I am interested in comments from caregivers who loved ones have additional serious medical problems and how they affect their AD if at all. Or comments from anyone that has knowledge on this subject.
My dh has COPD and a heart condition. He is 64 and is in stage six. I read parts of Big Tree Murphy again this weekend and was amazed how my caregiver stages follow those she explains on her web site almost step by step. I think her web site is so informative and I refer to it often.
JudithKB, my husband was diagnosed at 68 with AD. He also has COPD, VaD, high cholesterol, emphysema, had had a small stroke (apparently during the night that neither of us knew about and only affected his vision a little), and Restless Leg Syndrome. My husband never would wear the mask for COPD....
It took me a year to get the PCP to order the MRI and set up the appointment with the neurologist, because my husband passed the AD test! A year after the AD was confirmed and he was seeing the neurologist, at the next annual physical, with the PCP's approval, we stopped the Lipitor for High Cholesterol, and once he could no longer understand the eye charts or know his letters, we stopped the eye drops for glaucoma.
The only two medications that I am keeping him on are Prevacid for his stomach and Mirapex for his Restless Leg Syndrome. He is in the final part of Stage 7. I am just making as sure as I can that he is not in pain at this point.
my DH has suffered sleep apnea for years but wouldnt be able to use a mask either. he has vascular/AD dementia and high bp which has ironically leveled out during mid-late stage 7. only meds at this point is prilosec for acid reflux which is still bad and bp med as 'needed' when it gets out of range. he also suffers cronic urinary tract infection and or enlarged prostate which is a constant source of concerns now for many years- but we treat as it occurs instead of preventative as we have for yrs with daily antibiotics. we must all evaluate their needs and adjust accordingly to keep them pain free and as functionable as possible. mary i agree you are doing a super job with all DH has going on. divvi
Mary, I also applaud your caregiving efforts. Dave has a lot "going on" and he evidently has a strong heart to sustain him all this time - in addition to your loving caregiving. My DH had a strong heart and low BP and Cholesterol but he had Parkenism and both AD and VD. I am forever thankful that he was able to "pass" before he became to Stage 7. Given his strong heart and low BP, I thought he would linger years longer....but you can never tell. divvi, your dh evidently also has a strong heart...My dh was on Neurotin for leg cramps. Miraplex did not work for him.
Where to start! Let's see, some of DH's issues are a result of exposure to AO in his two tours in Viet Nam.
While he was on active duty, he was notified about high triglycerides and later a bruit was heard but nothing further was done and he continued in his flight status. After he retired, he was told he was now boarderline diabetic and I was the one who went to the dietitan to learn about keeping things under control..did he? Ha.."what do they know"...was his attitude. Then after we moved to the Central Coast, at one point in the early 90's he was going to the bathroom like a race horse, drinking water like there was never enough and losing wt without trying and he thought this was just fine....I begged him to see the doctor but NO even though one of the doctors said he wanted to do some testing he would not go having one excuse after another. I finally bought a book about this and asked him to read it..did he? NO..Finally, I left on my Marine Corps duty and left the book open and told him if he did not take care of this an dies of complications from untreated diabetes I would not go to his funeral and the kids could have the flag I would be so angry. So finally he did..and was tested and put on glucatrol. (sp). But did he pay attention to diet along with it. NO..did he listen to me, NO.Finally his doctor, a female, called me to say she was going to refer him to another physician, a male, and perhaps he would listen then...a macho thing if you get my drift...Did he pay attention to the new doc? NO not really. Then in 2004 he mentioned to the podiatrist that after 9 holes of golf his legs tire. So an ultrasound was ordered and showed blockages and DH was finally sent to a cardiologist who did an angiogram of the heart prior to doing anything for the legs and that is when the blockages of the heart was noted ( he had been on meds prior to this for hypertension and chloesterol) and so a by pass procedure was to b done..it was to be a 5 way but when the doctors got in there it was discovered he had so much calcification in the aorta they reversed the decision and went to a 3 way bypass. All went well until the 3 month mark when he had fluid in that lung, drained, next at followup it was found to be collapsed, then filled again and he was hospitalized for several days and nearly died from the treatment. He was put on ameoderone (sp) and that didn't go well either. Finally he has a dx of mild copd ( quit smoking 27 years ago), then in 2007 he had a femoral by pass of the left leg after the stent in that leg failed. He also has a stent in his right leg and in a renal artery. Then in 2 008 he had a TIA located in the pons...a lacunar stroke..the kind related to hypertension...and then in 2009 the dx of AD. In 2000 and 2001 he had total hip replacements.
So bottom line... Diabetes and neruopathy form that as well as some vision issues on insulin Heart Disease...had bypass surgery Ischemic Heart Disease Hypertension A-Fib High cholestrol Severe vascular disease Alzheimer's Disease Sleep Apnea since 1991 ( moved him out of the bedroom until he got tested..GRRRR) I now have to watch him take the meds I have been setting out for sometime now. If I don't watch him, he would get into the box and go after the night ones...or not take them, or not take the night ones. The doctor appointments seem endless for routine checks but he is doing pretty well inspite of himself.
Interesting thing his MRI when he had the stroke didn't say anything about brain bleeds...did talk about white matter and I did not understand any of this but I would bet it hinted and what we deal with now.
His diabetes is all AO related. I also think he could have helped himself if he didn't think he knew more than the doctors do..for a long time he was non compliant..
Now he is cheerful and tells everyone he feels wonderful, not a thing wrong with him..he is just feeling so great and can't believe he is 81..sometimes neither can I. And now you know why our neuro has declared my problem with DH will be his stubborn attitude and behaviour.
My DH has: Spino-cerebellar Ataxia Type II with global dementia due to 32 years of cerebellar atrophy. And a TIA around 10 years ago..it co-incided with dementia issues. Coincidence? Only other thing we treat is Reflux because he had strictures from all the scaring from acid.
Type 2 Diabetes Peripheral Neuropathy Charcot foot - Diabetes related Sinal Stenosis and anything else that could possiblly be wrong with the back Chronic stress fractures High blood pressure - under control with meds. Previous brain bleeds
My point in starting this thread was I have been wondering how the medical conditions my dh has might affect his AD and/or how his AD might affect his other medical conditions. At the present time I can't see how one condition is affecting another condition.
Judith-- my husband doesn't have other medical conditions, but I would think that the problems dementia causes with communication would have the potential to exacerbate any concurrent conditions. Also, I would think that if the person is irritable and uncooperative due to dementia, it would make treatment of other conditions more difficult and potentially less successful.
I do remember reading a study by the Alz Assn a while back that compared hospital costs for a patient with dementia and without, for treatment of another identical illness. The costs were much higher for the dementia patient; it must cause complications with care.
I can...our neuro told us that IF one is predisposed to AD there are things that can push him or her over the edge to it perhaps some years before they might actually display symptoms. Trauma to the brain which can come from anesthesia ( my dh had 2 hip surgeries 2000 and 2001) and he had several angiograms with the light twilight anesthesia, he had triple bypass surgery with complicatons and that is when the memory loss issues started to show themselves despite being told that it would self correct..it didn't only got worse, then another general anesthesia for femoral bypass surgery, and finally a lacunar TIA which is related to hypertension. Go and do a search on brain bleeds and alzheimers. I did that the other day when on another thread it was mentioned. I think the cholesterol issues also with a person who has serious vascular disease may play a part and I think these things are just being discovered as keys to what causes this.My mom was always thin but she had cholesterol issues and benign brain tumors ( menigiomas) or however you spell it...my uncle the same thing...others may have it set off by exposure to chemicals as an aunt was thought to have developed this disease and also a friend's husband who worked for Alcoa, Purina and I think DuPont at different times..
Also look at boxers and football players now where the medical world is studying them as they develop AD or various other dementias..they have all had head traumas!
Mimi - that is why whenever they find the cause they will find it is not just one thing. Aside from those that carry the gene, I believe there may be a type 3 diabetes for some, others triggered by things/changes in our environment or what they are doing to the foods we eat. They are finding more AD genes but the question why do some have the genes and never develop AD and other do? It could be what is going on in our lives that triggers it.
there is still so much unknown - way too much is unknown. Keep going researchers.
I don't know where to start...DH was diagnosed with terminal (2yrs to live )prostate cancer in 2002, from that the knees and arthritis got worse..He is somewhere near stage 4-5 dementia.. He is totally blind from macular and recently was scheduled for knee replacement surgery...In doing the labs to prepare for that, they found an enlarged heart with the lower front side not functioning at all..That surgery did not happen for obvious reasons... AND now DH is thinking about suicide..He has always been a controlling person and the idea that he might not choose when he wants to die is getting to him... In the last few hours,he has ask how many sleeping pills he should take to end it all, and if hurling himself down the stairs would break his neck and kill him instantly, and if he ask the PCP to give him pain pills for his knees would that do the job.. Suddenly he's decided to sell some of his collections that before he'd put up a fight to part with.. Y membership, he says he'll not renew... says a waste of money, if he's to die??? I made a hurried appointment with his dr, and tomorrow, hopefully he'll suggest something that will clam him down. DH has even decided that it'll not be more than 2 years before the BIG day.. Clearly dementia talking... Brain scans were done and we'll get those results tomorrow.. I tried to reason with him about the effect his suicide would have on me and the family... To no avail..thinking only of himself and see pain as something he'll not tolerate... Tho I explained that pain management would keep him comfortable til the natural end came, still he hears none of that.. Now when I leave the house for even a few minutes.. I'm afraid of what I'll find when I return.... Another phase of this dratted disease that we caregivers get without asking.. I'd be interested in hearing from others who might have had a similar situation...Would it be best to commit him for round the clock observation ? Do Dr's do that or do they medicate to zombie state??? I have to say, I didn't see this phase coming... Thanks for listening.. It helps so much to talk about this to others who are walking the walk... stumbling all the way..
peggy, my husband, a few years ago, sent off to the Hemlock Society to find out how to commit suicide with meds. He never mentioned it to me and I didn't mention it to him. And he never acted on it. But to be brutally honest, I often wish he HAD. He's now bedridden in a nursing home, blank eyed, curled hands, the whole bit, while much of savings have gone down the drain to pay for aides to care for him at home before he went to the NH. His mind is gone. Pain management will keep him comfortable if all he has is cancer, or heart problems, I guess, but the mental pain they go through before they can no longer think straight can be awful. Start thinking about the future without him. Keeping him alive for YOU can be selfish.
Judithkb, I guess I really didn't answer your question that started this discussion...I just listed what my husband had and the medical treatment for each...
I honestly think that they truly have no relevance to AD...HOWEVER, once that they have AD (that we are not yet aware) and have any surgery, they get worse. No matter what the procedure, their brain can't cope with it all and they can no longer hide some of the symptoms and we become aware that something is wrong, if we aren't already.
Any falls can send them in a tailspin - and sometimes the tailspin causes the falls.
The medications for other illnesses don't seem to affect the disease -
One thing I've noticed lately with so many losing their spouses, is that the 8-10 years after diagnosis doesn't seem to be true with this group....on an average, I think it is more like 4-8, with three or four notable exceptions....these spouses are having "events" that seem to have a faster decline.
Some here are in their 10th yearn or more, and a couple have only been diagnosed for 3 years....
There is nothing I have seen or heard that will slow it down or speed it up....for very long.
I have stated over and over again - first you learn patience; then you learn flexibility; and mainly you have to accept what is happening and go with the flow....fighting it, trying to slow it down, trying to keep them as they were, it is not going to make a difference - except that you will have put yourself through way too many emotional upheavals (and maybe your spouse as well).
When your spouse is at the end of the road, and seems to be content to stay there, you look back to see if anything would have made any difference....and in our case it would not have.
I have been privileged to have had my husband for two months shy of 50 years - my best friend and lover - the other half of me. He hasn't been in his body for a long time now, but I'm taking excellent care of him - it is the least I can do. But no medications given or kept from him would have altered his path.
Accept the disease, love your spouse, care for them, take excellent care of yourselves, and keep coming to Joan's for advice, ranting, raving, answers, and love.....
Thank you Mary...beautiful. You are so right in so many ways. I often feel like a YoYo....one day he seems good and then the next day so much worse. A big down hill slide since the first of the year. We are in our 5th year now and I know the down hill slide from here on is going to be worse and worse.
Our darling little dog became very ill this week. She had an eye condition that was so sad and we took her to the Vet. She is on meds and eyedrops now and seems to be improving. This was so upsetting to my dh because he thinks of her as his baby.
Briegull, thanks for your honesty and frankness. On the day (!) that my husband was admitted to the nh I talked to the nh in-house doctor and he said I would have to make a choice as to the level of medical care provided. 1 - full active medical care including hospitalization if appropriate 2 - full active medical care in-house only (no hospitalization) 3 - 5 By this time I was overwhelmed and unable to listen to exactly what these entailed, but you can imagine. The lowest level of care would be something like nontreatment of medical conditions except alleviation of pain and discomfort.
I could not make a choice at that moment, which means that he is officially at level 1 which is the default. Only I did choose for non-resuscitation which is also the default. I will see the doctor on Thursday and I'm thinking for the time being I will opt for level 2. But this is hard. What is his quality of life? I change my mind about it from day to day.
On the news yesterday it was suggested that the air quality may play a part too..they know somg plays a part with lung diseases..and that perhaps also with the neurons in the brain..
On FOXNews today the doctor who does the housecall section said that there is strong consideration now being given to testing kids as young as 10 for cholesterol to begin the corrections far earlier than starting to check this in people in the 30s. The goal is a healthier life style and with all the junk the kids have at their finger tips now, this is not a bad idea.
My concern in giving statins to children are the side effects especially the memory problems. If they want to help children give them supplements like garlic and eat a handful of almonds daily. That will lower cholesterol also (it did with me). Most important is get out an exercise and eat healthier.
JudithKB...my DH has serious heart problems, and I can't see where they affect his AD much. His AD DOES affect the heart conditions, however, or at least they way we are treating them. We have decided not to treat the heart stuff invasively, because as many have said, anesthesia seems to progess the AD. DH has a thorasic aortic anuerysm, a-fib, prolapsed mitral valve, and complete blockage in at least 1 artery. They proposed an angiogram to assess the blockage, I turned them down as bypass surgery is the only treatment. Also turned down surgery on the aneurysm. He does take medication (wafarin, bp and cholesteral meds, and metoprolol) for his heart, and I don't think they affect his AD either. I got some very good information and advice from some on these boards. Research all the meds, research anesthesia and AD, etc. Best of luck!
Hi JeanetteB I've had this conversation with families many times (being a treating physician). Ideally the conversation would have started out understanding your goals for him (longevity, longevity with limits, comfort, maintaining relationships, eating, etc), his limits (what would be too much for him and/or cause him to suffer such as ICU care for example), values etc and then the physician could explain how different levels of care may fit the goals and limits. I find the laundry list of options (dialysis, cardioversion, major surgery, vent care etc) can overwhelm patients and families and it is good to start back at the basics: what does he enjoy and how can we achieve that? Hopefully the physician explained that the last option was not so much nontreatment but maximum treatment oriented towards comfort. Here is how physicians are supposed to approach listening to families and patients: https://files.me.com/joshandsusie/7z72nw
For JudithKB I would say that initially other chronic illnesses (i.e. comorbidities) are somewhat independent but they make complications from Alzheimer's a little more severe or the recovery process a little longer (from a pneumonia for example). Sleep apnea can make alzheimer's worse and alzheimer's can make sleep apnea worse. But for the most part, other serious medical conditions will simply give the body less reserve. As someone already mentioned, a flare of a serious medical condition, like a COPD exacerbation, can cause a slight but permanent change in memory worsening. So my feeling is not that the diseases directly affect each other but that as each separate medical condition has a flare or complication, all the diseases together just make it a little harder for the body to deal with it.