Dear Dr. Roach: We believe a young family member has symptoms of prosopagnosia, possibly with a genetic basis, as an older relative has had the same problem all of her life. He has no sense of direction, and gets lost frequently while driving on what should be familiar roads, even using GPS. He can’t recognize landmarks, buildings or roads that should be familiar, as he has lived in the same small town from birth, but he has no problem recognizing faces. He can visualize his destination, but not the route to get there. This causes him anxiety and embarrassment when he gets lost once again while driving to what should be a well-known destination. An online search gave information mainly on face blindness, but only passing mention that agnosia of places exists.
He is an above-average student looking forward to university. He is in good health, has never suffered a head injury, is very active in sports and outdoor activities and has a good circle of friends. If he moves to a university residence in a larger city, he will be on his own. Are you aware of any support group he could contact that would suggest some coping strategies or give him further information about this unusual condition?
Dear M.L.: Prosopagnosia (from Greek, literally “without knowledge of faces”) is a condition that people can be born with or can acquire, usually through damage to the brain (such as a stroke). It causes people to be unable to recognize faces. I’ve read about it but have not seen a case. Your description of being unable to recognize places does sound similar in some ways to this condition, so I contacted a researcher, Dr. Jason Barton, at the University of British Columbia, who told me he thinks your family member may have a condition he and a colleague recently described, called developmental topographic disorientation.
This condition, despite being only recently described, seems to be more common than I would have thought, had I known it existed before doing this research. There’s a website, gettinglost.ca, with much more information and a member forum to discuss strategies.
Dear Dr. Roach: I am an 82-year-old male who has had a constipation problem for many years.
I did find a solution to this problem by using 17 grams of polyethylene glycol every third day, along with a stool softener every morning and evening.
I also try my best to eat as much dietary fiber as possible, but I find it difficult to consume the recommended daily amounts. The average cereal contains only 2 grams, or 8 percent of the daily requirements. Other foods, such as veggie sticks, noodle soup, other veggies, high-fiber bars, etc., help, but I need much more. What fiber regimen would you suggest to help support healthy bowel activity?
Dear K.V.B: There are many high-fiber cereals, some that will give you an entire day’s worth with one serving. I recommend one with no added sugars. Similarly, some of the products you mention are high in added sugar and sodium, but there are healthy options. (Note: I strongly recommend starting slow and gradually letting your system get used to more fiber. Otherwise, bloating, distention and gas are likely side effects.)
If fiber alone isn’t adequate, polyethylene glycol 3350 (Miralax and others) is a good choice for occasional use. Stool softeners are safe for everyday use.
Email questions to ToYourGoodHealth@med.cornell.edu.