Understanding

Lately Gregory has been asking "What?" when I say or ask something.

Today I asked, "Is it because you don't hear me or that you don't understand me?

He replied, "Wow, I don't understand that one."

An Update

Dear Family and Friends, 

I turn 67 today. What must that feel like? I don't know for sure. I guess it is what it is. Also celebrating my mom's passing two years ago today. My dad's passing seven years ago earlier this month. Ah, mortality!

Briefly, this trip has been difficult but I (we) are surviving it. G has been quite disoriented, further loss of language, more trouble naming things, getting dressed, loosing things, managing eating meals, etc. I have been on duty 24/7 so it has been very difficult for me ... he is having a great time:-) Most of the things he was able to do independently at home are no longer working. Hopefully some of them will come back when we are home. 

Meanwhile, we enjoyed TX with family and friends and now MX. Long leisurely days. G has been drawing with colored pencils. We both have been reading alot. Have been to all our favorite MX restaurants, shops, beach, etc. Taking naps, sleeping in, up late.

Been at the beach half a dozen time with one more scheduled. Found a great hotel (The Tropicana) to "rent" our chairs from this time around. 140 pesos ($11.00 US) gets each of us a lounge chair and shared table under a Palapa (palm woven umbrella) on the beach, towels, the use of their huge pool and any available chair at the pool, a shower or foot bath to clean off the sand. The rental fee also entitles you to 100 pesos ($7.86) worth of food: a drink and we each have been getting a club sandwich for lunch. And you can stay all day until 8:00 at night and watch the sun go down. 

Some nights we walk the Malecon (Boardwalk) and people watch, enjoy entertainment, listen to music, stop in a few stores. In our local neighborhood we have gone several times to a coffee shop to end the evening with a Cafe Latte and Tres Leches Cake. 

We walk down the mountain from the guest house but take the 50 pesos (($3.90) taxi ride up. Every day at 5:00 we have coffee and a Pan Dulce (Sweet Roll) that we purchase from the local Panadería (Bread Shop.) We usually do one thing a day. For example if we go to the beach during the day, we stay up at night. If we go out to dinner and the Malecòn afterwards, we stay up during the day.

Its been fun visiting with Susan and David, the guest house owners, and after 10 years or so have become friends. Several times we have watched sunset over a Margarita on their terrace. Tonight for my birthday they are making diner (Tuna on the grill) and got a Tres Leches Cake for my birthday (my favorite: a white cake made with two kinds of milk and also soaked in a third kind and a touch of rum. It is frosted with butter cream and a mosaic of thinly sliced fruit.)

We have made great use of my iPad and have watched streamed movies every night we have stayed up on the mountain. I have also downloaded a number of books so I guess that I have successfully made the leap to e-books although will never give up holding a real book in my hand.

One day until we come home. Will be nice to TRY to get back to routine and to our own bed, kitchen, neighborhood, etc. Not sure if this will be the last time we are able to travel but not ready to think about that yet. Need to think about a new kitty (Mariah died in February) and I always need to play with the possibility of also getting a dog.

Anyway all for now. Will be in touch when we are home and settled in. 

Lots of love,

We appreciate having you be part of our life,

Michael & Gregory

Experiences

We don't discuss our experiences anymore
We just share them.

The Suggestion

Don't remember the exact interaction but I do remember having to quiet myself, take a breath and figure out how to respond.

"It could be worse!" he suggested.

I was able to breath again and we continued our interaction.

Marbles Anyone

Forgetting the name of an actor, after accumulating 60+ years of facts and figures in one's mind, should only be the worst of Alzheimer's/ Dementia Disease. However, I like that Mr. Reardon ends the article with: "Maybe I should be thankful to the threat of Alzheimer's. It reminds me to live life as fully as I can. Or, as Gwendolyn Brooks writes, "conduct your blooming in the noise and the whip of the whirlwind."

(Tribune illustration by Mike Miner / March 10, 2012

http://www.chicagotribune.com/news/opinion/ct-perspec-0311-alzheimers-20120311,0,6707658.story

Holding Hands

Like petals of a tightly closed rose
Like butter spread on warm toast
Like a kitten closely snuggled in your arm
Holding my honey's hand makes me happy so.

Today

“What day is it,?" asked Pooh.
"It's today," squeaked Piglet.
"My favorite day," said Pooh.”

Or maybe ...

Was his anger part of the changes that Alzheimer's brings or maybe we just had an argument. Couples argue you know. I hadn't thought of that for a while since I try to be so careful in my interactions with Gregory, usually taking most of the responsibility for keeping our life even and feeling the failure when they go awry. But sometimes a good "fight" is what every successful couple needs. Alzheimer's or not! Just thinking.

Frontal Lobe Dementia

Taken from depression-guide.com this information about Frontal Lobe Dementia seems to describe what I have seen Gregory experiencing rather than the typical Alzheimer's symptoms. I have mentioned this previously but wanted to do so again.

Frontal lobe dementia is the name given to any dementia caused by damage to this part of the brain. It includes Pick's Disease but can also be caused by other diseases. They all have similar symptoms and prognoses.


Pick's Disease (Frontotemporal lobar degeneration)


A progressive dementia occurring in middle life characterised by slowly developing changes in character and social behaviour, or impairment of language, due to degeneration of the frontal and temporal lobes of the brain.
Some dementias, however, do not follow this pattern. Vascular dementias have recently been characterized by specific diagnostic criteria. They can be summarized by sudden onset of dementia and step-wise progression with focal neurological findings and positive brain imaging. Lewy body dementia is characterized by early appearance of symptoms in the course of dementia, accompanied by progression and hallucinations. Primary progressive aphasia includes early dissolution of speech in an otherwise cognitively intact individual. They can become globally aphasic in spite of being able to continue to run a household or even work. Eventually 20% per year progress to dementia, which appears similar in the advanced states to Alzheimer's disease.

Frontal lobe dementias are characterized by early psychiatric symptoms followed later by cognitive impairments. Frontal lobe syndrome is therefore the presenting symptomatology: apathy, poor social judgment, and bizarre behavior. Histologically, the frontal lobe dementias are proven to be characterized by Pick's cells (Pick's disease). At the present time, these diverse histological types are clinically indistinguishable.

Symptoms of Frontal Lobe (aka Frontotemporal) Dementia:

• Impairments in social skills
  - inappropriate or bizarre social behavior (e.g., eating with one's fingers in public, doing sit-ups in a public restroom, being overly familiar with strangers)
  - "loosening" of normal social restraints (e.g., using obscene language or making inappropriate sexual remarks)
• Change in activity level
  - apathy, withdrawal, loss of interest, lack of motivation, and initiative which may appear to be depression but the patient does not experience sad feelings.
  - in some instances there is an increase in purposeless activity (e.g., pacing, constant cleaning) or agitation.
• Decreased Judgment
  - impairments in financial decision- making (e.g., impulsive spending)
  - difficulty recognizing consequences of behavior
  - lack of appreciation for threats to safety (e.g., inviting strangers into home)
• Changes in personal habits
  - lack of concern over personal appearance
  - irresponsibility
  - compulsiveness (need to carry out repeated actions that are inappropriate or not relevant to the situation at hand.
• Alterations in personality and mood
  - increased irritability, decreased ability to tolerate frustration
• Changes is one's customary emotional responsiveness
  - a lack of sympathy or compassion in someone who was typically responsive to others' distress
  - heightened emotionality in someone who was typically less emotionally responsive

Persons with this form of dementia may look like they have problems in almost all areas of mental function. This is because all mental activity requires attention, concentration and the ability to organize information, all of which are impaired in frontal lobe dementia. Careful testing, however, usually shows that most of the problems stem from a lack of persistence and increased inertia.


What are the differences between Pick's disease and Alzheimer's disease?
The main difference between Pick's disease and Alzheimer's disease is that the damage occurs in different areas of the brain, at least in the early stages. In most cases of Pick's disease, the frontal and temporal lobes of the brain are the areas affected and with Alzheimer's disease, the temporal and parietal lobes are affected.

Who gets frontal lobe dementia?

Frontal lobe dementia, including Pick's disease, can affect both men and women. Although it can affect people at any age, it usually begins between 40 to 65 years of age.

Duration and Treatment of Frontal Lobe Dementia - FLD

The length of FTD varies, with some patients declining rapidly over two to three years and others showing only minimal changes over a decade. Studies have shown persons with FTD to live with the disease an average of eight years, with a range from three years to 17 years.


No medications are known currently to treat or prevent FTD. Serotonin-boosting medications may alleviate some behaviors.

Facts and Tips about Frontal Lobe dementia

• Frontal lobe dementia is the form of dementia. It is degenerative disease which mainly affects frontal lobe of the brain.
• Change in personality, loss of language skills, ability to carry out difficult tasks are other features of frontal lobe dementia.
• Clinically, Pick disease may be identical or very similar to frontal lobe degeneration. 
• Persons having age between 40 to 65 years are mostly affected by frontal lobe dementia.
• Frontal lobe dementia causes slow decline in behavior and judgment. 
• Symptoms of frontal lobe dementia are very similar to vascular dementia and only brain image can make a distinction between them.