Post #191,224
1/23/05 12:45:22 AM
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Thanks. I mean that. :-)
It's been an education, no doubt about that.
We're lucky in that they did very well in the sale of their home (near Concord, MA) and she was able to get a long-term-care insurance policy a few years ago. They also have good health insurance and Medicare, so their hospitalization costs and doctors appointments have been covered. We're very fortunate that money hasn't been an issue. We have hired CNAs that help out and they are here about 20 hours a day, except on Sundays. Even with all the help, it's still hard - especially on my wife. She works so hard to keep the supplies stocked, the appointments kept, research their conditions and try to understand the treatments, research the drugs and side effects, and them in as good a mood as possible, etc., in addition to her 9-5 job. She's always been very close to them. I help out, but she carries most of the load.
They both have fallen several times in the last 30 months. Luckily, the last time was many months ago. About 2 years ago he cracked some ribs falling on a coffee table (when my wife was not more than 2 feet away); she cut her head falling about 6 months ago. Luckily, it hasn't been more serious. I sympathize with your experience. Even if you're right there they can still fall. :-( They're so frail now that a major fracture would probably do them in.
We've seen how good a rare doctor can be in helping to try to figure out the best way to treat him; we've seen aids in nursing/recuperation homes be in such a rush that they crushed time-released morphine tablets (leading to a 6 hour dose being absorbed all at once) and shovel food into him faster than he could swollow it (leading to aspiration pneumonia within a week on 2 separate occasions). We've seen how expensive hospital and nursing home care is, how poor the care is in too many cases, and how much better it is to have them at home. No matter how good the facility is, you can't be there to watch all the time to make sure that the over-worked or over-tired staff is not making a mistake. :-(
"Underappreciated?" I dunno, Ash. Certainly, as a society we don't appreciate the elderly as much as we should in many respects. But getting old seems to be something that humans aren't really designed to do. For every Bertie that does wonderfully into their 90s, there are thousands of others who slowly lose themselves long before then. The brain - seat of the mind - wears out, but their bodies keeps going. Dementia treatments probably won't solve the problem - merely slightly delay the inevitible in most cases, IMHO.
There are times when he doesn't know my wife's name and thinks she is one of the aids that takes care of him. For the last month or so she has been concerned every evening wondering where her young daughter is that she sleeps with every night. :-(
[link|http://www.technologyreview.com/articles/05/02/issue/feature_aging.asp|Do you want to live forever?] - I would have to say No.
Thanks for your indulgence and support - I guess I needed to vent a little. I appreciate it. :->
Cheers,
Scott.
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Post #191,226
1/23/05 3:17:47 AM
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Food.
Our culture spews out so many words/day - no one Could keep up. Even re just.. tracking down all the titles of so-called Professional societies! Publish/perish guarantees an infinite supply of words. Decisions.. decisions..
My experience in early '80s, of going out-of-country with a friend, so she could try the techniques of a Dr. Gerson (too long a story for sound bites) showed me what 'nutrition' can do regarding so-called incurable so-called 'diseases'. (Yes I have er Issues with much of the pill-formulizing / especially pill-Selling approach; trouble with the 'disease' characterization and then with -- the treatment of symptoms: the very pardigm of allopathic medicine.)
I have even more 'trouble' with the massive %iatrogenic deaths, accepted as 'normal' throw of the dice. (And my disdain for the products of Murican med schools became solidified - while working with same, delivering heavy-ion beams to real patients.. along with real physics. I saw how they worked and how little most understood of even - the consequences of the ability to use a 'beam' with the precision of a scalpel -- and how it was that these usually regressed to "what they'd been taught" - about protons, etc. etc.) 'Science' ken is not anywhere near #4 even, in what gets you through US Med schools - though non-stuttering pronunciation of sodium ethylmercurithiosalicylate is a big Plus.
Fresh, organically grown vegetables, meat treated as a source of the little *needed* protein (as a daily %total) + some bio-active enzymes and a few other things like goats-milk yogurt, sweetened for Murican tastes: such a regimen {there are books} has produced results which even I have witnessed. Quite fewer grains than we suppose are nice - or even, hardly-any - another surprising one. Lo-carbs - now seeming to be as much about vanity weight-loss (for many) as about general nutrition.. is another plank in the platform, but never the sole principle. (We have to bear in mind that carbs --> sugars and Muricans are rife with varying degrees of diabetes, mostly untreated until well-along..)
Last I was around a US hospital, any knowledge or concern-about 'human nutrition' (from chiildren through old people) was apparently well off any radars. One needed only to look at the crap served to reach that inference. Could be a little better today (?) ever since Sen. ___? tossed $100M into NIH some years ago and mentioned loudly to the boffins (as described in a quite recent Frontline), some results of a survey:
Showing the %Muricans who regularly employ alt.medicine approaches to their health AND a certain other factoid: only 28% of those in a large-enough study for decent stats: ever TOLD their AMA guy about what they were doing! (if they had an AMA guy).
Relevance: there's some evidence too, that the sort of sane nutrition as has been seen to promote robust health generally, and as is seen to assist the immune system in doing what it does best .. can, apparently also effect changes in cognitive faculties. (No 1st-person experience of such changes, BTW. 2nd person/ long-time observer hearsay, though.)
It's not my style (not much of an innate Interest) to follow the progress / and lack of same of this complex matter of Good Health over years and years - but circumstances have rubbed my nose in aspects. I have visited 'havens' where the PDR is Not the bible nor is "what Rx to prescribe today?" the question often asked.
I've also had long chats with a person given '3 mos' to live == 'incurable cancer'. (Her recovery to evidently good, say 'robust' health a year later - was labelled by her ex-MD as it usually is: 'spontaneous remission'. She was pretty young.) Talked to others, there; not all thrived. There is a Murican mindset re medicine. And it is taught assiduously. There are also loonies who are their own worst enemy - foolishly eschewing the utility of standard medical blood work-ups, ignoring diagnoses, etc. One can always use the data / need not follow the PDR 'remedy'. er PDR == Physician's Desk Reference
(Another factoid probably Googleable: the 'average' Murican over (65? years of age, forget #) is on *13* different 'medications'. You do the math for 13! interactions as in factorial. Or even 10!)
I suspect you could Google for more material than a normal person would want to digest.. but the possibility exists that -simply- paying very close attention to what these folks are living-on might produce surprising results -- and is an option highly unlikely to Harm.
And yes: non-contaminated 'live' food is not as cheap or abundant in (most) stores as is normal fare. Wild salmon (not farm-raised, for a number of reasons) costs typ 50+% more. Salmon appears to be right up there BTW in desirability for the protein ration, not only for its improvement of the Omega-3 ratio of lipids.
More would be proselytizing. Trouble is: we are ALL stuck with 'anecdotal evidence' -- especially when we experiment on ourselves (I have - still am).
But if you are seeing no signs of progress - I suggest only that, there are alternatives to much of the pharmchem suggested today as 'normal maintenance' for those the age of your charges. You may not be able to reverse the mental losses, no matter what you do -- still, 'medicine' is pretty ignorant about pretty much, especially when: being Sure "there is no course-of-treatment for ___" IMO.
Alas, there is no Truth.com, except in the eyes of True Believers. I know I could do better than I do, but then I'm lazy - even about further researching. I accept the crap shoot, in any case. Eschewing standard nostrums often demands a prodigious amount of extra work; many lack the time even to begin finding, say, "whom do I trust for assistance/consultation?" (Just as there are few chapels for the spiritually inclined who eschew organized 'religion', I suppose ;-)
Luck --
moi
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Post #191,233
1/23/05 10:30:46 AM
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Few options.
He can't eat now. He has lost sensation in his throat and thus doesn't know when food is going down the wrong way. His cough reflex is very weak now. :-( He has a [link|http://www.chclibrary.org/micromed/00049200.html|g-tube] and his diet consists of 6 - 8oz cans of [link|http://www.allegromedical.com/dietary_supplements/adult_nutrition/ross/jevity_1_2_formerly_jevity_plus_8_oz_cans_case_of_24.P176482|Jevity 1.2 Cal] per day. Modifications to this diet have caused changes in his strength and activity level (with indicators in his blood and urine chemistry) so it's not really an option, unfortunately. Even before his g-tube, his [link|http://www.tracheostomy.com/|tracheostomy] seemed to make eating more of a chore.
"Why put him through all that?" Well, he's still fighting and still seems to enjoy being around. He loves watching Willy Nelson video tapes and DVDs, petting the dog, looking outside. Changes in his condition have been so gradual... We never imagined that we would be doing these things for him (we thought they each would eventually fall and/or have a heart attack). It's not as bad as it looks or sounds, really. The tracheostomy improved his breathing tremendously and the g-tube has eliminated the aspiration pneumonia episodes. He's much healthier with them than he was before. Both have kept him out of the hospital for over 6 months. It's a hassle (weekly oxygen delivery, humidifier and vacuum pump noises all the time, going through a multistep process to feed him 4 times a day, etc.), but it's easier than having to drive to visit him at a nursing home and eliminates constantly worrying about whether they've made a mistake.
She has had trouble swallowing liquids for quite a while and has an aversion to them but can't explain why. She has symptoms of Parkinson's and Alzheimer's and is being treated for both. She has had angina for years but is from a "meat-and-potatoes" background with a family history of extreme obesity (300+ pounds) and heart-attacks at young ages. She's outlived all her siblings. She eats the same food we do, but in smaller portions. She's actually in pretty good shape, considering...
There's no doubt that diet is very important. The skeptic in me is very suspicious of those who claim to have found the [link|http://www.ediets.com/news/article.cfm/cmi_385383/cid_1|magic brain diet] though. For years we were told that cholesterol was bad even though something like 80% of the blood cholesterol level was not affected by diet. More recently we're told that infections of various kinds seem to be the cause of plaques that form in blood vessels. They have suspicions that change over time, but they don't know, contrary to the way drug companies and the popular press present things. :-( As you say, too many who practice medicine don't really bring a scientific outlook to it, and the hoi polloi is in little position to evaluate these things, unfortunately.
He's on a dozen or so medications and she is as well. We also don't want to just throw pills at the problems, but they each have multiple conditions that do require treatment. The drugs aren't perfect, but we try to keep an eye on potential side-effects and only give them if we've seen evidence that they help. As you say, it's nearly impossible to understand how all of these things interact. :-(
We can all do better. Eating less is probably more important than eating the Just-Right foods. Exercise and using one's brain - trying to learn something new nearly every day - is important. Moderation is important too, especially in one's emotions - it's important not to be angry or anxious. That's what I think, anyway. Maybe I should write a book. Yeah, that's the ticket! :-)
Cheers,
Scott.
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Post #191,252
1/23/05 2:15:16 PM
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"Brain Diet" is missing the latest.
Mainstream medicine is getting on the Turmeric bandwagon now, particularly as a preventative for Alzheomer's (though it's suspected to be helpful in preventing some cancers also).
Unlike the poorly designed and misinterpreted (deliberately or from stupidity) "controlled studies" of modern medicine, Turmeric is backed by strong "hearsay evidence". It's used in significant quantity in the daily diet in India, which has one of the lowest rates of Alzheimber's in the world.
[link|http://www.aaxnet.com|AAx]
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Post #191,297
1/24/05 5:25:04 AM
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Accord
Ah so.. given those details, I can't add anything you haven't well considered.
My way of trying to deal with the plethora of incomplete, conflicting and/or just sloppy data I encounter is most often 'nici nici' ~~ "not his.. not this.." ie. I (now) deem it an axiom that we all are better at bringing experience to recognizing "what seems Wrong" / doesn't fit.. than picking out The Best course (after all, that is what we once believed a Doctor could and would do, with virtuosity). Also, as likely you've seen - it takes subtle linguistic acrobatics to actually induce a rethink of an MD's strategy, even if you spot a clash. Walking-on-eggs, there..
I do see, in combining my observations with those of others who deal with their own triage: that perusal of the voluminous lists of side effects of *every one* of those 'medications' just has to be done; every MD is on full-race. [always frosts me that these suckers are so euphemism besotted that they cannot bring selves to Just Say DRUGS instead of the polysyllabic med-i-Kay-shuns mantra].
Reading the blood workups with comprehension is often revelatory (sometimes need to bug them to ADD some more from blood chemistry menu, with mucho tact) . Where any of these, like say renal function? are flaky -utterly basic, that- there's where the side-effects list can flag. The poor kidneys, liver have to flush all of these drugs and natch, regeneration is least in the oldest.
I guess you've noted these multi-$Billion/yr. -statin variants like Crestor\ufffd - re that Hot focus on EZ roto-rooting of arteries. I've seen these suckers prescribed for people with obv. renal problems - in COMBO with other items equally unkind to kidneys, liver and ___! It also appears that today it is pharmacists who have become the main safety net for the n! problems of over-Rxing. Of course, it should be clear to most folks here, who understand stats: NO ONE is spending more than the token-$ for PR - re all these expectable interactions among popular drugs taken by millions. No profit in That - and proving malfeasance?
cf. Firestone Tires VS Rollover-SUVS + lawyers. Did I mention - we are so fucked.
Recent spotlights on the corrupt methodology of FDA just might finally galvanize a few reforms: currently for all drugs - it is not necessary to run a comparo of existing copy-cat drugs VS New one, for relative efficacy. Just the placebo VS New and enough tests for some nominal stats of non-lethality.
(And of course - as pitched to the MDs: each new one "Is Vastly Better" cha cha cha.)
Scary, that biz-medicine is just like biz-biz. What a surprise :-0
Hang in there. You're paying more attention than the vast majority (say they do). I don't know many folks who can sustain a constant check on the reasonableness of 'procedures'; even for myself I would likely quickly drop the manic initial followups needed to umm calibrate an MD, and just keep watch on the periodic test data. I don't know any better way to make use of the system as it is, and the fact that my Interests typ haven't much been about biology. Mea culpa - sloth again..
Cheers,
moi
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