She can’t talk coherently, and in her anxiety she throws up and voids herself. Medication controls the bulk of this for her but still, there are moments and there’s a fine line the physicians walk between controlling anxiety and turning her into a zombie. They’re concerned people and continually adjust meds as mom’s body changes and degrades so she’s both in control and as aware as she can be but not panic stricken in her memory chasm.

She has a rotten tooth. It broke off and the nerve is exposed. She doesn’t travel. And because it’s a back molar, it’s a dental surgeon’s task to get it out; this is a hospital procedure. At this point, I confess neither the nursing staff nor I really knew how to get this all done. Enter the regular dental technician.

Saving lives and sanity. This wonderful lady helps folks like my mom on a regular basis in the nursing home. She’s seen mom several times and this time identified the issue and said she could take care of getting a referral into the surgeon and sorting out the travel arrangements.

I suspect mom will be heavily medicated with surgeon approved meds, we’ll load her into a wheelchair and use a para-bus or ambulance to move her to the hospital. Reverse the procedure for the return trip.

I have to confess my anxiety is terrific on this one but I also have to say my kids have been terrific. Mayo and I are slated to travel soon and my kids have said, “Don’t worry, we’ll take a day off work to take care of Grandma.”

I have to say it’s taking the entire village and the family to handle this problem, but I’m a very fortunate man to have both helping me through this small crisis. And more importantly, they’re doing it for mom with love.

We already know how important it is to see a physician and get an early diagnosis – and start taking appropriate meds to slow down the onset of Alzheimer’s. But there’s another side to the problem we rarely investigate and one I wish I had thought of or known about 8 years ago when my mom first started down this road.

It’s simply confidence.

The first reaction is one of denial – “I don’t forget things!” but inside you know you do. After a “certain age” we all worry about forgetting stuff and wandering down the road to this diagnosis. Confidence and fear go hand in hand.

The second reaction is one of losing confidence to go out – to engage with others because, well, because you’re going to make a fool of yourself forgetting something and “people will know”. My mom was an amazing faker and I’ve seen her have a long conversation with an old friend and them immediately turn to me asking, “Who was that?” Social skills kept her moving long after somebody with less skills would have been needing superised care. Even the social workers working with her were fooled many times until they got to the actual testing/memory scores and realized the issues (one of the rookies never did figure it out and we had more problems with that – but that’s another story).

The point today is that support groups and basic programes such as this one in the UK are really important for this initial stage of building confidence and helping individuals to remain engaged with their friends and family.

It’s far too late for my mom but if you have a loved one that’s just been diagnosed with Alzheimers Disease – do contact your local Alzheimer’s society and have them find a local program like this for you and your loved one.

Now here’s an interesting bit of research that actually may reverse Alzheimer’s disease or cure Alzheimer’s

It’s called “deep brain stimulation” (don’t try this at home) In simple terms, the brain is exposed in an operation, electrodes are inserted near the area of the brain you wish to stimulate, a battery is hooked up and inserted under your skin near the collar bone. This apparently is done under a local anesthetic and you’re conscious the entire time.

Is this Voodoo?

Apparently it has been used with some success on Parkinson’s disease and the stimulation interferes with the diseased pattern of nerve functioning – preventing the diseased brain areas from firing neurons in the stimulate areas. This allows the brain to compensate and develop healthy neural pathways while the diseased areas are incapacitated. It is also being investigated for both depression and Tourette’s Syndrome as well as being used for the Parkinson’s.

Dr. Andres Lozano at the University of Toronto has just done some preliminary research on six patients. The simple explanation is the hippocampus is the part of the brain that communicates between long and short term memory and is one of the first areas of the brain to be hit by Alzheimer’s. After one year of stimulation, not only was the problem prevented but the brains of at least two of the six patients had actually grown new cells (increases of 5 and 8%)

This is extremely interesting work but the prof cautions (and rightly so) that it is very early days in this Alzheimers research and they plan on doing a larger trial to collect more data.

Note this data has been presented at a conference but it has not been peer reviewed yet. The media picked it up on some news releases and that’s where it sits.

Interesting stuff – no Alzheimers cure but another possibility after more testing. Stay tuned.

Alzheimer’s caregivers face some pretty difficult situations but sometimes there’s a glimmer of humor in the mix.

You have to understand my mom isn’t a violent person nor is her friend. They sit beside each other in the sunroom and both have similar levels of Alzheimer’s disease.

A few months ago, I got a call from the nursing staff saying the two of them had had a disagreement and my mom slapped the other lady.

Now there are two things you have to know here. The first is that people do change under the influence of Alzheimer’s and some do indeed become violent. The second is that whether this is caused by the disease or not, slapping somebody else is a criminal offense and mom could be charged. (Theoretically this could see her put in a psychiatric facility and medicated heavily)

The nurse told me the other family would not be pressing charges and I took a deep breath of relief. Apparently, there was no mark and 2 minutes after the slap, they both had forgotten it and were chatting again.

A month after that, I got yet another call about a slap. Again, my stomach dropped somewhere to my knees.

But this time, the friend had done the slapping. Mom was on the receiving end with no mark and two minutes later chatting and forgetting.

I confess I giggled (partially with relief) and told the nurse that “What goes around, comes around.” We both had a little chuckle about it all (in a most professional way of course) in our mutual humanity and understanding that these things do happen but are not part of the common behavior for either one.

But what do you do if you’re a caregiver at home? Where’s the line? While we can’t tolerate abuse towards our loved ones – how much do we take from our loved ones?

Tough questions indeed and not as easily answered as the other family and I were able to make.

However, there is a new treatment entering the final stages of clinical approval that involves injecting dye (a chemical called Flutemetamol) into the body (through the arm – not the head) and then scanning the head with a PET scan.

The dye locks onto the plaque causing Alzheimer’s and shows up as a red glow on the scan.

Diagnosis is pretty much a given when you can see concentrations of the plaque in forebrain areas. One issue as I understand it right now is the level of Alheimer’s and the level of “glow” is being studied to determine when the disease really hits. In other words, you may have a “glow” from the dye but not be exhibiting any symptoms. Will you then develop symptoms?

The expectation fron GE Healthcare is that if the trials continue to be successful, a commercial startup can be expected some time in 2012.

Thinking Voodoo therapy? Well, apparently a research team headed by Andrei Sommer at the University of Ulm in Germany showed that red lasers when applied to the brain drove water out of the cells. And if they could get chemicals into the blood stream near these cells, the water-starved cells would suck it back into themselves. (As an aside, it is notoriously difficult to get chemicals into brain cells – a self-defense mechanism we seem to have)

So when the compounds in green tea were taken orally and the red laser applied, the research team found the 60% decrease.

Red laser treatment alone reduced the plaque by 20%.

What isn’t clear (but heavily claimed by health food proponents) is whether there is any cure for Alzheimer’s using green tea without laser treatment. Or whether there’s any effect at all.

The jury is still out on this one folks but hey, green tea is good stuff and it doesn’t hurt you. This one falls into the “I don’t know but it can’t hurt me so let’s all drink it” category.

Every patient in this Alzheimer’s treatment research was tested to begin and then tested twice a year to chart the progress of the disease. Researchers were trying to determine how fast the onset of the disease was and the effects of standard of care over a 4 year period.

Over 90% of patients used standard medications over the 4 years but each lost an average of 2.4 points per year on the Mini-Mental Status Examination and gained 4.5 points on the ADAS-cog tests. In other words, they lost the healthy memory points and gained the illness points.

7.4% of patients died during the 4 years whlie 13.4% were institutionalized.

But 17% did not experience a “major event” defined as functional disability or neuropsychiatric symptoms. In other words, 17% of those diagnosed and treated did not deteriorate significantly over the 4 years of the study.

This was considered surprising (it sure as heck surprised me) and treatment teams are going to have to take another look at the deterioration rates and prognosis for patients diagnosed with this disease.

The one thing that wasn’t clear from the journal was if there were any behaviors the 17% did that they other groups did not. In other words, could exercise, music, stimulation or ?? be a factor here? In my mind (and for my peace of mind) I’d surely like to know about this aspect of Alzheimer’s treatment research

You’d think stress reduction would be because of the physical exercise but apparently not. U.K. researchers surveyed almost 100 people between 50 and 88 years old. Surveys were done on two groups – those that participated in exercise programs and those that did not participate in exercise but did garden.

The gardening group reported the least amount of stress (to a significant level apparently) Both groups reported equal amounts of social support so it wasn’t the “help” they were getting but the environment.

The researchers speculate that the anti-stress benefits of gardening might be due to “engagement with nature” resulting in “cognitive restoration” when individuals feel that they are getting away from the routine of daily life.

Or, it could just be that gardening is good for you.

Reference: Jemma L. Hawkins (Cardiff School of Health Sci- ences, University of Wales Institute, Cardiff, Wales CF5 2YB, UNITED KINGDOM), Kathryn J. Thirlaway, Karianne Backx, and Deborah A. Clayton, “Allotment Gardening and Other Leisure Activities for Stress Reduction and Healthy Aging,” Hort-Technology 21(5), October 2011, 577-585. (American Society for Horticultural Science, 1018 Duke St., Alexandria, VA 22314.)

But patients are also (quite often) given anticholinergic drugs that are used to treat gastrointestinal problems, allergies, urinay incontinence, depression and some nerve-system based problems such as Parkinson’s.

According to Dr. Denise Boudreau – the Associate Scientific Investigator at Group Health Resarch Institute in Seattle, “If someone is taking both types of drugs, cholinesterase inhibitors and anticholinergic medications, they will antagonize each other and neither will work.” The study was published online in the Journal of American Geriatrics Society finding that 37% of Alzheimer’s patients were also taking at least one other anticholinergic drug as well.

The good news in the study is that there was no rise in either death rates or the rate of hospitalization in nursing homes associated with this drug combination study.

Bottom Line

Drugs don’t work well if they’re combined but death or placement in nursing homes doesn’t increase over those not using the drugs. I suspect then it would be more a quality of life issue – incontinence or Parkinson’s symptoms for example not being treated because of the Alzheimers medication interaction.

You may read about the relationship between Herpes Virus Type 1 and Alzheimer’s and the meds taken for the Herpes fighting off Alzheimer’s. Here’s my take after looking into it a bit further than the basic news releases.

One – it’s really preliminary research and requires a ton more research (only found so far in one study) It was done in a lab with cells and not in realy people.

Two – It’s partially a genetic cause/relationship. So if you have a certain kind of genetic makeup, and you have Herpes (the estimates are upwards of 80% of North Americans have it even if they are symptom-free) then you “may” find the antiviral drug ‘Acyclovir’ will help delay the onset.

Three: It’s controversial and researchers are lining up on both sides of the issue. “Studies are increasingly showing a link between Alzheimer’s and the herpes virus” according to Dr. Elaine Bearer, from the University of New Mexico School of Medicine.

Anti-viral drugs are freely available through physicians but it’s one of those things we really can’t say yet. And there’s too many “depends” conditions

Bottom Line

Interesting research indeed and certainly it would be one avenue for some folks (those with the specific genetic code – yet unnamed in data I’ve seen) to delay the onset of Alzheimers disease