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What Is “It”?

Portrait of Elderly man looking out window

With regards to this website, I am largely of the mindset that unless it is helpful, it’s not worth sharing. But these are the tough discussions we must have in order to make any real progress. I’m not the first one to call out the elephant in the lab, but I think we should talk about the multifaceted riddle that is Alzheimer’s disease.

When Max was a baby he had a really high fever, so high that it caused a seizure.  The doctors put him on anti-seizure medication just to be on the safe side.  He fully recovered.

When Max was six, he shot himself in the eye with a rubberband as he tried to launch a balsa wood airplane.  He had some bleeding behind his eye so they kept him in the hospital for a day to two.  He fully recovered.

When Max was eight, he fell off the top bunk, landed on his head, and broke his wrist. They x-rayed and casted his wrist.  They ignored his head.  He fully recovered.

Max played football in high school.  He had his bell rung many times, but only one official concussion.  He fully recovered.

Max experimented with drugs and alcohol in college.  Nothing “serious”, but tried a few “mind expanding” hallucinogens and was drunk enough, many times, to not have any recollection of the night before.  But every time, he fully recovered.

Max got a good job at a busy corporation.  Climbed the ladder for many years.  Had little sleep, a poor diet, and drank too much.  He married, had children, and eventually went through a long, exhausting divorce. His life was lonely and stressful, but he fully recovered.

Max gained weight as he aged.  He developed diabetes, high blood pressure, and painful, arthritic joints.  But he managed those problems with insulin, statins, and ibuprofen. When any of those conditions flared up, he swallowed a pill and fully recovered.

Max’s vision and hearing started to go.  His glasses didn’t help, and he didn’t like how the hearing aides fit.  He had some bad teeth that made eating unpleasant, so he usually just ate soft foods like ice cream and pudding.  Moving around became so difficult that he preferred to sit most of the time.  He got out of breath just walking from the bathroom back to his recliner chair, but as soon as he sat down, he fully recovered.

Max started to get forgetful and suspicious.  He accused his kids of stealing from him.  He could not remember to take his medication or pay his bills.  He needed help to shower and dress but wouldn’t let anyone assist him.  When he fell and broke his hip, he was hospitalized and Alzheimer’s disease was added to the list of diagnoses.  This time, he did not fully recover.

Now Max and his family are fighting for a cure for Alzheimer’s disease.  He has had a lifelong history of unquantified brain trauma, exposure to toxins, long-term stress, sleep deprivation, heart and small vessel disease, isolation and depression, malnutrition, sensory organ failure, medication mismanagement, and a mother who had dementia.

I am an advocate for Alzheimer’s research and want to see an end to this disease.  I just don’t buy the fact that we’re going to find a single smoking gun.

Here are my questions:

Is Max’s new diagnosis an acute neurological condition?  It’s a brain lesion much like a stroke or traumatic brain injury.  Should we treat it as such?

Is the diagnosis of Alzheimer’s evidence of a singular disease?  We can’t diagnose it or treat it, so what is the point?

Brain scans show evidence of atrophy, but has this occurred over time?  How much time?

Has one or several of Max’s experiences over the course of his life, commingled with whatever dumb luck is coded into his DNA, accelerated the disease process?  Was he destined to end up in this condition anyway?

We assume there must be an accumulation of plaques and tangles that are either the by-product of trauma or disease or the cause of it.  Of course, we won’t know unless we actually biopsy his brain after he dies.  But what does that prove?

And the question that is burning in the minds of so many people around the world who are willing to commit billions of dollars to research is just further evidence, in my mind, that the focus is largely misguided:  Do they make a pill for that?

The more accurate, though less optimistic, question just also happens to be paired with much more affordable answers:

“How can we better treat cumulative brain trauma and manage lifestyle disease?”

Let’s talk about that!

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One comment

  1. I agree that any and all of these things could account for the onset of Alzheimer’s in later life. There could also be a genetic predisposition. But there is such an epidemic of it–I think I read somewhere that 1 in 4 are now predicted to get it?!?–that another frightening possibility is that it’s something environmental. Is it something in the air, water, or food chain? Is it from using microwaves, aluminum pots, or Teflon? If you think about that long enough, you can go insane. So I try not to think about it.

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