The following is contributed by Bruce Haglund.
A wise man from Germany, now living in Salt Lake City, reminded us in an article in the January 2014 Ensign of an old proverb:
“The best time to plant a tree is 20 years ago. The second-best time is now.”
How does this proverb apply to Alzheimer’s disease prevention?
Research by neuroscientists has demonstrated that the changes in the brain and body resulting in an Alzheimer’s disease diagnosis begin to occur up to 20 years before symptoms are noticeable to the person afflicted. Research has shown this applies for early-onset Alzheimer’s as well as the more common late-onset form of Alzheimer’s.
If changes in the brain resulting in Alzheimer’s begin 20 years before symptoms present, when is the best time to begin efforts to prevent Alzheimer’s disease?
The answer: 20 years ago, but the second-best time to begin is now!
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There is no cure for Alzheimer’s disease and no meaningful treatment, so taking steps now – at whatever your age – to prevent the onset of Alzheimer’s and ameliorate the risk of Alzheimer’s is imperative.
If you’re asymptomatic now, how do you know if that 20-year clock is already ticking for you?
Can anything be done to prevent the onset of Alzheimer’s?
When you have 15 minutes to consider the questions I’ve asked, listen to this TED Talk by Lisa Genova, the author of “Still Alice,” a novel about a woman who suffers from early onset Alzheimer’s, as my wife did:
I believe it’s urgent for everyone to take steps now to lessen the risk of being diagnosed with Alzheimer’s and why I double dose Cardio Miracle, each morning and each afternoon, as a vital part of my regimen to avoid this dreaded disease. You’ll know why if you permit me to share a 10-year segment of our family history and some of what I’ve learned about Alzheimer’s.
My Wife’s 10-Year Battle
My wife, Buffy, was an avid reader. She read “Still Alice” shortly after it was published in 2007, but we had no thoughts that Buffy’s life would begin to mirror Alice’s life in just a few more months.
Until late 2008, Buffy and I rarely thought about Alzheimer’s disease. We had no family history of the disease, we didn’t know anyone who had Alzheimer’s, and we knew little about it. That changed all too quickly – in such profound and challenging ways that tears run down my face as I write about our experience.
When Buffy took our youngest son to a routine appointment with our family doctor in the fall of 2008, Dr. Oldroyd noticed something in Buffy’s gait that prompted her to ask Buffy to perform some simple tasks. “Close your eyes and touch your nose with your index finger.” How hard can that be? Buffy missed her nose by an inch, touching her finger to her cheek. “Buffy, can you draw a circle inside a triangle?” Again, a simple task for you and me, but Buffy’s attempt looked like the scribbling of a five-year old child. After a few additional tests, Dr. Oldroyd thought Buffy was manifesting stroke-like symptoms and phoned Dr. Di Stefano, a neurologist, to arrange an appointment for Buffy as soon as possible.
Filled with trepidation about what was happening to her and because of Dr. Oldroyd’s suspicion of a minor stroke, Buffy began some research and read “My Stroke of Insight: A Brain Scientist’s Personal Journey” by Dr. Jill Bolte Taylor to try to learn what might be wrong with her brain.
Our world changed with the first consultation with Dr. Di Stefano on November 20, 2008. Dr. Di Stefano concluded on clinical grounds and his review of her MRI and PET scan that Buffy’s progressive deterioration strongly suggested an atypical, early onset Alzheimer’s-type dementia. Buffy was just 55 years old. The diagnosis rocked us to our core, and we dreaded the unknowable future that we were now forced to face.
Looking back on the previous year, we then understood why she had been getting confused and even lost driving to familiar places in Irvine where we’d lived for 30 years. We then realized it was more than simple forgetfulness when she forgot to put flour in the cookie dough before putting the cookies in the lower oven when she had turned on the upper oven. We then realized that we missed the signs that pointed to Alzheimer’s.
The silver lining of that initial consultation was the beginning of a 10-year, deep, trusting friendship with the doctor who would be our guide through the Alzheimer’s maze we hoped to escape. Dr. D and Buffy were about the same age, were both raised in Pasadena, and had many common life experiences that instantly bonded them. So deep was Dr. D’s interest in Buffy that he offered to make a position available for Buffy on his staff. Although her decline was too steep for her to work in his office, Buffy felt so complimented to think that Dr. D thought well enough of her to consider the possibility.
On the drive to the doctor’s office in Newport Beach each month, after transitioning from the 405 freeway past John Wayne Airport to the 55 freeway, Buffy would ask:
“What day is it?”
“What month is it?”
“What are those three words he’s going to ask me to remember?”
She knew there was going to be test – the mini-mental state exam administered at the beginning of each appointment to give Dr. D a quick read on how the signs of dementia were affecting her that day. She knew the questions, too, but she had no idea what the answers were.
I’d respond with a smile, “There’s no cramming for this test!” She’d ask, “Why do you have such a good memory?” I’d respond, “So when you add my memory to yours and divide by two, we’ll have an average memory per capita.”
As strange as it might seem because of the serious circumstances of our visits, there was never an appointment with Dr. Di Stefano that we didn’t look forward to and enjoy. Often, after leaving his office, Buffy would suggest that we invite Dr. D to have dinner with us. She appreciated his medical care and the personal connection. Each month, we knew as we watched Dr. D hurry to his next appointment after finishing with us that he had again given us his undivided attention and more than our allotted time.
As with most Alzheimer’s patients, Dr. Di Stefano prescribed the two types of medications the FDA has approved to treat the cognitive symptoms of Alzheimer’s disease (memory loss, confusion, and problems with thinking and reasoning); however, the medical literature acknowledges that these drugs cannot cure Alzheimer’s or stop it from progressing.
As Buffy and I learned, none of the medications available today for Alzheimer’s dementia slows or stops the damage and destruction of neurons that cause Alzheimer’s symptoms and make the disease ultimately fatal. One expert even refers to the prescription of these drugs as a ruse. The drugs are taken with the hope that the cognitive decline is slowed; the medications are taken on faith because there is no way to measure their efficacy.
We sought more answers, so Dr. Di Stefano engaged doctors at UCLA Medical Center to conduct another MRI and PET scan. The experts at UCLA diagnosed Buffy with dementia with Lewy bodies – the second most common type of progressive dementia that, in addition to dementia, offers the unwanted bonus of hallucinations and dreams acted out while sleeping. That was a prospect we feared.
No one wants to accept a diagnosis for which there is no cure and no effective treatment. Because of the differing diagnoses of Dr. D and UCLA, we sought a third opinion from the University of California – Irvine’s Mental Impairment and Neurological Disorders (MIND) Clinic. Buffy endured exhaustive cognitive testing for two days and was depressed to see the clear cognitive deficits in the test results. The neurologist at the UCI MIND Clinic concluded Buffy suffered from Hashimoto’s encephalopathy, another disease with brain impairment, but not dementia. Dr. Di Stefano strenuously disagreed with this diagnosis, but because Hashimoto’s encephalopathy responds to corticosteroid therapy, when there is no cure for Alzheimer’s or Lewy body dementia, we felt we had to try that course of treatment. We were hopeful as we discussed next steps with the MIND Clinic’s staff.
It turned out we were hoping against hope. This course of treatment turned out to be a detour of several months, filled with a dramatic, negative, manic response to the drugs prescribed. On a flight to Hawaii in 2012 to celebrate her birthday, Buffy talked energetically, non-stop the entire way about the book she was going to write about her “Strokes of Insight” during the previous few years. Buffy felt filled with personal insights on the insidious nature of progressive dementia and needed my help in writing her book since she had lost the ability to use the computer. Even though she had lost the ability to read – she couldn’t find her way from the end of the line on the right to the left side of the next line – she was determined to write a book that others would read to help them in their battles with dementia-related diseases. Her only complaint in 10 years was: “I’m so frustrated I can’t read.”
We were willing to try anything, so we also subjected Buffy to repetitive Transcranial Magnetic Stimulation (“rTMS”) therapy, an experimental treatment I learned about that had been tried with some Alzheimer’s patients. After a few sessions, the doctors felt Buffy was showing some signs of improvement and encouraged us to continue the treatments for an unspecified, but extended period. Buffy felt no changes or improvement (it didn’t help her with her reading struggles) and the treatment was going to cost thousands of dollars with no guarantee of improvement – just endless sessions of being hooked up to a machine using magnetic fields to produce small electrical currents in her brain that in some mysterious way might help.
As we discussed more rTMS therapy Buffy said, “I’d rather spend the money on a trip to Europe.” Buffy liked nothing better than travel to new places, and the top item of her bucket list was seeing all of the Johannes Vermeer paintings at museums scattered across Europe.
She’d already seen all of Vermeer’s paintings in U.S. museums, so together we planned a three-week itinerary for a vacation to check off the 22 Vermeer paintings housed in European museums. Like Alice in “Still Alice,” Buffy was still true to her travel-loving self and even in her compromised state was up for an adventure. That she was “still Buffy” was something I recognized and appreciated every day, but also began to mourn as her cognitive decline progressed inch by inch, day after day over, year after year.
One of the hallmarks of Buffy’s personality was her independent, preternaturally cheerful, can-do spirit. The loss of her independence – the ability to drive herself, fix our meals, help others, and go on walks without help – was hard for her to accept. One Sunday, driving to church after she had lost the ability to walk on her own and had a hard time sitting up straight without help, I suggested that we use the wheelchair that day. Buffy said fiercely, “If you think I’m going to church in a wheelchair you can turn the car around and take me home right now.” It was a struggle as walked side by side into the church, but we made it. Still Buffy, even though my suggestion was not greeted with her normal cheer!
Still trying to navigate the dementia maze with hopes of a better outcome, we sought yet another opinion at the University of Utah’s Center for Alzheimer’s Care, Imaging and Research. After reviewing Dr. Di Stefano’s notes, all of the prior imaging reports, and the UCI cognitive test results, Dr. Norman Foster and his team at the University of Utah confirmed the initial diagnosis: early onset, atypical Alzheimer’s disease. We were too numb to be devastated again.
The Utah doctors gave Buffy a simple prescription of things to do each day: (1) exercise – she was to walk as far she could each day, (2) socialize with others, spending time with family and friends, and (3) stimulate her brain. Sadly, Buffy was already unable to do the kind of brain-stimulating exercises people often do, like jigsaw or crossword puzzles. At this point in her decline Buffy was happiest sitting with friends, listening to her favorite music, and repeatedly watching every Rick Steve’s Europe travel show. I learned to navigate Nærøyfjord in western Norway like a native.
Each person’s battle is different depending on the part of the brain affected. Buffy lost visual-spatial orientation skills in the first years of her decline; she lost her long-term memory five years into the battle. At the airport on our last trip together she said, “Do you think we’ll ever get to go to Europe together?” Our several trips to Europe were some of the best times of our life together, but they were no longer part of her recall. There is no predicting the trajectory of the decline or the particular challenges patients will face. As we heard when comparing notes with a close family friend whose wife was also afflicted with Alzheimer’s, “When you’ve seen one Alzheimer’s case…you’ve only seen one Alzheimer’s case.”
The Challenge of Buffy’s Last Three Months
Although Buffy was the one afflicted, caring for her during her 10-year battle with Alzheimer’s was a joint exercise as her decline progressed from one plateau to another in her abilities to care for herself. Our five children and I were determined that Buffy would never see the inside of an assisted living facility, so I tried to balance work at home with 24/7 caregiving. Events like the arrival of grandchildren, holiday celebrations, and what little travel we could manage were filled with joy, but always tempered with what we knew we wouldn’t be able to experience in the future we’d dreamed of and planned for together since our marriage in 1976.
Caregiving is stressful work, but it’s not without its rewards. As hard as it was, it was a service I was privileged to provide to the woman I fell in love with as a college student. Her core character traits – Buffy was guileless, patient, cheerful, kind, forgiving, fun, and loving – were manifest daily and motivated me to be a better husband and caregiver. As difficult moments became more frequent, I remembered what our oldest son said to me in the early stages of the battle: “Dad, just imagine what Mom would do if the shoe were on the other foot.”
In early April 2018, our youngest son quit his job in Utah to join me in California to help care for his mother. Just two weeks later Buffy began hospice care at home, which meant a twice-weekly visit from Patty, who would gently bathe and dress Buffy, and a weekly visit from Andrea, Buffy’s attentive nurse and my trainer. Andrea scheduled her visits for her last appointment of the week so she could stay longer with us and help me learn how best to care for Buffy at this stage.
Alzheimer’s patients lose the ability to swallow, and the inability to eat both hastens and portends the end. For the last 10 days of her life Buffy was on a regimen consisting only of morphine, an anti-anxiety medication, and water sponged onto her lips because she’d lost the ability to swallow. She was so restricted in her movement that she couldn’t even willfully wink. Thankfully, as our family members entered our bedroom to visit, she always knew who they were and strained to express her love for them over and over and over again. She never failed to tell her friends who visited and Patty and Andrea, our hospice caregivers, that she loved them. As Andrea left our home the evening of June 29, 2018 she said, “I think this will be my last visit, and I’m going to miss hearing ‘I love you!’ from Buffy.” After Andrea left, Buffy and I spent a peaceful evening listening to her favorite music.
One of the overwhelming emotions we shared in the final weeks of her life was intense, heartfelt gratitude for the care and concern for her, me, and our family that was so evident from the great people that shared our lives. During the last five years of Buffy’s life, she had a visit every day from one of her Irvine friends. Friends and family from out of town came to stay with us for days to help me provide the sociality that Dr. Foster prescribed.
Of course, our children and grandchildren regularly visited during the 10-year battle to take their mom on walks around the lake near our home and along the Heisler Park bluffs overlooking Buffy’s favorite spot in Laguna Beach. When they took Buffy for a drive along Pacific Coast Highway between Laguna and Corona del Mar, they would stop at the landmark old shack above Crystal Cove for a mint chocolate chip shake. As Buffy would struggle to walk down the stairs in our home, our young granddaughters would cheer her on: “Come on, Dama – you can do it! Good job, Dama!” Our family was a support, comfort, and joy in ways that I can’t adequately express, but you can see in this photo, taken just a few months before her death, the joy Buffy still was experiencing.
I awakened early on June 30th knowing this would be our final day together. Surrounded by our children and grandchildren, Buffy slipped quietly away in the early afternoon as Dvořák’s “Songs My Mother Taught Me” was playing softly in the background as Buffy taught her children a final lesson about death with dignity.
That evening I sent Dr. Di Stefano a quick e-mail about Buffy’s passing. He responded with this note:
Dear Bruce:
Your e-mail deeply touched me. I firmly believe that connecting with certain patients and family is an important element in effectively treating them, and in guiding them through the journey on which their disease takes them. For me and many doctors it is like receiving a bonus when anyone takes the time to express how much they valued our care, and the good feelings are intensified when one does it as eloquently as you do. Thank you very much for having shared all of that, especially while you have been saddled with so much responsibility as well as sadness regarding Buffy’s condition.
Those pictures that you sent are a wonderful gift as well. Buffy is beautiful and the photos show a glow from within which is reassuring that there were plenty of happiness, joy and good times in her life, the best of it with you and your children, I am sure.
You and Buffy will never leave my mind. I view you as her hero and I sensed all along that she felt that about you as well. You handled everything about as perfectly as anyone can. Knowing that will always bring you some comfort, and probably your whole family as well.
You have my sincere wishes for you to get through this transition with all the faith, fortitude and grace that you have always shown.
Best regards,
Dale
Remembering Her Farewell
Buffy was “still Buffy” to her last breath. On the first anniversary of her passing I wrote this poem to describe Buffy’s final moments of mortality:
A year ago, she bid farewell
With a smile and just one tear,
Her body then an empty shell,
But her spirit strong…and near.
The soul that we all loved and knew,
That evidenced no guile,
Mouthed a silent “I love you,”
And she managed one last smile.
We hugged and cried together,
Knelt in thankful family prayer
For the wife, mom, and grandmother
Whose life we were blessed to share.
At the finish of her mortal race,
After a ten-year valiant fight,
She still displayed the peace and grace
That made our home so bright.
Her memories and her vitality,
That Alzheimer’s cruelly stole
When it masked her true personality,
Are now restored…and whole!
The Good News!
She’s still Buffy – now more than ever!
Take Action Now
“The best time to plant a tree is 20 years ago. The second-best time is now.”
When I read those lines in the Ensign in 2014, I immediately thought of the 20-year horizon in the development of Alzheimer’s symptoms.
Cardio Miracle wasn’t available 20 years ago, but I began my Cardio Miracle regimen when it was first introduced in 2014 – and I’m grateful to John Hewlett, Cardio Miracle’s founder, for getting me started.
In 2007, I was diagnosed with stage IV non-Hodgkins lymphoma. In 2008, just months before my wife’s diagnosis, I was also diagnosed with a rare condition for which less than 300 cases have been reported in the medical literature. During the most stressful period of my life as I cared for my wife and attended to my own ongoing health challenges, I experienced – and continue to experience – Cardio Miracle’s beneficial and energizing effects every day.
The right side of my brain tells me I should have a sense of urgency in supplementing with nitric oxide-boosting Cardio Miracle because:
- Research has shown that the caregiving spouse of an Alzheimer’s patient faces a 600% increased risk of developing Alzheimer’s because of shared risk factors and the stress of caregiving.
- Research at a world-renowned Midwestern medical institution examined the link between nitric oxide production and Alzheimer’s disease and concluded that maintaining nitric oxide levels at optimal levels may be a beneficial strategy for preventing the onset of Alzheimer’s disease. While the causes of Alzheimer’s disease remain unknown and there is still no known cure, there are actions you can take to reduce your risk of an Alzheimer’s disease diagnosis.
- Research results published in the Journal of Neuroinflammation demonstrate that in Alzheimer’s disease, the endothelial cells – the lining of the inner walls of the vascular system in the brain and where nitric oxide is naturally produced – are inflamed. Increased nitric oxide supports the health of the brain’s 400 miles of arteries, blood vessels, and capillaries.
Taking Cardio Miracle to supplement my nitric oxide production and support better overall health is a vital part of my plan for aging well.
Buffy’s doctor at the University of Utah said, “What is good for the heart is good for the brain. Do the things that are good for the heart — diabetes management, blood pressure control, exercise — and you help the brain, too. They are good for trying to reduce the risk of Alzheimer’s disease.” I’ve experienced the cardiovascular benefits of Cardio Miracle evidenced by the return to normal blood pressure I experienced during those stressful years of caregiving.
Don’t look back 20 years and wish you’d taken steps then to mitigate the potential effects of a disease as devastating as Alzheimer’s – take action now. Follow Dr. Foster’s advice: exercise, socialize, and stimulate your brain. Follow the advice of the National Institute on Aging that includes following a heart-healthy diet. And let Cardio Miracle support you as you live your own life to the fullest and care for your loved ones in sickness and health.
If you’re already taking Cardio Miracle, keep taking it! Don’t wait to be prescribed the medications that didn’t seem to do anything for Buffy.
If you’re not taking Cardio Miracle, start immediately – plant that tree! That 20-year clock is ticking for many of us; we just don’t know who until it may be too late to arrest the decline through improved blood and oxygen flow to the brain. To give me better odds of not having to cope with Alzheimer’s disease myself or burden my children with the caregiving challenges I experienced for 10 years, I’m double dosing daily with Cardio Miracle, and I urge you to begin each day with Cardio Miracle.
Dr. Leo Galland, an internist and author of numerous books on healing, advises everyone to make lifestyle changes to prevent Alzheimer’s disease. “Today is the day,” he said.
You can learn more about Cardio Miracle at:
