Dr Dale Bredesen writes DHA is not made in the brain.
I decided to increase my DHA intake with an OTC fish oil pill.
I try to check my lab every four months.
LDLp less than 300
LDLc 30
Total Cholesterol 106
HDLc 61
nonHDLc 45
Total cholesterol(106)
minus HDLc (61)
minus LDLc (30)
equals Remnants 15
My triglycerides are not fasting: 69
Having a great lipid panel on low dose inexpensive statin and nicotinic acid (enduracin)
Atkins type diet (high fat, low carbohydrates)
is helping me prevent further vascular disease which could contribute to stroke and cerebral ischemia.
Prior lab link
I show my wife my platypus (see below). I tell her I am going to start carrying this around for comfort. She looks at me strangely and I say "I don't mean outside the house, at least not yet."
Peter the Platypus
The platypus is an addition to our animal menagerie at our home that keeps our life interesting.
Through our backyard at night we look for:
1- Rocky the squirrel
2- Oppie the possum
3- Freddie the Fox
4- Bobbie the bobcat.
We have a wild time here in Topeka.
I am presently writing:
Alzheimer' is Inexorable. Year Four
Grit and Fortitude required
This present year I signed up to attend Dr. Dale Bredesen's recode program which I was very skeptical of until I read about the success of Julie Gilbert. I still worry her main problem was depression.
I am gaining more respect for Dr Bredensen link
Recode nutritionist visit link
3 years two months since my AZ was diagnosed and things are better than can be expected.
How can I measure if my Alzheimer’s is getting worse?
Jan. 21, 2021
Today was full of accomplishments.
1- It took me a month to finally call AAA to change my car battery.
2- Today I drove for the first time since Jan. 20, 2020.
3- I picked up a prescription at the drive through.
4- I went to get my blood work.
I still have some items I have procrastinated for a long time to get done.
Get my scale fixed. First attempt failed.
Get Best Buy to return the DVD I sent in to be fixed a year ago.
This past month has been full of political news. Yesterday I watched more of the Presidential Inauguration than ever before in my life. I know more about politics now than ever before. Of course I remember very little of what I learned in college after reading the Federalist Papers.
Hence, on some levels I am smarter than I was when my diagnosis of AZ was made in December 2017.
I have actually done better on my MOCA (Montreal Cognitive Assessment). I made up my own test that I failed everyday, the TOCA (Topeka Cognitive Assessment that I fail everyday. I wrote about it in my last book. For example, what are we having for dinner?
I do think I am slowly and mildly getting worse but it is very difficult to quantify. My wife agrees with this.
I decided to choose things I do well and see when I no longer can do them.
1-Taking my 15 medicines and supplements.
2- Driving
3- Cooking breakfast and lunch for myself.
4- Making my evening cocktail which involves several steps. Manhattan and Old Fashioned.
5- Getting lost on my walk
I am now hopeful I can maintain my present mental state for another three years. We just made plans to go to Europe for two months.
I read Michael J Fox's book. Here is my review.
Michael J Fox is a profile in grit in dealing with a horrendous disease, Parkinson’s disease. In his third book on his PD titled No Time Like the Present he writes: “I will go through any amount of pain or pressure to achieve my goal.”
I remember thinking I saw Mr. Fox at the MCI airport in Kansas City. I knew the hospital I was doing an Infectious Disease Fellowship had an excellent Parkinson’s Department. I knew of his diagnosis of Parkinson’s Disease. He was with a much taller blonde woman. I caught Michael’s eye as I passed him and we nodded to each other. He did not seem disabled.
Since then I have loved seeing him on TV. The Good Wife and the Fireman series. He clearly showed his disability in those episodes. He writes about these roles in his third autobiography,
No Time Like the Future.
An Optimist Looks at his future.
His books are autobiographical about his trials and tribulations since being diagnosed with Parkinison’s Disease 1991.
I have not read the previous best selling memoirs. I recently purchased this new third book because it struck me how he used his personal experiences with PD to write the book. I have not been able to find another first person narrative such as myself with Alzheimer’s to document the experience in a diary format.
Early into the book I envied his excellent humor and excellent writing ability.
He writes about his character, Louis Canning, in The Good Wife on page 32. “I know from experience that people have an aversion to anyone who moves differently.”
“Louis Canning succeeded in preempting that reaction by projecting a friendly and forthcoming demeanor.”
People are surprised I have come public with my diagnosis. I think it is similar to the stigma of cancer. I want to reinforce the idea that Michael presents on his “philosophy of less is more on page 33. Despite his decreased motor abilities he has found “there is more to less than I thought”. I want to decrease the stigma of having Alzheimer’s. I am not ashamed of my diagnosis. After 3 years and one month I show that “memory is not all it is cracked out to be’. I think Michael’s movement obstacles would be much more difficult for me to deal with.
Michael says on page 65, “more difficult and difficult to accept is the diminishment of movement”... “it's a lesson in humility”. For me there is no shame and few obstacles to a great life other than returning to work. Learning to control my anger is a challenge.
In many ways I envy aspects of Mike’s life and his personality. His courage and determination to learn to play golf. I gave up golf after too many golf balls last in the lake. His coterie of famous stars that support his efforts are examples. Still I would not change places with him.
Michael often writes people think of Parkinson's disease as simply having tremors. It points out it is much worse. To be frozen from diminishment of movement.
I write that people think Alzheimer’s is forgetfulness, dementia and loss of self. My prior three books try to show it’s not all that bad. AZ is inexorable and there is no cure but there are years of mild cognitive impairment that don’t prevent having a full life with pleasure and joy. As I always write: memory is not all it is cracked out to be.
On page 110, Michael writes “If you don’t take risks, there is no room for luck.” I like that but in my New Yorker contrarian way, that includes a chance for bad luck. However in my fourth year of AZ I am willing to take more chances. I entered into the costly Recode program. Now I read about a promising new drug entering into phase 3 trials.
We made reservations for two months in Europe next summer since Covid vaccine has come out. I’m not sure I want to forgo those plans, since enrolling in a drug trial may require me to have monthly visits.
On page 114 is a Michael’s anagnorisis.
I learned this word on Word Genius this week and wondered how I would ever use this word I never heard before? Here is the definition: “The point in a play, novel, etc., in which a principal character recognizes or discovers another character's true identity or the true nature of their own circumstances.
Michael expresses a new circumstance of his usual optimistic attitude. “I’ve always been confident, positive, doggedly determined; but doubt is beginning to mitigate my conviction.”
On page 160: “Have I oversold hope as a panacea.... My optimism is suddenly finite”
Page 186: “The third fear is like an inner minefield that you traverse as you identify, accept and process truths----such as the inexorable advance of middle age and beyond. It’s the realization that we all have an expiration date, secret but certain.”
Page 187, “In the same “nothing to fear speech, Franklin D. Roosevelt also said, “Only a foolish optimist can deny the dark realities of the moment.”
Michael writes, “ I accept the optimism part, but now, I also admit to it’s foolishness.”
I wonder why Michael has not started an anti-depressant?
He seems to help himself with acceptance of his situation. This is the point of anagnorisis for Michael. “While you won’t die from Parkinsonism, you will die with it” Complications from the disease such as the diminished ability to swallow, can lead to aspirating food or pneumonia.” page 201.
Finally Michael comes to realize he can’t golf anymore. More importantly he realizes he can’t act anymore because his speech is so impaired. Page 208.
Not unexpectedly he ends his book on a positive note. I encourage the reader to buy the book and see what it is.
We were stuck in Florida last year due to Covid19, struggling to decide when and how to leave for Kansas as we believe Florida would become a hotspot. Now it appears we can get the Covid vaccine sooner than in Florida than in Kansas.
Hence we are thinking of driving down once we get scheduled for the vaccination unless we can get it sooner in Kansas. Next two weeks will decide it for us. Biden's speech on getting the vaccine was very hopeful. Of course he may not get the funding from Congress? Seems he should get the funding since he controls both houses. Just now the news came in there were not enough vaccines for second doses?
On Zoom I had my first appointment with Atma Clinic's nutritionist.
1-She went over my usual diet,
2- wanted me to go off diet soda as she says they are diuretics,
3- thought my cells were dehydrated and I need to drink 150 ounces of water a day,
4- advised I eat 'clean liver' from grass-fed cow's,
5- wants me to eat healthier fats,
6- and to eat green leafy vegetables from organic farms to avoid the insecticides.
At our next visit in a month, I would like her to go over my lipid results from my Cognoscopy lab shown below:
My holistic nutritionist prefers this brand of vitamins.
I criticized Dr Bredensen's book The End of Alzheimers. I show why I had a change of heart here:
I gained more respect for Dr Bredesen link
Tour de force analysis of dementia case link
This NEJM Case study is extremely informative and instructive about the differential diagnosis of dementia.
In my Geriatrics private practice, I concentrated first on checking for the reversible causes of dementia.
The NEJM rules all of these out.
Before brain scanning and histology, Dr. Brice offers a diagnosis:
Next step Brain Scan
Of course, I relied on the radiologist's interpretation.
I have great optimism for next year despite my being in the fourth year of having Alzheimer's.
I decided to not get my teeth cleaned on Weds. Seems silly to risk an invasive procedure with the vaccine soon to be available.
I read a very interesting Case 41-2020 in NEJM: A 62-year-old man with memory loss and odd behavior.
It demonstrates that not all dementia is Alzheimer's but AZ is the most common cause of dementia.
Also shows the importance of psychological evaluation.
It's interesting that with all the lab testing many of the tests I had in Dr. Bredesin's cognoscopy were not done or at least not reported.
Massachusetts General Hospital goes through a differential diagnosis of rare causes of dementia.
1- Vascular brain disease
2- Obstructive Sleep
3- Huntington's disease
4- Lewy body dementia
5- Tauopathies (such as progressive supranuclear palsy)
6- White matter disease such as Multiple Sclerosis
7- Slow-growing tumors such as meningiomas.
8- Pituitary tumors invading suprasellar structures
9- Normal Pressure Hydrocephalus
10- Infections such as HIV, syphilis
11- Prior disease such as Creutzfedt-Jacob disease
12- Spontaneous intracranial hypotension can cause Frontotemporal brain sagging syndrome.
13- Hashimoto's encephalopathy
The diagnosis is Frontotemporal lobar degeneration consistent with Picks Disease.
