Starting Insulin today

 Good news yesterday from my endocrine Doctor.

He said starting insulin may improve my energy level. 

I hope to exercise more

Lab result;

I had a "very bad day" yesterday was it from the COVID shot or a busy day for me?

On Oct 24 I had a very busy day.  I usually just rusticate in my basement man cave due to my usual of lack of energy.

I had an appointment for eye exam to get Px. glasses. 

We went to Cold Stone for Ice cream which was a big treat since we never do it. 

I guess I overdid it because my fasting glucose was 437 ketones zero on Oct. 26.

My ketones are always at least 0.5.  

Then we went to get our Covid vaccine. 

Ginger said I was walking well all this time. 

On Oct 25 I started being very unsteady on my feet and Ginger my confusion was much worse.  

On Oct 26 Ginger said I returned to my baseline. She thinks it was due to my Covid shot.

I think I was recovering from a big active day.

My arm was sore when I went to sleep.

My glucose today at 1:30 PM today fell to 380 thanks to my Invokana.  

New drug for AZ

 Earlier this week, the pharmaceutical companies Biogen and Eisai announced encouraging results from a clinical trial for patients with Alzheimer’s disease: a monoclonal antibody treatment, called lecanemab, reduced cognitive decline by 27% in people with early-stage Alzheimer’s compared with those on a placebo after a year and a half. Outside observers say the trial could offer hope to some of the millions of people afflicted worldwide, who are largely bereft of treatments.

Amid the excitement, however, many questions linger, including why this treatment shows promise when others based on a similar strategy have failed. For years, researchers have tried to target a signature feature of the illness: a buildup of amyloid plaques in the brain, clumps of protein that disrupt neurons and other cells. But drugs that break down or otherwise inhibit these plaques haven’t clearly subdued symptoms. The new treatment is, apparently, the first to do so.

The field has been roiled in controversy: Another Biogen drug, aducanemab, was approved by the Food and Drug Administration (FDA) last year over concerns that, despite clearing away amyloid plaques, the evidence it alleviates patients’ symptoms was unconvincing. No other approved Alzheimer’s treatment targets the disease’s presumed roots, only its symptoms. Before aducanumab, U.S. officials hadn’t greenlighted an Alzheimer’s drug for almost 20 years.

Science spoke with Alzheimer’s experts about this week’s announcement and what’s next for lecanemab and the field.

What did the clinical trial find?

In a press release, Biogen and Eisai shared outcomes of their study, which included 1795 people with early-stage Alzheimer’s disease. The participants were randomly assigned to either receive lecanemab or a placebo, given via an intravenous infusion every other week for 18 months. The primary test was comparing cognitive decline between the two groups, based on a classic dementia scale called Clinical Dementia Rating-Sum of Boxes (CDR-SB). “I grew up using it and love it,” says Joy Snider, a neurologist at Washington University in St. Louis, of the assessment tool, which was developed at her institution. She heads the Knight Alzheimer’s Disease Research Center Clinical Trials Unit there, which enrolled nine patients in the lecanemab study. One advantage of this assessment, Snider says, is that it includes information from family members on how patients are faring, along with other measures.

In the study, people getting lecanemab still had cognitive decline, but it progressed 27% slower than in those on a placebo. That translates to 0.45 points on the 18-point CDR-SB. Although the difference is modest, it’s spawning hope. “This does make us feel a little better. These drugs do work,” Snider says.

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Lecanemab had side effects, most notably certain brain abnormalities seen with other antiamyloid therapies, including swelling and small hemorrhages in the brain. Neuroimaging turned up these concerns in about 21% of patients on lecanemab, and 9% of those on the placebo. Although these abnormalities often produce no symptoms, about 3% of those getting lecanemab did have symptoms from them.

Doctors aren’t sure how the apparently gentler slope of cognitive decline would be perceived by patients and their families. “Does that mean that grandma is going to have a few better days, a few better months, a few better years?” asks Jonathan Jackson, a cognitive neuroscientist at Massachusetts General Hospital (MGH). “It’s still an open question.” He and others hesitate to make grand pronouncements, especially after last year’s flameout of aducanemab. “We’re all feeling a sense of wariness and caution,” Jackson says. “We want to dig into the data before we make any large conclusions.”

Why did this drug meet its goals, whereas others failed?

No one knows for sure, but there are some theories. One is that lecanemab works a bit differently from other antiamyloid drugs. Some “try to bind or remove amyloid once it has aggregated into these large plaques,” Jackson says. Aducanemab, for example, primarily binds to amyloid protein after it has clumped together. Lecanemab, on the other hand, swoops in at an earlier stage, targeting “protofibrils,” strands that will consolidate into plaques but haven’t yet. Evidence across many trials and other research suggests the earlier in the disease process one goes after amyloid plaques, the better. For that reason, says Jackson—who describes himself as an amyloid skeptic—lecanemab “has always been one we had a lot of hope for,” even years ago when it was in early development.

The length of the lecanemab trial also made it easier to detect differences between patients not getting the experimental treatment and those who were. Assuming an Alzheimer’s drug works, the effect “will be bigger the longer your trial happens,” says Bart De Strooper, director of the UK Dementia Research Institute at University College London. And indeed, Biogen and Eisai noted that lecanemab failed to show a meaningful impact on cognition after 12 months, but did at 18 months.

The trial also included only people who had evidence of amyloid in the brain—something that’s been true of more recent trials but not older ones studying antiamyloid therapies, De Strooper says.

Does a diverse trial population matter?

One notable feature of the lecanemab trial was that about 25% of its participants were either Black or Hispanic, a relatively high number in the world of clinical trials, where marginalized groups are woefully underrepresented. “We’d like to think that people have equal access to our science,” says Jason Karlawish, co-director of the Penn Memory Center at the University of Pennsylvania, but practically speaking, they often don’t.

Furthermore, these populations also have a higher risk of Alzheimer’s disease than non-Hispanic white people, for reasons researchers don’t fully understand. “We want a drug that works in everybody,” Snider says, another reason trial diversity is so important.

For Jackson, who studies the impact of diversity and inclusion in human subjects research and directs the Community Access, Recruitment, and Engagement Research Center at MGH and Harvard Medical School, the new trial’s population presents an opportunity to research this disparity. According to one theory, dementia risk might be greater in Black and Hispanic people because they have higher rates of diabetes and cardiovascular disease, which can impact the brain, he explains. Probing how well lecanemab—“an antiamyloid therapy which really focuses on a pure presentation of Alzheimer’s disease”—worked in Black and Hispanic participants could offer biological insights into their illness. “I think this is going to be the first opportunity for us to have enough data on ethnic and racial minorities” in an Alzheimer’s trial to tease apart that information, Jackson says.

What will be the impact on the Alzheimer’s field?

Lecanemab is “not a cure, it doesn’t make people better,” Snider cautions. But she’s excited that it’s targeting known disease pathology and has some effectiveness in patients. (Still, scientists caution that especially after the aducanumab experience, they’ll feel more comfortable once the companies release more complete trial data.)

Other antiamyloid antibodies are in trials, and De Strooper says he’d love to see the development of small molecule drugs that can be swallowed instead of injected. Lecanemab’s impact on patients so far appears modest, but Jackson hopes emerging therapies “out in 3 or 4 years may be much more significant shots on goal.” Superior performance could come from researchers learning how to build better and safer antiamyloid therapies, he says, as well as determining who is best suited to receive them.

That said, “I still think we can’t just focus on amyloid,” Snider says. Future antiamyloid treatments may be an improvement over this one—or they may not. “This drug may be just as good as we can do” with that strategy on its own, she says, especially in people who already have symptoms. “We don’t treat cancer with one drug, we have a cocktail,” she says. Physicians need a similarly diverse toolkit for Alzheimer’s disease, where inflammation and other factors are also key drivers.

What questions remain?

A lot! First, researchers want to see more data from the lecanemab trial, which the companies say they’re planning to release in late November. Biogen and Eisai have applied for accelerated FDA approval. If it’s granted, there’s much interest—and some trepidation—about how the rollout of lecanemab will proceed in the real world. Snider wonders whether people on anticoagulant drugs, which reduce blood clots and which many older people take, may be at higher risk of brain bleeding from lecanemab. “That’s going to be a big question,” she says.

Karlawish wants more information on how patients fare long-term. Right now, assuming the companies’ announcement aligns with their trial data, the therapy seems “worth taking” or at least considering by those for whom it’s designed. But, “What haunts you in clinical practice is how long does the drug work and how long should you continue it.” He and others also worry that Alzheimer’s clinics aren’t equipped to handle a therapy like this, which requires infusions for potentially many patients and likely imaging to look for side effects. Karlawish would love to see a registry that tracks people on the treatment in order to help guide doctors and families facing difficult choices. “We don’t have an adequate workforce to roll this drug or a drug like it out into clinical practice,” where patients have enough trouble just getting a diagnosis, he says. 

Lecanemab is now being tested in people with evidence of amyloids—and, often, familial or genetic risk factors—but without symptoms. A burning question is whether the therapy can stave off dementia. At least a decade before glaring symptoms, there must be subtle signs of disease, De Strooper says. Preventing them from worsening is another frontier.

Green tea

Based on an article referenced by @dalebrendesen I stared Green tea today. 

AZ and feeling c0ld

Human beings have a system within the core of their brain called autoregulation, which regulates core blood flow, blood flow into the periphery, and other important physical tasks. As dementia attacks the brain and causes chemical and physical changes, it also affects the person’s autoregulation system. In addition, as human beings age, they lose subcutaneous fat, which is the padding under the skin of a person’s extremities, such as arms and legs. When this happens, the blood vessels are now right below the surface of their skin, and therefore more exposed to outside temperatures. Now, imagine a person living with dementia sitting in a room at maybe 74 degrees Fahrenheit, which is below the normal human body’s temperature of around 98.6 degrees. With the person’s autoregulation system having been damaged by dementia, the brain now tries to protect the body’s core by constricting the blood vessels of the person’s extremities, such as their hands, feet, or up to their knees or elbows. It’s going to make those areas colder to keep This, in turn, will make their hands and feet feel cold, which makes the person feel like they need to warm up. Your person living with dementia may feel like they need another layer of clothing when, in reality, the coldness is in their extremities. So, putting on another shirt, sweater, or pair of pants will not solve the issue and can cause overheating of the core as the autoregulation system is damaged and no longer expands the blood flow out to the hands and feet. Why being notoriously cold can cause further harm Heat can be very dangerous to the elderly. It can be serious and lead to almost immediate consequences when not quickly addressed. But how about the cold? Can it lead to further damage if not properly addressed? The unfortunate answer is yes.While less risky than heat, when a person living with dementia is frequently cold, they’ll be less likely to .In addition, as human beings age, they lose subcutaneous fat, which is the padding under the skin of a person’s extremities, such as arms and legs. When this happens, the blood vessels are now right below the surface of their skin, and therefore more exposed to outside temperatures. What you can do to help When a person living with dementia feels cold even though the room is a commonly considered to be at a comfortable temperature, adding gentle warmth to their extremities can help. Something like a gently warmed rice or bean sock or offering a warm cup might help. By providing warmth to the hands and feet, the blood vessels will start to relax and the blood will start to flow more openly into those areas. As some of the blood begins to circulate back from the core into the arms and legs, it’ll help the person feel more comfortable again.Unfortunately, this warmth isn’t going to last, so you may want to consider offering things episodically that are warm, can be held, and can be manipulated. However, make sure to always follow safety precautions and follow temperature checks. Be extremely cautious about using things like a heating pad that could get too hot, as an older person’s loss of the fat layer below the skin of their extremities makes them highly vulnerable to injury. Similar to how you’d heat-check an item for an infant, consider laying the object on yourself for a while to better determine whether this item could get too hot.Consider warming a towel in the dryer and, when not too hot anymore, laying it across the person’s feet. You might be able to watch the person relax as the warmth sets in, as it is giving them that much-needed circulation.

I decided to drop out of the scientific trial I was participating in after almost 5 years.

I am having a good morning. I feel alert and less confused. Thus I surprised my wife when I told her I didn't want to go to my trials MRI this afternoon. I wanted to drop out of the trial completely. I quess it is not very altruistic of me but I was told the study would last only 5 years. I get virtually no feed back from them. I had an MRI after my subarchnoid bleed. I want to use what little energy I have toward getting back to walking.

My worse day after 4 years of Alzheimers

One might think my worst day was when I fell on my face and had a subdural hematoma. Or when I was flown to get an MRI after falling down and hitting my head on the glass down and found to have a subarachnoid bleed. Today I woke up a little more confused than usual. I don't know why. Today was dreadful for me not because I had to start the prep for my colonoscopy but because I was not allowed to eat anything. I have been having a snack every hour because it comforts me. Not having those snacks made me feel miserable. The fasting did result in dropping my morning glucose from 220 to 170.

Can Ozempic help with Alzheimer's?

The drugs, which belong to a class of medications called glucagon-like peptide 1 (GLP-1) agonists, work by altering the metabolic system and lowering inflammation throughout the body. Scientists suspect this could help slow the progression of neurodegenerative diseases like Alzheimer's disease and Parkinson's disease.May 12, 2023

I gain hope with this article (excerpt below)

Benefits of routine for Alzheimers link

 My diagnosis of Alzheimers was diagnosed in Dec 2017.

Now about 4.5 years after I don't want to travel anymore.  

It's just too stressful for me.

Stress makes me feel depressed.

Ginger left for Greece on July 8, 2022

My wife will be home by 2 AM on Tues. July 26,  2022

 from cruise to Spain and Portugal.  

Total 16 days away.

Routine helps me do well on my own 

Keeps me content.

Ginger insists on having a housekeeper come twice a week.

She is also paying for a geriatric homecare visit 2- 3 times a week just to check on me.

My routine:

Sleep (very important)

1-I sleep a with CPAP machine from 9 PM till 8 or 9 AM. 

I take some sleep supplements. 

2-Melatonin to keep sleep times consistent.

3-Ashwaganda link

I try to sleep till 9AM.

Daily Routine

Morning TV. I have an 85 inch tv screen.

I like Morning Joe.  I "tape" it.

It's 2 hours long and I speed through the commericals. 

The 'Smart' TV is a boone as well as a bane

The boone part is that the picture on the screen is wonderful. 

The bane part is when I misplace the remotes.

After watching about 3 hours of TV while looking at my computer writing twitters and blog entries I develop some mild anxiety.

I then swtich to entertainment TV.

I own many DVD's.

I am 8 seasons into the series VIKINGS.

Meals

I have coffee and diet pepsi to put off breakfast as long as possible.  I fill my 8 cup water pitcher which I have no trouble drinking it all because of all the pills I take.  

I take my prescription pills first thing in the morning.

I start to make a Salmon sandwich for breakfast/lunch. 

I found this article on Alzheimers to be excellent.

 What to expect with Alzheimers link

For me this was very true when I was diagnosed with AZ in Dec. 2017. This is why I have written a yearly account of how I have been doing over the last four years. 

                                         YEAR FOUR

Presently I am writting the YEAR 5 book to be titled: Trying to Avoid Falling Off Cliffs. 

One of my first concerns was what was my prognosis?

I read that Namzaric could keep me at a level cognition for 2 years. 

Then I learned it was usually a heart attack or stroke to cause a sudden severe drop in cognition.

I have had 2 falls with 2 cerebral bleeds. 

After the subarchnoid bleed my navigation skills became worse.

SAH  link

Falling off a Cliff link

Subdural hematoma link

I was surprised how sensitive I became.  Especially in having arguments with my wife.  Very stressful and I would be depressed the rest of the day.

I am also surprised how easily I am fatigued.  Long phone calls can cause it.  I say goodbye to friends and family because I get tired. 

I also lost interest in doing many things especially leaving the home to go on little trips.  I rather stay in the comfort of my TV and man cave.  I still like grocery shopping.  Last week my Aide drove me in her car to Sams and I bought $296 worth of groceries on my own.

I regret not doing balance exercises after I first noticed was having balance problems

Vitamin D Update

 Back in Idaho I purchased a DEXA scan.

The hospital in Burley didn't have one.

I took a course in Washington state to learn how to interpret them.

Pretty simple. 

I also learned how important giving enough vitamin D.  

I began checking my patients levels in Jan

To my surprise the advised dose of 1,000 IU was often not sufficient for even the low levels that were considered normal at that.  

Subsequently in my book The Tubby Traveler from Topeka, I told people to take 5,000 IU a day.

Amyloid effect on Brain

 

The study's findings were published in the peer-reviewed Chem Catalysis, a Cell Press journal. 

Amyloid plaques are the hallmark of Alzheimer's Disease and other neurodegenerative diseases, however it is still not clear if and how such plaques contribute to the progression of these diseases. 

The study offers an explanation on how the plaques damage the brain by breaking up important neurotransmitters.

Research for the study was led by Prof. Raz Jelinek and PhD student Elad Arad, in collaboration with Prof. Hanna Rapaport and Avigail Baruch Leshem.

They discovered catalytic activity caused by the beta-amyloid fibrils. This is the first study to find this link.

"Our findings open intriguing new avenues of research into the molecular factors in neurodegenerative diseases that could bring us closer to therapeutic treatments," says Prof. Jelinek.

Visit with KUMC Neurologist Dr Swerdlow YEAR 5

 Dr Swerdlow tested me the usual way that he does.  

Because he does the test each time it improves the accuracy of the test. He said I did a little worse this year but considering I had a subarachnoid hemorrhage link, he said the difference from last year was not significant.  I know my naviagating skills in a new setting is very bad and Ginger believes I clearly have a cognitive decline since my March fall and SAH athough as she watched me do the test she was impressed how I remembered the different memory tests.  Especially, when I  a drew  a complicated picture of boxes and triangeles after a 15 minute delay.  She sees me not remembering so many short term memory things such as my appointments, whether I got the mail, conversations we had. I have had this type of short term memory since August 1, 2020 when I made this TOCA TEST LINK.

Dr Swerdlow wanted me to get an MRI because of urinary incontinence to rule out Normal Pressure Hydrocephalus.   

My wife went away to Europe for a month. I did okay with the executive functions I still have.

 My recent memory is bad but I can still get by for a short period with my wife gone to Europe.

I have maintained the following skills:

1- Take my medicine in the morning.

2- Monitor my BM's so I don't get constipated. I recently started stool softener and prunes.

3- Deal with my 2 TV remote controls. 

4- Sign on the internet to write blogs and twitters

5- End my AM fast with a Salom sandwich Salmon sandwich link

6- Order TV discs on Amazon .

7- Call friends and family.

8- My many supplements link

9- I don't drive anymore and I am running out of my favorite foods;

        Can of soup which only takes 4 minutes in microwave.

oi        Premade packages of Chopped salad

       Fry hot dogs

I am satisfied with these meals.  I don't drink alcohol anymore.

8- Despite taking my Ozempic shot each week, I stll feel hungery so I have a snack every hour.

           Pear

          Plum

          Pistachios

         Yogurt

        Premium protein drink each day

I finally got my glucose under control by stopping ice cream

Stressful morning due to no TV

 Many failed attempts to get TV to work. 

I did all the usual things to fix it.

1- Is TV plugged in? 

2- Change batteries in remote control.

3- I called Cox to make certain I was connected.

The real problem was my wife is in Europe and I couldn't get her to check my work. 

I did change the batteries but I think I replaced with more bad batteries. I changed the batteries again and that solved the problem.

My 85 inch smart TV allows me to record all my political shows.  It also allows me to fast forward on the recorded shows.  

I rely heavily on my morning TV for news of the day.

Especially Morning Joe which I find very entertaining.  

All the energy I spent on trying to solve this problem makes me fatiqued. 

Anxiety not too bad, especially as I resolved the probem.

On my first visit to the memory center I was told not to spend too much time on TV and Computer.  

I don't know what I would do without them. 

Socialization is fine but people don't understand the rules of engagement with Alzheimers. 

 I have lost a couple of friends because they don't understand my problem.

Sleep article

 

During deep sleep, the brain appears to wash away waste products that increase the risk for Alzheimer's disease.

A host of new research studies suggest that this stage of sleep — when dreams are rare and the brain follows a slow, steady beat – can help reduce levels of beta-amyloid and tau, two hallmarks of the disease.

"There is something about this deep sleep that is helping protect you," says Matthew Walker, a professor of neuroscience and psychology at the University of California, Berkeley.

The research comes after decades of observations linking poor sleep to long-term problems with memory and thinking, Walker says. "We are now learning that there is a significant relationship between sleep and dementia, particularly Alzheimer's disease."

The strongest evidence involves deep sleep, he says. That's when body temperature drops and the brain begins to produce slow, rhythmic electrical waves.  (I do get cold at night during sleep)

So Walker and a team of scientists set out to answer a question: "Can I look into your future and can I accurately estimate how much beta-amyloid you're going to accumulate over the next two years, the next four years, the next six years, simply on the basis of your sleep tonight?" 

To find out, Walker's team studied 32 people in their 70s who had taken part in a sleep study that looked for the slow electrical waves that signal deep sleep. None of the participants had memory problems.

The scientists used brain scans to monitor levels of beta-amyloid in each participant for up to six years. And the results, published in the Nov. 2 issue of the journal Current Biology, showed people who got less deep had more beta-amyloid. 

"We have a specific sleep signature right now that seems to help us better understand where you may sit on the Alzheimer's risk trajectory in the future," Walker says.

Other studies have found that a lack of deep sleep is associated with higher levels of tau, which forms toxic tangles inside the brain cells of people with Alzheimer's.

Scientists have some ideas about why deep sleep seems able to reduce both beta-amyloid and tau.

SHOTS - HEALTH NEWS 

Genetically Modified Rat Is Promising Model For Alzheimer's

In 2013, a landmark study of mice found that their brains switched on a sort of dishwasher during sleep.

"So things like amyloid beta, which are implicated in Alzheimer's disease, seem to actually be removed more rapidly from the brain when an animal is asleep versus when they're awake," says Laura Lewis, an assistant professor of biomedical research at Boston University.

In 2019, Lewis led a team that showed how this dishwasher works in people.

"We realized that there's these waves of fluid flowing into the brain during sleep," she says. "And it was happening at a much larger and slower scale than anything we'd seen during wakefulness."

What's more, each wave of fluid was preceded by a large, slow electrical wave.

So now scientists are looking for ways to induce the slow waves that signal deep sleep. Lewis says it's easy — in rodents.

"There's a specific deep brain structure that if you stimulate it, you can cause these sleep-like slow waves in the brain," she says.

In people, there's some evidence that rhythmic sounds can increase slow waves. 

It's also possible to boost slow waves by treating certain sleep disorders, says Dr. Yo-El Ju, an associate professor of neurology at Washington University in St. Louis. 

Ju was part of a study of people with obstructive sleep apnea, which repeatedly blocks the airway. These patients "seem to have a change in their ability to clear proteins or waste products from their brain," she says. "And people with sleep apnea are at higher risk for dementia down the line."

So Ju's team looked to see what happened after patients had been treated successfully for apnea. The scientists found that treatment resulted in more deep sleep and more beta-amyloid cleared from the brain.

And Ju says there was another effect: Participants' brains began making less beta-amyloid. 

"So I don't know whether it's that sleep increases clearance or whether sleep decreases the production of waste products," she says. 

Either way, sleep is important to brain health, Ju says – though she admitted to being a bit sleep deprived on the day we spoke.

"My 2-year-old decided to sleep in my bed and eat a tortilla and a banana at 2 in the morning," she says. "But usually I get a pretty good sleep."

Why Am I exhausted today?

 I had a great night of sleep.

I awoke at 10 AM.  

We went to the bagel shop.  One large cup of coffee did not wake me up.  

We went shopping at Sams.  I walk slow. I don't get out of breath. 

I am back on all my supplements.

After being off them for a month I feel no differnce.  supplements link

Patients would come to me complaining of fatique.  After I ruled out anemia and thyroid problem I 

would start Prozac.  The patient usually responded withib 5 days and stayoed on the antidepressant.

The most important thing for a depression is exercise but that is the last thing the patient wants to do.  

I do go up and down a flight of stairs 10 times a days.  I am also on citalopam.  

I quess it can chalk it up to my Alzheimers.  A bad day.  I haven't had any arguments either.

In my 5th year having Alzheimer's my attempt to achieve contentment each day

Best thing is to have 8-10 hours sleep after taking:

1- Magnesium L Treonate 4,000 mg Link

2- Melatonin 5 mg

3- Ashwagandha link

Key is to avoid stress which causes me to feel bad with subsequent anxiety and depression. 

Arguments with my wife is a main cause of this.

Each moring after taking all my prescription medications(plus a stool softener) I get a cup of coffee with 90% dark chocolate to get my flavinoids.  

I also drink a can of diet coke.  This seems to help me have a bowel movement.  

I drink these while in my man cave in the basement watching morning JOE on my 85 inch TV.

I also now eat 2 piece of dried prunes.  

Despite talking probiotics each day I find this helps me have a BM. 

Again having a BM helps me with my contentment. 

I also am on my computer while watching TV. 

I was advised by someone at memory center to not do TV and computers.  

I get great satifaction by writing my blogs and twitters. 

I try not to eat till noon. 

Right now despite that 14 hour fast my glucose only dropped 4 points, 212 to 208. 

I take Invokana. 

It doesn't seem to work as well as before.

I quess I  shouldn't take cream in my coffee?

I will have to stop all carbs especially anything with cream in it. 

With my on twitter and blog I usually get tired and switch from news to something entertaining on TV.  

Right now I am watching Better Call Saul series. 

At night I am rereading the Richard Sharpe series by Bernard Corwall.  I often remember some of the passages.  Other than the enjoyment I hope I am refiring the neurons that I forgot. 

I am not doing the walking that I should.  That is a big lapse in my program,  if I get axious I will pace in the house which helps. 

I was off my supplements for a month on the trip to Ireland.  This week I started all of them again.  Hard to determine if they do any good for me?

I don't usually call people. I get tired after long phone conversations. 

I have a Men's group on Zoom everyweek.  I always enjoy that.  We usually discuss a book that we have chosen to read. 12 men from my Episcopal church. 

I can still make my lunch

 I had a set back with my Alzheimers when I fell and had a subarachnoid hemorrage on March 7 link SAH

I can still make fasting lunch.

Most difficult part is slicing the red onion.

Is everything bagel salt.

Sliced salmon from SAMS. 

Capers

Cream cheese.  Much better than cream from Ireland. 

Although the butter from Ireland is great. 

I find if I don't have a satisfying tasting meal like this I get anxious. 

On other mornings I will toast my 100 calorie English muffin till it is crunchy, then put crunch peanut better on it, and then roast it till the PB is a little dark.

I then add 3 slices of bacon on it.  

Again very satisfying and something I can make myself

 I went off my ice cream diet with my fasting glucose going down to 182

I am thinking Glucoset has not gone down to usual 155 is because I eat a fruit bowl every day w whipped cream to get the antioxidants?

I mention true grit in the title of my last book.

 

This quote may explain why I have gone publc with my diagnosis. 

Many people hide their diagnosis of cancer because there is often a stigma atttached to it. 

The same is true of Alxheimers.

I am writing the fifth year of my experience with Alxheimers to shine a light on what is the progress of the disease. 

FIVE CHARACTERISTICS OF GRIT: 

from Internet Applied Psychology

1- Courage

2-Conscentiosness: being thorough, careful or vigilant 

3- Perseverance

4-  Passion

Peter Attia makes a good point about AZ below:

I fell and had a Subarachnoid hemmorhage on March 7, 2022.

I feel my abiltity to write the above blog shows I have made a major comeback from the SAH.

SAH link

Supplement link 39 pills 

Many Docs are against this type of pill burden. 

Pill burden is a concept of the past since our experience with treating HIV successfully. 

I stopped supplements on my last trip last month.

Did I notice any problem? HARD TO TELL.

I am felling better back  home at with less stress of travel.

Dr Dale Bredesen has a book  about the AZ survivors who are on his Recode program. 

His introduction is excellent.  

The meat of the book:

p19 Kristen (first patient on Recode for nine years)

p45 Deborah (memory improved considerably)

p55 Edward  (positive PET scan)

p67  Marcy (chelations)

p87 Sally (IV anti-amyloid medicine made her worse)

p96 Frank (nine years maintains improvement)

p128 Julie (coauthor of second book: The End of AZ The Program)

For me I need to apply my true grit towards more exercise.

Weight after ice cream diet and cruise from Norway to Ireland for Tauck tour in Ireland.

You don't go to Ireland for the weather. 

However the MAGNUM ice cream bars are outstanding.

I was on an ice cream diet.  My weight did not go up but my Hgb A1C went up to 9.2

My vision got  a little  blurrry.

 I think I have sarcopenia.

My muscle mass has dropped from 36.8 lbs in Nov 2021 to 34.3 lbs in March 28, 2022.

Atfer my ice ceeam diet I gained a pound of msucle without resistance trained .

I went up to 35.6 lbs of muscle mass on 5-16 -22

Lack of paitence for both of us

My wife has guided me through the recent Norway cruise. 

It was not much fun for me as I had trouble navigating around the ship on my own.  It was was worse for my wife as she worried so much about me getting lost.  Especially now at the Moxie hotel in Dublin, when I go virtually across the street to buy some Magnum ice cream at the local  

grocery store.  I admit I get turned around easily and lose my way. 

I don't panic and ask for directions.  A panhandler heelped me out the othe day.  Once a day we get into a bad argument.  I'm not sure why it happens.  In my opinion I think it is because she gets so angry with me  so quickly.  Yesterday she was trying to fit 3 big soda and water bottles into my backpack.   I got impatient and whiped the backpack off me which almost hit her and made her more angry.  The mutual anger just escalates.  Almost a daily occurrence when we go out. 

In the hotel room she takes great care of me.  Much more patient in this controlled setting.  She is very viligent as we cross the streets with traffc. Great deal of stress on her. 

Update on trip to Dublin, Ireland

 We had a great lunch today. 

The food was better than the 15 day Ocean Viking Cruise.  Surprising.  I thought my taste buds were failing but now I realize the large ship can't achieve the same quality as a small restaurant, at least on this trip.  Especially as always with resoto.

Again surprising the beef was so much better in this Irish restautant.  The taste was amazingly good.  

I was so happy to find a great meal again. 58 Euros including good tip. 

Last night we went to a Irish restaurant, Flanagan's and I ate an Irish Lamb stew.  It had very little flavor.  

I am still on my ice cream diet.  I am very pleased with the Magnum bars here. 

It was partly sunny today in the fifties. 

I bought a skull hat for 15 Euro.  

I really need it to the wind, which I find very chilling.