Where did I put my car keys? I know I had them an hour ago. Well, they're not in my purse. Good grief! I have to be to the school at three. I have to find those keys. Okay, brain, think this through... What did I do when I got back from the store? I came in the front door, put my purse on the coffee table, went out again to bring in the groceries, set them on the counter, started to put them away, and then went to check the messages on the answering machine. What did I do then? Oh yeah--I called Jane back, and then went to get the permission slip for Peter's field trip. I can't forget, I have to bring the ice cream sandwiches for that. Oh my gosh!! I left the keys on the counter with the ice cream. What a dingbat I am!
Sound familiar? If it doesn't, I want to trade brains with you, please. I can't tell you the number of times I've had to play the "retracing game" to find something, or remember what I did yesterday. Generally, I have a pretty good memory, but we live in a world with a heck of a lot of input, and sometimes it gets hard to keep everything straight--especially things we've done so often that specific incidents tend to blur together, like bringing in the groceries. Most of us develop little tricks to keep ourselves from forgetting the things we need to mentally track. I'm a committed list maker, and Ked and I picked up the habit early in our marriage of putting things we need to take out of the house later right by the front door, or with our keys, so we can't leave home without noticing them (unless, of course, we forget the keys.) Last week, when daylight saving time rolled around, we set our clocks on Saturday morning so that we wouldn't forget later that night and wind up late for church the next day. Our little tricks usually work, and we manage to get by in the world without too many major memory lapses.
Some things are harder. Ked's great with names and faces. I, on the other hand, have given up hope that I will remember the name of someone when I first meet them, no matter how many times I repeat it in that first conversation. I could repeat a name so often that the person I'm meeting thinks I have obsessive-compulsive disorder, and still draw a complete blank the next time I see them. This can be rather humiliating, especially if I've done the OCD imitation on the previous encounter. Ked's weakness is a definite need for shopping and "to do" lists. If it's not written down, he will not remember it. It's that simple. (This is one of the reasons that I'm a committed list maker.) On the other hand, he can hear a tune once, and whistle it note for note twenty years later, so I suspect he's just not wasting brain cells on trivial things that can be just as easily stored in a list. That's a simple matter of priorities.
With our various memory failings, we sometimes have talked about what would happen if one or both of us started losing more and more of our capacity to remember anything. This is a topic that's close to home for us. Just a couple weeks ago Ked helped his parents move his grandparents into a care facility, because of the increasing onset of dementia. His mom has cared for both her parents for many years, as her dad succumbed to Alzheimer's and her mom to another form of dementia, until eventually her dad no longer even recognizes the woman he married over sixty-five years ago. Both of them had reached a stage where Mom could no longer provide all the physical care they needed, and she reluctantly has had to let them go to a place where they can receive the additional care they need. It's been hard for the family to watch vibrant, engaging people lose more and more of themselves, as their memories slowly have faded away.
The signs were small at first, maybe losing those car keys more often. Then it became more of a problem when they could find the keys, because Pappaw would go driving and sometimes couldn't remember how to get home. Finally, Mom and Dad started to have to find creative ways to keep them out from behind the wheel at all, for their own safety, and that of others. More and more of Mom's time became devoted to chauffeuring her parents, and cooking for them and cleaning for them, and taking care of their medicines, and dressing them, and so on, as they became increasingly less able to do these things for themselves. It was an enormous commitment, and an act of daughterly love and devotion.
It was also a sobering reality. Alzheimer's has some hereditary connections, and when both parents, or grandparents, have severe memory failure, you can't see it daily, or even sporadically, without thinking about whether their fate will also be yours. No one, of course, really wants to dwell on it, and I discourage my husband's lamentations over his own memory lapses. Just because he forgot the milk doesn't mean he's going to lose himself. However, we can't but be aware of the topic, and we watch documentaries on the subject occasionally, and read what comes our way with interest. We're glad to see that they are making progress all the time in the study of the brain generally, and dementia specifically. It helps us face future possibilities when we can also see future understanding, treatments, and potential cures.
It will probably be a long while before the brain is a completely open book. There's not a computer so complex in all the world, but doctors and scientists are making constant strides in reading its pages, and as they read it more thoroughly, they are slowly starting to learn how to keep the brain from losing its storehouse of memories and information. The more they see into it, the more they can see exactly what is going on, and the more they see what is going on, they more they can learn how to repair the damage when it stops working properly.
We've seen such things throughout the history of medicine. Body systems that were once a complete mystery are now much more clearly understood, and thus treated. In centuries past, the most brilliant doctors of their times didn't have the necessary understanding of organ functions, or bacterial and viral infections, or drug interactions to treat the things which our doctors now see as routine. Cancer used to be an automatic death sentence. Now it would be difficult, if not impossible, to go through life without knowing many, many cancer survivors. In the future, things which baffle our medical practitioners of today will be the routine treatments of the next generation. In my husband's family, of course, we hope that dementia will be one of those breakthrough cases. It is too late for the grandparents we love, and all we can hope for at this point is that they will be comfortable and happy and well cared for, but research goes on, and we hope it will not be too late for their children's generation.
One promising advance in the fight against dementia is new technology being developed for early detection--before symptoms even give the alert that something is going wrong in the brain. Gizmag has an article titled "New 3D Imaging technology promises early detection of Alzheimer’s and Dementia" that has encouraging news about progress in researchers' efforts to see inside the working of the brain:
This is just one of the new technologies the article describes. Another is magnetic resonance spectroscopy, which "allows a non-contact x-ray view of biochemical processes within the regions of the brain under examination." Neurologists can read these images and distinguish between Alzheimer's and normal aging, or other, milder forms of cognitive impairment. These new technologies are opening up the secrets of the brain, and allowing doctors to diagnose more accurately, and observe whether the treatments they are developing are effective. This will make their research so much more efficient and fruitful. If they can see direct evidence of whether they're on the right paths, it will allow them to charge ahead on the ones with the most promise, and walk away more quickly from the dead ends. The article concludes on this positive statement:Increasingly higher-resolution imaging techniques making major contributions to early detection are now being presented at the European Congress of Radiology (ECR 2007), held in Vienna from March 9 to 13, 2007, and attended by some 16,000 participants from 92 countries. University Professor Dr. Daniela Prayer from the Clinical Department for Neuroradiology at the Vienna University of Medicine states, “Although we cannot yet depict individual cells, we can image ultra-tiny bundles of fibre with high resolution. That is a spectacular breakthrough!”
Voxel-based morphometry allows for the volume of grey matter and white matter in the brain to be determined to the nearest cubic millimetre. A reduction in brain mass (atrophy) in certain areas indicates Alzheimer’s disease and in other areas, other forms of dementia, according to Professor Prayer. An MR study by Professor Dr. Riccardo della Nave and his colleagues at the University of Florence, for instance, found that certain degenerative phenomena occurring in the left thalamus and in a zone in the left cerebral cortex are the first signs of family-related Alzheimer’s disease. “These findings are quite valuable. They enable us not only to differentiate precisely but also to detect the patterns of the disease before symptoms even occur and to check the efficacy of new drugs, namely, whether they can really stop the loss of brain mass.”
All in all, Professor Prayer notes, “the new methodological advances of magnetic resonance technology provide us with a hopeful view of the future in terms of the early diagnosis and efficacy testing of therapies for dementias. If this happens in the near future, the spectre of old-age dementia will lose much of its threatening effect.”That would be a blessing of indescribable magnitude for our family.
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