Nilvadipine Gets Big Trial | Dementia & Alzheimer's Weekly

Nilvadipine Gets Big Trial | Dementia & Alzheimer's Weekly

The Path Of Destruction

All of the literature, pamphlets, books and articles that I have read about Alzheimer’s Disease over the past 7 years address it in very generalized terms.  Until recently, I had not read or seen anything that specifically walked the reader down the progressive path of destruction through the brain.

Now a straightforward 3 minute, 15 second  video does just that. The video, sponsored by the Cure Alzheimer’s Fund and narrated by actor, David Hyde Pierce, is viewable by a link currently posted upon Bob DeMarco’s web site, Alzheimer’s Reading Room.    To visit Bob’s informative and empowering  web site and watch the video, go to alzheimersreadingroom.com. Then click on the right side panel link entitled, What is Alzheimer’s Disease? What it does to the Brain Video. 

In addition to what the video presents, I also dug out and reread through my copy of Rita Carter’s, The Human Brain Book, to substantiate and help me better understand the destructive path of AD through the brain.  This book was released in September 2009 by Dorling Kindersley Publishing (DK) , N.Y.

What is presented here is my view based upon these two informative sources.

Short Term Memory and Data Encoding Center

The first area of the brain that Alzheimer’s Disease zeroes in on for attack and destruction is the Hippocampus.  Located roughly within the core of the brain, This structure is the unique “home plate processing center” for all incoming sensory data.  It is within the Hippocampus that all incoming sensory information from the outside world is subjected to registering and electrochemical encoding. To borrow a term from our computer software world, the Hippocampus “formats the data” into  a memory that the brain can recognize, transport, then retrieve back in reverse as a recalled memory later.

Next, it can then be transported via its neural network circuitry out into other portions of the brain for storage; to be accessed as a memory at a later time.  

Virtually all memories that become encoded and stored elsewhere in the brain stop first within the Hippocampus for this formatting process  The inability to form or make new short-term memories is a common sign that AD may be present and has begun to entrench itself.  The sad part is that, by the time the Hippocampus starts to come under siege, the disease may have already had as much as a 10 to 12 year head start.

Language Processing & Storage Areas

As AD progresses further, the next area of the brain that is subjected to onslaught is the collective language processing and storage areas including Broca’s Area of the Frontal lobe, Wernicke’s Area in the Upper Temporal lobe, and finally, Geshwind’s Territory within the lower Parietal lobe.  

As these areas are invaded and pillaged by amyloid protein plaques and tangles, the AD patient experiences an inability to find the right words to use to speak with, to speak coherently and to understand what you are trying to say to them.  Written words within a book, a magazine or on a I-Pad screen become progressively harder to read and comprehend.  Eventually, the person looses all of their ability to read, recognize and  to comprehend the meaning of the words and sentences.

The Emotional Nerve Center

Next on the list for conquest and destruction is the area of the brain known as the Amygdala located within the Limbic system.  It is within this portion of our brain that emotional memories and reactions are stored and activated.  Once it comes under siege, the AD patient has difficulty controlling their emotions.  Their attempts to express circumstance appropriate emotional reactions is also thwarted and compromised.  

Spend 30 minutes with an AD patient as a nurse or caregiver and you may witness a jumbled up presentation of emotions all of which may have nothing to do with the person’s surroundings or what you have said or done.

Understanding What You Can See, Taste, Smell and Hear

What am I looking at?  Why doesn’t that pastrami sandwich taste like I remember it? Why does my coffee or tea smell funny?  What the hell was that sound?  I hear my wife’s voice but it does not go with that body and face in front of me! I can’t make sense out of it!

As the area of the brain storing these sensory memories becomes flooded with plaques and tangles, neuron cells that maintain order and recall of all of these senses are killed off.  What you were looking at 15 minutes ago does not look like a piece of cheesecake at all.  The sound you heard of the cat purring may now sound like a revving up motorcycle.  The smell coming from that fresh bouquet of roses now seems to smell like doggie poo on the lawn.  All of those orderly sensory recollections are being scrambled, disabled and finally destroyed.

This explains the predominantly bewildered or frowning expression upon the persons face when AD strikes these portions of the brain. 

They can no longer make sense out of what they are seeing, smelling, tasting or hearing. What they are able to make out is further distorted,

jumbled or altered in a bizarre fashion.

Your Fondest, Oldest Long-term Memories

The back  of your brain is known as the Occipital lobe.  It is the hope chest area of your brain where all of your very oldest and earliest memories are carefully tucked away.  Where you were born, the name of your favorite grade school teacher, your first sweetheart, memories that are all now being smothered under the blanket of amyloid tangles.  This area of the brain comes under attack during the late stage of AD.

Coordination & Balance

The area of the brain that warehouses all of your coordination and balance memories lies within the Cerebellum.  Once this area is subjected to attack, your hands don’t work right any more. You may find that you are unable to hold a spoon or pick something up. You cannot seem to move your feet or stand upright upon your legs without toppling over. Walking, moving, turning and operating your limbs and torso become increasingly more difficult.  

Deep Core Bodily Functions

Breathing, your heartbeat and the basic operation of your internal organs are attacked last. The nerve command center for these controlling signals lies within the Hypothalamus. This is a sugar-cube sized area situated near the brain stem.

Once these areas are overcome, no more electrochemical signals come forward telling your heart to beat, your lungs to inhale and exhale, your liver or stomach to work.  If you have not already expired from AD prior to this, the shut down of your deep core functions here serves to turn out the light switch for the final time.  From the time that AD strikes the Hippocampus until the Deep Core bodily functions

are shut off can range between 8 to 10 years.

Well prior to this end stage, a substantial number of AD patients have already passed away from pneumonia, an infection or a secondary disease complication from say, diabetes.

Final Thoughts

None of what has been set forth here is pleasant at all.  It is profoundly more unpleasant to see it happen for real in front of you with a mom, a dad, or a brother or sister. This is what an AD patient and caregiver are up against as they fight and rally against this disease.

Throughout the misery and heartache of all that has been spelled out here, your patient or your loved one still remains a thinking, feeling, spiritual human being.  They are trying their utmost each day to retain their dignity, their pride and their sense of purpose while being erased in bits and pieces.

Be mindful of this in your daily contact and work with them. They deserve our compassion and loving assistance rather than pity, disdain or avoidance.  Alzheimer’s World is their world not yours, but you must enter it each day in order to help, to reassure and to be the beacon of hope for them.

Jeff Dodson

May 17th 2011

My Thoughts On Caregiving

Our culture and the entertainment industry idolize those who are skilled at drawing attention to themselves.  Creating “buzz” for oneself appears to be the popular activity while engaged in song, performing upon the stage or having a television or internet presence. We celebrate youth, vitality, high energy and lots of noisy activity.

Our media and paparazzi do not make it a practice of camping out on the doorstep or hovering in a low flying helicopter over the homes or businesses of those whose mission is the care of others who are ill or in need.  No Lady GaGa’s, Katy Perry, Snooky or Tea Party members demanding attention or face time among the caregiving community or even hanging out there.  

There are multitudes of people needing 24 hour a day care and none of them are stirring up any attention about themselves.  They suffer and struggle through their days mostly in the shadows and in silence.  They are victims of the “Three Is” (invisible, indoors or institutionalized in nursing homes).

Those most in need of a caregiver tend to be aged, suffering from chronic or terminal illness or otherwise incapacitated. No sensationalism or provocative activity going on with citizens  in this category.  Mostly just ordinary and common folks who have found themselves at a junction that may well turn out to be a defining moment for them in their life going forward. They are debilitated in a way physically or mentally that demands the intervention of nursing care, a CNA or a caregiver.  Unable to help and care for themselves as they used to be able to do.

Caregiving compels you to take your eyes off of the daily news and entertainment headlines and personalities and direct your attention upon the victims of those Three Is.  Without realizing it, over time you migrate away from a position of being self-absorbed.  You migrate towards providing first for the physical and psychological needs of your patient or family member.

Caregiving teaches you to live your life in a way you have never lived it before. You start out   from a place of selfishness, of you first, of how come I got picked? As you emerse yourself in the care of another, the place in which you begin to inhabit and act from is a place of selflessness.

There comes a price that you must pay for making a personal transition such as this and that is that you will loose a few years off the back end of your life. Your life will be somewhat foreshortened because of the physical and emotional intensity that you have been subjected to. After all is said and done and your work has been completed, you will have undergone a personal enrichment that you would not have experienced anywhere else. Call it transcendent growth.

Neither society, nor our colleges, nor our culture prepares you for this purpose.  

It is time for a change.

Jeff Dodson

May 13th 2011