November 24, 2016

On Thanksgiving, a Special Nod to My Two Oldest Friends, My Two Newest Friends, and My Caregiving Friends

I have more genuine friends today than ever. I had many more acquaintances when I was working, and especially after I joined the AA and gay communities. I have fewer acquaintances today but more genuine friends who are loving and caring and remarkably diverse.

I have elderly friends and young friends, gay friends and straight friends, friends whose families have been in America for generations, and friends from the UK, the Netherlands, Nepal, Bangladesh, and the Gaza Strip.

I retired from BNA -- where I worked for 40 years -- almost 22 years ago. I still have good friends from those days.

I've written frequently about my friends, and I'm thankful for all of them. But I want to give special thanks today for my two oldest friends, my two newest friends, and especially my small army of caregiving friends.

My Two Oldest Friends

Jack & Marty
I had lunch last week with my two oldest friends -- Jack and Marty -- and their wives. Jack and Marty would want me to clarify that when I say "oldest" I don't mean most elderly. I’ve just known them longer than other surviving friends.

Actually, my relationship with Jack is the oldest (i.e. longest ). I've known him since 1950 when we were students at Cornell's School of Industrial and Labor Relations. We were acquaintances then, not really friends.

The real friendships date back to 1957, when we three lived in a house at 31st and Q Streets in Georgetown. The house still exists, but I think it has reverted to what it was originally: a single-family, three-story residence. When we lived there, it had been broken up into three separate apartments, one on each of the three floors of the house.

Our apartment was on the second floor. Two young women (from South Carolina, I think) rented the first floor apartment. Vola Lawson -- along with a strange woman we never got to know -- had the third floor apartment. We were all recent college graduates starting our professional lives in Washington.

The rooms in all three apartments opened onto the three-story central stairwell that was a feature of the house. This layout contributed to our feeling that we were part of a continuing, integrated house party. It was great fun, but it lasted less than two years. By the end of 1958, we had all gone our separate ways.

November 22, 2016

After That Election, What Is There to Be Thankful For? Lots! My Families Top the List.

I've always loved Thanksgiving. But this year, more than ever.

It's my favorite holiday because it's focused on family and friends without the over-the-top commercialism of Christmas. And, unlike Christmas and Easter, it's a holiday everybody can celebrate regardless of religion or lack thereof.

This happy holiday is particularly welcome this year, after 18 months of presidential campaigning that was more mean-spirited, hate filled, and divisive than anything I've seen in my 87 years.

Of course, there were some negative aspects to our earliest Thanksgiving. Here is a reminder:
I celebrated Thanksgiving in an old-fashioned way. I invited everyone in my neighborhood to my house; we had an enormous feast; and then I killed them and took their land.
– – Jon Stewart

Before writing today, I reviewed my earlier Thanksgiving posts. They tell you more than you could ever want to know about my families. This time, I'll just give you a few updates on my three families:
  • my genetic family,
  • my Kathmandu family, and
  • my Pokhara family.

The Schappi Family in China
My genetic family includes son Todd and daughter Ann; Todd's three offspring: Jessie, Emily, and Colin; Jessie's four children: Kaylee, Mckenzie, Camden, and Hannah; and Emily's two children: Emarie and Emyra.

I've commented before about my good fortune that we all live in the Baltimore-Washington area. This week, many of my contemporaries are traveling all over the U.S. -- even the world -- to celebrate Thanksgiving with their far-flung families. With one exception, all of my family will celebrate the holiday at my son's house near Frederick, Maryland -- about an hour’s drive from my house.

November 12, 2016

What's the Cause of My Recent Energy Surge? Maybe it's the New "Anti-Aging" Pill.

In my last post, I described my new routine -- trying to do stretches and exercises throughout the day. And on most days, I am also making the half-mile downhill walk I described in an earlier blog post. 

I'm an 87-year-old man who should have been diagnosed with Parkinson's 10 years ago. Most people my age – and most long-term Parkinson's patients – are usually just too tired to get the kind of exercise I’m enjoying these days.

I haven’t always had this kind of energy, either.

Several causes of past extended fatigue come to mind:
  • my “summer from hell” years ago,
  • my shingles attack last spring,
  • Washington’s record-breaking summer heat and humidity.

These past weeks of pleasant fall weather have certainly given me an energy boost, too. It just feels good to be outside.

So… the stretching, the exercises, the walking, and the autumn weather have all contributed to this recent burst of energy and activity. But there’s something else – the new "anti-aging” pill I started taking over a month ago. 

It's very strange for me to tout something like this. I’ve frequently urged others not to fall for the magic pill hype we occasionally hear from TV hucksters like doctors Oz and Mercola.

Yet here I am, promoting a dietary supplement I ordered online without a prescription. Here’s the pillbox description: "a daily health product designed to optimize and support your most critical metabolic systems," including
  • "DNA repair"
  • "cellular detoxification"
  • "energy production" and
  • "protein function." 

The pill is called “Basis,” the only product so far from Elysium, a new company. In “New York" magazine,” journalist Benjamin Wallace calls it "either the most sophisticated fountain-of-youth scam ever to come to market or the first fountain-of-youth pill ever to work."

November 10, 2016

I No Longer "Exercise." I Just Keep Moving.

Maybe I’m playing name games with “exercise” and “moving.” But I feel like what I started doing recently may really be slowing down the progress of my Parkinson’s disease (PD).

In the past, I’d tell myself "You need to exercise!" I'd think about scheduling 30 minutes later in the day and I’d wonder: Should I play one of my exercise videos or work out a program of my own, using my collection of printed exercise instructions?

I was pretty good about doing some type of exercise, convinced it was treating my PD at least as much as my meds. If I was a good boy, I’d exercise four or five days a week.

In time, I figured out which body movements from the videos and printed instructions seemed to help most. During the past several months, I’ve mostly “winged it,” avoiding the videos and printed materials, and instead spontaneously creating my own “routines” of stretches and movements that have proved helpful.

My home gym from the start has been my bedroom. The equipment? The bathroom sink, the railing at the bottom of my bed, and the Harvard chair. But now I exercise throughout the house and throughout the day. The kitchen has become a favorite venue. I use the counters and sink for stretching and doing standing push-ups. I get to work as I wait for the microwave oven bell to tell me lunch or dinner is ready.

Today, I ate lunch standing at the table in my upstairs office, where I keep a small refrigerator and microwave. While eating my Trader Joe's "Thai-style citrus chicken salad," I marched in place.

Before sitting in any chair in the house, I do some stretches. While seated, I try – but often forget -- to do some of those seated exercises I've learned.

November 6, 2016

Are the Meds You’re Taking Really Appropriate? A Reference for Older People

Most medications – both prescription and over-the-counter -- are not tested on older people. Nobody knows for sure what dosages are really appropriate for this demographic.

I've written about the subject before. I've noted that I usually begin with half the recommended dosage shown on the pill bottle whenever I start a new med.

Last week, I stumbled across a report on the internet that referenced an important source of information about the effects on older people of many well-known medications: the American Geriatrics Society's 2015 updated Beers criteria for potentially inappropriate medication use in older adults. Turns out it’s one of the most frequently cited reference tools in the field of geriatrics.

"As we grow older, at least one in six of us is likely to experience serious side effects directly related to the medications we take," said Todd P. Semia, co-chair of the AGS Beers criteria panel.

The main table in the Beers criteria includes a list of potentially inappropriate medications for most older adults. When I examined that list, I found one of my own prescribed meds on it -- nifedipine. My blood pressure (BP) doctor prescribed this drug for me to use when I get temporary BP spikes during my “off periods,” when the carbidopa-levodopa I take for Parkinson's disease is wearing off.

For all the potentially unsafe medications, the table shows the recommendation, the quality of the evidence supporting the recommendation, and the strength of the recommendation. For nifedipine, the recommendation was to avoid it; the quality of the evidence was high; and the strength of the recommendation was strong.

I'm not too concerned about this particular "red flag," since I take nifedipine only as needed, and never more than 1/3 of a pill. However, I had been taking it more frequently these days, since I'm trying to cut back on the carbidopa-levodopa... a reduction that can lengthen my off periods and raise my BP. 

November 1, 2016

The Five Stages of Parkinson's Disease and Me

Parkinson's disease (PD) strikes people in many different and idiosyncratic ways, leaving them to experience a broad range of symptoms. While those symptoms may be mild or severe, and while they may occur frequently or infrequently, PD appears to have five different stages. The time spent at each stage varies. And skipping stages – like moving from stage one right into stage three, for example -- is not uncommon.

Here are the five stages:

Stage one: During this initial phase of the disease, a person usually experiences mild symptoms, such as tremors or shaking in a limb. During this stage, friends and family can usually detect changes -- such as poor posture, loss of balance, or abnormal facial expressions.

I didn't have the tremor, and I still don't. The most noticeable clue was that my right arm would no longer swing freely. Observing this rigidity, my kids urged me to see a neurologist.

Stage two: In PD’s second stage, the person’s symptoms are bilateral -- affecting both limbs and both sides of the body. The person usually encounters problems walking or maintaining balance. Difficulty completing normal physical tasks becomes more apparent.

For me, the stiffness and rigidity mainly affected my right arm at the outset. While I now experience some malaise on my left side, the right arm remains the most affected limb.

Stage three: In stage three, symptoms can be rather severe, and may include the inability to walk straight or to stand. There is a noticeable slowing of physical movements during this stage.

Stage four: This stage of the disease is accompanied by severe symptoms. Walking may still be possible but is often limited. Rigidity and bradykinesia -- a slowing of movement -- are often visible. During this stage, most patients are unable to complete daily tasks, and usually cannot live on their own. The tremors or shakiness -- characteristic of the early stages of the disease -- may lessen or even disappear for unknown reasons.