It's a frikin epidemic

Tuesday, November 29, 2005
Well I think the jet lag has finally started to go away. No matter what I do, I’m waking up at midnight. But at least now I’m getting back to sleep.

So, everyone I talk with back here inquires how my vacation was. I gently (or I think it’s gently) let them know that I was clearing out my folks house, that they are now in assisted living as we’re pretty sure Mom is mid-stage Alzheimers and Dad was no longer able to keep up with the house, finances, food & clothing all by himself. Then almost everyone shares a story of Alzheimers in their family, or someone close. I had no idea this was so widespread, and growing. From the research I’ve done on-line, there are lots of people studying it but no definitive statements as to cause or prevention. Certainly no hope of cure.

Mom seems to fade in & out. There are times when she’s right there with you, and then on the next interaction – the phone rings, or you ask her something, or she turns her head & catches sight of something – she’s gone again. I had the folks over to their old house a couple times. The second time, Dad had a list of things he wanted to gather. We picked out some books from the living room bookshelves. Mom would read a title – or try to, and then she’s reach for a book – which she could not lift from the shelves. Granted, the ones she reached for were larger, coffee-table size books but her weakness is very troublesome. At one point, Mom & I ended up in the guest bedroom, which was pretty much cleared except for several antique quilts. She recognized them, saying her grandmother had probably made them. We unfolded one to look, and I refolded it. She glanced at the next one, then back to the first saying “Oh, I think my grandmother made this” and unfolded it again. And again. And again. It was like being in some bad science fiction movie but it was real and it was my mother.

One of the processes that is very broken is her ability to reason. For example, my brother John was there over the weekend. When he arrived on Friday, she was still in bed at 12:30. She was too cold to get up. (I think she’s down to about 8% body fat.) She hadn’t eaten anything yet either. So John said, let’s get you dressed in warm clothes” pointing to the warm things in her room. Her reply was “I don’t know whose clothes those are.” She knew she was in her bed, in her room and there normally would be a bridge to ‘therefore these must be my clothes’ but there isn’t.

I have not seen that she’s aware there’s something wrong. She doesn’t question why they moved, nor why people correct her a lot. We are trying not to do this too much, but it’s hard when she says “I don’t have any clothes” or “I don’t have any jewelry” or “I don’t have any money”. We all try to be moderately cheerful and say “O, look at your closet full of beautiful clothing” or “Here’s your jewelry” and show it to her.

I had only noticed one time during the visit that she was aware that we thought there’s something wrong with her. It was a paranoid, bitching, “why are you all conspiring against me” kind of day. But we dealt with it head on. She fought hard for an hour or so, but we kept being straight with her and not getting too mad in return. It wore her down and after her nap she was fine & cheery again. John said that during his visit she was pretty upset when she asked “Who’s is this?” referring to the CD player from their house, that Greg had gotten over to their place and hooked up. When John said “It’s yours, from your old house” she burst into tears. He thinks it’s because she then thought she should have recognized it.

Mom also told John that she'd like to visit the house, because she hasn't been back. I'll bet she doesn't remember that I was there visiting a couple weks ago.

Her primary care physician (PCP) isn’t helping. Mom had an appointment a couple weeks ago and the PCP put her on an additional, diuretic blood pressure med. There isn’t a spare ounce of water in this woman. Result was, coupla days after Mom started taking the additional drug, she passed out. Fortunately, she was with Dad in his doctor’s waiting room at the time. She’s no longer on that drug. We still don’t have a diagnosis for her, although she has started seeing a specialist at the local, highly rated memory disorders clinic. Her first appointment was during my visit, and the doc saw her alone, only calling Dad in for the last 15 minutes. We don’t yet know the findings, or even the process for this but Mom was scheduled to have an MRI today (I hope dad got her to go) and from what I’ve read, the evaluation + MRI are done to eliminate possible causes of dementia. If it’s nothing else, then it’s Alzheimers. And even that doesn’t tell you too much.

And, last week, Dad called Greg very quietly, muffled in a pillow to say that Mom didn’t recognize him. I tell people this & they say “Oh yes, my father | mother | father-in-law | etc. called the police on their spouse | kids saying there were strangers in the house.”

It’s a frikin epidemic.

Hopeful sidebar: There is some interesting research being done with respect to vitamins, like in this article from the BBC:
Folic acid cuts dementia risk

Eating plenty of folic acid - found in oranges, lemons and green vegetables - can halve the risk of Alzheimer's disease, a study has suggested.

US National Institute on Aging experts monitored diets over seven years. They found adults who ate the daily recommended allowance of folates (B vitamin nutrients) had a reduced risk of the disease.

UK researchers said the study added weight to previous suggestions folates could reduce Alzheimer's risk. … there’s more on the link.

And I’m also interested in vitamin D. In medical work done before I left the states, I was found to be waaay low on vitamin D. I always crave to be outside in the sunshine, and found myself with seasonal affective disorder – at least that’s what I interpreted the not wanting to get out of bed on the dark, gloomy days was! Discover Magazine had a recent story on nutrition, and the sidebar on vitamin D said, in part: “Vitamin D is unusual in that we don’t get it from our food: We synthesize it by being out in the sun. But our whole cultural evolution has been to remove us from sunlight. … We realized that vitamin D deficiency was a problem 50 or 60 years ago, when children living in cities in the northern United States began to develop rickets. In response, a major public health program began adding vitamin D to milk. And that was pretty effective; it almost eliminated rickets from the United States. Now, cases of rickets are reemerging. Children’s Hospital in Oakland is seeing frequent incidences. The recommended daily allowance for vitamin D is 400 international units—about what you get in a glass of milk. If you’re outside on a sunny day, though, you make almost 20,000 IUs. Four hundred is a drop in the bucket. It’s enough to prevent rickets, but that’s about it. Low vitamin D levels increase the risk of certain cancers, possibly multiple sclerosis as well, and possibly other conditions like asthma.” Walter Willett, professor of epidemiology and nutrition at the Harvard School of Public Health.

So I’m happy that I moved from the northeast to California. It’s not nearly as sunny here in Munich, though. But the extra vitamin D that I’m taking seems to be helping.