Tuesday, June 29, 2010

Lack of reality leads to a reality check

Over the last few weeks have had these thoughts that if my father (dad has dementia/alzheimers) passed away before my mother that we might be able to bring my mother home to live with us, finish out our basement, etc. I understand that this is just the hope-full part of me that wants to hang on to some thought of renewal or future. But then reality of my mother's condition hits me square in the face. We attempted to take my mother out to eat with all of her grandchildren this past week. The plan was to take her out of the memory care facility, go to lunch, come back and then visit with my dad. But, my mother threw a fit, and could not understand why we could not also take my dad. I told my mom that we could not because of his dementia/behavior. She then flatly denied that my father had dementia or alzheimers. Mom basically has lost touch with reality. The LCSW that works with us has been telling me all along that mom's reality checking or degree of reality contact is just not there. Unfortunately it is true. That combined with her history of RX drug addiction, personality issues, depression and anxiety, will most likely make it impossible for her to ever live alone again. It's just a sad reality. My mother might not have dementia but in many ways she is just as sick as my father.

So, that is the story of how my mother (who I love so) has lost touch with reality and at the same time given her son a reality check.


Anonymous said...

Aloha Mr.Sivak,
I read most of your blogs and wanted to inform you about what my sister has done for my mom, who has the dreaded A.D.affliction. My mother in-law died at our home from it at 80yrs. old, suffering from the disease for about 3 years.She had lost her memory to even eat and just withered away in her bed.We did everything we could to help her,but trusted the doctors and ourselves to attend to all her needs.Not knowing how to really help her because she was not able to speak,so we had no way to communicate to her about her needs. Eventually she passed away. From that experience we learned how A.D. ravages the victims mind and body functions.So when my mom started to get the early dimentia type symptoms which gradually started to advance to early stages of A. D..So I told my sister who lives with my Mom and cares for her, about what to expect from this horrible disease.I continually called her to ask about how my mom was doing and of course it was the usual bad news. Some days she was calm,some days she was agitated and would yell and scream at everyone including all the grandchildren.She would soil her clothes,remove her clothes at times and needed to be fed after a while because she wouldn't eat on her own.Her appearance was just like someone who had once been full of energy at one time to someone who looked totally out of it,with no enthusiasm or glimmer of hope to see or care about what happens tomorrow. As the days went bye she only got worse.She would pace furiously from place to place, fell down on her face,bruised her cheekbone and forehead and continued to drive my sister crazy.My sister was getting to the end of her rope,she tried different vitamins,she consulted with her doctors about different medications for my mom,because the meds they prescribed either made my mom worse or had some weird side-effect that made her worse.Eventually she said my mom was not eating and fighting her about swallowing her food or drinks or her meds.So one day she prayed as to what she was going to do to remedy this impossible problem with my mom.She decided to get the Medical Marijuana License for my mom as a patient and for herself as a caretaker to try and sedate my mom from pacing and to mainly arouse her hunger to eat again. The marijuana was folded into her yogurt and worked and she continued to administer it to her in proper doses thru trial and error.She then started her on Caffeine capsules which is also not those horrible drugs with awful side-effects.Given to her orally 3 times daily she then took a wait and see outlook if this new course of action would work.To her surprise and mine. My mom has been just amazing from her new found remedy.She is now feeding herself,she now goes to the toilet by herself better,She calls my sister by her name Jennie which she didn't before and she actually converses on the phone to me, not like before, but with better word association than before. She smiles more and also has a really great glow in her face like Life is back in her being.My sister and I can't believe it,she was right on deaths doorstep a few months ago.Truly a miracle to us both.Call me if you want to verify this story it is really amazing.Ph.(808) 861-6691 ask for Brian Akiona

Joseph J. Sivak MD said...

Aloha Sir,

As a physician I have not had the experience in patients of cannabis or caffeine pills helping any AD patients. There was some data over the last couple years and mixed results, some small studies saying it worked and some saying it did not do anything.
It also brings up the question for me of when I hear of how wonderful it is for agitation in dementia, as to if we are really even talking about AD. A lot of things and behaviors look like AD.
I even get questions frequently as to why we can't just self-diagnose it in ourselves our or family.
Of course we need a real doctor and a real work-up to diagnose the disease, since it is a real entity.
As far as my work, I tend to get the other side of things, with caffeine abuse and MJ abuse and dependence. That is all the people with anxiety and mood and impulse problems and memory disturbance caused in part and sometimes directly by the MJ dependence. People insist it is the only thing that works and yet they would not be seeing me if it worked, now would they. They demand I fix things for them but I can't do much to help with all those other substances crossing the blood-brain barrier. Substances they refuse to give up.
Mostly the debate of Medical MJ has more political and economic relevance than clinical relevance.
As you know the situation has gotten way out of hand in California where there are skumbag doctors, some not even licensed or real physicians, selling prescriptions to potheads for no real medical reason.
As far as the classic use, there are also many options for nausea associated with chemotherapy for cancer, which work as good as MJ and are pretty much legal in any state.
So I am assuming your suffering mother has had a full work up and a good physician has diagnosed AD. If the method you are using is working so well, it would be wonderful for your treating physician to write it up and present it and share the clinical success with other physicians.
I hope your mother continues to do well. God Bless.

Joseph J. Sivak MD said...
This comment has been removed by the author.

Talking about the book with the Lake Superior wind....... a calm day