5 Steps to prevent Heart Disease

Sunday, June 16, 2019

Good comeback from my fall.

Father's Day dinner.
Two days ago I fell on my face with a subsequent large black eye.
Today I can open my eye easily and have no pain.
The cosmetic part can be easily covered up with sunglasses.

I go to my son's wedding next week.   I will probably need makeup for the photos.

Alzheimer's patients are known to have sudden sharp declines in mental ability.
I think that is mostly due to strokes.
My last systolic blood pressure was 100.
I also keep my cholesterol very low.
My last Hgb A1c was 7.8.
Thus I am very optimistic.
Hence we just book another cruise to Japan in Feb. 2020.
I an quite happy and having a great time.
I just finished my yearly testing for the KUMCR research trial which is a non-treatment.
It was three days of testing.
3 hour cognitive exam
MRI
Tau Pet Scan.

I enjoy doing it as I feel I am paying it forward.
They give me $100 each year as compensation.
It gives me a sense of accomplishment.

Day one



Day two


Day three Father's Day




Saturday, June 15, 2019

My first black eye in my life



I went to help a carpet cleaner take a bookcase out of the basement, out the back door and up the hill to the street.  It was arduous for me but I thought I had it, until we dropped the bookcase while I was still walking.  I guess I had so much momentum I just kept going without stopping, I was moving forward and heading to the ground. I took 3 steps trying to slow down and regain my balance instead I went faster till I walked off the grass crashing into the concrete driveway.  I have had a few falls in the last two years due to my poor balance.  This was a very hard hit on concrete with my face bouncing off the ground.  I was dazed but got up and finished some of the cleaning work.  I had a slight headache.  I asked my partner if I was bleeding.  He said just a little.  When I looked in the mirror I had a small scrape above my left eye with little bleeding.  I put a bandaid on it and went back to my research.  Later when I got back up to check on the carpet work, he looked at my eye and was sorry to see the eye was swelling up.  I looked in the mirror.  I probably missed my best window of opportunity to prevent the swelling with ice.  I put iced peas on my eye but the swelling became much worse.  Very little pain.  I am on a blood thinner so I was worried about getting a sub-dural hematoma.  I told my wife to call 911 if I pass out.  There was no bleeding into the other eye so I was not worried about an orbital bone fracture.  There was also no pain on palpation of the bones. 

I told my wife I can't do this work anymore. 
I am too light for heavy work and too heavy for light work.
In truth it is the result of my poor balance that has worsened since my diagnosis of Alzheimer's. 
The damage of the fall could have been much worse.
Fractured hip is high on the list. 
Just as I gave up my medical license and let my wife drive most the time I need to keep adjusting my behavior. 
I go up and down the basement steps 8 times a day.
I must stop going down the steps carrying items in both hands. 
As my Dad said years ago, "always go down steps with one hand on the banister". 
I gave up going on a ladder years ago. 



Tuesday, June 11, 2019

Off statin for 2 months, my cognitive testing seemed better to me


July 9,  2018
I had my first cognitive testing at the KUMCR Alzheimer's Center.  It took 3 hours.
It was stressful but not as bad as my Neuropsychological Assessment in Florida done on
4-1-17
10-5-17
10-10-17
at three different dates.
You can see the results of my Florida testing in my book:
I Am Waiting for When I forget I have Alzheimer's. YEAR ONE.

Update:
I had my second cognitive testing at the KUMCR Alzheimer's center.  Again it took 3 hours.

Interesting, I thought I did better on the test today than I had on the prior tests.
I was on Namzaric already when I took the first KUMCR cognitive.
I took todays test and had less stress than the prior tests.
My palms were sweating after the first hour which I don't remember having before.
  I was a little warm however my concentration was intense.
I have not taken Atorvastatin 10 mg since 4-2-19.  
LAB results off statin replaced with Niacin link
Perhaps that helped me with this test?

I suspect I did better after reading Moon walking with Einstein.

I learned to build memory palaces by reading the book.

Those techniques are too slow to apply for the short term memory tests.

However I did learn enough about improving my associations with the list of words by being more imaginative in making the quick tags.
I told the tester most people can only remember 5 to 9 words on a list. She seemed surprised.
She would come back to the list periodically and I found each time I remembered more words.
I think I ended up remembering more than 10 on the list on the third effort.
This success has given me hope that I may remain in early phase of impairment for years more.
I hope now to be able to write my YEAR 3 version next year.

In any event after the difficult testing I felt I had done better than one year  ago.

I took my second one hour MRI at Hoglund Scan center at KUMC.
Again it  was not so arduous this year.
Clearly because I used my two memories palaces to pass the time
I would think of my list of 55 European countries.
Then I would think of my list of top 16 trips.

Finally I would use the relaxation exercise taught by Alzheimer's Society.
I would chant
Sa
Ta
Na
Ma

over and over again.



Tuesday, May 21, 2019

Early preview of chapter I wrote for Year Two Today

May 21, 2019
The last remaining Seven Wonders of the world.
The Great Pyramid of Giza is the oldest monument on the list of the Seven Wonders of the Ancient World.
17 months ago I learned I had Alzheimer’s disease.
I had no idea I would make it to this point to go to see The Great Pyramids.
We made the plan with hope and it succeeded.
This is the message of this book. I hope I can write a Year Three book with the same story.
Riding the camel was not on the bucket list.  My wife talked me into it.
It was challenging.
The worst  part was the moment the camel stood up.  
They said to lean back but I forgot to do it.
They gave no warning.
One second the front legs go up and I wheel back and then the back legs stand and I truly felt I was going to fall off.
My balance is poor.  
No camels to ride in Brooklyn, NY.

I survived the whole ride.
It didn’t help that a horse collapsed three feet away pulling a carriage.
I was shocked to see the horse lying on the sand entangled in the gear of the carriage.  Then they say “get on the camel”
All very disorienting.  
At the end I was glad I did it.
The experience of the camel sitting down was much easier for me.
I dismounted with one of the two guides helping me get my right foot over the head of the camel.

I got good potential photos for the cover of this Year Two book.
We left the Four Seasons at 8 AM.
It’s Ramadan presently.  Europeans don’t visit this time of year.
The desert wind was cooling and very pleasant.  
At the end I had perspired more than I have in a long time but it kept me cool in the breeze.
Riding downhill and being told to lean back, was terrifying.

Today I am very happy.  I feel a great sense of accomplishment.  
I don’t have any more items on my bucket list.
It was a great day of adventure.

Choose which photo I took today should be cover for Year Two

The last remaining "seven wonders of the ancient world"

The Great Pyramids of Giza 


Photo One

Photo Two


Photo Three


Photo four


Photo Five

Monday, May 13, 2019

Second memory palace

I made my second MEMORY PALACE of TOP 14 trips. 

  The first memory palace I made was done using the first floor of my house.  I memorized 44 European Nations.  Each day I go through them.  I do it also if I have trouble sleeping.


The second memory palace took much less time to make because it is only 14 items.

1- I start at the top of the steps going to the basement.
   Mount Everest

2- At the bottom of the stairs I turn right and see a photo hanging of me and my kids in front of
    Machu Picchu

3- I look above and there is a map of South America.  
    Chiva Bus/Train ride in Ecuador 

4- I turn left and walk along a wall of books.
    Great Wall of China

5- I turn continue around the round and see a wooden turtle
    Galapagos

6- I sit down and wrap a red blanket around me as I am usually cold.
    Antarctica

7- While sitting I watch TV and my computer feeling I am in a palace.
     Potala Palace, Tibet

8- I look to the left and there is a mural of Zion canyon.  I think of the best National Park.
    Lake Louise, Canada

9- I look across the room and see the wooden Komodo dragon at top of book shelf.
     Komodo dragons, Indonesia

10- I turn and see my wife coming down the stairs.  Her favorite place is:
      Petra, Jordan

11- I guide her right to show the photo of Andrew and I at
     Haleakala Mountain, Maui

12- Then at the next dresser I show her a photo of Andrew when he was around 8 years old.
       It reminds me of when I took Luke at the same age to"
       Glacier National Park,  Montana

13- I walk her to the next room where a Michael angel statue killing a demon which I purchased with my daughter Sarah in:
      Venice, Italy 

14- My wife then reminds me her daughter's Newfoundland dogs are visiting:
      Husky sleigh ride in Finland north of the Arctic circle with her. 

Sunday, May 12, 2019

Top Two travel experiences my wife and I have enjoyed together.

1-Chiva Bus/Train ride, Ecuador




2-Husky sleigh ride in Finland 



My son (younger) and I hiked down into and up the Haleakala Mountain in Maui. 


My son (older) and I hiked a mountain in Glacier National Park.


My daughter and I spent five days walking around Venice, Italy

Top Places my and I have visited # 6-10



6- Antarctica 



7- Potala Palace, Tibet


8- Lake Louise, Canada


9- Komodo dragons, Indonesia


10- Petra, Jordan


Top Ten Places my wife and I have visited.


I am about to visit the Pyramids of Giza in Egypt.

I am into the second year of Alzheimer's.

I decided to go through my photos and make a Top Ten list now while I can.

It was work but it was fun.

I will also commit the Top Ten to a memory palace so when I am on the cruise I can rattle them off, and in hopes the Memory Palace will last longer than my present diminishing memory.


# One         Mount Everest fly by

# Two         Machu Picchu

# Three      Chiva Bus/Train ride Ecuador  

# Four.       Great Wall, China

# Five         Galapagos









Thursday, May 9, 2019

Compare stopping Atorvastatin first replacing with Nicotinic acid 1,000 mg then adding on Zetia a month later



I think the chart above is difficult to digest.
I will try to help.
It was very difficult to get all the numbers and dates in order.
I hope I didn't make any major mistakes.
Let me know if I did.

I circled two boxes in green (green)
I think these two colu\ns are the most interesting. Follow yellow lines.

The inexpensive ROUTINE LIPID PANEL vs. NMR ADVANCED LIPID test (both done) 5-1-19
Non-fasting blood sample.
 It's a good way to see how your body handles the triglycerides post prandial

Notice how close the
TC (total cholesterol) 171 to 175
TG(triglycerides) 118 to 113
HDLc 61 to 63
nonHDLc (my favorite) 110 to 109
No discordance here, despite my Diabetes Type 2

Not much difference between the two lab techniques. 
It gives me confidence in the reliability of the inexpensive local lipid lab.
SURPRISING RESULTS?
This brings me to the first two columns on your left.
The experiment is about the effect of
Atorvastatin (Lipitor) 10 mg  vs Nicotinic acid (Enduracin) 1,000 mg

Lipitor does better in every category, evenith HDLc, TG and non-HDLc!

No doubt a statin is better than Enduracin. 

Always start treatment with low dose statin.  If not contraindicated. 

Enduracin is still a good add on drug for synergy even at 1,000 mg.  
See the Compell trial. 

Then to reach target add Zetia. 

Some might ask me,
"Why take a statin.  Your non-HDL is not so bad at 110."

I know I have atherosclerosis via CAC and CIMT

I also am high risk with type 2 Diabetes mellitus. 

I would like to keep my non-HDLc less than 70-80 

Both LDLp's were done on statin.

I would like to keep my LDLp less than 1,000

Next phase of experiment is to add Zetia to niacin.

UPDATE ADDING ZETIA TO ENDUR-ACIN WHILE ON 12 DAY CRUISE

5-1-19
No statin, on  Endur-acin 1,000 mg a day. 
TC 171
LDLc 86
HDLc 61
Remnants 24
TG non-fasting 118



6-12-19 After 12 day Mediterranean cruise. 
 No statin, on Endur-acin 1,000 mg a day and Zetia

TC. 152
LDLc 76
HDLc 59
Remnants 18
TG fasting 85

I find this interesting. 
Enduracin and Zetia do a good job without statin. 
I thought my cognitive exam was better this year compared to last year.
Cognitive exam for Alzheimer's yesterday link.

Some might argue Statins are good anti-inflammatories for AZ. 
However if it is all about how low you can go with LDLc,
perhaps the two drugs without statin is better?

I am waiting for my LDLp to return in a couple of days







Sunday, May 5, 2019

Gretchen Reynold's NYT article on Exercise helping memory



This is an excerpt from Gretchen Reynold's NYT article


At KUMCR where I am participating in an Alzheimer's trial (non-treatment), I was told to do at least 150 minutes of exercise a week.

I think it is also important to keep LDLp less than 1,000 or LDLc less than 70.
Blood pressure should be kept as low as possible.
Blood glucose should be controlled as best as possible.
I keep my weight down with diet medications including diabetic meds such as Invokana, Victoza and Metformin.

Other than that I try not to try every nostrum on the internet.
I try to concentrate on having fun.
I am taking a Mediterranean cruise next month.  Very excited about it.


Gretchen Reynold's article with my editing to make reading easier for an Alzheimers patient link






Saturday, May 4, 2019

This blog was very challenging for me to write.


 My Alzheimers was diagnosed in Dec 2017


Making the chart before was very difficult for me.

Having finished it I felt a great deal of accomplishment.

When reviewing articles I often transfer them to my goggle docs and then edit them with colors to make it easier for me to focus.  If you find an error please let me know.
I recently posted a big mistake on calculating non-HDL cholesterol.

I had to re-calculate it several times for the Advanced Lipid test which did not give it to me automatically as the Routine Lipid panel

TC (Total Cholesterol)
minus
HDLc

= non-HDL cholesterol










We left for Australian Circumnavigation Oceania Cruise on Dec. 5, 2018

We got off the cruise Jan. 16, 2019 and flew to Hawaii.

We left Hawaii and flew back to Topeka, KS on Feb 7, 2019 

Putting together this blog and summary index card for me with Alzheimer's  was a big challenge 
with the dates and numbers. 

Comparing Advanced NMR testing with routine lipid panel

On and off Lipitor and Enduracin (nicotinic acid)

                                              Above
                                      Feb/28/19
Baseline NMR test after cruise and Hawaii.
On STATIN.  
Off Enduracin



Above
May1-2019 
NMR report
Off Lipitor (statin) and On Niacin(Enduracin) 1,000 mg



                       Above Routine Lipid Panel

                            APRIL 2, 2019

OFF Nicotinic Acid 1,000 mg but on Lipitor 10 mg

                           Above       Routine Lipid Panel
MAY 1, 2019
OFF Lipitor but on Nicotinic Acid 1,000 mg and Lovaza 4,000 mg.
Glu 149  keto 1.9  wt 214.6




Non-HDLcholesterol goes up off Lipitor 10 mg for one month


I went off Lipitor 10 mg a day for a period of a month to see if my memory would get better with Alzheimer's.
I still have short term memory loss so it is very difficult to tell.
My non-HDL Cholesterol went up to 110 from 70.
My non-fasting  triglycerides went up to 118 from 90 despite taking Nicotinic acid 1,000 mg a day and increasing my Lovaza (omega 3's) to 4,000 mg a day.
The next part of my experiment is to wait for my LDLp level to come back.
Then I will start Zetia instead of going back to Lipitor.



The above lab from 4-2-19 was after being off Niacin and Omega 3's.
I was on Lipitor (atorvastatin 10 mg)
This was after a 34 day Oceania cruise around Australia.
Non-HDL cholesterol was excellent at 70.
NON-fasting triglycerides were excellent at 90.

I have been on Atkins or Low carb high fat diet since 2011.
Usually I am in nutritional ketosis.






Thursday, May 2, 2019

Tuesday, April 30, 2019

Still enjoy learning despite 17 months since my diagnosis made.




"The Balkan peninsula is, according to some definitions, what lies south of the rivers Sava and Danube from the city of Belgrade."  

"Slovenia, too, was once part of Yugoslavia. It is their recent independence that has allowed for the Slovenes to re-proclaim their desire to be considered Central European".

Is Slovakia part of the Balkans- No link
Slovakia was a part of Czechoslovakia and gained indendence in 1993 when splitting from Czech Republic after democratic elections

Kosovo is still part of Serbia. 


Which Present Day Countries Were Once a Part of Yugoslavia?
  • Bosnia and Herzegovina.
  • Croatia.
  • Macedonia.
  • Montenegro.
  • Serbia.
  • Slovenia.






Through my life, I am chagrined to admit I often confused Baltic States and Balkan states, despite knowing WWI began with the assassination in Sarajevo and had a close childhood friend who was born in Estonia. 







Monday, April 29, 2019

Is Trump's Coup

"Coup Attempt link wiki


"On the eve of 16 October 2016, the day of the parliamentary election in Montenegro, a group of 20 Serbian and Montenegrin citizens, including the former head of Serbian Gendarmery Bratislav Dikić, were arrested;[7][8] some of them, along with other persons, including two Russian citizens, were later formally charged by the authorities of Montenegro with an attempted coup d'état."

On 28 April 2017, Montenegro's parliament voted 46-0 to join NATO, while the majority of opposition parties kept boycotting parliament sessions and protesters burned NATO flags outside.[19]
Tensions between Montenegro and Russia continued to escalate thereafter.[37]

Sunday, April 28, 2019

Cruising may be best way for people with Alzheimers to travel.

Two stops on my next cruise. 


1-Kotor, Montenegro


"Kotor is a beautiful walled medieval city of twisting, pink-paved streets, markets and architecture reflecting Byzantine to Venetian influences
. Stroll through the compact old town, admire the impressive walls and tour the imposing St. Tryphon Cathedral, consecrated in 1166."

I will soon be on a cruise to Kotor.




2-Dubrovnik, Croatia


"Enjoy a walk through this famous walled medieval city and its exquisite Venetian monuments. 
See the Franciscan monastery and explore the Rector's palace and the cathedral. 
Or explore the countryside with a visit to lovely Cavtat, an enchanting seaside resort that began life as a Greek and then Roman colony.
 Then visit a local family in a Konavle Valley village and enjoy their hospitality over a traditional welcome of brandy and figs with a serenade by local musicians."

Dubrovnik is the next stop on the cruise. 



I took a Viking cruise from Amsterdam to Bucharest

"The longest river in the European Union, the Danube River is the second-longest river in Europe after Russia's Volga. It begins in the Black Forest region of Germany and runs through 10 countries (GermanyAustriaSlovakiaHungaryCroatiaSerbiaRomaniaBulgariaMoldova and Ukraine) on its way to the Black Sea.'

I did get to Bratislava by Viking cruise, water levels higher?
I did not get to Moldova or Ukraine. 

New itinerary for Eastern Europe Cruise






Slovakia, Slovenia Serbia,

Part 2 of researching countries of Europe that I put in my Memory Palace.

Slovakia

1- Bratislava (the new Prague?)
I visited here on a Viking river cruise.  It was wonderful.

2- Velvet Revolution link
"Gentle Revolution was a non-violent transition of power in what was then Czechoslovakia, occurring from 17 November to 29 December 1989. Popular demonstrations against the one-party government of the Communist Party of Czechoslovakia included students and older dissidents. The result was the end of 41 years of one-party rule in Czechoslovakia, and the subsequent dismantling of the planned economy and conversion to a parliamentary republic."

3- Considered the poor sister of the Czech Republic, not to be confused with Slovenia formerly part of Yugoslavia.

4- High Tatra mountains are a huge tourist attraction. Photo link

5-"Radiocarbon dating puts the oldest surviving archaeological artefacts from Slovakia – found near Nové Mesto nad Váhom – at 270,000 BCE, in the Early Paleolithic era"

6-"Slovakia joined the European Union and NATO in 2004 and the Eurozone in 2009."

Slovenia

1- A major Eastern European Success Story! 

2- First former Yugoslav country to become a member of the European Union.

3- About the size of Switzerland and has produced several Olympic Ski Champions

4- Venetian harbor towns on the Adriatic coast.

5- "The Julian Alps are a mountain range of the Southern Limestone Alps that stretch from northeastern Italy to Slovenia, where they rise to 2,864 m at Mount Triglav, the highest peak in Slovenia and of the former Yugoslavia."

Serbia (Montenegro was part of this country)

1-"Still suffer an ignominious reputation as Balkan bullyboy cultivated by former leader, Slobodan Milosevic"
 page 349 The Travel Book. Lonely Planet. `

I visited Belgrade via Viking Cruise.  
There was still some destruction present in the Capitol when I was there. 
Otherwise nice city. 

3- "Adriatic Beaches set against spectacular coastal mountains."

4-Kosovo is not a country of Europe. It is part of Serbia. 
"Kosovo, self-declared independent country in the Balkans region of Europe. Although the United Statesand most members of the European Union (EU) recognized Kosovo's declaration of independence from Serbia in 2008, SerbiaRussia, and a significant number of other countries—including several EU members—did not.Apr 5, 2019"
5- Has Europe's deepest Fjord