December 28, 2012

My 4am Meditation Hour Is a Baby Step toward Iyer's "Joy of Quiet"


(I've used this photo before, but I like it and just may use it for all my posts on meditation)

Writing yesterday's post about Pico Iyer's "joy of quiet," I was reminded that for about one hour almost every day I have that joy. Lots of good things have happened in 2012, but near the top of the list is developing a meditation technique that works for me. 

It evolved slowly. Now, I engage in my version of  "mindfulness meditation" at about 4am (or whenever I get up for my middle-of-the-night bathroom visit). Typically, the meditation now lasts for about an hour. Then I go back to bed and sleep soundly until 7 or 8 o'clock.

The house and street outside are quiet at 4am. I sit in a straight-backed chair with a pillow in my lap, where I  rest my arms. Then I grasp my hands in the much joked-about "secret handshake". Here I'm meditating indoors as you'd expect this time of year.


(Please, no comments about the look-alike photos!)

December 27, 2012

My "Home Alone" Is a Far Cry from Pico Iyer's "Joy of Quiet"

I posted yesterday about my "best Christmas ever" despite spending it "home alone with no presents." I woke up this morning to this view from my living room window:


When I turned on the computer, "Weather Channel" popped up to advise me that it would be like this for the rest of the day, except the snow would change to rain. So, I decided, another day of "home alone." By lunchtime, I was feeling quite smug about how much I was enjoying another day by myself and living with solitude.

Then I realized I'd been far from alone. In the morning, I'd exchanged emails with at least half a dozen people. I'd checked out what my Facebook friends had to say about their Christmas holidays. I'd looked at a couple of YouTube videos. I'd checked the NY Times online.

Hardly home alone. The only time I'd really been "home alone" (and awake) for an extended period was during my hour-long meditation at 4am.

December 26, 2012

Home Alone with No Presents-- Probably My Best Christmas Ever


My families -- the Schappis and the Nepalis -- understand me well enough not to be offended by this... I hope! But for those who don't know me that well, the title of this post no doubt is puzzling. I'll explain.

But first by way of background, it might help to know I'm a man of many quirks and contradictions. For example:
  • I hate shopping in stores. The doors to a shopping mall are the Gates of Hell to me. 
  • I love online shopping. I buy most everything I need with one-click on Amazon.com
  • I love Thanksgiving because it's family and friends, uncorrupted by gift-giving. 
  • I don't care much for Christmas because it's been taken over with excessive spending and gift-giving. 
  • I love being with family and friends. 
  • I need lots of alone time.
My Traditional Christmas
My pal Bill Feldman and I have a lovely tradition: I join his family and friends for the Passover Seder and he joins me for the Christmas Eve service at St. John's Church in Lafayette Square. We have supper at his house before the service. So I come out ahead on this tradition -- two Feldman-prepared meals, which are always excellent.

On Christmas Day, the Schappi family -- me, daughter Ann, son Todd, granddaughters Jessie and Emily, grandson Colin, Jessie's husband Dan, and Jessie's two daughter, Kelsie (now age 6) and Kensie (age 1) -- come to my house for dinner. I'm NOT a cook. Daughter Ann is, and she prepares the meal. I do the grocery shopping and the cleanup.

In recent years, Todd, Ann, and I have tried to simplify the Christmas gift-giving by exchanging e-mails in which we each provide Christmas wish lists. Lately, we've even added internet URLs to help buyers find the items.

December 20, 2012

Not Your Typical Holiday Greeting and Video

I had planned today to post the second of my two-part year-end look at my supplements -- the three I now take (Part 1) and the embarrassingly long list of those I used to take.  But then I realized this evening begins the four-day Christmas holiday weekend.  So I decided I to come up with a way to send "Season's Greetings."

My initial thought was to search for an appropriate video on YouTube. Once again, my  4 a.m. meditation came up with a video  idea. It;s not really connected to Christmas.  But then neither am I.

Year-End Update: My OTC Supplements -- Fewer Are Better: Part 1 -- My Three Remaining Supps

Yesterday I reviewed the prescription meds I take and noted that I've found that "less is more."  For several of the meds, I've been cutting the prescribed tablet in half and have found that, as a result, the med works just about as well and often with fewer side effects  AND I cut the cost in half.

Today let's look at my over-the-counter supplement,   Tomorrow I'll take up the much longer list of supps I formerly took but have stopped taking. For the sups, my catch phrase is "fewer is better."

I subscribe to several health newsletters and magazines and , since starting this blog, have followed postings on the web dealing with health issues.  And I've enjoyed researching health topics.  Needless to say I've come across numerous reports, studies and personal stories touting a variety of supplements for treating -- and often miraculously curing -- all sorts of ailments.

When it comes to supplements related to my own ailments and needs, I dismiss many  of the reports I see as clearly bogus and come to the same conclusion when I research others.  Still I'm often left with claims for supplements that appear to have some validity and that are backed by seemingly legitimate scientific studies and findings.

In the past, when it seemed a supplement might possibly help me, I frequently decided, "What the hell.  Why not give it a try?  What have I got to lose?" But, thanks to this blog and my own curiosity, I've done considerable  research and reading about dietary supplements and, as a result, I've had an almost 180-degree turn around.

A year or more ago, my bathroom and kitchen shelves were well-stocked with a variety of OTC pills. Today I'm taking only three.  I'll list them at the end of this report.  But first, here's what let to my change of attitude and action:

December 19, 2012

Year-end Update: My Medications -- Less Is More

Continuing my year-end look at the past year and where I am today, let's take a look at my prescribed  medications, where I've discovered this year that less can be  more.

Parkinson's Disease meds
 Two prescription medications are most commonly prescribed for PD and I've been taking both since my diagnosis over three years ago.  Today, I'm actually taking a smaller dosage of both than was originally prescribed. For somewhat different reasons, I'm pleased with this cutback.

  • Sinemet (generic: Carbidopa/Levodopa):   My initial prescription was to take this three times a day  plus an "extended release" (double the standard dosage) at bedtime.  Ideally this med should be taken at even intervals during the day so that the level remains about the same in the body.  The extended release is to keep the dosage up for the longer time that presumably happens overnight.  But when I started getting up at 4 to 5 a.m. for my "meditation hour," it occurred to me that this gave me the chance to take this med on a uniform six-hour schedule -- 5 a.m., 11 a.m., 5 p.m. and 11 p.m. So I suggested, and my neurologist agreed, that I didn't need the double dosage at bedtime but instead could continue the regular dosage.  So now I'm taking one less dose than initially prescribed.
This may save me a little money, but this med is not horribly expense.  The main reason I'm happy to be taking less, rather than more, is that prolonged usage of this med often results in levodopa-induced dyskinsia, the uncontrollable body movements that we see with Michael J. Fox and others with Parkinson's.
  • Rasagiline (Azilect):  This is used alone or with levodopa in treating Parkinson's. It is, by far, the most expensive med I take.  I recently paid about $500 for a 90-day supply.  My prescription calls for taking  a 1.0 mg tablet once a day.  In researching this, I noticed that the initial dosage prescribed by some doctors was 0.5 mg.  I asked my neuro if, given this and the cost of Azilect, I could cut my 1 mg. tablet in half and just take that dosage.  With his approval, I'm doing this.  I keep renewing the prescription at the 1.0 mg level, since this costs the same as 0.5 mg.  By cutting the tablet in half, I cut my costs by half.   Also taking Azilect with tyramine-rich foods, such as aged cheese, may cause a hypertensive crisis (a dangerous increase in blood pressure.  So when it comes to Azilect, less is more from the standpoint of both my love of cheese and my bank account,

December 18, 2012

Year-end Update: Aging and Me . . . and Us

Morituri Salutamus

But why, you ask me, should this tale be told
To men grown old, or who are growing old?
It is too late! Ah, nothing is too late
Till the tired heart shall cease to palpitate.
Cato learned Greek at eighty; Sophocles
Wrote his grand Oedipus, and Simonides
Bore off the prize of verse from his compeers,
When each had numbered more than fourscore years,
And Theophrastus, at fourscore and ten,
Had but begun his "Characters of Men."
Chaucer, at Woodstock with the nightingales,
At sixty wrote the Canterbury Tales;
Goethe at Weimar, toiling to the last,
Completed Faust when eighty years were past.
These are indeed exceptions; but they show
How far the gulf-stream of our youth may flow
Into the arctic regions of our lives,
Where little else than life itself survives.

As the barometer foretells the storm
While still the skies are clear, the weather warm
So something in us, as old age draws near,
Betrays the pressure of the atmosphere.
The nimble mercury, ere we are aware,
Descends the elastic ladder of the air;
The telltale blood in artery and vein
Sinks from its higher levels in the brain;
Whatever poet, orator, or sage
May say of it, old age is still old age.
It is the waning, not the crescent moon;
The dusk of evening, not the blaze of noon;
It is not strength, but weakness; not desire,
But its surcease; not the fierce heat of fire,
The burning and consuming element,
But that of ashes and of embers spent,
In which some living sparks we still discern,
Enough to warm, but not enough to burn.

What then? Shall we sit idly down and say
The night hath come; it is no longer day?
The night hath not yet come; we are not quite
Cut off from labor by the failing light;
Something remains for us to do or dare;
Even the oldest tree some fruit may bear;
Not Oedipus Coloneus, or Greek Ode,
Or tales of pilgrims that one morning rode
Out of the gateway of the Tabard Inn,
But other something, would we but begin;
For age is opportunity no less
Than youth itself, though in another dress,
And as the evening twilight fades away
The sky is filled with stars, invisible by day.
Henry Wadsworth Longfellow
[These are the final stanzas in a poem written and delivered by Longfellow on the occasion of  the 50th reunion of his 1825 class at Bowdoin College.  The title refers to the popular myth that the Roman gladiators, facing death in the arena, cried "O Ceasar, we who are about to die, salute you."]

December 17, 2012

Year-end Update: Parkinson's and Negligent Me

A Parkinson's pal  confronted me last week, saying "the title of your blog is 'Aging  and Parkinson's and Me.'  You write a lot about aging and, certainly, a lot about you.  But I haven't heard anything in a long time on how you're doing with Parkinson's."

That called me up short and reminded me that the reason I've neglected to write about my Parkinson Disease is that I've neglected to do what I should be doing about my PD.  The car crash a year ago August and the resultant cracked vertebrae  and ongoing lower back pain has given me an excuse to stop doing my BIG exercises for Parkinson's and to overlook clear signs that some of my Parkinson's symptoms are worsening.

So it's time both to write about it and do something about it.

Recap
I was diagnosed with Parkinson's Disease (PD) in September 2009 at age 80.  I'm sure I would have been diagnosed earlier if I'd had the tremors that usually accompany Parkinson's.   But I didn't then and still don't now, over three years later.

My early warning signs were a loss of the sense of smell three or four years prior to my diagnosis.  Then a couple of years later family members pointed out that my right arm wasn't swinging much when I walked, another early sign of Parkinson's.   Finally I began having lots of problems with my balance.  This led me to get checked out by a neurologist with the resultant  PD diagnosis.

Since balance was my main issue, my neurologist recommended I take the BIG exercise program designed specifically for people with Parkinson's. He wrote a prescription (the needed passport for getting my sessions covered by Medicare) for the Georgetown Hospital's program.

December 14, 2012

Home Alone with No Presents -- Possibly My Best Christmas Ever!

My families -- the Schappi's and the Nepali's -- understand me well enough not to be offended by this -- I  hope!  But for those how don't know me that well, the title of this post no doubt is puzzling. I'll explain.

But first, it might help, by way of background, to know that I'm a man of many quirks and contradictions.  For example:
  • I hate store shopping.  The doors to a shopping mall are the Gates of Hell to me.
  • I love online shopping. I buy most everything I need with a one-click on Amazon.com.
  • I love Thanksgiving because it's family and friends uncorrupted by gift-giving.
  • I don't care much for Christmas because it's been taken over with excessive spending and gift-giving.
  • I love being with family and friends.
  • I need lots of alone time.
My Traditional Christmas
My pal Bill Feldman and I have a lovely tradition-- I join his family and friends for the Passover Seder and he joins me for the Christmas Eve service at St. John's Church, Lafayette Square.  We have supper at his house before the service. So I come out ahead on this tradition -- two Feldman-prepared meals, which are always excellent. 

On Christmas Day, the Schappi family -- me, daughter Ann, son Todd, granddaughters Jessie and Emily, grandson Colin, Jessie's husband Dan, and Jessie's two daughter, Kelsie (now age 6) and Kensie (age 1) -- come to my house for dinner.  I'm NOT a cook. Daughter Ann is and she prepares the meal. I do the grocery shopping and the cleanup. 

In recent years, Todd, Ann, and I have tried to simplify the\ Christmas gift-giving by exchanging e-mails in which we each provide a Christmas wish list of gifts we might like.  Lately we've even added internet URLs on where the gifts could be found and purchased, 

Help Resolve the Fiscal Crisis: "Sock It to Me"

Taxes are what we pay for civilized society.
-- Justice Oliver Wendell Holmes, Jr
.
And I am not paying my fair share.

The AARP and other lobbyists have convinced our politicians that all seniors are greedy old geezers who will vote them out of office if they dare touch our Social Security and Medicare benefits or increase our taxes. People over 65 vote at much higher rates than younger people and, as a result, we have become a protected political class.

I agree that low and lower-middle income seniors should not have their benefits reduced or their taxes raised. But upper income seniors, like me, should be paying more and getting less. 

For at least 25 years, seniors have been doing much better economically than younger workers. The median net worth of households headed by adults 65 or older rose 42 percent in real terms between 1984 and 2009. During the same period, the median net worth of a household headed by adults younger than 35 shrank 68 percent, according to the Pew Charitable Trust. 

From the beginning, it's been axiomatic that each American generation should live more comfortably than the last. For the first time in our history, that's no longer true. Today's economy and our tax-and-benefit structure make it increasingly difficult for my children and grandchildren to enjoy the standard of living attained by my generation. 

I've called my generation "The Lucky Generation". Newsweek  recently referred to today's Millennials as "the screwed generation."

December 13, 2012

Alzheimer's: New Brain Scans Advance Diagnoses, While Real Treatment Remains Unavailable

For six months now, a new brain scan technology has been available which clearly detects the presence of beta amyloid plaques in the brain. These accumulations of protein – and the dementia that develops – are the hallmarks of Alzheimer’s disease.

Here’s the rub: the burgeoning science of detection is speeding ahead of our ability to treat the disease in any meaningful way. Does it really help to know that Aunt Clara is on the inexorable slide into dementia, when there’s not a thing anybody can do to help her?

So far, more than 300 hospitals and imaging centers in America already offer the scan, according to Eli Lilly, which sells the tracer substance doctors use to detect the plaques.

In a November 15 New York Times article titled Alzheimer's Detection Advances Outpace Treatment Options, writer Gina Kolata outlines several unusual issues with this new brain scan technology:
  • Diagnostic scans typically don’t require special certification for doctors. Concerned about the implications of flawed interpretation – and certainly aware of the unavailability of meaningful treatment for AD – the FDA requires doctors to pass a test before they can use this new equipment. By mid November, about 700 doctors had passed the test. 
  • The scans are expensive – several thousand dollars. Most insurance providers, including Medicare, do not cover the cost. 
  • Insurers (and employers) are prevented by law from using results of genetic tests to discriminate. The same legal protection does not apply to scans. If a patient’s scan shows amyloid build-up, she can be denied insurance for long-term care. 
  • Radiologists typically use patient information as part of their image interpretations. Not here. Concerned that radiologists’ analyses might echo doctors’ comments, the FDA requires that technicians know nothing in advance about the patients whose brains they’re scanning. 

December 12, 2012

Music Therapy for Alzheimer's

Decades ago, before I had started doing any research about the brain, I knew there was some special connection between music and memory. My friends and I remembered music lyrics long after we’d forgotten other information from the same era. As he slipped further into dementia, a beloved neighbor could still sing after he’d lost the ability to speak.

I’m never surprised when I read promising stories about music therapy for people with Alzheimer’s disease (AD). Music affects some deep part of us, in a region of our brains where synapses apparently keep firing, even when they’ve shut down in other zones. It can do things that are particularly useful to people with dementia, like elevate mood, bring relaxation, suppress agitation. Mothers have known music’s special power since the beginning of time; it’s no coincidence that lullabies are sung, not spoken.

On her Brain Blogger site on December 7, writer Amy Wong described a small study that yielded interesting, if not surprising, results. Twelve people with AD, and 17 healthy people as a control group, were shown simple song lyrics on a computer screen. In some cases, viewers saw the words and also heard them being sung. In other cases, the lyrics were shown and spoken (by the same person who sang them). A third scenario had the lyrics appearing silently on the screen.

December 11, 2012

Iceland: Climate, Culture, Vikings, Hotdogs!


After writing the post that follows, I found the above video which combines two of my loves -- the new one for Iceland and the old one for crazy Brits. Now back to my original post:

I knew very little about Iceland and had no particular interest in seeing it until the idea of a family trip popped up during one of my early morning meditations. Go figure.

The idea occurred to me in late October; a month later, we were there. What we saw in our week of travels was fantastic. But learning more about Iceland was fascinating as well. Here's a rundown of Iceland factoids:

Climate: I packed for Antarctica. What I found was a climate not much colder than Washington DC's,  although late November in Iceland was perhaps more like January here.

December 10, 2012

Iceland's Recent Economic History: As Fascinating As Its Scenery

I started to write a report on some of the interesting facts I've learned about this intriguing country: its climate, history, the Northern Lights.... Then I came to "Iceland's Economy." I knew its boom and bust during 2008's global recession had been bigger than most. As my research continued, I thought, "Wow! This story shouldn't be buried in the middle of a general report on Iceland. It deserves featured billing."

See what you think.

The 2008 Meltdown
In 2007, the U.N. named Iceland the best country in the world to live in, based on life expectancy, education levels, medical care, income, and other criteria.

October 2008 saw the global recession take hold, stranding Iceland in an ocean of debt. Within three weeks, major banks were declared insolvent, the krona plummeted, and the interest rates for car and home loans doubled. By early 2009, it was clear that almost 90 percent of Iceland's businesses, including some of the largest, should have declared bankruptcy. The central bank estimated that this assessment was true for about 30 percent of households, too.

Unlike what has happened in the U.S. and Europe, the Icelandic government, financial sector, and federation of businesses agreed on a comprehensive debt-relief program for households and small to medium-sized firms. The program has seen many legal challenges, some still unresolved, but so far 12 percent of Iceland's household debt has been written off.

In terms of total debt collection, this approach has left the financial sector with as good a result as possible, avoiding the pain of sending most firms and many families into bankruptcy, unemployment and dispossession.

Thanks to this tempered approach to debt write-down, Iceland's economy is now growing faster than most in Europe, and unemployment is less that 5 percent, after hitting 9.3 in early 2010.

Street Protests Bring in the World's First Openly Gay Prime Minister
Icelanders took to the streets after the 2008 economic crash, and in 2009 voted into office a new coalition led by Social Democrat Prime Minister Jóhanna Sigurðardóttir. As a result, Iceland has the world's first openly gay prime minister. In July 2010, when laws were passed allowing gay couples to marry, she tied the knot with her long-time partner.

The new government is now investigating most of the main protagonists of the banking crisis. Parliament is still deciding whether to press ahead with an indictment brought in September 2009 of the former prime minister for his role in the crisis.

Iceland's special prosecutor has said the country may indict as many as 90 people, while more than 200 -- including the former chief executives at the three biggest banks -- face criminal charges.

The former CEO of what once was Iceland's second largest bank was indicted last December for making illegal loans and is now awaiting trial. The former head of another major bank has undergone stints of solitary confinement as his criminal investigation continues.

Iceland's response stands in stark contrast to our own. Here, no senior bank executives have even faced criminal prosecution in the sub-prime mortgage meltdown that crippled our economy.

For this political junkie, Iceland's handling of the 2008 recession is -- in its way -- as spectacularly beautiful as the sight of the Svínafellsjökull glacier that brought me to tears.

December 7, 2012

Iceland and Four Generations of Schappis



Shown here are three of the four generations of my family that ventured to Iceland the week after Thanksgiving. At left we see Jessie, then her father (and my son) Todd, and her brother Colin. Cuddled in the middle is six-year-old Kaylee. Those not shown are Kensie (Jessie's one-year-old daughter and my other great-grandaughter), Jessie's husband Dan, Todd's companion Jill, and yours truly. My daughter Ann and my granddaughter Emily weren't able to join us.

As I wrote in an earlier post, the idea for the trip suddenly popped up during one of my early morning mindfulness meditation sessions in late October. The eight of us arrived in Reykjavik, Iceland's capital, on Sunday morning, November 25. 

What follows is basically a photo journal of our week in Iceland. Next week, I'll describe our discoveries in this beautiful and interesting country.

December 6, 2012

Everyone "Seems in a Hurry To Get Nowhere"

That quote leapt off the page yesterday as I read a Washington Post story about the lack of respect drivers today show funeral motorcades on area roadways. Hearse drivers bemoaned how impatient and rude people have become with funeral convoys, cutting into the lines of procession cars, blocking their way, even leaning on their horns.

A funeral driver remembered how the somber passage of a funeral procession caused other drivers to slow down and -- he liked to think -- ponder their own mortality. Today, people routinely ignore the "Funeral" signs on each motorcade car, the blinking emergency flashers, the line of headlights. They show no interest in making way for the passage of the dead.

Now, he said, everyone "seems in a hurry to get nowhere."

I thought "Wow! That sums up our culture today."

Our Hurry To Get Nowhere
I brooded about this quote off and on during the day.

December 5, 2012

Insomnia and Jet Lag and "Meditation"

First, a confession: I planned to write this report on Monday and post it on Tuesday. But on Monday the temperature in D.C. soared to a December 3 record of 71 degrees: a delight after Iceland! And on Monday night the Redskins played (AND BEAT!) the New York Giants.

So I "worked" in the yard that afternoon. The "work" consisted mainly of watering my newly planted trees and shrubs, then sitting on the back porch. And I needn't tell you what I did Monday night. Hail to the Redskins!

I'm glad I stumbled upon the very moving Alzheimer's video for Tuesday's post.

Second, an explanation: Monday's piece about my back was mostly written before the Iceland trip and easily tweaked on jet-lag Sunday. But I quickly got an e-mail from a dear friend who said, "I don't give a damn about your bad back. I want to hear about Iceland!"

I'm putting off that report for a few days, since I was using a new camera that proved old dogs have trouble learning new tricks. My photos didn't do justice to the amazing landscape or my amazing family. So I've solicited their photos. I also want to gather my thoughts about Iceland and the trip.

Now on to the subject for today.

Jet Lag and Insomnia
I'm a lifelong traveler. For years, jet lag and insomnia inevitably accompanied the start and end of every trip, particularly during the past decade's travels to Nepal and SE Asia. I've used -- and abused -- Tylenol PM and Ambien to deal with the travel trauma.

December 4, 2012

"From His Window" -- A Moving Video about Alzheimer's

From His Window is a touching music video about Alzheimer's. Produced by the Moore Center -- in partnership with Musicians for a Cause -- it focuses attention on issues families face as they care for loved ones with AD. The Moore Center offers support for people affected by Alzheimer's through its "Moore Options for Seniors" program: http://www.moorecenter.org.

The video needs no further comment from me.

December 3, 2012

My Aching Back and My Home Office Ergonomics

Forget my Parkinson's and my prostate cancer. What's been troubling me most for over a year is lower back pain. After trying acupuncture, reiki, chiropractic, and a variety of other treatments, I'm finally experiencing some progress.

Identifying what's really helping is difficult because, as usual, I've been trying several different things. But I'm convinced the work I've just begun with the physical therapy department at Georgetown University Hospital is already helping, and promises to be a major factor in future progress.

When I was first diagnosed with Parkinson's, my neurologist recommended I take the BIG exercise program designed specifically for people with PD. He wrote a prescription for the Georgetown Hospital's program.

I worked with Lisa Ebb, one of their physical therapists, and found the BIG program helped my balance and improved my shuffling, stooped gait. I was unusually faithful in keeping up with the program until the August 2011 car crash that triggered the back pain . . . and gave me an excuse for slacking off. I need to start doing the exercises again, since the balance problems have resurfaced.

A month ago, my neurologist prescribed a BIG refresher course, and I asked to be scheduled with Lisa again. At our initial consultation, Lisa decided that rather than resume work on BIG -- which I know how to do and just need to do it -- we should see what could be done about the aching back.

November 30, 2012

Seven Exercises to Prevent Memory Loss

I know: lists you find on the internet are often pretty stupid.

This time, I came across a list on AgingCare.com, a site for people taking care of their aging parents. It was part of an article titled "Prevent Memory Loss: Exercise Your Brain to Keep Your Mind Active." The list was created by Sue Maxwell, who heads the Lee Memory Care Clinic, in Ft. Myers, Florida. The facility provides evaluation, treatment, family counseling, and community outreach for people affected by memory loss. There are even one or two ideas here that I might try.

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It is very important to keep your brain active. Here are some simple exercises that take a few minutes out of your day and help prevent memory loss.
  • The obvious one: play games. Any board game is OK such as Clue, Are You Smarter Than a 5th Grader, Monopoly, Pictionary to name a few. Card games are also very important. Or, computer games. It is important to have your brain do new things and not just do the same thing over and over like playing Bridge, or crossword puzzles. Most importantly, have fun while exercising the brain.
  • Switch it up. Here is a fun way, but challenging way to exercise the brain: If you wear your watch on the right hand, switch it to the left. Every week change your watch from wrist to wrist. Teach the brain to look at everyday things differently. Even think about a different way to drive to church, grocery store and work—get out of the ho-hum of doing the same thing the same way every day. Stop being a creature of habit. This one is guaranteed results!
  • Switch sides. Try this one: If you are right-handed, try writing with your left and vice a versa. Shave with your other hand or blow dry your hair with the non-dominant hand and see what has to happen for the brain to complete this exercise. Change hands with the phone. If you always talk on the phone with the same ear, then try the other one. The brain hears differently in each ear.
  • Go back in time. Pick an activity that you used to do in the past like playing jacks, shooting pool or maybe even jump rope or hula hoop. Don't be surprised if you need some extra practice. Most of all have fun and keep with the new activity until your skills return.
  • Learn a new activity. How about line dancing? It requires you to remember the steps – which takes mind-body-coordination and its fun. Any type of dancing accomplishes the same memory goal: learn and remember new steps, body positions and techniques. Other new endeavors: golf, chess, or take an adult education class at the local community college.
  • Practice active listening. Sit in the living room while watching TV and close your eyes. Use all the senses to understand the world around you. After the program has concluded, then go back in your mind and state how you felt and repeat what your heard. Paying attention without any other interruptions is very important — try not to multi-task.
  • Be good to yourself. Eat healthy foods... add nuts, berries and fish rich in omega-3 oils. Try drinking green tea in the afternoon for a boost. Give up those snacks rich in carbs and fats. In addition, walking is one of the best forms of exercise and doesn't cost one penny. So get off the coach and dust off those sneakers and head out for a brisk walk.
You will be amazed at how simple it is to exercise your brain and stimulate neurons and dendrites on the opposite side of your brain.

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November 29, 2012

Mercola: NIH in Bed with Big Pharma?

Yesterday I wrote about the dangers of conflicting interests – profits v. truth – when Big Pharma conducts drug studies.

Implicit in my post was the notion that studies conducted by non-profit or government entities – particularly NIH, the second biggest study funder after Big Pharma – would be fairer, more reliable, less driven by return-on-investment, more committed to public welfare.

Today, none other than Dr. Joe Mercola – the guy I’ve lampooned for hawking coconut oil on his website for $65 a gallon as a treatment for Alzheimer’s disease – asks us to think twice about the reliability of all drug studies, including NIH’s. Even at our government’s most prestigious research facility, Merocla suggests today on his website (Merocla.com), there’s the taint of industry collusion, all driven by greed.

Perhaps there are important issues to consider in Mercola’s warning, even if it is painful to think that NIH is really in bed with Big Pharma.

Mercola wraps up his alert with these comments, which sound like the voice of reason itself:

November 28, 2012

The Tale of Avandia and Big Pharma: Why Critical Skepticism Matters as We Review Drug Studies

The front page of Sunday’s The Washington Post featured an article by Peter Whoriskey titled “As drug industry’s influence over research grows, so does the potential for bias.”

In a nutshell, the writer tells the story of how in 2006 Big Pharma giant GlaxoSmithKline (GSK) managed to land a glowing 17-page report about their diabetes blockbuster Avandia in the prestigious New England Journal of Medicine (NEJM), even though:
  • there was apparently clear evidence linking Avandia to increased risk of heart attack and death, 
  • the drug trial had been funded by GSK, 
  • all 11 authors of the report received money from GSK. 
Four years later, in 2010, Avandia had disappeared from American drugstores. An FDA scientist estimated that while doctors in this country prescribed Avandia – propelled by laudatory reports like NEJM’s – 83,000 people using the drug suffered heart attacks or died.

A Washington Post review found that the NEJM published 73 articles about new drugs between August 2011 and August 2012. Here’s how Whoriskey characterized the literature over those 12 months:
Of those articles, 60 were funded by a pharmaceutical company, 50 were co-written by drug company employees and 37 had a lead author, typically an academic, who had previously accepted outside compensation from the sponsoring drug company in the form of consultant pay, grants or speaker fees.
My sense of smell is non-existent these days, but even I get a whiff of something unsavory here. Is Big Pharma’s drive for profit superceding public welfare?

November 27, 2012

Loene Trubkin on the Death of Our Pal, Hugh Yarrington




Hugh Yarrington
1942 - 2012

My friend Loene Trubkin has been battling cancer for years, amazing her friends with her good spirits. Then, several months ago -- perhaps encouraged by her writing class -- Loene unleashed her anger in a remarkable poem titled "Karma." I was so impressed, I asked Loene if I could post it on my blog, and she agreed.

Knowing that she and a mutual friend of ours -- Hugh Yarrington -- had exchanged many emails about their personal struggles with the disease, I asked Hugh to write an introduction to Loene's poem. Hugh's intro and Loene's poem are here: http://bit.ly/JxucJp.

Our friend Hugh died last Tuesday morning. I asked Loene if she'd write a remembrance. Again, she agreed. 

/////////////////////////////////////////////////////////

My friend Hugh died this week.

After working together in the 1980s and early 90s, Hugh and I lost touch. Fifteen months ago, he contacted me. He had just been diagnosed with a high-risk form of multiple myeloma, a cancer of the blood plasma. He was reaching out for information and support, and he knew I had been in treatment for several years. Over the next months, we exchanged dozens of emails.

I have known many cancer patients, most of them courageous fighters, resilient in the face of unpleasant news and worse side-effects. But Hugh was sui generis. He couldn’t help being fascinated by and studying the science even as he was suffering the torment, to a budding chef, of all food tasting like “Adriamycin mush.” He loved the steroids that most patients hate, because they gave him wide-awake nights to read math and physics. As soon as a chemo round finished, he was outside, walking, slowly at first, to regain his strength while plotting the day he could return to the golf course, carrying his own clubs. Even though he knew his outlook was grim, he decided his attitude would be to “piss on this disease,” even if it meant he was “just ginning up as much courage as I can because I’m scared.” 


November 26, 2012

Online Pharmacies: Caveat Emptor!

On Black Friday, I wrote about the hidden costs for prescription drugs.

Today, Cyber Monday, I’m sharing some information about buying drugs via online pharmacies (OPs)… and why that practice carries risks. My source is the September, 2012 edition of Consumer Reports’ “onHealth” bulletin.

My interest in OPs (especially those in Canada) isn’t new. Who wouldn’t want to get the best price for a product he needs? Enter “online pharmacies” into the search bar (off to the right, below) if you want to check earlier posts.

CR doesn’t pull any punches here. It offers three compelling reasons why buying drugs this way isn’t a good idea:

November 23, 2012

Hidden Drug Costs

So what if this is Black Friday and I'm supposed to be following the masses to the malls.  I hate shopping in general and shopping malls in particular.  Thank God for Amazon one-click!

Rather than go out and spend money, I'll be a contrarian and talk about  possible ways of saving money on prescription drugs.

We know about costs hidden in the products we buy. Without giving it much thought when we purchase something, we’re also paying for packaging, for research and development, for marketing, for transportation, for employee salaries and benefits, for building maintenance… the list goes on.

The same issue -- hidden costs -- applies to the drugs we buy, as a recent article in Consumer Reports’ “onHealth” bulletin reminded me. In this case, though, it helps to know exactly where those hidden costs lie, because we might actually be able to do something about them.

November 22, 2012

Celebrating Thanksgiving with "Generation Alzheimer's"

There’s much I can be grateful for this Thanksgiving:
  • a family that’s healthy, busy, and close by, 
  • many wonderful friends of all ages, 
  • a house I love, and
  • generally good health… in spite of Parkinson’s prostate cancer, and a nagging back. 
I’m also excited to be taking my extended family -- including great grandchildren! -- to Iceland on Saturday for a week of adventures. Among other things, we hope to see the Northern Lights. The moon will be a bit past new, and if the weather is clear – and solar activity cooperates – we might be in luck.

.I also will be remembering a dear friend who died on Tuesday after a valiant battle with myeloma and I'll be thankful for the talks we've had during the past year that deepened and enriched our friendship,

When I saw this article  on CNN’s Health page, I realized – again – how many blessings I can count this holiday. It’s title: Celebrating Thanksgiving with “Generation Alzheimer’s."

If you’re like me, the article might sharpen your gratitude, too. If you’ll be sitting down for turkey with a loved one who has Alzheimer’s -- as millions of American families will -- you might find a few tips to help make your special time together as wonderful as possible for everyone.

I should have had my kids and grandkids read the article before coming over for dinner today.

Happy Thanksgiving!


November 21, 2012

Letters of Love and Thanks Between My Late Wife Diana and Her Parents


Thanksgiving is my favorite holiday since it is focused on family and friends without all the commercialism that has overwhelmed Christmas. The importance of family bonds, particularly in times of crisis, is on clear display in a moving exchange of correspondence I recently discovered between my wife and her parents back in 1948, ten years before we were married.

The LeBlanc Family



Diana LeBlanc Schappi
7/26/1928 - 5/23/1979
Diana was born in Sendai, Japan, where her father was on a teaching sabbatical. She grew up in  Cincinnati, Ohio and graduated from George Washington University in 1948 with a degree in political science. She began her career as an editor at the Bureau of National Affairs (BNA -- now Bloomberg/BNA) and worked there until her death from cancer in 1979.

Anna G. LeBlanc
10/2/1896 - 6/18/1986

Known to me (and others) as Nancy -- and to my children Todd and Ann as Nana -- Diana's mother was  born in  Lithuania, spent her early years in Baltimore, and then moved to Cincinnati  where she married Dr. Thomas J. LeBlanc.  
   

Thomas J. LeBlanc
6/28/1894 - 9/8/1948

Dr. LeBlanc received his bachelor's degree from the University of Michigan in 1920, his M.S. from the same university in 1916, and his D.Sc. from Johns Hopkins in 1924. He served with the Rockefeller Foundation as a fellow and then a staff member until 1922. In that year, he became assistant professor of  preventive medicine at the University of Cincinnati's College of Medicine and became head of the department in 1934.

The Emperor of Japan honored him with a scroll for his service as head of the Institute of Human Biology at Tohoku Imperial University in Sendai, Japan. Earlier, Mexico presented him with a gold medal for his work in yellow fever control. During the epic Ohio River flood  in 1937, Dr. LeBlanc with two helpers inoculated over 24,000 people in six days for tetanus, typhoid, and other flood-related illness.

He was a true "Renaissance Man." His short story, Boyhood in the Bush, is included in anthologies of American non-fiction. He wrote for H. L. Mencken's American Mercury. I've framed several notes Mencken sent him urging him to submit more stories. Hanging in my office den where I'm now writing is a "Dear Tom" letter from Sinclair Lewis thanking him for writing "one of the best reviews of the book Arrowsmith either in America or in England."  LeBlanc and Lewis were friends.  In a letter to another friend, Lewis commented that Tom LeBlanc "was pretty much the model for Dr. Terry Wicket"  in Arrowsmith.

Here's my favorite part of Lewis' letter to Tom:
I deny your right to be called a scientist, because I have been reading your stuff in the "American Mercury"  and you're too good a writer to be from now on  respected as  a scientist.

November 20, 2012

Optogenic Stimulation: New Promise for Treating Neurodegenerative Conditions Like Alzheimer’s and Parkinson’s?

Are we one step closer to using tweaked embryonic stem cells to treat neurodegenerative diseases like Alzheimer’s and Parkinson’s?

An article I saw in today’s edition of the e-journal “Medical News Online” gives me another little jolt of hope.

I’m about four years into my PD diagnosis, and at 83, I can’t realistically hope that this latest news holds promise for me personally. And then there’s this frequent caveat: this particular laboratory success occurred using human stem cells transplanted into rodents’ brains. We all know there’s a long trail ahead before we can duplicate these triumphs with human subjects. Still….

Researchers at Sanford-Burnham's Del E. Webb Neuroscience, Aging, and Stem Cell Research Center (La Jolla, CA and Orlando, FL) successfully made neurons derived from embryonic stem cells actually direct cognitive function. If the achievement can be broadened, engineered stem cells might well be used to replace brain tissue damaged by AD or PD (or other conditions, like brain injury), enabling patients to function more normally. If our ability improves to diagnose these degenerative conditions sooner, we might even find a way to prevent their onset.

November 19, 2012

The Looming Threat to Medical Research Funding

As negotiations begin to avoid the year-end fiscal cliff, powerful lobbies are girding for battle. Defense spending will surely become a combat zone. In another arena, labor unions and the AARP are marshaling forces to prevent reductions in Social Security and Medicare benefits. No question: these issues will be major battlegrounds in the weeks ahead.

But I fear that other areas of discretionary spending will end up taking big hits, because it's easier for policymakers to trim where the public won't see much immediate impact. I worry that cuts will occur in an area I care most about these days: medical and health research.

As an 83-year-old man with Parkinson's Disease, prostate cancer, and a big fear of dementia, my concern about these funds admittedly is based on self-interest. But major research breakthroughs in recent years suggest we may be on the verge of finding cures or at least major advances in treatment for costly diseases like Alzheimer's, Parkinson's, and cancer. Given the potential savings in dollars and lives, funding this research brings a positive cost/benefit ratio... certainly much higher than the cost/benefit ratio for the Iraq and Afghanistan wars.

November 16, 2012

President Obama Celebrates Tihar in the White House

In the post that appears after this one, I report on the celebration of Tihar or Deepawali at my house.  I just learned about this celebration of the festival (called Diwali in India) at the White House.

I liked the celebration at my house better, even though it was somewhat more modest, because it was with loved ones.

But President Obama describes the meaning of the festival better than I did.

Celebrating Nepal's Deepawali/Tihar in DC's Palisades



As we get ready for our two big holidays -- Thanksgiving and Christmas -- my Nepali friends are just ending the second of their two biggest festivals. Both occur in the fall as the harvest is ending. The dates vary with the phases of the moon.

Dashain
Dashain comes first, and it's the main event. Nepalis in country and abroad do their best to get home for this festival -- at 15 days, their longest. Over the past decade, I've been fortunate to have celebrated Dashain four or five times in Nepal.

During Dashain, the goddess Durga is worshiped with many offerings and thousands of animal sacrifices for the ritual of drenching the goddess in blood (not my favorite part of the festival). But the emphasis is on family gatherings and the renewal of community ties.

Dashain was celebrated in October. On the festival's final day, the family elder gives the red tika blessing to family members. I performed that function for the first time last month as the elder (by far!) in our family.

Tihar/Deepawali
The second of the big two festivals is Tihar, or Deepawali -- which literally means "row of lights." It lasts five days and honors Laxmi, the goddess of wealth and good luck. I've also celebrated Tihar in Nepal several times and really enjoy it.

November 15, 2012

Pending Medicare Settlement Eases Rules for Home Health Care

In a proposed settlement of a nationwide class-action lawsuit, the Obama administration has agreed to scrap a decades-old practice that denied home health care, skilled nursing home stays, and outpatient therapy to Medicare beneficiaries if there was no expectation that the services would result in medical or functional improvement.

This proposed change could help people with chronic conditions like Parkinson's, Alzheimer's, multiple sclerosis, stroke, and injuries of the brain or spine. It also would provide relief for families and caregivers who are often stretched financially and personally to provide care.

Until now, the federal government had been following an informal "stability presumption" under which Medicare coverage for home health care was automatically denied for patients whose conditions were "stable" or deteriorating during the coverage period. A showing was required that the services would result in medical or functional improvement.

Neither the Medicare law nor regulations require beneficiaries to show a likelihood of improvement. But some provisions of the Medicare manual and guidelines used my Medicare contractors establish more restrictive standards under which coverage could be denied or terminated if the patient reaches a plateau or is not improving.

This practice resulted in denying coverage for degenerative diseases like Alzheimer's and Parkinson's.

Here's an example of the crazy results from this practice:


November 14, 2012

A Report on My No-Lipitor Experiment


Back in July, I wrote a series of posts about a new book, Are Your Prescriptions Killing You? The author is Armon B. Neal, Jr., a consulting geriatric pharmacist who received the 2010 achievement award from the American Society of Pharmacists. Neal also writes AARP.org's monthly "Ask the Pharmacist" column. So, he's no quack. 

One of those posts was titled "If you are over age 60, stay away from statins at all cost!" It concerned a chapter in Neal's book about statins, which he described as "among the least effective and most dangerous drugs on the market." He went on to say:
I stop these drugs on all the older patients I see because they are invariably at the root of nearly all their problems.
Neal is particularly opposed to prescribing statins for men over 80 who have shown no sign of heart disease.

That's me. I've been taking the most popular statin -- Lipitor -- to control my cholesterol for almost 25 years. Neal said that if your HDL (the so-called "good cholesterol") is over 45, you shouldn't worry about the other numbers (the total cholesterol reading and the one for LDL, the "bad cholesterol").

After my regular physical earlier this year, my doctor reported that my HDL good cholesterol number was "a splendid 68," well above Neal's benchmark of 45. So I decided, "What the hell, I'll take a Lipitor holiday and see what happens." That was exactly four months ago.

November 13, 2012

Preventing Cancer: Diet and Exercise

I’ve been writing about curcumin – the active ingredient in the Indian curry spice turmeric – for months. It’s been used medically for millennia in south Asia, and touted in overwhelming numbers of peer-reviewed studies demonstrating its ability to prevent and treat many illnesses and conditions. Just enter “curcumin” in the “Search This Blog” bar below on the right, hit the "search" button, and you’ll get lots of links to posts about this unheralded wonder substance.

So, I wasn’t surprised to see this comment in an article by Pam Harrison in the online journal Medscape.com titled “Specific Plants Protect Against Specific, Not All, Cancers”:
Probably the best example of a phytochemical that serves as an anti-inflammatory is curcumin. “Turmeric is the most potent source of curcumin, and curcumin is the most potent anti-inflammatory phytochemical we know,” Dr. Beliveau told Medscape Medical News.
The article offered a variety of examples to support its headline. Here are some of the bullet-points:

November 12, 2012

Sunday in the Woods with John

Maybe Sondheim will compose a musical, like his Sunday in the Park with George, after he sees this blog post and the accompanying photos.

I had several ideas for a post today, but they would have required spending time indoors. Today and tomorrow are probably going to be the last with temps around 70 degrees, sunshine, and the fall foliage past its peak but still beautiful. So, spending the day outdoors won out.

I've been using my back pain as an excuse for not taking the neighborhood walks I've always enjoyed. But since I want to be in better shape for the family trip to Iceland after Thanksgiving, I decided to do what my back doctor told me to do a year ago: "just walk through the pain."

So guess what happened on my walk today? The back pain gradually eased, and I thoroughly enjoyed the walk. But -- no surprise -- I also found I was seriously out of shape and had to stop and rest more than before.

November 9, 2012

Dementia: Impact of Light, Melatonin, and Circadian Cycles


I’m taking the family to Iceland later this month to see – we hope – the Northern Lights. 

At this time of year, the island nation gets only about five hours of light a day. The nights are very long – good if you’re hoping to see the Aurora Borealis, bad if you’re one of the millions of people who suffer from Seasonal Affective Disorder (SAD). I’m not really one of them, but I’ve still been wondering how I’ll feel during a week with really brief, dim daylight. I even get mildly depressed when we switch back to standard time.

And so, I was especially intrigued by a series of articles about light, mood, and dementia I just saw at AlzheimersWeekly.com.

Blue-White Light, Sleep Tight
In one very small study involving male patients with dementia in a long-term care facility, blue-white lights were installed in the main room, where patients ate their meals and participated in activities.

Blue-white light is most like real daylight, and researchers thought that simulating daylight would encourage patients to remain active and awake during the day. The extra boost, they hoped, would help regulate the men’s sleep-wake rhythms -- associated with the 24-hour biochemical “circadian” cycle of the hormone melatonin -- enabling them to get deeper, satisfying sleep at night.

November 8, 2012

Supplements Update, #2: Antioxidants and Calcium -- Get Them from Food, Not Pills

Before the welcome (as it turned out) interruption of Election Day, I started a series of posts on the latest findings about dietary supplements, which we buy each year to the tune of $30 billion. The first report involved the lack of evidence for claims that supplements treat cancer, and claims for omega-3 fatty acids and antioxidants in general.

More on Antioxidants
According to current thinking, oxidative stress may play a role in aging and chronic illnesses, like heart disease, cancer, Alzheimer's, Parkinson's, even cataracts. There are thousands of antioxidants in fruits, vegetables, whole grains, coffee, tea, chocolate, and wine. As a first line of defense, some antioxidants suppress formation of free radicals, while others "scavenge" to remove them before they do damage, or repair damage when it occurs.

Some familiar nutrients that act as antioxidants are vitamins C and E, beta carotene, and selenium. Many others are phytochemicals, such as quercetin and other flavonoids. Still others are enzymes, like glutathione peroxidase and superoxide dismutase.

November 7, 2012

A Perfect Way To Spend Election Day


I spent much of this Election Day touring the Library of Congress and the U.S. Capitol with my good friends Zahed and Sony and their three young children. Zahed and Sony became U.S. citizens earlier this year and, after our tour, returned to their polling place in suburban Maryland to vote for the first time. 

This was a perfect way to spend the day! I've been depressed by much of what's been going on (or, more accurately, what's NOT been going on) in our political system and with the growing inequality in our society. Given the crucial issues confronting us, I've been dismayed by the failure of both candidates to discuss these issues and to campaign instead using superficial trivia and negative personal attacks.

One thing that has kept me optimistic about our country is my involvement with immigrant families. I've posted before about my two Nepali families: Bhawana and Nimesh (who live with me) and Laxmi, Rahel and Ramesh, with whom I frequently stayed when they lived in Pokhara. I see them frequently now that they live in Washington.

My Bangladeshi Family
Zahed and Sony also are treasured friends. Their story is an example of what hard-working immigrants can still achieve here despite how tarnished the "American Dream" has become today.

November 6, 2012

Supplements Update, #1: More Fail the Test

More than half of us take dietary supplements and spend nearly $30 billion a year on them. But scientific studies continue to find little support for the claims that they truly help us. Back in February, I did a series of posts about the most popular supplements. Here's a link to the last post in that series; you can work your way back from there -- http://bit.ly/whYrES.

Since then, I've continued to follow reports on new studies. As a distraction from the tidal wave of election news the last few days, I've decided to do an update on supplement developments since February. As usual, most of the reports concern supplements that -- when tested -- failed to live up to their hype.

Here's a rundown:

Supplements To Fight Cancer
A review of the scientific evidence for the National  Cancer Institute found little support for marketing dietary supplements as protection against cancer. That evidence suggested that high doses of some supplements can actually increase cancer risks.

November 5, 2012

Drumming for Parkinson's


I don’t know anything about drums. A small exception: my housemate Nimesh often plays his Nepali drum, and – if his wife Bhawana and I are lucky – he’ll add a vocal accompaniment. It’s fun having live music in the house. 

Then earlier this week I got an email from Jessica Burns, an intern at a music management company in California. Among other duties, Jessica helps promote Shauney "ShauneyBaby" Recke, a drummer who tours with different musicians, including Sting and the Pussycat Dolls (Sting I've heard of; I know nothing about the Pussycat Dolls, but it's a great name).

Shauney did something else -- the reason Jessica reached out to me in the first place -- that got my attention. Two years ago, Shauney founded “Drum for Goodness Sake,” an organization that promotes drumming – with its various therapeutic attributes – as a means to help people dealing with cancer, dementia, Alzheimer’s, Parkinson’s, and stress-related disorders.

I’d read that many different forms of physical exercise were beneficial for patients with some of those conditions. I’ve written on this blog how some of them -- including tai chi, dance, and singing -- have helped people, like me, with Parkinson’s. Drumming? That was a new one to me, but I get it.

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