December 20, 2013

Happy Holidays -- See You in 2014

This is the way the past year has been going here in the nation's capital:

I'm looking forward to seeing these guys up close on my February cruise around South America:

But now I'm taking a two-week vacation from blogging. 

December 19, 2013

Helpful Tips for Critical End-of-Life Conversations

Only as her mother lay dying did Ellen Goodman realize she'd never had a real end-of-life conversation with her. By then, it was too late. Her mother was suffering from dementia.

The Pulitzer-Prize-winning columnist wrote:
The only conversation I had with my mother -- and this is often true of people -- is when she would see someone and say "If I'm ever like that, pull the plug." But there was no plug to pull.  
After all the years I'd written about these issues, I was still blindsided by the inevitable. 
The last thing my mom would have wanted was to force me into such bewildering, painful uncertainty about her life and death. I realized only after her death how much easier it would have all been if I heard her voice in my ear as these decisions had to be made. If only we had talked about it.
That was seven years ago. In 2010, Goodman and some colleagues -- with media, clergy, and medical professionals -- gathered to share stories of “good deaths” and “bad deaths” among their own loved ones. That exercise launched "The Conversation Project" to give families the tools to broach the difficult, emotional topic.

Gap Between What We Say We Want and What Actually Happens
The Conversation Project prompts us to think about having "The Conversation" by citing these findings:

December 18, 2013

"World Death Rate Holds Steady at 100 Percent"

In the past weeks, I've attended two memorial services for dear departed friends and joined the rest of the world in paying tribute to Nelson Mandela. And so I've wondered, how DO we deal with death and dying?

Let's consider these deaths:
  • Nelson Mandela: To be sure, he was a heroic, inspiring world leader. Still, the death of a seriously ill 95-year-old doesn't strike me as tragic, or even sad.
  • Vola Lawson: I knew and loved Vola -- former Alexandria city manager -- since 1956. She died of sudden cardiac arrest last Tuesday. I posted a remembrance on Friday and attended Vola's funeral on Monday. She was 79 and enjoyed a rich, full life. I cried when I heard the news of her death, and tears still well up when I think how much I'll miss her friendship. But I sense that friends who knew about our close friendship are surprised I'm not more grief-stricken.

December 17, 2013

Dissolvable Under-the-Tongue Apomorphine Strips to Resolve Freezing of Gait in Parkinsonians

A Canadian company -- Cynapsus Therapeutics-- is developing a thin, quick-dissolving strip for Parkinsonians who suffer freezing of gait (FOG). When they have a FOG episode, they’d simply put one of these strips under the tongue. The “rescue therapy” then takes effect within a minute and a half, according to the company’s product explanation.

Called APL-130177, the sublingual film delivers a quick dose of the FDA-approved drug apomorphine, currently available only in injectable form. This new delivery system – in final human trial stage – eliminates the pain, stress, injection site irritation, and considerable awkwardness that accompany the needle method.

It’s another piece of good news for PWPs, who have recently learned about the availability of a new ankle bracelet that senses the onset of FOG and delivers an audible cue to the wearer’s earpiece – a cue as simple as the word “walk.”

December 16, 2013

Two Christmas Toys To Fight Hypertension and Stress

My kids and I have agreed to stop exchanging Christmas presents. Hurrah!

So I decided to give myself two presents instead. With any luck, lower blood pressure and increased serenity will be the REAL gifts.

The December 2013 issue of the Mayo Clinic Health Letter included a report about portable, at-home medical devices that may help lower blood pressure. It featured two devices, with this caveat: some people might very well achieve the same results on their own without paying the $300 to $400 that each of these devices cost.

But I decided they'd make excellent Christmas gifts to me from my son and daughter.

Zona Plus -- A handgrip device
Gripping an object -- and holding the grip -- is a form of isometric exercise that may affect several body functions related to blood pressure. Such exercise appears to calm the fight-or-flight response and may allow blood to flow easier and with less pressure.

Zona Plus is a hand-held device that calibrates grip strength and guides you through two two-minute repetitions of continuous gripping on alternate hands. The instructions recommend doing the exercises five times a week.

The Mayo newsletter indicates that research on handgrip devices is limited, but evidence suggests regular use can result in a ten-point drop in both systolic and diastolic blood pressure. People with blood pressure at or above 180/110 should avoid isometric exercise until their bp is better controlled.

December 13, 2013

Vola Lawson: Happy Warrior, Great Friend

Vola Lawson
9/14/1934 - 12/10/2013

Vola, a treasured friend, died Tuesday night of cardiac arrest. I learned yesterday morning with the publication of her obituary in the Washington Post. We had one of our regular bridge games at my house last week, and we were scheduled for another next Tuesday. She almost always brought Willie, her beloved Jack Russell Terrier shown here in his favorite place: Vola's arms.

Vola and I met in 1956, when we had apartments in the same house in Georgetown. We became close friends, then kept in touch through our career-and-family years. In the past few years, we started seeing each other more often and rekindled the tight bond we'd enjoyed over half a century ago. I'm so glad we did.

December 12, 2013

New drugs -- "pharmacoperones" -- for Alzheimer's and Parkinson's?

Can a new drug that targets “misfolded” proteins cure neurodegenerative diseases -- like Alzheimer’s, Parkinson’s, and Huntington’s – as well as diabetes, cystic fibrosis, and inherited cataracts?

Scientists have known about misfolded proteins for years. Until recently, they assumed these misfolded proteins just didn’t work, accumulated, and caused disease.

Healthy protein molecules assume very precisely folded 3-D shapes. Mutations mess up those folds, and problems develop. The cell’s “early warning system” then moves the misfolded proteins to a different location within the cell. The misfolded protein isn’t destroyed in the move, only disabled.

Dr. P. Michael Conn and his team at Oregon Health & Science University have apparently developed a new type of drug – a pharmacoperone – that essentially rescues misfolded proteins, returning them to their original location and thus enabling them to resume their proper health-sustaining work inside cells.

December 11, 2013

What I Want for Me: Fewer Entitlements, More Taxes. It's Only Fair!

As I write, Congress is about to adopt a budget compromise that will avoid another government shutdown. But that action will only delay addressing the clash of generations. We're seeing a growing transfer of our nation's wealth from the increasingly disadvantaged young to the increasingly advantaged elderly. We're kicking this football down the field again. Some "progressive" Democrats in Congress are even proposing an increase in Social Security benefits. 

An 84-year-old lifelong liberal Democrat, I'm dismayed that many liberals insist on defending seniors' entitlements to the last dollar. It's a position that's politically expedient, but intellectually lazy. Even more stupid is the position of Republicans who vow never to increase taxes.

The Two Faces of Social Security and Medicare
Social Security was adopted because of the perception, accurate then, that the elderly were poorer and more vulnerable than everyone else. Though no longer valid, the view persists. And as senior power at the voting booth grows, politicians of all stripes fear touching Social Security and Medicare, the behemoths of federal spending.

December 10, 2013

NT219: New Promise for Treating Neurodegenerative Diseases?

Can a newly created compound that inhibits an element of aging really treat brain diseases like Alzheimer’s, Parkinson’s, and Huntington’s?

Scientists at the Hebrew University of Jerusalem, working with a new company that – no surprise – has already filed for a patent on the potentially profitable product, are betting, “Yes it can.”

Their findings were published last week in the journal Aging Cell ("A novel inhibitor of the insulin/IGF signaling pathway protects from age-onset, neurodegeneration-linked proteotoxicity"). The compound in question has a name: NT219. Its creators claim it impedes a particular aging process – without extending lifespan -- to protect the brain from neurodegenerative diseases.

Protein Build-ups in People Only as They Age
These brain diseases share several features: they seem to result from protein accumulations, and happen to people later in life. They don’t occur in much younger people, the way cancer does. So what is it exactly about the process of aging that makes people vulnerable?

December 9, 2013

Holiday Dinner Video Spoof and My Four Diet Basics

Love the spoof. I've done my share of fad dieting through the years. I've experimented with Atkins, low carb, vegan, and many others . . . looking for that quick and easy way to shed pounds. I've thought about starting a self-help group called "Five Pounds Overweight Anonymous" for the legions who go around saying "If I could just lose five pounds!" Trouble is: five pounds would no longer be enough for me.

At this stage in life, I've decided to relax and just follow a few generally accepted precepts for healthy eating. As someone who can still squeeze into the "moderately overweight" slot, I was delighted to post this report earlier this year:
The Mildly Overweight Live Longer! 
How about that? Researchers from the CDC and elsewhere pooled data from 97 studies from over a dozen countries, tracking nearly 3 million people (
Here are some of the findings:
  • Overweight people had a 6 percent lower overall death rate than those of normal weight. (Data were adjusted for age, gender and smoking.)
  • For people over 65, the mortality benefit of carrying a few extra pounds was even better. 

December 6, 2013

And Now He Belongs to the Ages

Ritalin for Parkinson's? I'm Encouraged. But Will It Make Me Even Grouchier?

I saw a recent report that Ritalin, the drug used to treat ADD in children, might help Parkinsonians like me with balance problems and other PD symptoms. Searching the internet for more info, I found that Ritalin might improve fine motor skill by enhancing levodopa, the standard medicine used to treat Parkinson's.

Other studies indicated that the drug alleviated fatigue and helped with "freezing of gait," a common PD issue. Someone in my support group said he had used Ritalin and found it helpful.

Should I Take Ritalin?
I'm a strong believer that "less is more" when it comes to pills, prescribed or OTC. Every new pill increases the risk of bad interaction. I checked Ritalin against my current meds on and didn't see any red flags for potential adverse interactions.

December 5, 2013

Gloria Steinem: Immigration Reform as Solution to Critical Caregiver Shortage

Gloria Steinem, who received the Presidential Medal of Freedom two weeks ago, is now fighting for immigration reform. At first, it seems an odd cause for Steinem, best known as an activist for women.

Immigration Reform IS a Women's Issue
In an interview reported by the Washington Post, Steinem elaborated:
I want to correct the inaccurate image of immigration in the media. There is an idea that women's issues are over here and immigration reform is over there.
Three-quarters of undocumented workers are women and children. When the image in the media is potential terrorist or drug dealer or, at best, a male farm worker, it is an unrealistic portrayal of who immigrants really are.
We need to make sure that our news blogs and sources are more accurate about this imagery and what this nation needs as a workforce. There's an idea that high tech jobs, which culturally are still dominated by males, are more important than caregiving jobs, which culturally are still dominated by females. That is simply not true.
We live in a prosperous country and have a higher life expectancy and we need more caregiving workers. In the interest of accuracy and in supplying the expertise that this society really needs, I hope we can reflect reality in what we write into law.
Steinem expands on her theme in this video:

December 4, 2013

Parkinsonian Bum Arm = Shorter Blog Posts?

I hear a crescendo of voices shouting “Hooray!”

Parkinson’s Disease and My Right Arm
Most people -- including doctors -- recognize Parkinson's disease (PD) when they see the  tremor, which usually begins in one hand. But about 20 percent of us with PD don’t experience the tremor . . . an absence that often delays diagnosis, as it did in my case. That belated diagnosis four years ago came only after my kids, noticing that my right arm didn't "swing" naturally when I walked, urged me to see a neurologist.

Thanks to medication and exercise, I'm doing pretty well. But I see increasing signs of PD-related muscle stiffness and rigidity. The disease continues to target my right side, particularly my arm. A ligament tear three years ago weakened it, compounding the problem.

For the past couple of months, I've been frustrated by the many typos and other errors I'm making when writing on the computer.  I'm probably averaging six or more errors for each line I type. I'm trying to cut back on the time I spend on the computer.  This doesn't help.

The Damn Computer Keyboard Doesn’t Work!
Typically, when things go wrong, I look to assign "blame" elsewhere. So the computer keyboard was my first target; So I tossed it out and tried a new one. When that didn't work, I tried another. Here's evidence of how well that worked:

December 3, 2013

Alzheimer's / Dementia Rates DOWN!

I have Parkinson’s disease and prostate cancer. But I follow the news about Alzheimer’s disease (AD) with similar interest . . . maybe even more. Slipping into a fog – overwhelming my family with care and worry and dissipating my estate and their legacy  – is my biggest health fear. .

So I was happy to find some “good” dementia news.The New England Journal of Medicine reported recently that people are less likely to develop dementia today than they were 20 years ago, and that the onset of cognitive impairment seems to be happening later in life than before. (That last finding isn't a "home free" pass for me.)

Study co-author Dr. Kenneth Langa at the University of Michigan Medical School in Ann Arbor said:
We're very encouraged to see a growing number of studies from around the world that suggest that the risk of dementia may be falling due to rising levels of education and better prevention and treatment of key cardiovascular risk factors such as high blood pressure and cholesterol. Our findings suggest that, even if we don't find a cure for Alzheimer's disease and dementia, there are social and lifestyle factors we can address to decrease our risk.
His team suggested that two key factors explain the positive trend:
  1. People are getting more education, which stimulates the brain, and
  2. People are getting treated for – or avoiding – heart disease, a major dementia risk factor.

December 2, 2013

The BRAIN Initiative: an Update

This past April – to great fanfare – President Obama announced the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative. The White House website heralded the project this way:
Today at the White House, President Obama unveiled the “BRAIN” Initiative—a bold new research effort to revolutionize our understanding of the human mind and uncover new ways to treat, prevent, and cure brain disorders like Alzheimer’s, schizophrenia, autism, epilepsy, and traumatic brain injury.
Needless to say, the news set the neuroscience community abuzz. For its reach and boldness, the project was described as “a moonshot for brain research.” As a person with Parkinson’s – a disease of the brain – I got pretty excited, too.

In the months since the announcement, questions have understandably arisen. Was the BRAIN Initiative too general? Was it adequately funded? Were research dollars safe? With various projects spread among different agencies and organizations, would results become fragmented and compromised?