Sunday, July 31, 2011

Look Into My Eyes

I used to play a game with my grandson where I put my forehead against his and said, “Look into my eyes!” For some reason he always thought that was funny. It might have been my goofy tone of voice, or else he could see something in my eyes no one else could.

Recently I found out just how deeply an optometrist can look into my eyes. While I was on vacation, I saw some flashes of light in my left peripheral vision and a few quick Internet searches later discovered that it could mean a detached retina. Knowing that doing something soon was the key, I tried to find someone to look at my eye on a weekend in a tiny town in Maine. Well, that just didn’t happen so I made an appointment as soon as I got home.

After dilating my eyes, the optometrist used a powerful scope to examine them. His verdict was that my retinas were in fine shape, and I didn’t have any eye disease. That was the best kind of news for me to hear. After all, my vision is horrible and I didn’t need anything to make it worse.

Now it seems that eyes may be a way to detect Alzheimer’s. Anyone who has been through the diagnostic process, especially with younger-onset dementia, knows just how painstakingly slow, and expensive, getting a diagnosis can be. It is no wonder that some people skip the testing and just assume they have Alzheimer’s.

Researchers have found a couple of different biomarkers in eyes that would indicate Alzheimer’s disease or the risk of getting Alzheimer’s disease. A new study from Australia discovered that blood vessels in the eyes of people with Alzheimer’s were a different width than those who did not have the disease.

Several years ago, researchers at Boston University found amyloid (the substance in Alzheimer’s plaques) in the eyes of people with Alzheimer’s. Some of the original researchers have been working several years on a laser scanner for early detection of Down’s and Alzheimer’s.

It takes years for research to be put into common use and the eye test for Alzheimer’s is no exception. So it doesn’t look like easy detection will happen soon.

You may be wondering why researchers would be trying to detect Alzheimer’s early when there isn’t a cure available and all current medication does is delay the symptoms, not the disease. One of the most compelling arguments for early diagnosis is to make sure you have Alzheimer’s and not a treatable condition.

It took us nearly two years to get a diagnosis for Jim. At first, we thought his symptoms might be from depression. When treating the depression didn’t help, he was checked for vitamin deficiencies, diabetes, AIDS, and other conditions that we probably didn’t even know they were ruling out.

After psychological testing, we learned that Jim had dementia—and the most likely cause was Alzheimer’s. This brought about a new series of tests. One scan indicated damage from a stroke, but a more sensitive scan showed general brain atrophy rather than stroke damage. A few specialists later, the Alzheimer’s type of dementia diagnosis seemed most likely.

So how would earlier detection have helped? If Jim had been able to take the Alzheimer’s drugs, they would have been more effective during the early stages of the disease. More important to us, we didn’t ignore a treatable condition with the assumption that he had Alzheimer’s.

I had good insurance, or we could not have afforded to explore all the possible reasons for Jim’s problems. Not everyone is fortunate enough to have insurance to pay for the endless testing to rule out reversible conditions.

If an eye exam could be used as a screening tool, it would be an inexpensive way to monitor your health. Looking into your eyes could mean you would know if your symptoms are from Alzheimer’s, or whether you need to keep searching for a different, and possibly treatable, cause.

Copyright © July 2011 L. S. Fisher

Friday, July 22, 2011

Never a Dull Moment

Last Friday, I visited Four Season Living Center to deliver a packet to the Walk to End Alzheimer’s team captain. I parked my car in my usual spot. My eyes automatically settled on a certain window; I swallowed hard and blinked back the tears. Jim lived in that room for four years, and we spent a lot of time there. Each day when I visited him, I didn’t know what to expect, but it seemed like there weren’t too many dull moments.

I didn’t recognize the lady behind the reception desk, but while I was talking to her, Danna walked up behind me. She greeted me with a smile and a hug.

“The lobby looks different than it did when the deer came crashing through and jumped into Jim’s room,” I said. For the benefit of the new worker, I briefed her on the deer story.

“It’s strange that you walked in here today,” Danna said. “I just got off the phone with Gwyn’s family. They wanted to know if we had a copy of the newspaper article about the deer. Gwyn passed away last week. Suddenly. She was only 46.”

I was shocked, and it took a minute for it to soak in. Gwyn, gone, when all I could think about was her sense of humor and how she was so full of life.

Danna called Gwyn’s family back and I talked to them. It seems that Gwyn had often told the story about the day the deer came to visit the nursing home. I promised to send them the “deer” story from my journal. Here is an excerpt from the story. 

Oh, Deer!
When I arrived at Four Seasons, I saw broken glass in the lobby and the admissions office.
“Linda, did you hear what happened?” Richard, the administrator asked me.
“Yes, they called me, but I can’t visualize how it happened.”
“The deer broke through that window over there,” he said pointing to a gaping hole in the south wall. “Then he ran across the lobby and into Pat’s office...”
“And I was talking on the phone,” Pat said, “this deer came charging into my office. I was just petrified. I just hung the phone up. I can’t even remember who I was talking to. The deer crashed out my window and ran across the lawn. Then we saw him leap through a resident’s window.”
“Then Lois ran down the hall and into Jim’s room and jumped on the deer,” Richard said.
“What? You jumped on the deer?” I asked, looking at the director of nursing. It was hard to believe that someone would do such a thing. “Where was Fred when all this was going on?” Fred was the nursing home’s adopted greyhound.
“He was right here, but he seemed to be as surprised as we were,” Richard said.
I walked rapidly down the hallway, hit the button to disarm the alarm and pushed the door open to the Alzheimer’s unit. Jim’s room was a shambles, with fragments of glass still in his air conditioning unit. Smears of blood on the floor, and deer hair stuck in the cracks and crevices made Jim’s room look like a crime scene. 
Gwyn and Mary started filling me in on the morning’s events: When the six-point buck made his unexpected entry through the window, most of the residents were in the dining room eating breakfast, except Jim, who was wandering the halls.
Mary was just getting ready to take Jim to his room to feed him when the deer careened into the room, glass and blood flying everywhere.  Lois arrived on the scene, pinning the thrashing deer to the floor with her best wrestling hold. Gwyn grabbed a blanket and told Lois she should get off the deer.  Gwyn threw the blanket over the wounded animal, then decided to sit on the deer to make sure it didn’t get up and run down the hall.
“I was sitting on the deer, hanging onto both antlers, and he started bleeding out of his mouth.  I said awwwwwwww, and let go and started petting him. Someone said ‘what are you doing!’ and I grabbed hold of both antlers again.”
Conservation agents responded to the 911 call and cut the wounded deer’s throat. The agent asked Gwyn if she had a hunting permit.
“No, why?” Gwyn asked him. She was alarmed, wondering why she needed a hunting permit when all she did was sit on the deer.
The agent started writing.  Oh, no!” Gwyn was thinking, “I’m going to get a ticket!” Instead, the conservation agent wrote out a permit allowing Gwyn to keep the deer.
“I’m from Arizona,” Gwyn told me, “where the deer stay in the woods where they belong!  I had never even seen a deer up close. I don’t know what I was thinking, other than I couldn’t let that deer get to my residents!” 

Like I said—never a dull moment. I can still hear Gwyn’s husky voice and her laughter.

Copyright (c) July 2011 L. S. Fisher

Monday, July 11, 2011

My Recollections, Our Memories

“Mom and I went to the Mennonite restaurant to eat, and there was a hearse parked right in front of it,” I said to my brother, Donnie. I had stopped by the nursing home to visit him while I was in town. “I couldn’t help but wonder if a coffin was in the back—in this sweltering heat! Mom said, ‘Even hearse drivers have to eat.’” I told Donnie about my covert glance into the hearse, and we shared a laugh about my concern.

Donnie’s speech is slurred from strokes, and I have to listen closely to hear what he has to say. The hearse story reminded him of a memory. “Do you remember when Butch Gardner bought that old hearse? He thought he was really going to get the girls to go out with him, but none of them would ride in the hearse.”

I laughed at the memory of the hearse. “That wasn’t Butch that owned that hearse,” I said, delving into my own memory. “It was a guy named Bruce—he was Claude and Leroy’s cousin. He was a good-looking guy, and I did go out with him in the hearse. Mom and dad disagreed on whether I could go or not, but they finally let me. The date turned out to be the two of us and a whole carload of kids in the back.”

“Yeah, I remember riding in the back,” Donnie said. “I thought it was Butch.”

“Remember, we went to a creek and went swimming. That was my ‘date’ in the hearse.”

“I think that was our club that went to the creek in the hearse,” Donnie said.

“I believe it was too,” I said. A big group of us country kids formed a club and went on different activities together. Butch was in that club, so that’s probably why Donnie thought the hearse belonged to him.

“Do you remember the skating party?” I asked. “That was the second time I ever saw Jim. I told Jim our club was going to be at the skating rink and he met us there. He wore a shirt with the sleeves ripped off.”

Donnie nodded and I knew that he too was remembering Jim. After Jim and I greeted each other, he went to get his skates. I sat on a bench next to Claude to lace up my skates. “Is that guy bothering you?” Claude asked. I’m sure he thought Jim was some kind of local punk. “If he is, just say the word and I’ll straighten him out!”

I reassured Claude that I knew Jim and had invited him to the skating party. I was touched since Claude was a mild mannered kid and Jim was a former Golden Gloves boxer.

Donnie and I laughed over our shared memories.

In a serious moment, Donnie said, “I think I know more people that have died that I know who are alive.”

“I know what you mean,” I said. The memories I had just shared about Claude and Jim, once a shared memory between the three of us, is now mine alone. Both of them are gone.

I kissed Donnie on the cheek, feeling good about our visit. Some days he is depressed or upset, but today we had found a happy place in our shared memories.

Our visit made me remember how vivid Jim’s memories were before dementia erased them. Before dementia, little slices of life lived in Jim’s memories long after I had forgotten them. I thought about how sad it was when our memories were gone, and how lonely I felt when Jim couldn’t remember our special times together.

Our memories are flawed because we each see life from an individualized perspective. Certain moments in life are etched into our brains with clarity, while others are fuzzy and out of focus. The older we get, the more memories become so buried that we may never retrieve them again.

Memories may be distorted by time or disease, but if we voice our recollections, those reminiscences are a way to reconnect to a shared past. After stories are erased from our brains, they can linger forever in our hearts.

Copyright © July 2011 L.S. Fisher

Tuesday, July 5, 2011

This Amazing Country

Around Independence Day, we often examine our reasons for being proud of our country and count our blessings for living in America. To celebrate this holiday, we eat ourselves silly at picnics and backyard barbeques, take advantage of sidewalk sales, listen to patriotic music, have fun in the sun, drag out all things red, white, and blue, and set off thousands of dollars worth of fireworks. We fairly explode with pride in our country.

I went to the lake to see the magnificent fireworks shooting into the sky over the dam. The display was rivaled by nature’s thunder and lightning. I overheard a woman talking about her plans to watch a pyrotechnical display in a nearby town the next night. She said the best vantage point was the nursing home parking lot. I thought of how Jim hated the sounds of fireworks because they sounded like war to him. I tried to keep him away from the sights and sounds of the holiday. Do you know what an impossible task that is? I wonder if other people with dementia might not understand why the night is full of loud booms and bright lights.

No doubt, we live in an amazing country with opportunity for all. This doesn’t mean everyone appreciates the wide-wonderful country we call home. We find a lot to complain about on a regular basis—the price of a gallon of gas, the government (especially when our political party is not in power), the weather, taxes, and all those immigrants—illegal or not.

This country was built on immigration. Other than Native Americans, we are in this wonderful country because our ancestors pulled up roots and transplanted themselves in America. I cannot imagine how a person could leave his homeland and start over in a new land, or in a new world, as it was known. They came here knowing they would never go home again. To me, this is as attractive as it would be to move to a different planet.

Our newspaper ran a contest for local people to write about why they were proud to be an American in fifty words or less. Since Saturday morning was a more laidback day than normal, I read the short, short essays written by proud Americans. One really caught my eye. Vietnam veteran, Larry D. Stevenson, wrote: “Drafted into the Army, served a tour in Vietnam where I was involved in heavy combat. Received this nation’s second highest combat award, the Silver Star. Came home to a country in turmoil over the conflict. What makes me proud of that? The rights we, as Americans, have to voice our opinions for or against our government’s actions.”

When we can be proudest of the freedoms that hurt us most, we have achieved a higher level. I’ve often noticed that the men and women who have sacrificed the most for this country understand this more than others.

We aren’t proud of our country because everything is perfect. Part of the amazing part about our country is the way we embrace the imperfect, contrary to our own personal preferences, and our tolerance for the melting pot of nationalities and personalities that make up the citizens of this country.

We can bellyache about what is wrong in this country fully confident that although others might not like it, they can’t stop us. Before we label a practice or person as “un-American” it is time to give serious thought to want makes America special. Could it be that the very things we think are un-American are, indeed, the embodiment of why this is a great country?

Copyright © L. S. Fisher July 2011