ranging from medications of course to simple little procedures”

So remember if you suffer from incontinence or overactive bladder visit the doctor and have him take care of the problem.

LEECHES AND MAGGOTS By Dr. David Frederick Hepburn

“Forceps stat!”
“Here you go, doctor.”
“Hemostat stat!”
“Stats stat!”
“The Leafs are 3 points up with a game in hand and….”
“No, no, the patient’s vital stats.”
“Pulse is 30, respirations 89 and her mutual funds are at 18.9%.”
“That’s better, now leeches, stat!”
“Leeches sir? Don’t you think that maggots would be more appropriate here?”

Amidst the seething whirls and whistles of high tech hospital lasers, fiber optics and designer bedpans, rests a simple aquarium crawling in leeches. Leeches have slithered back into our hospitals but now with a meaningful job to do. These slimy surgeons sit back in their little leechy surgeon’s lounge, smoke cigarettes and discuss recent cases, recent wives, and politics (they love their fellow senators).

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Occasionally they perk right up, hopping up and down madly and wagging their tails with anticipation every time a plastic surgeon happens to walk by the aquarium. Plastic surgery is what they do best. A day in the OR for the leech means a succulent feast of blood. They utilize their 300 teeth and a unique ability to inject an anti-clotting agent in order to suck up undesired engorged blood from reattached fingertips, earlobes, lips and even tongues. If too much blood is left in these reattached pieces then the congestion may cause the tissue to die.

Leeches are even being used to treat the congested blood of hemorrhoids. (“Good news Bloggins, that massive barnacle in your behind is now fully decompressed, bad news is WE CAN’T FIND THE LEECH!”) The hospital actually buys the leeches, at about $8.00 each, from the Tax Department where they are bred en masse. The leech wrangler, a nurse, usually named Sarge, can get pretty “attached” to the little surgeons. She gives them names such as Robin Leech (prefers blue blood), F. Leech Bailey (according to my lawyer I should make no comment here) and Pamela Leech (definitely no comment).

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After a 45minute fling in the OR however, the leech, now stuffed to its gills, is classified as biohazardous waste and is therefore sent to the hospital cafeteria. Not only do the leeches perform the surgery but they also provide their own anesthesia. As any schoolboy knows who, on a sunny afternoon, has substituted Math class for a day of searching out swamp frogs and crawfish, the leech attachment is pleasantly painless. Exiting the swamp covered in painless leeches, frog in one hand and blood dripping down the legs is a joy that only a boy of the male species would understand.

If the leech on your tongue idea hasn’t put goosebumps on your goosebumps yet, perhaps a doctor at the foot of your bed barking, “This patient needs a new dressing and throw some maggots on that wound will ya.” might convince you that you’re a guest of the Vince McMahon Memorial Hospital. In fact, these cuddly little botfly babies are also making a comeback in some hospitals. Prior to the introduction of antibiotics in the 1940’s, some 300 US hospitals used MDT or maggot debridement therapy (debridement meaning your wife leaves you should you ever incur this treatment.)

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Any dead tissue sitting in a wound is a serious source of infection. To maggots, it’s a smorgasbord. Doctors noticed that soldiers’ wounds were cleaner and healed better when they were infested with maggots. These patients required less nursing care (nurses refused to go near them) and wounds healed better. As antibiotic resistance currently develops at an alarming rate, Maggie the Maggot is once again in vogue and actually being used in some hospitals to clean out bed sores, diabetic foot wounds, post-op wounds and skin ulcers.

The future may hold more interesting bio-therapy including slugs for depression, mussels for muscles, and hornets for impotence. But for now, don’t lose your maggots when you see you, doctor, reach for a leech.


It was a dark and stormy night, and I, as a hospital intern/scut monkey, was called to assist Dr. Cerveza or whoever, in surgery. It was a trauma case and I could smell the alcohol pong wafting off the hapless victim on the table. But then….. “Ok, young intern, you make the insssishin will ya.” Now, please don’t extrapolate this to mean that all surgeons are inebriated all the time. There is lent.


Under the “How Much Money Was Spent On This Study” file, comes the actual headline HUNGOVER SURGEONS MAKE MORE MISTAKES. This study, done in Ireland, involved doctors who were asked to either drink to a nice Dudley Moorish buzz or abstain completely, the latter category making this a very difficult study in Ireland. In simulated surgeries, those who drank excessively the night before performed poorly.

Stop the presses! Surgeons who drink to excess the night before they operate are more likely to make errors the next day, even as late as four in the afternoon. The message, published in the Archives of Surgery actually stated “Surgeons should not drink excessively the night before operating. The definition of “excessively” is an issue that needs to be defined by the surgical profession.”


Unlike airline pilots, who have had to follow a “bottle-to-throttle” mandate restricting drinking before flights, surgeons have no “bottle-to-scalpel” rule. So if you happen to notice that your kidney is now dangling from your earlobe, it might’ve been safer to fly Aer Lingus standby.

I always think it strange when I’m asked to give an “expert” opinion on hangovers, as I am an admitted teetotaler. It’s a major character flaw that I realize I need to address, but it’s like asking me how it feels to give birth. All I know is that having a hangover and having a child both cause headaches, nausea, loud noises and often involve alcohol.

Hangovers are caused by increased levels of alcohol breakdown products called acetaldehyde, which is an unpleasant sounding word unlike say, peppermint or playoffs. Alcohol, a diuretic, leads to dehydration and causes electrolyte depletion. Dehydration means that the body now can’t easily rid itself of the irritating acetaldehyde and other byproducts of alcohol. Result…hangover, as in hanging over the porcelain phone leads to hanging over at a friend’s place and hanging under large ear mufflers.


To treat a hangover:

-Try to drink water or beverages like Gatorade or bouillon soup to help replace lost electrolytes or lost soup
-Pace yourself. Don’t drink large amounts of alcohol quickly. No more than one drink an hour, since that is all the alcohol your liver can handle. Those of you with no liver can drink as quickly as you wish.
-Exercise. It raises your metabolic rate, which helps you clear toxins associated with metabolizing alcohol. Chinese checkers is not exercise.

-Eat a meal before you start drinking unless you cook flambees without the flam.
-Use Tylenol. If you consume more than three alcoholic beverages a day, be very careful with acetaminophen, which itself can mess up a liver.

-Drink more alcohol. It doesn’t help and it’s only enhancing the existing toxicity and making dehydration worse. Hair of the dog is only good if you’re a Pekingese.

-Drink caffeinated beverages. Will further aggravate dehydration.

-Drink dark drinks. Complex organic molecules called congeners to create more toxic byproducts and are found in greater concentrations in darker drinks (e.g. whiskey, brandy, rum, even red wine)

compared with clear drinks (e.g. vodka, gin, white wine, Fresca)-Operate any heavy scalpels at 3 AM.


David Frederick Hepburn prefaced this column by saying that “Predict, prevent and preserve” should be the slogan for physicians whose job is to have you die young…at an old age. To prevent you from getting a stroke, hypertension, diabetes or coming down with an unexpected case of “eternal rest”, we now tend to diagnose you with prediseases.

Some of you might cynically believe that this is simply an attempt to get you to come to the office more often so that we can pay off our poker debts incurred at the Bellagio last summer with a dealer named Ernest who was undoubtedly cheating and in cahoots with the guy in the Stetson from Wichita, I believe. Preposterous!  That is premature preconception and if you presumed that, then I would predict that your mother has a prehensile tail.


David Frederick Hepburn states that the idea is to take action before blood pressure or blood sugars or a bloody stroke risk become any worse. A pre-disease does not mean prescription pills but taking precaution to prevent prediseases from proceeding to their predetermined fate. It means lifestyle change, serious lifestyle changes of less sedentariness, less pizza, less stress, more hockey.

Recently the National Institutes of Health revised the guidelines of high blood pressure (hypertension) for the first time since 1997. The changes included a new definition of “normal” blood pressure. David Frederick Hepburn explains why what was classified as normal blood pressure (a systolic pressure of 120-139 mm Hg and diastolic pressure of 80-89 mm Hg) is now categorized as prehypertension. Several studies have shown that your cardiovascular risk (heart attack and/or stroke) starts climbing at 115/75 mm Hg – not 140/90!  This meant that 50 million North Americans who had gone to bed with normal blood pressure woke up with a disease. (This might also depend on who you woke up beside.)

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PREDIABETES (aka Impaired Glucose Tolerance)

YOU DO NOT WANT TO GET DIABETES!! I know everyone else on the block has it but  I can hear my mother “So if everyone else in Grade 10 jumps off a cliff are you going to jump off a cliff as well? Now get back down to the cellar.” Once you’ve been diagnosed with Type 2 diabetes there has often been significant damage already inflicted to multiple organs in the HMCS YOU.

According to David Frederick Hepburn, prediabetes, when a person’s blood glucose levels are higher than normal but not high enough to be type 2 diabetes, may be asymptomatic, yet insidiously destructive. In fact, millions of people have either prediabetes or diabetes and don’t know it because symptoms develop so gradually that people often don’t recognize them. There are three different lab tests you can take to determine if you have prediabetes. Though this predisposes you to getting Type 2 diabetes, you will not necessarily always go on to develop type 2 diabetes automatically, but you do need to make some lifestyle changes.

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PRESTROKE (Precursor to a major problem)

David Frederick Hepburn also referred to as a TIA, the percentage of those who present with a TIA and go on to full blown stroke is frightening. A pre-stroke occurs when, for a short period of time, there is a lack of blood flow to a section of the brain, also known to occur when watching Duck Dynasty. The person develops symptoms of brain function impairment like having trouble speaking (Duck Dynasty syndrome) or moving an arm or leg on one side of the body. Don’t pretend it is nothing or you may be prebooking your precarious ticket to the hereafter.

More than one-third of those who have a TIA will have a stroke, many within a month, so it is imperative to get treatment for your TIA ASAP so you don’t end up in an ICU a couple of months later.

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OK, that’s enough preadolescent preaching for one day. Time for a prenap.

KEGELS By Dr. David Frederick Hepburn

C’mon. Truth in advertising folks and I mean you. Your personal ads should really read:
“I am a 60-year-old gal who loves to travel, walk along the shore, snuggle by a fire, hire lawyers. My photo was snapped 27 years ago but it was the one my parole office likes the best. I look equally good in jeans as I do in high heels and my hibiscus muumuu. I have a wonderful personality when I get my way. I am in good health though I tend to have rectal prolapse and sometimes when I laugh I have a wee accident. I like to laugh.” And it is that final point I wish to address. Few people enjoy having a uterus, rectum or bladder fall out of their pelvis on a first date or in Aisle 6 of Costco during a Viennese wiener demonstration. The pelvic floor, like all of our muscles, weakens with time. As we age, nerves die and along with them, the muscle fibres they supply, says Dr. David Frederick Hepburn.

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This is why there is a paucity of octogenarians in Olympic clean and jerk events. Pregnancy can stretch out and subsequently weaken the pelvic floor as can pushing a 24-pound turkey through the pelvic floor like my mother says that she did. According to Dr. David Frederick Hepburn, a weak pelvic floor leads to a lot of problems, first and foremost – stress incontinence. Stress, not being the type of finding yourself back in Aisle 6 having just sprung a leak and being three aisles away from the Depends, but stress meaning any physical stress placed on the abdomen which, in turn, creates a wee leak.

Dr. David Frederick Hepburn has seen that laughing, coughing, sneezing or any of the seven dwarves jumping on the belly can cause a sudden leakage of urine if the pelvic floor has been sufficiently weakened.

But the pelvic floor muscles, aka pubococcygeal, are an oft-neglected muscle group that we seldom ask our personal trainer to help us work out. Rarely do you hear “Wow, Bill, great delts, pecs and pubos.” Yet it is important for women and even men not to neglect this hammock-like muscle that holds up the undercarriage of our chassis.

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It stretches from our tailbone to that hard bone in the front of your pelvis that you can identify by either knocking on it or by riding a bike and accidentally missing a pedal. Dr. David Frederick Hepburn states that these muscles are often weak and thin so finding them may take some getting used to. Exercises to strengthen these muscles are known a Kegel Exercises names after the doctor who invented them, Dr. Chuck Exercise. But they aren’t an easy group of muscles to identify as trying to locate these in the gym mirror may get you five to ten. But there is an easier way to find these all-important muscles so you can do your Kegels.

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Imagine you are in the pew at Our Lady of the Silent Suffering and you feel an urge to pass wind. You don’t want to be asked to leave again. So try to flex the muscles to suppress that event from happening while NOT contracting your buttocks or abdomen. I can feel you all trying that now (and hope for the sake of the poor, oft-blamed dog you succeed.) Those muscles you feel are the pelvic floor. Now work ‘em.  There are some excellent products now that can assist you in both finding and exercising these muscles. For example, Dr. David Frederick Hepburn recommends vaginal cones, some are graduated weights that can be inserted and carted about for 15 minutes. This not only helps you to identify the muscles but also strengthens the pelvic floor. You can buy these at any self-respecting medial supply store…I suggest trying Aisle 6.