Sun Tel: Doctors stumped by patients' good innings

Doctors stumped by patients' good innings

By James LeFanu, Sunday Telegraph
Last Updated: 12:24am BST 20/05/2007

The news that Doris Vollbrecht is soon to follow her older sisters,
Julia and Gertrude, in receiving a centenarian congratulatory telegram
from the Queen reflects the remarkable increase in longevity of recent
decades. Indeed, Her Majesty now dispatches on average more than a
dozen such telegrams a day, an almost twentyfold increase on the 200 a
year when she first ascended the throne.

The birthday itself will no doubt be a happy occasion, although it
carries the risk of the well-recognised centenarian hand (or arm)
syndrome.

Family doctor Kevin Hockridge, from Swansea, writing in the British
Medical Journal recently, describes how one of his patients was
admitted to hospital the day after his 100th with reduced movement of
his right arm that was attributed to a small stroke.

"When he subsequently came to the surgery, I was surprised that his
right hand grip was as strong as ever," he writes. Further careful
examination revealed signs of repetitive stress injury of the shoulder
joint from having shaken so many well-wishers' hands. "He was,
needless to say, delighted to hear of his much less serious
diagnosis."

This reflects the more general hazard in this age group where an
eminently treatable condition is misinterpreted as being due to some
incurable "chronic degenerative" disease. Those with pain and
stiffness in the joints may too readily be labelled as suffering from
"arthritis" when a simple blood test would reveal the true cause to be
polymyalgia. That responds almost miraculously to a small dose of
steroids.

Similarly, while the efficiency of the lungs, as with all organs,
tends to decline over time, symptoms that show shortness of breath and
wheezing may be due to "late onset" asthma that, as in younger
patients, responds well to broncho-dilator drugs, such as salbutamol.

Then, as reader Anne Smith, from Kent, points out, some age-related
conditions can be beneficial. She lives in a townhouse with a
staircase of 36 steps from the front door to her bedroom.

Her memory is not quite as sharp as it was, but this has markedly
improved her exercise programme. "I can never leave the house without
having to return upstairs to the bedroom at least a couple of times to
retrieve a handbag, gloves, spectacles, keys and shopping list," she
writes.

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