Medication and Opinions

I mentioned a few days ago a medication, Seroquel, that Mom has been taking for a little over a year now. Just as with turmeric, I began to read about it because of someone else’s suggestion. A friend discontinued her mother’s prescription because she read quite a few negative articles on the internet about the increased risk for mortality associated with the off-label use of quetiapine fumarate (Seroquel) for dementia-related psychosis in elderly patients.

From what I understood, the reason Dr. Tee prescribed the medication for Mom was precisely this, dementia-related psychosis. So, after reading many articles all of which confirmed what the others were saying, I quickly went about trying to alert Pop and the sisters to get Mom off this stuff. In the middle of the week during which I was stirring everyone up, I went to an annual appointment myself. My ob/gyn has an undergraduate degree in chemistry. So I brought up this subject to him, relating to him the content of the frightening articles I had read.

His advice? First of all, calm down. Then, if someone is under the care of a neuropsychiatrist, he/she is going to be all right. This kind of doctor is familiar with the exact dosages required for his/her patients, whatever their condition may be. The problem arises when poorly informed people distribute inaccurate amounts to various patients in nursing homes. Because the caregivers are trying to calm someone or even sedate him or her, they use this drug unwisely.

His conclusion is that when properly used by a competent and qualified person, there is nothing to worry about. My conclusion is, if Mom were in an ordinary nursing home (not specifically for Alzheimer’s patients), I would be very concerned. Since she is not in a home(she's at home), I am going with my doctor’s assurance that she is not in any danger from using the professionally prescribed amount at this point.

Turmeric Has Two R's

Yes, turmeric really has two r's, though many people misspell or mispronounce it. It is an inexpensive substitute for saffron. I just spent some of my Sunday afternoon reading about turmeric. The reason I felt the need to read about this common Indian spice is that someone recently mentioned that sprinkling it on our food is good for our brains. Suggesting its possible use for Alzheimer’s patients, the person seemed to think he could tell a difference in his mental acuity after only a few days.

After reading for a while, I decided to write to warn people that the old adage still stands: if it sounds too good to be true, it probably is. In other words, you should check with your doctor before consuming inordinate amounts of the stuff. I found lots of hopeful information and many “maybe’s.” Curcumin (the active ingredient in turmeric) has been used for thousands of years as a safe anti-inflammatory in a variety of ailments as part of Indian traditional medicine. A 2004UCLA-Veterans Affairs study involving genetically altered mice suggests that it might inhibit the accumulation of destructive beta amyloids in the brains of Alzheimer’s disease patients and also break up existing plaques.

A small study of Asian individuals between 60 years old and 93 years old found less cognitive disability in those who regularly ate foods containing turmeric. In other promising but very early results from laboratory, animal, and human studies, curcumin has kept several kinds of cancers from starting, growing, or spreading. When turmeric was given to laboratory animals with diabetes, both blood sugar levels and blood cholesterol levels showed general decreases.

Traditionally, turmeric has been taken orally as a remedy for bronchitis and other respiratory conditions. In one study, it was the most effective of 25 herbal products in killing H. pylori, the bacteria that causes stomach ulcers.

So, why the CAUTION? Because turmeric may not be well absorbed from the intestines, many animal and human studies have used injected forms of turmeric or chemicals derived from it to achieve effective blood levels of its active components. While they may be commercially available in other parts of the world, injectable forms of turmeric are not sold in the United States. That's the part that sends up a red flag for me.

Individuals with stomach or gallbladder conditions should not take supplemental turmeric, because it may alter production of stomach acid and increase production of bile, possibly worsening those conditions. Pregnant women should also avoid taking large amounts of turmeric due to the possibility of a miscarriage. And supplemental use is not recommended while breast-feeding.

Just thought I would throw out a few ideas for those who have heard about the use of turmeric. It may be good, but I believe in checking with the doctor first. The medical community is reluctant sometimes to grab on to new remedies (or old ones brought back around). But they usually have a great deal more information on hand than most of us. For example, Seroquel…well maybe we’ll talk about that tomorrow.

One Year Later...

I began chronicling this portion of our lives on June 24, 2007. Since that time, all of the physical causes for memory loss that the neuropsychiatrist mentioned have been ruled out. Whatever she asked Pop to do, medically, he did. And Mom’s health continues to be good (for an 83-year-old!). She actually seems to be in better health than Pop.

However, she has begun to shuffle her feet instead of walking normally. Evidently she has lost her sense of space. Most likely the dementing process has damaged the areas of the brain that control muscle movements. When a person begins to have difficulty walking, it is time to do an inspection to eliminate dangerous areas, such as: bathrooms where handrails are needed, scatter rugs that may slide when a person steps on them, and traffic patterns that become cluttered. (See pages 89-90 of The 36-Hour Day for a more detailed list of safety suggestions.) We are all on the lookout for areas concerning Mom’s safety.

One year after the first visit, Mom is on three medications, the antidepressant, Seroquel, and Depakote. The doses have been adjusted a time or two, but the three work well together. Her mood is stable most of the time, and sleeplessness has not been a problem. Sometimes she becomes quite confused in the late afternoon though. At these times Pop takes her for a ride around the neighborhood. Upon returning home, she appears to be more content and feels “at home.” The most important (and most difficult) aspect concerning the giving of medication is consistency. The more dependable the schedule for giving her her pills, the more predictable her behavior. And that, my friends, cannot be stressed too much!

One year later, the “no-driving” stipulation is in effect. Only occasionally does Mom mention something about driving her car, and that is usually when she has missed a dose of her medications. That is when her anger flares almost out of control. But she does not drive. (She thinks she does drive, most of the time.)

As far as their financial business, Pop is just as private as always. There was talk concerning who has his Power of Attorney and who has Mom’s. But the truth is, we don’t really know. At first, they had each other’s. He insisted he would take care of the matter, but no one has been informed about it if he has.

The home-health directive has not been followed the way Dr. Tee originally asked for it to be. She wanted Pop to have someone into the home three times a week to help with house-cleaning, cooking, or visiting with Mom. So far none of this has come to pass. He has had one lady come to clean. She was so thorough that he says he only needs her about once a year. Of course, if she had not been efficient, he would not want her back at all. I think they just don’t want “strangers” in their home. They (he, especially) would much prefer that the daughters make a schedule and take turns bringing them food and helping clean. For the record, they get this treat three times each week by the three who live closest to them.

Be an Advocate

I have copied this info from the national website of the Alzheimer’s Association:

On January 20, 2009 - just a little more than five months from now - a new President of the United States will take office.

No matter who you want to win the election, as supporters of the Alzheimer's Association, there is one thing on which we all agree: the next president must make the United States the world leader in Alzheimer’s care and research!

That's why, as part of our advocacy and awareness initiatives for World Alzheimer's Day, we're asking caring and compassionate individuals like you to sign the Alzheimer's Association Proclamation to the next President! Make your voice heard in support of more Alzheimer’s care and research!

We need at least 50,000 signatures to be delivered to the new president in January!

Inauguration Day may seem far away, but we don't have any time to waste. We need to build a constituency to gather 50,000 signatures and impress the new president!

Please sign the Proclamation to the Next President now. By clicking on the following link, you can fill in the info needed to add your name to the proclamation:

http://alz.kintera.org/proclamation

Wednesday, 8/20/08

Gloria called Channel 13 KERA to find out why we were unable to find the documentary listed for Sunday. They said that it will be aired on Wednesday, Aug 20, at 7pm for us.They also said that if we like it and want to purchase a copy of it, it will be available to purchase.