Presentations

Monday, March 25, 2013

Dreams and Lewy Body Disease


I’ve always been a dreamer and often awaken in the night puzzling over what remote area of my brain produced those mini-motion pictures. My dreams are often a mystery, especially when I wake up with vivid images of my nighttime adventures.

We all dream, but some people cannot remember their dreams when they awaken. I tend to remember mine and find myself inspired, disturbed, or downright puzzled. I kept a dream journal for a long time as a means to jumpstart my writing. I am amazed at how many ideas I can glean from my dreams.

Just a few of the images I remember from last night: (1) I dreamed my house was connected to my work and a former employee had removed my cat’s litter box and let her outside. (2) I had gone to the dentist (whose office was at a mall) and forgot to remove the clothing protector when I left, but managed to accidentally put on two fancy scarves that didn’t belong to me. (3) My sister and I hopped on a trolley to return to the mall to get my coat and return the scarves.

Does any of that make sense? In a strange way, most of it does relate vaguely to something that happened the day before. Think about Dorothy and the Wizard of Oz. Her dream from the bump to her head was a fascinating distortion of the events leading up to the tornado.

Did you know that studies before 1950 showed that most people dreamed in black and white? That began to change during the sixties, and now about eighty-eight percent of us dream in color. Nearly ninety-six percent younger than twenty-five dream in color. This change is believed to be the result of the changeover from black and white film to color media. It really makes sense if you think about it.

One of the theories behind dreaming is that dreams are our way of consolidating our memories and attempting to make sense of them. We dream during the REM (rapid eye movement) stage. While our eyes move, normally, the rest of our body is paralyzed. In our family, several of us have, or have had, paralyzing nightmares. During this event, we are trying to wake from a bad dream and realize that although the mind is awake, the body cannot move. It is a disconcerting feeling, to say the least.

On CBS This Morning, Dr. James Galvin talked about a study from Mayo Clinic about dreams and the connection to dementia. This study showed that if you act out your dreams by kicking, shouting, punching, or thrashing about, you are at higher risk of developing dementia. In fact, the study shows this is the strongest predictor of developing Lewy Body disease.

Approximately 1.3 million people in the United States have Lewy Body disease. Both men and women develop the disease, but it is more common in men. Lewy Body disease is under diagnosed because of symptoms it shares with Alzheimer’s and Parkinson’s, but subtle differences help physicians make a diagnosis. Now, added to other differences, acting out dreams may be another indicator of the disease.

Lewy Body disease is best treated with a comprehensive approach by a team of specialists. Cholinesterase inhibitors, such as Aricept, work well on Lewy Body disease. In fact, it is believed the cholinesterase inhibitors are more effective on this disease than on Alzheimer’s. The movement disorders associated with Lewy Body is treated with Parkinson’s medication. Antipsychotic drugs should not be used for hallucinations because they react differently on persons with Lewy Body disease. These drugs worsen symptoms in fifty percent of those using them, and can cause a fatal reaction called neuroleptic malignant syndrome (NMS).

Of course, one of the problems with Lewy Body disease is REM Sleep Behavior Disorder. This is often treated with melatonin or clonazepam.

It is important to remember that if you move around and act out your dreams, it does not mean that you have Lewy Body disease or that you will develop it. If you develop signs of dementia, it is something to mention to your team of physicians during testing to determine the cause of your cognitive problems.

The connection between sleep and function the following day is strong. A lack of sleep or disturbed sleep affects our thinking process. Now, acting out during sleep means a person is five times more likely to develop Lewy Body dementia than those who sleep quietly during dreams.

Sleep is essential to our health and wellbeing. The REM stage of sleep is when our minds can take us places we will only reach through dreams.

Copyright © 2013 by L.S. Fisher
http://earlyonset.blogspot.com    

Saturday, March 9, 2013

Spring Forward

Tonight, or should I say early tomorrow morning, is the time to set our clocks for daylight saving time. We know which direction to change the clock by reminding each other to “spring forward.”


So, I don’t have a problem with springing forward, but changing time, doesn’t work for me. But then, I don’t have any choice in the matter. I can’t continue using standard time when the rest of the country sets their clocks forward. Heck, it’s hard enough for me to be on time under the best of circumstances.

When the time changes, it takes weeks before my biological clock gets back in sinc with the clock on the wall. Anytime I travel to a different time zone, I go through this big mental adjustment. Whether I travel east or west doesn’t seem to make much difference. Either one will throw me for a loop, either while I’m there or when I get home.

One year, I carefully entered a schedule into my cell phone for the Alzheimer’s Advocacy Forum in Washington DC. I’m probably the only person who ever went to that much trouble, just to realize that I somehow managed to have the schedule set to Central time and every event I had painstakingly entered did not switch to the new time zone. Sure, the phone changed, but the entries did not change with it.

It seems that as I get older, I’ve reverted to questioning things—like daylight saving time. The first thing I found when I Googled the time change was that it is not “daylight savings time,” it is “daylight saving time.” In all honesty, we have the exact same number of daylight hours no matter what time the clock says. The whole idea is to rearrange time to suit our lifestyle, not to save any time whatsoever. Rearranging time is, of course, the biggest advantage.

The downside is that it messes up some of us for days, if not weeks. On the Monday following the time change, more auto accidents occur. Work productivity suffers.

I remember many years ago when I worked at a different job, we noticed one employee did not show up to work the day after the time change. One of my co-workers called him.

“What cha doin’?” he asked.

“Drinking coffee,” the missing employee replied, “like I always do this time of day.”

Boy, was he ever surprised to find out he was sitting there drinking coffee when he was expected to be at work.

Regardless of the extra daylight hours at the end of the workday, I always feel like an hour of my life has gone missing. It usually means an hour less of sleep for me since I can’t seem to go to bed early enough to get a full night’s sleep under the best circumstances.

It so happens that the older I get, the harder it is to make any fast moves and springing sounds like it could be beyond my speed. So, if springing is too hard, we could simply move forward. Each year we can move forward just a little slower.

Technically, it is not yet spring although the rain last night and the sound of dripping snow were hopeful signs of impending spring weather. All I know is that this is one year that proved that silly groundhog was wrong in his prediction—really, really wrong.

Before long, it will be officially springtime. Maybe by then, I’ll forgive Puxsutawney Phil for his faux pas. By summer, I’ll have adjusted to the time change and can enjoy the extra hour of evening daylight, which is after all the advantage of daylight saving time.

Copyright © March 2013 by L.S. Fisher
http://earlyonset.blogspot.com

Saturday, March 2, 2013

Worrywartitis and a Storm Called Rocky


I tend to be a worrywart and when I heard the predictions last Monday, it was all I could do to keep from freaking out. We had just weathered a storm that dumped a foot of snow on us and then the models were calling for another six to twenty-two inches with thirty-mile-an-hour winds. I kept telling myself they could be wrong.

No amount of self-reassurance could keep me from worrying. I was awake more than asleep on Monday night as the storm raged. My cell phone said “light snow” but the wind-driven snow was anything but light.

By morning, I knew I’d be foolish to head out to work in the storm. Monday evening, we arranged to have some of the office staff picked up and taken to work. It was a good thing because we had major power outages at the electric cooperative where I work.

I was able to make some phone calls from home to help a little, but the brunt of the work fell on other staff, and, of course, the linemen who braved the blizzard to restore power to the people sitting in cold, dark homes.

As the storm named Rocky raged on, we became more aware of the damage. Nearly two-thirds of our system was in the dark.

I made it to work on Wednesday, and the rest of the week was a blur of calls and stories of how people coped without power—some of them for four days. The calls ranged from one extreme to the other—pleasant understanding to unbridled anger. The longer the outage lasted, the more exhausted our employees were and the more frustrated the members became.

Many conversations stuck with me, but I think the one that hit home the hardest was the lady talking about an elderly couple who were staying in town. They wanted to go home. She said, “He has serious health problems and didn’t bring enough medication. She gets so upset when things don’t go right. You know how people can get.”

“I certainly do,” I said. “I’m the same way. When something doesn’t go right, I get upset.”

The tension was broken as we had a laugh about human nature.

Throughout the week, I thought of the message Pastor Jim gave on Sunday. He said fear has many names and one of them is worry. I’m not sure where he got the statistics he quoted, but they made perfect sense to me.

Jim Downing said that forty percent of what we worry about never happens. I would say looking back at what I worry about, that’s probably a little low for me. But then, I’m a worrywart so it stands to reason that my personal fruitless worrying would be higher than average.

Thirty percent of worrying is about the past and can’t be changed. I saw an example of that when one of the employees asked me if she could take off next Monday. She needed to watch her grandchild, but she was afraid that she would be needed at work. I put it on the calendar and told her, “Sometimes family just has to come first. It took me a long time to realize that and I missed a lot of events because I put work first.” With tears in her eyes, she relayed a story of when she put work first and had never stopped regretting it.

Twelve percent is over criticism. I used to get my feelings hurt easily, but I outgrew that. I think to overcome worry about what others think of me, I’ve acknowledged that I’m not perfect and some people cannot be satisfied. I can’t do much about those who criticize me, but I can either use the criticism to improve myself, or if it’s unwarranted, let it die. I learned a lot about criticism this week.

Ten percent of worry is over health—yours or a loved one’s. I think we worry more about our loved ones that ourselves. One time I needed surgery and Jim kept insisting I tell my mother. I wanted to tell her when it was over. He couldn’t handle the stress on his own and he called her! I know that Jim’s dementia worried me more than it did him.

Eight percent of our worries are about real problems. Sometimes, worry can be a positive thing because we prepare ourselves. Some of those who worried about the storm used their concern as a springboard to prepare. They arranged a place to stay; they fired up generators or wood stoves. They became ingenious and went into survivor mode. Sure, they were as inconvenienced as anyone else, but they found a way to make the best of a bad situation. One woman fired up her grill to melt snow water to flush her toilet.

I wish I could say knowing the statistics means I’m now worry free, but it doesn’t. As long as snowstorms are wicked enough to have names, many of us will worry. Action does help alleviate some of the worry, along with faith and trust in a higher power.

Copyright © by L.S. Fisher, March 2013