Alzheimer’s

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I remember my final day as a neurosurgeon. “Washing” a human brain with two humongous syringes of sterile physiologic saline, the same way my mother of blessed memory used to baste a chicken.

I thought maybe as a psychiatrist I had a chance, at least a fighting chance, of preventing a disaster like the one I was standing there trying to treat. Read more on The Decisions You Make…

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She was, and is, a close and cherished friend. Someone decided she had Alzheimer’s.  At least somebody said she did.  She had wonderful plans for retirement.  Now the retirement community she had been dreaming of did not seem to want her and her husband around.  She has just made the decision (I don’t know with who’s help) that it is a better idea she does not drive. She would surely not remember the details of how the diagnosis was made.  I wonder if it had been made properly.  Probably not.

Read more on All That is Demented is not Alzheimer’s…

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Most of the time I see a single piece of research related to psychiatry reported by multiple news services, I figure the institution that produced it has a prizewinning public relations person.  I figure it is popular for some kind of unspoken agenda.

Maybe it is consistent with some level of political correctness.

Do you think that’s a cynical thought?  Perhaps I should be a little more cautious. Read more on Cynicism and Alzheimer’s…

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Do Not Go Gentle into That Good Night, that old Dylan Thomas poem, is a favorite of many mature adults, including me.

Do not go gentle into that good night
Rage, Rage against the dying of the light

Let’s face it — none of us is getting any younger.  And as we age, we’ve got to choose – will we rage, or will we just go gently.
I remember someone who alleged they wanted to work with me telling me they were interested in working with an emeritus neuroscientist.  He was a very sharp guy, at least as far as I could tell from his academic publications.  He had been with the system a long time and published much.  I had not, since I’ve never seemed to fit into that system any better than most other systems.
The project fizzled for a number of reasons, not the least of which was the news that his family was up in arms because this elderly gentleman had given the overwhelming bulk of his life savings to one of those delightful online scams.
I have not checked what the country of Nigeria is doing in terms of industry, but they seem to be leading the way when it comes to these scams.  They promise tremendous amounts of money, starting with an email to a recipient that purports to be a personal email but which surely has been delivered in bulk.  All the recipient has to do is advance a little money to get a lot.  A greed factor then takes over, and the recipient advances more and more money in hopes of a big payoff — which does not seem to happen. Anyone who has not received at least one such email is probably not a big internet user, to say the least.  I have received them in three languages, and I do almost all of my internet work in English.
It has been known for a long time that old folks are most often prey to the financially unscrupulous.  Personally, I think that the isolationism and diminished social function that often come with aging play at least as much a part in this as neuroscience does.  But for the moment, let’s assume that at least some of the problem is a loss of judgment that comes with age. Assessing individual financial capacities may be helpful — for families and guardians and stuff — but there is a delirious amount of variability here.
The typical American solution of let’s-make-more-rules may not be the way out.
At quite a young age, I saw my Grandfather-of-Blessed-Memory tell my mother that he had a daughter in Boston – even though she was standing right in front of him.  He simply could not recognize her.  As she stood there crying like a fountain, I knew I was in some kind of trouble.
Read more on No More Cognitive Loss for Age…

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I don’t care if Dylan Thomas was drinking himself to death while that was being written.  It is a sentiment close to my heart, and undoubtedly the stanza of poetry I quote most often.

Dylan ThomasDo not go gentle into that good night
Old age should burn and rage at close of day
Rage, rage against the dying of the light.

I will not accept  the allegedly inevitable cognitive loss of age.” 

I suppose my mother did me a service at age 10, when she dragged me fairly close to the oversized window of an oversized ladies room, and told me never to linger trying to make myself attractive, for it would be a waste of time.  I was – in the opinion of my parents – destined for brains, not beauty.

Time lost in fixing my appearance would be noted sardonically by my father, and bother him, as we wasted his time. 

But my strong suit was my brains, and even I agreed that I should work on them — working very hard in school — and that way I could win in life. I actually took my mother seriously, for a very long time. It was not until my late fifties that I started to be anywhere near a fashionable woman’s size, finding to my amazement that people found me attractive, and taking more notice myself than ever in my life.

But even now, I don’t give a damn if they call it “cognitive loss for age” or “dementia,” I want nothing of it.

Nothing at all. 

Read more on Memory Problems Can Be Prevented And Treated…

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Okay, let me get this straight.  We are looking for new science to stop an aged population from getting Alzheimer’s and getting dependent on others for that structured “senile” type care that is expensive and — let’s be honest — usually not enough to keep people really productive.

The first of the two studies reported here is basically saying that people with lower amounts of measurable beta amyloid marker have more cognitive decline over the nine years studied.  Another report on the elusive “marker” for Alzheimer’s.  If someone can tell with a blood test that you got it, what are you going to do? There are several drug companies, presumably including the folks at Avid Pharmaceuticals, who sponsored the second study, for a molecule that binds to the protein that ends up in microscopically visible “tangles” that show up in biopsies and autopsies of Alzheimer’s type brain tissue. It is also reported that educated people are less likely to get Alzheimer’s.  Frankly, this sort of finding is usually attributed to a “use it or lose it” analogy to the physical workout.  In some ways this is true. I remember some lovely studies when I was in France that led La Nation to tell seniors to slowly practice memorizing their shopping lists, and they did indeed seem to improve their recent memory.

I also remember a study I suspect the rest of the world has forgotten, called the “Minneapolis Nun Study.” Read more on Misguided Research Is Dithering Around Alzheimer’s Again…

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Even I – a supposed expert — have only scraps of information on this drug.

I remember a wonderful professor in medical school, who introduced me to her mother, who had some problems with dementia.  Mother had improved greatly, it seemed, in a loving homey institution on a medication called “Centrophenoxine” — which I have since learned is also called “meclophenoxate” or “Lucidryl.” Read more on Mostly Harmless “Smart Drug” — But No Endorsement (Yet)…

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I first found out about this list of so-called “Influential Doctors in the USA Today newspaper and did not finish the article before I became aware of two powerful realities: 1. This list does not sound like it will help people who need a doctor, but more likely it will benefit someone else in the health care industry.  2. Nobody compiling a list of influential doctors is going to add me because I’m a professional pain in the rear-end of the other doctors on the list.

It sounds like one of those times when somebody is making money from patients pockets by marketing drugs or services, via insurance companies or drug companies. 

Hello “parasite!”  Hello person-making-money-from-sick-people without adding “value” to healing them. Read more on Turning The Brain Back Ten Years And Slowing The Decline…

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She was a friend.  Other people sometimes live their entire lives in one place and keep friends for life, but she was more distant, clinging to me loosely, trying to live off free advice.  Like almost all the friends I have in one particular region, she was a therapist. Not a bad thing to be, and I believe her to be a competent therapist. But she had the same problem most people in my age group have.  She wanted help fighting it.

I suppose the name for it these days is “cognitive loss for age.”  Not Alzheimer’s, that “presenile”  (the earliest cases described by Kraepelin himself was in mid-fifties) dementia, but getting older.

Mainstream medicine comes up with names and categories and prescriptions, that may or may not offer significant clinical improvement. The human spirit comes up with, well, at least a little good anger. If there is one piece of poetry I quote more than any other, it is Dylan Thomas “Do not go gentle into that good night/Rage, rage, against the dying of the light.” Of course this brilliant Welsh poet, the way I heard it, died of alcohol poisoning in New York; not exactly how I plan to rage against the dying of my light. Oh, how many people who have tried to feed me alcohol I have told I cannot afford to lose any brain cells by that method.  I need everything I have to continue to live by my wits. Read more on Advice From A Poet About Memory Loss…

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The last time I saw my maternal grandfather, my Zadie, alive, he was mostly bedridden, in an institution for the aged in Springfield, Massachusetts.

He was 88 years old. He had long since retired from his profession of pawnbroking and about eight years before had been hauled in by the police since he was unable to locate the rented room where he desired to live alone, limiting his contact with his three daughters so that he could reassure himself he was not a burden.  My mother worked frantically to convince him that she was indeed his daughter who lived in Boston.  After a while, she finally elicited a smile from him.

Alzheimer's Brain

“Boston.  I have a daughter who lives there.” His inability to recognize my mother left her crying uncontrollably, despite my then meager (I think I had only recently become a doctor) attempts to explain to her what was then known about his brain disease, known as Alzheimer’s. Read more on Alzheimer’s Prevention Not As Important As Looking HOT!…

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