Those Who KenKen, Do

I have a healthy fear of my potential for an unhealthy brain.  For all the improvements modern medicine has made in the last century, though, there is not much to be done on my part to allay my fears.  In the case of the Alzheimer’s disease I stand to inherit from my mother, I think breakthroughs are on the horizon.  For now, though, even the best advice the medical community can give leaves me a little discouraged.

I am told to maintain good cardio-vascular health.  Yup.  Fine.  And what good will that do me?

It will prevent the forms of dementia resulting from an oxygen starved brain.

Will it do anything for the kind of dementia to which I am genetically pre-disposed?

Nope.

I get advice to eat healthfully, get plenty of sleep, and limit stress, alcohol intake and blows to the head.  I don’t want to dismiss what is obviously a set of reasonable guidelines for better overall health, but, truth be told, I was looking a little more of an edge.

As a last resort, it seems, there is a well-meaning segment who suggests that I do the crossword puzzle to stave off Alzheimer’s disease.  If asked, I will say those folks are full of baloney.  In my mind, this is the medical equivalent of treating bullet wound to the belly with a shot of whiskey and a dirty rag.  The whiskey might dull the pain and the rag will keep the blood off of the settee, but, for all your efforts, you’ve done nothing to fix the problem.

The crossword advice, like the whiskey and rags, just masks the symptoms.  It doesn’t untangle the plaques.

Throwing caution to the wind, I have embarked on a different path.  Deciding not to mask my symptoms with crossword puzzle wizardry, I have decided to take a different approach.  This morning I tried my hand at the KenKen puzzles that the paper offers.  At first glance, one might think this is right up my alley; number games…math…logic…

Ahh, but that is where you would be wrong.

Instead of gently stimulating your brain and subtly rebuilding alternate neuro-pathways around less effective synapses like crossword puzzling might do, KenKen highlights the severity of your memory loss, punishes you for every minor lapse in concentration, and leaves you reeling from the startling horror of hearing your internal monologue stutter through the list of number combinations to get two numbers between 1 and 6 to add up to 11.

After just a few minutes of “well these two blocks are either a 1 and 4, or a 2 and a 5, unless, of course, it’s a 4 and a 1, or a 5 and a 2, which works if these other three blocks are mostly odd, but only if there is a 6 in the corner, which means that the bottom right is a 1, 3, or 5, but then I can’t use the 5 or the 1 for the first two blocks” I found myself praying that the plaques in my brain were already forming.  That way, I supposed, there would be something, at least, holding my grey matter together.

There is the old phrase “those who can, do”.  For my first efforts, though, I have to say I KenKen not…

The Other Waiting Room

One of my New Year’s resolutions was to catch up on the doctor’s appointments that I have neglected over the last 4 or 5 years.  There’s a bunch of them…

Ack.

One of the downsides of actually going to the doctor is, of course, the risk that they will ruin your perfect health with their silly questions.  It’s rather like looking at my balloon-headed beast with her allergic reaction to some bite or another, suddenly I began to itch.

Does this hurt?

Well…now that I think about it.

And your asthma?

Hmmm…wheez…It’s fine.

How long have you had that lump?

Huh?

So, today I had to have my mammogram redone and a follow-up ultrasound, just to be sure.  I am fine.  All is well so no need to worry.

Frankly, I wasn’t all that worried going in.  Maybe I was being naive, but I just knew that it wasn’t an issue.

Once I was sitting and waiting, though, my anxiety level started to rise.  You see when you have a diagnostic appointment rather than a routine check up, you wait in a different room.

Both waiting areas are similarly equipped.  Both have herbal tea or ice water available.  Both have a lovely selection of magazines and calming music being piped in softly.  While the views vary slightly from one end of the building to another, both have windows letting in the sunshine.

Both waiting rooms also have gas fireplaces, although, in the larger room for those waiting for annual screening appointments, it was off the last time I was in, despite the chill of February.  Today, on the other side of the building despite nearly 80 degree outside temps, the fireplace was blasting away.  What’s more telling I suppose, is that several woman huddled nearby.

That wasn’t the only telling difference.

While the on other side most people are respectful of the serene environment, they are, in general, cheerful.  There are occasional giggles.  People chat.

There are no giggles on the diagnostic side.

My fellow waiters, if not definitively sick, have real symptoms; a reason other than the calendar for being where they are, and for many of them a growing familiarity with this room.  And in that room is a respectful, somber, anxious silence.

With luck I will never go back to that side of the building.  For the many women who will, I am offering up a silent prayer.

The Burden of Proof

Years ago I found myself reading Erich Segal’s novel, Doctors.  It is the story of two students on their way to getting their medical degrees.  One of the early chapters opens with their very first lecture in medical school, in which the fictional professor prefaces his lecture by writing a number on the chalkboard.  The professor goes on to explain that of all the known human ailments, that number represents the number for which modern medicine has cures.

The number was something like 28 or 29.

I found that humbling.

I was, once again, reminded that I was going to die.  Not anytime soon, I hope, but inevitably….

Recent years have brought about a growing body of knowledge on Alzheimer’s disease.  Last Summer seemed to be brimming with news about successes in identifying proteins in cerebro-spinal fluid, accessible with a spinal tap, that mark the presence of Alzheimer’s plaques in the brain.  Just before that I remember reading that researchers had finally found a way to image plaques within the brain.  Finally developing a radioactive dye that will attach to those synapse twisters, PET scanners can be used to not only confirm a diagnosis and monitor the progress of the disease but also to measure the effectiveness (or lack of effectiveness) of treatments.

All of this is hopeful news indeed, especially for those of us at higher risk of developing Alzheimer’s disease.

It is, however, in this stage between identifying the disease and learning how to manage or cure it, posing a dilemma for the medical profession.  In an article in today’s NYTimes, Gina Kolata writes of the ethics of telling a patient news that is, in the words of Dr. Lawrence Honig of Columbia University, “psychologically invasive”.  Now that there can be proof of the diagnosis, is it too much of a burden to be bourne by those who have yet to feel the effects?

It is, of course, a deeply personal question?  I, for one, believe I would like to know.

What to do with that information then is the harder question…