The lot is cast into the lap, but its every decision is from the Lord. -Proverbs 16:33
“On January 10, 49 B.C.E., General Julius Caesar entered Roman territory by crossing the Rubicon, a stream in what is now Northern Italy. In crossing the Rubicon, Caesar began a civil war that signaled the end of the Roman Republic. Julius Caesar was a very popular military and political leader who expanded the borders of the Roman Republic through what are today France, Spain, and the island of Britain. Caesar’s popularity and independence created tension between him and other elected officials in Rome. The Rubicon was a shallow river that served as a boundary between Rome and its provinces. Caesar crossed from a part of Gaul, where he was serving as governor. It was against the law to cross into Roman territory with an army, and Caesar knew this—he knew he was starting a civil war. He may have quoted one of his favorite plays when crossing the stream—Alea iacta est, “the die is cast”. (Romans were familiar with throwing (casting) dice as a game of chance.) The Roman civil war that followed lasted five years. It ended with Caesar being named Rome’s “dictator for life.” Years later, the Roman Republic dissolved and the Roman Empire emerged—with Caesar’s adopted son, Augustus, serving as its first emperor.”
Hi all! I hope you have had a great week. I know several of you (probably most, but I am acutely aware of several of your current situations) have had a terribly hard week, and for that I am truly sorry. My mom is slowly fading away, worn down from 14 years of this stupid disease. Backtracking, the disease is actually quite smart…and hard to treat and impossible, as of today, to cure…but its day is coming to an end soon, Lord Willing.
The above quote is an odd one to use in a dementia blog, but it will make as much sense as most of what I write in this blog if you give me a couple of minutes 😉
Lisa Genova, the amazingly talented neuroscientist and writer of the book that became the self-titled movie Still Alice, spoke in a Ted Talk (LINK) and referred to a “tipping point” after which there was no turning back when one has what I will call here “pre-dementia” and moves to having the disease.
Her conversational words were as follows: ” How many people here are 40 years old or older? You’re afraid to admit it now. This initial step into the disease, this presence of amyloid plaques accumulating, can already be found in your brains. The only way we could be sure of this would be through a PET scan, because at this point, you are blissfully unaware. You’re not showing any impairments in memory, language, or cognition … yet. We think it takes at least 15 to 20 years of amyloid plaque accumulation before it reaches a tipping point, then triggering a molecular cascade that causes the clinical symptoms of the disease. Prior to the tipping point, your lapses in memory might include things like, “Why did I come in this room?” or “Oh … what’s his name?” or “Where did I put my keys?”
She goes on to add:
“So what happens when amyloid plaques accumulate to this tipping point? Our microglia janitor cells become hyper-activated, releasing chemicals that cause inflammation and cellular damage. We think they might actually start clearing away the synapses themselves. A crucial neural transport protein called “tau” becomes hyperphosphorylated and twists itself into something called “tangles,” which choke off the neurons from the inside. By mid-stage Alzheimer’s, we have massive inflammation and tangles and all-out war at the synapse and cell death.”
Great way of explaining the disease…and a stunning wake up call. It heralds like a royal bugle team “What must I do to stop before the tipping point????”
Back to the odd intro: Caesar. Smart guy likely, and certainly a tremendous people motivator. (See, I am trying to keep my New Years’ Resolution of finding the best in people, even bad ones…. 😉 ) Caesar decided that crossing the Rubicon was no big deal despite the fact that it was breaking Roman Law and would cause the stink of stinks in the region. He was the 1st century equivalent of Sinatra singing My Way. I think he was just so arrogant that he figured this tipping point river was only for others…and the entire Roman world felt the consequences. Aren’t you glad you aren’t like that??? Me too. I stay way away from the Rubicon. I see a tipping point and flee in the opposite directions.
(Awkward pause while multiple people who know me are shaking their heads….)
Friends, we stink at this stuff. Despite the fact that AT LEAST 1/3 and perhaps 1/2 or many more of all dementia cases were preventable (!!!), we march the troops on toward the tipping pointed Rubicon of bad brain health. I have written dozens of pieces about prevention at the Cornbread table and will write dozens more because, until drugs are improved and cures (Note the plural…it will be a cocktail of drugs, therapies, and the like…) are found, our best hope is to never cross this river to begin with. So to that end, I am writing a piece here with reminders to protect your heart and your brain. If you have passed te Rubicon already, I am truly sorry. 🙁
Behold the dreaded RUBICON… and the letters within that show how to avoid it:
Regulate: If you want to protect yourself, as best you can, from this disease, you MUST regulate your body chemistry. Blood pressure…keep it right. Take meds if needed. Same with blood sugar. Same with cholesterol. It would be much better if we were in such good health that these weren’t an issue, but if they are an issue…regulate them and work on making them right…before crossing the Rubicon. While you are at it, a key to fixing these measurements is eating pretty much exactly the opposite of how many of us eat today. The Mediterranean Diet and the MIND diet have been shown to help fight off the disease, at least for many!
Unplug from the 24 hour news cycle, de-stress and sleep while you are at it!- Stress is a contributing factor to dementia and to high blood pressure which is, in and of itself, a contributor. Find a happy place. Music and art for a double bonus… In addition to managing stress, inadequate sleep is certainly shoving many toward the river. We need 3 good sleep cycles per day. For some that may mean 6-7 hours, but for most it is more. During sleep your brain’s chemistry does amazing things in cementing memory, in clearing out the bad stuff, and in making us more resilient. It is a badge these days to brag how few hours sleep we get and this simply needs to end. Netflix can wait… Sleep! Lastly, Obstructive Sleep Apnea is a risk factor for the disease that can normally be fixed. Wanna stay away from the Rubicon? Have a sleep study.
Bug your doc– This is a biggie. If you experience any of the 10 Warning Signs of Dementia, talk to your doctor asap for a few reasons. First, it may very well be a completely treatable thing that mimic dementia. There are a lot of them. Seciond reason….nearly every existing treatment works better early. The promising new class of drugs (monoclonal antibodies…they typically end in -mab after a lot of letters), currently being blocked by CMS for some lame reason (and we will be protesting again about this in KC on Monday) will require early detection. If your doc seems disinterested, change doctors or get a 2nd opinion. Splashing in the Rubicon may be at stake. Oh, and speaking of docs…have your hearing and vision tested and address issues there as well. Not doing so has been shown to push us further down that path… Oral health too. Gum disease seems to have a link as well… Lastly, if you smoke, get their help quitting. That is a biggie! It was probably a cause for my mom. She stopped smoking 20 years ago, but the blood vessel damage had likely already happened.
Interact and Inquire– The brain is, in many ways, like a muscle. We have to interact with others as much as sometimes we pride ourselves at hating to “people”. (My grammar teachers are surely sickened by using people as a verb…) Isolation is like wearing skates at the riverfront. Force yourself to get out there! Good ways: Learning a new musical instrument, another language, or another art form have been shown many times to improve Neuroplasticity. Your ability to fight off that last step into the Rubicon’s tipping point might very well be based on how neuroplastic your brain is. Think of it like a mouse maze. Which maze would be easier to escape…one with one exit and a million non-connected paths to it or one with oodles of each? The latter even I could escape from…
Counseling– Depression is a factor in crossing the river’s tipping point. Don’t just suck it up. Find a good counselor and work through problems. Take meds if necessary. Depression can also lead to overeating, excessive alcohol consumption, drug use, high blood pressure, and a bunch of other things that push you to the water… Don’t fear counseling, fear not doing it. You matter. If you are a believer, there is solid Christian counselling available if you search for it. 🙂
Ongoing exercise regiment– 30-45 minutes of rigorous exercise, 3-5 times a week. PLEASE REMEMMBER THIS: What is good for the heart is good for the brain…and for staying out of the Rubicon! Exercise can also decrease fall risk. Exercise hard enough that you can still talk to others, but you would have a challenge singing at that effort level. Walking is great, but don’t dilly dally. 😉 Note: It is interesting how interconnected these things are…and how bad we can be at them. 🙁
Noggin protection– While this MAY be out of your control (some TBIs for example), some aspects are not. Falls and head trauma are terrible for tipping point tiptoeing. Protect your head. Frequent concussions are one reason why veterans are much more likely to develop the disease.
Is it possible to do all of these things and still get soaked? Sadly, yes. My mom, minus the smoking earlier ijn life, did much of this quite well. The older we get, the closer to the river we inch just by living life. Age is the greatest risk factor of many. Not everything can be fixed. Some damage has already been done. However, staying as far back from the Rubicon as possible will certainly delay it if not prevent it in many, mnay people! I am trying to do better and I hope you do as well. If you aren’t wanting to think about it, I understand completely. I feel the same way. However, don’t wait until Alea iacta est, “the die is cast” and be sad that you knew better. Today is the day to get better. Today is also a good day to #EndALZ so we can stop thinking about it. 🙂
Thank you all and have a great weekend!
Update: Mom is slowing down on her morning eating and even my stepdad at lunch is having a hard time getting her to eat all of her food. She isn’t losing weight yet, but we both feel like there is another transition downward coming soon. Stinkin’ disease 🙁
Wanna help? 3 things for now.
- Donate to my Longest Day event. It is just 6-7 weeks away. Sigh…I am trying to hurry back in shape from 8 months of creeping toward the Rubicon. (Do as I say, not as I always do…) Here is the link: LINK
- Create a Walk to End Alzheimer’s Team: LINK The Walk is in the fall, but it will be here faster than you can shake a stick!
- Pray- For a cure. For the patients. For the caregivers. For medical wisdom. For AIM in their fight to get FDA-approved drugs covered. We are protesting again Monday in KC and elsewhere… Pray His will be done and for our patience too. Pray in thankfulness that believers will live for eternity some day without this disease… There is no Rubicon in heaven, but there is a river of crystal ahead some sweet day...