Tuesday, October 30, 2007


I never think about nutmeg except briefly at Thanksgiving to once again note that I have none on my shelf when it's time to make pumpkin pie. Thanks to Dr. Jacob Schor, however, I must reconsider my nutmegless status in the interest of keeping my marbles intact.

This Denver naturopath is a wealth of knowledge about natural remedies of the herbal variety and their value in keeping body and mind intact. He muses over nutmeg whilst grinding same for his holiday recipes, and he includes both recipes and scientific abstracts in his current newsletter.

Of particular interest to me in my never-ending quest for brain protective strategies is news from India about the acetylcholinesterase inhibiting qualities of this spice. Acetylcholine is a neurotransmitter which allows neurons in charge of memory functions to communicate with one another in order to both make 'em and keep 'em (memories that is).* Acetylcholinesterase is the enzyme that breaks down acetylcholine, and the inhibitor of same allows acetylcholine to work longer in the gap between memory-preserving neurons.

That is how current medications for Alzheimer's disease, including Aricept and Exelon, work. London pharmacologists screened a number of Indian herbs for this activity and found that even weensy bits of nutmeg extract diminished the activity of acetylcholinesterase inhibitor by 50%.

I don't even know if I really like nutmeg between never having it in the cupboard and not having a very discerning palate. I think I could learn to like it, however, if it supports my aging brain!
*This is why anticholinergic medications like benadryl and other antihistamines (used for allergies and sleep), oxybutynin (used for bladder control), and amitryptilline (used for sleep and chronic pain control) can befuddle susceptible older persons and should not be used.

Monday, October 29, 2007

Leftover life to stow

Residual stuff. Another one of the problems with dying is a lifetime of memories in the form of treasured stuff, and what to do with it all. Hire someone, one friend told me, "I know a great gal who will pack up all her clothes and belongings for $35/hr." Oh my, that just doesn't feel right to me, so I'm going the PYOS route.

The low point? Advertising furniture on Craigslist.com and having a rocket scientist and his MD wife show up and dicker with me over the price of two lovely chairs from her living room. The high points? Three sets of warm and wonderful people coming by to take her plants...for free. One young lady smiled at the grouping of pots around her at the elevator and chirped "Hi guys." She then sent me an e-mail a week later to tell me how much she was enjoying "the pleasure of their company."

Another fellow showed up after work on a brisk and blustery late afternoon. He struggled to get the really big plants out the door with nary a leaf lost, then fretted over whether or not the shock of the cold air would harm then. He too sent a note of thanks with assurances that all plants survived the drive to their new home.

This weekend, my mom's caretaker from heaven (who allowed me to keep her home weeks past when it was really feasible) came and picked up the beds and loads of linen. That which she can't use is destined for family in El Salvador.

My lesson? I would much rather send all these things complete with attached memories out the door with people who appreciate them, and free works for me. That strategy makes for bright moments in a difficult undertaking.

Wednesday, October 24, 2007

Tea Drinking May Help Preserve Hip Structure in Elderly Women

Better hip structure, well who doesn't need that? The news, however, on an in-depth read is all about bone density and not about shapely. Oh well, this is good news nevertheless.

Australian researchers checked out aging Aussie hips in tea drinkers compared with their tealess peers. Over 4 years of analysis, those who took tea topped the teatotalers with respect to bone mineralization, losing a mere 1.6% of their hip density compared to 4.0% lost by the non-tea group.

I just bought a box of green tea powder from some hyped up tea-selling teenager at Park Meadows Mall. It's sort of disgusting, but if it helps me hang onto my hips, I'll choke it down.

Tuesday, October 16, 2007

The trouble with dying

Well, I suppose there's lots of troubles with dying. But the one that strikes me most through the years, and now most immediately as my mom winds down, is how difficult the process is, far more so than the actual final event.

Unless one dies suddenly and unexpectedly, one never goes from lively to dead in a quick and easy process. I spent the summer waiting for my mom to have the big one, a quick and catastrophic stroke. Instead, she has had a series of tiny strokes that gradually have cut her easy mobility down to a standstill. First we battled bedsores from the lack of movement, now it's the lungs.

No movement means no deep breathing and no clearing of secretions. Her oxygen levels are now dropping, and it's taking more and more supplemental O2 to get them back up to near normal. I suspect she's throwing tiny clots from her barely moving legs and pelvis into her lungs, and these pulmonary emboli are blocking off the interface between air and blood that's critical to oxygen uptake into the bloodstream.

What a sad and slow downward slope this continues to be.

Tuesday, October 09, 2007

ACE inhibitors back in mobility news

I just read an interesting item about ACE inhibitors, a class of drugs used to treat hypertension, heart failure, and also known to help prevent kidney disease in diabetics.

Previous research suggested that ACEIs (such as lisinopril, enalopril, Altace, etc.) may provide a boost to aging muscles as well as to the heart. Over 600 women participating in the Women's Health and Aging Study were sorted into groups based on the type of blood pressure medication they were on. Over the three years of the study, those subjects on ACE inhibitors had significantly less loss of quadriceps muscle strength and far less decline in walking speed.*

The latest study was conducted by Deepa Sumukadas, M.D., of the University of Dundee, and colleagues (1). The researchers randomized 130 oldsters--all of whom had mobility problems--to receive an ACEI called perindopril or placebo over the course of 5 months. Those in the real deal group displayed improvement equivalent to six months of exercise training, motoring 31.4 meters further in six minutes than the control group. Perhaps creeping is more the operative word here than motoring, but those extra meters crept represented significantly more mobility.

Ann Cranney, M.D., of the Ottawa Health Research Institute had this to say, "Their results are promising and lend support to the hypothesis that ACE inhibition has a positive effect on physical function, possibly through effects on skeletal muscle."

Well why not, I'll see if a course of ACEIs brings back the fidgets to my immobile old mom.
*Diminished walking speed and muscle strength have been shown to predict the onset of disability, and worse--nursing home admissions and death--in older adults.

(1) Sumukadas D et al. "Effect of perindopril on physical function in elderly people with functional impairment: a randomized controlled trial." CMAJ 2007;177(8):867-74.

Monday, October 08, 2007

Dying of Immobility

This past summer, I assumed my mom would die of a massive stroke. Clearly, however, her blood-to-brain troubles are of the small vessel variety, and no one directly dies of from the death of a few neurons here and a few neurons there.

Her demise, it seems, will be the consequence of her increasing inability to move. Our bodies were built for movement, and the little fidgets, the yawns, the coughs, the throat clearings, the up from the chair and down again even if only to get the last piece of cake from the kitchen are necessary to the healthy functioning of our body. Okay, maybe not the cake, but certainly the effort spent to get it.

I'm not sure what took out those little adjustments in my mom's daily life--weakness, pain, the little strokes--but she doesn't even shift her weight in her chair anymore. As a result, she's got several 'hot spots' where the skin is red and inflamed, ready to break down into bedsores and chairsores. She increasingly chokes a little on her food, and her cough is weak and ineffective. She is now susceptible to pneumonia, a UTI, skin infections, and blood clots.

This is the way the world ends
This is the way the world ends
This is the way the world ends
Not with a bang but a whimper.
T.S. Eliot

Friday, October 05, 2007

Vertical ridges in nails

Ridgy and brittle, that's nails after menopause. While these vertical ridges may be a 'normal' part of aging, either the ridgy nature of the nail or the underlying cause of the ridges makes for nails that break under ordinary circumstances such as brushing your fingertips on the wall as you switch on a light.

After noting how my aging not-so-goldilocks responded to local progesterone cream, I decided to try the same on my not-so-goodlooking nails. Now, 18 months into the experiment, only two of my nails remain beridged and bedraggled. All the other groovy spots have grown out, leaving the attractive oval nails of old that I had when I was young.

I used over-the-counter progesterone cream (Puritan is a good place to buy) for the nail purpose. I wonder if I might've seen quicker results with the prescription strength cream I use on my scalp.