S2E42. Time Zones: Week 2

I’m sorry to foist this on you, but my experiment in preparing for a 7-hour time zone shift prior to our cruise is pretty much consuming my waking hours. And my sleeping hours, too, come to think of it.

This week was really rough on me. The good news is that I got into a rhythm of waking up at 4am as opposed to my normal 7:30am routine. But that was leaving me sluggish and pretty much wiped out during the day, even when I took a nap around noon.

It really had me perplexed because it was only 12 years ago that, following my first wife’s passing, I was on a regular schedule that had me getting up at 4:30am, working out on a treadmill and weight machine in my basement for an hour before showering and going to work. And I would feel physically fine and cognitively alert the whole morning (I had to be as I was a clinical psychologist on an acute care inpatient unit). Then I would take a nap in my office at noon and finish out the day, even putting in an extra hour or two at times.

So why was this so difficult? It appears that our circadian rhythms get a little cranky and less flexible as we age, but I didn’t think the difference between being 59 and 71 would have such a dramatic effect. Apparently, it does on me.

My new routine has me waking up at 4am and immediately walking for half an hour at a brisk pace. I moved my workout to first thing after waking up because I found I was too tired later on in the day to convince myself to do it.

Luckily for me, the new management company for our apartment building is renovating. They are painting the hallways a lighter color and changing the lighting so that it is like daylight out there…and early morning light is exactly what is called for when trying to fool your sleep-wake system into re-setting itself.

So my morning exercise of walking the halls (where 1 lap around is about 200 yards) is serving a dual purpose. If the hallways weren’t so fortuitously bright, I’d probably have to buy a light box and sit in front of it for a while after waking up. Thank goodness I lucked out and avoided that fate!

After my walk, I sit down with my computer, turn the brightness up full, and do The New York Times crossword puzzle, Spelling Bee, Wordle and Nerdle. It’s about then that Sally wakes up and I make her coffee and my tea to initiate our normal morning ritual. By then, the sky is starting to brighten and it feels like things are almost back to normal.

Sally is not all that enthusiastic about my attempt to prepare my body for Athens. Her natural rhythms would have her going to sleep around midnight, but she also likes to go to bed when I do, so my new hours have thrown a major monkey wrench into her routine. She reminds me that we went to Paris a few years back (6-hour time difference) and really didn’t do anything to fend off jet lag and neither of us can recall any severe effects. She has a point.

By 11am, I’m getting groggy and thinking about taking a nap. It takes me a while to appreciate the fact that I’ve already been up for 7 hours and I’ve worked out, so napping at 11am isn’t such an off-the-wall idea.

I’m eating dinner a little earlier than before (around 5:00pm instead of 6:30pm. After all, it’s not just your sleep but your hunger/digestive rhythms that need to adjust, as well.

Bedtime is the biggest problem. Early to bed means I can’t watch most of the Phillies games in the playoffs. Bummer! My compromise has been to get in bed around 9ish so I could at least watch a few innings. But that only left me the potential for 7 hours of sleep and, with the usual time it takes to fall asleep and the usual number of nighttime awakenings, I was only getting about 6 hours of actual sleep…and that just wasn’t enough for me, even with a mid-day nap.

So on Wednesday of this week, I moved my bedtime back to 8pm…and it worked like a charm! I got a good 7 hours of sleep and I felt fine the rest of the day. Now I know that I need to lock-in 8 hours in bed, no ifs, ands or buts!

As of today (Friday), I’ve got just 7 more days available to adjust. I’ve picked up half of the 7-hour transition I’ll be making, leaving a 3½-hour difference. I know I won’t be able to get all the way there, but I think I’d like to transition 1 more hour before we board the plane. That would be a 7pm bedtime and 3am awakening. Somehow, doing that never made it onto my bucket list!

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S2E40. Going Back To Sleep

It was just 9 weeks ago that I posted a blog about sleep (S2E31. Sweet Dreams Are Made Of This) in which I described my lifetime relationship with sleeping and napping.

I thought I had said all I needed to say about sleep’s importance as one of the five pillars of preserving brain health, but The Universe seemed to have a different idea. All of a sudden my inbox and social media feeds were full of articles about sleep and sleep hygiene…and it wasn’t even National Sleep Awareness Week!

So I played along and watched a webcast of an interview with Matt Walker, Ph.D., a sleep scientist at the University of California-Berkeley (you can watch the 1-hour event here: youtube.com/watch?v=ZaxGiYyUcyI).

A lot of the information he presented was new to me, so I read his book Why We Sleep.

WOW…was I ever impressed! It was a real page-turner! He keeps his use of jargon and scientific terminology to a bare minimum and has a knack for selecting just the right analogies to make the research he details come to life. But it’s the content he covers that is truly mind-boggling. It was humbling to discover how little I knew about sleep.

Did you know that all creatures who live more than a day sleep? Including insects and worms?

Did you know that only one side of a dolphin’s brain sleeps at a time because it has to stay awake to surface and breathe?

Did you know that just one hour of lost sleep can significantly impair your cognitive abilities and possibly even kill you? Apart from all the laboratory studies that demonstrate this, we have an unintended real-life experiment that is run every year. It turns out that the day after daylight savings time goes into effect (and we lose an hour of sleep by turning our clocks forward), there is a spike in the number of fatal heart attacks and car accidents. Conversely, when we turn our clocks back in the fall (and gain an hour of sleep), there is a corresponding drop in heart attacks and traffic accidents. 

Fascinating!

Apart from fun facts to know-and-tell, the research he described was simply amazing. He would begin by asking what happens when we sleep, then progress to how it happens, and end up answering the ultimate question: why does it happen?

For the purposes of this blog, though, the meaty part of the book involves sleep’s effects on memory.

Dr. Walker explains that the hippocampus maintains traces of your experiences each day and then, during sleep, it empties itself by sending important information out to a variety of cortical areas where it is permanently stored in the form of memories. It’s kind of like downloading the contents of a thumb drive onto your hard drive and then erasing it from the thumb drive so it has its full capacity available for the next day. One stage of sleep is responsible for transmitting the data and a different stage of sleep takes on the task of cementing it in place by strengthening the synapses where the information is stored.

If your early sleep is disturbed enough, the information won’t be transmitted and you won’t remember much the next day. If your sleep later in the night is disturbed, the newly planted memory won’t be consolidated and you won’t remember much, either.

So if you want to be able to remember more about what happened today, you’ll need a good 7-9 hours of high-quality sleep tonight…and for the next couple of days, as well.

If you don’t get good early sleep, the hippocampus won’t empty out and it will have limited storage space available the next day. That’s part of the dullness you feel when you haven’t slept well and accounts for some of the difficulty you have learning new information that day.

Unfortunately, once we get into our 60s, our sleep patterns begin to change…and not for the better. We tend to sleep fewer hours and the quality of that sleep is compromised by more awakenings…all of which wreaks havoc on our memory, immune system, emotional reactivity and judgement. 

It also compromises the nightly cleansing of the day’s chemical detritus which includes beta amyloid and tau particles, the accumulation of which are associated with Alzheimer’s pathology.

The take-home message here is that it’s not true that we need less sleep as we age. We need the same amount of sleep that we needed when we were younger to allow all of these crucial processes to be executed every night. The problem is that we don’t get the sleep we need as often as we should.

Putting all this together, it’s no surprise that getting fewer than the recommended number of hours of sleep on a regular basis is a risk factor for dementia. The relationship is so strong that researchers are now exploring whether sleep patterns can be used to predict whether or not you will develop a dementia a few years down the road.

Dr. Walker ends the book with a listing of things you can do to maximize your chances of getting the sleep you need (spoiler alert: taking sleep medication is not one of them). Here’s a link where you can review them: https://www.nhlbi.nih.gov/files/docs/public/sleep/healthysleepfs.pdf

The one change I made after reading the book had to do with my computer usage. 

I’m usually on the computer right up until bedtime, but it turns out that that’s a terrible thing to do. You see, the LED screen of a computer emits strong light waves at the blue end of the spectrum. It is this wavelength of light that triggers your circadian rhythm which tells you when to wake up and when to go to sleep. 

By bathing myself in blue light late at night, I was telling my brain that it was still daytime and so it delayed sending out the signal to initiate the sleep cycle until after I turned off the computer and went to bed.

I thought about changing my end-of-day routine, but realized I’m pretty much addicted to my computer use. Fortunately, the people at Apple have provided a solution. There is a program built into their computers and phones that will change the color emitted by their screens in the evening, going from blue-white to a soft yellow-amber. Problem solved! The program is called ‘Night Shift’ and you can find it by clicking on the ‘Display’ icon in System Preferences or Settings.

Alternatively, you can buy glasses that block the harmful wavelengths.

I’ll close with one more snippet from the book:

So, you ask, why is it that our circadian rhythm is triggered by blue light and not by full-spectrum sunlight?

You might recall that we are descended from fish and their aquatic predecessors. The circadian rhythm was an adaptation that evolved while we were living in water. But water filters out the other wavelengths of natural light leaving only the blues and greens. Eons ago, then, our evolutionary ancestors lived in a world that oscillated from darkness to blue and back again. And that’s the light pattern that controls your circadian rhythm to this very day!

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S2E39. The 50th Reunion

We were 21 and 22 years old. It was our last semester at Brown University. There were 7 of us: 4 girls and 3 guys. We shared the left half of a duplex at 43 East Manning Street in Providence, Rhode Island. It was 1972.

Five of us got together on Cape Cod this past weekend for our 50th reunion. We came from Oregon, California, Massachusetts, Connecticut and Pennsylvania. On Friday, we zoomed with the 2 missing classmates who live in New York and California. Although various combinations of us had gotten together over the years, this was the first time we had all been together since graduation day a little over half a century ago.

It was remarkably easy being together again in a shared living space. We brought photos and journals and letters we’d kept. We reminisced about how our group formed during the first 2 years at Brown, about our time on East Manning Street, and about the years since.

We shared memory after memory of our days together. Some of the stories were new to me. No one remembered everything. Some remembered more than others. 

Some memories were pulled into consciousness from the deepest of slumbers. Others were made richer and more complete by hearing different perspectives of the same event. 

There was one memory that only I of those who were there remembered. It was a sunny, crisp fall day during our sophomore year and we decided to walk to the Seekonk River which wasn’t very far away. On that afternoon, ripe milkweed pods were opening and the breeze was lifting the seeds out of their husks. Hundreds floated in the air all around us. It was snowing milkweed! I had never seen anything like that before, nor have I since.

I filled my pockets with the feathery fliers even though I didn’t know at the time what I would do with them. A few days later, I found a clear wine bottle and pushed them into it with a pencil. It was a sculpture…a work of art! 

I kept that bottle through the years, brought it with me to the reunion, and told the story of how it came to be. As I sat looking at it, the Jim Croce lyric “If I could save time in a bottle” popped into my head and I realized that that is exactly what I had done.

I have no pictures from that period, so looking through the albums was, to me, astonishing. My visual memories were weak, faded, and in soft focus. Looking at those surprisingly unfaded color photos was like dusting off my own history, restoring it, and mounting it on the wall. I had forgotten how young we were.

Paraphrasing Hillary Clinton, it occurred to me that it takes a village to not only make a memory, but to preserve it.

In 2001—29 years after our time together and 21 years ago—I had occasion to try to capture our experience on paper. Here’s part of what I wrote:

“It was a time of passions expressed and passions denied; a time of independence, intimacy, intensity, and insufferable debate…but never, ever, indifference…Did any of us know that in that shortest of times we had permanently stitched ourselves into the fabric of each other’s lives?”

We toasted the good fortune that first brought our unlikely band together and we toasted the serendipity that allowed us to celebrate it a lifetime later. As we did so, we made more memories to carry with us to a future reunion: walking on the beach, avoiding poison ivy in the cranberry bog, making dinners, eating ice cream in an old schoolhouse, listening to oldies, doing a pot gummy, and visiting with 2 other classmates who were in the area.

And, of course, we took lots of pictures to share with the pair who could not attend and to fill an album that will help preserve these new memories for all of us.

I don’t think anyone wanted it to end. We joked about having a 75th reunion, but quickly realized we would be in our mid-90s, and so we decided we might want to do this again a little sooner than that.

In 1973, just one year after we graduated, Marvin Hamlisch wrote and Barbara Streisand sang ‘The Way We Were:’

“Memories

Light the corners of my mind

Misty watercolor memories

Of the way we were

Scattered pictures

Of the smiles we left behind

Smiles we gave to one another

For the way we were

Can it be that it was all so simple then?

Or has time re-written every line?

If we had the chance to do it all again

Tell me, would we?

Could we?

Memories

May be beautiful and yet

What’s too painful to remember

We simply choose to forget

So it’s the laughter

We will remember

Whenever we remember

The way we were

The way we were”

But we didn’t forget the painful parts. It was a unique combination of laughter and sadness and youth and intimacy and time and place that created the unbreakable bonds that we still feel so strongly today.

And to answer the song’s question, yes…I would do it all again. In a heartbeat!

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S2E38. Dementia Prevention: Brain Games

The notion that playing brain games on your computer can help prevent dementia is rooted in the research on neurogenesis and neuroplasticity.

Neurogenesis is the process whereby you can grow new brain cells at any age. Neuroplasticity is the process whereby you can grow new connections between neurons.

In theory, then, anything you do that (1) grows new brain cells, (2) increases the number of synapses between neurons, (3) strengthens cells and/or (4) protects them from harmful chemical interactions should all help slow down the process of cognitive aging. The recipe is pretty simple: bulk up your brain mass while minimizing the things that can cause it to atrophy. 

But it’s not just a theory. The research supports this view.

Exercise grows new cells, increases synaptic connections and strengthens the quality of transmission of electric impulses from cell to cell by thickening the axon’s myelin sheath.

A brain healthy diet provides nutrients that support neurogenesis as well as antioxidants that help clean up neuron-killing chemical detritus (e.g., beta amyloid and tau) that are residuals of your body’s immune response (i.e., inflammation).

Sleep expels toxins that accumulate on a daily basis and also increases the strength of neuronal connections (synapses) which form long-term memories.

When we engage in cognitively challenging activities—especially new and novel tasks—we create more connections. That is why reading a book, learning to play an instrument or to speak a new language, and navigating around a different environment (e.g., traveling) are all brain healthy activities.

But what about playing computer games? The evidence is spotty, but it seems that there might be something there. Enough, anyway, to justify millions of dollars of new research to try to nail down just what it can and can not do.

In S2E29: Brain Training Is Hard Work! I discussed the intense effort I expended during my first week of working with the BrainHQ program. Now, 9 weeks later, I have some data I can report.

First, let me say that I over-did it. Playing these games for an hour each day was exhausting. However, it did allow me to quickly work my way through all 29 tasks covering 6 different functions: attention, brain speed, memory, people skills, intelligence and navigation. After 5 weeks, I dropped down to 30-minute daily workouts, which was much more manageable.

So how did I do?

The program provides you with a percentile ranking that shows how your performance compares to others in your same-age cohort. After 9 weeks, my scores have leveled off and I’m not seeing any more improvement. I placed at the 89th percentile overall among 71-year olds, with individual domain scores that range from the 86th to the 94th percentile.

What is valuable about this is that I now have a baseline measure of my mental status. Going forward, if I maintain my 89th percentile ranking relative to my same-age peers, it will mean that I am aging normally. If that number drops, it will mean that my cognitive decline is a cause for concern. If it goes up, it will be a cause for rejoicing as it will suggest that I am not experiencing the expected pace of cognitive decline.

That information has practical value, too. It appears that measurable and accelerating cognitive decline starts to appear about 6 years before a diagnosis of dementia is usually made. If I continue to play these games on a regular basis over the coming years, my scores should serve as an early warning system of any emerging cognitive problems.

The alternative, of course, is to get a full neuropsychological workup every year. Playing computer games is a lot cheaper and more fun, though.

The knock on using brain games to promote brain health is that, although you can get better at the games, your new learning does not generalize to everyday life and so it has no clinical or practical significance, even if your scores continue to improve.

This past Sunday, though, I actually had a real-life experience for which I directly attribute my success to one of the games I’ve been playing. 

In this game, designed to enhance your speed of visual processing, the computer screen is divided into 8 pizza slice shaped segments. Images of 11 birds are then briefly flashed all at once around the periphery. One of the birds, however, is different from the rest. For example, it might have a white body instead of a rust-colored body, or a white wing instead of a black wing. The task is to click on the slice of the screen where the odd bird appeared.

The more I played this game, the better I got. After a while, I was stunned at how accurate I was with only the briefest glimpse of birds on the screen.

Which raises the logical question: So what?

I’ll tell you what! Last Sunday, we were having breakfast at the home of Sally’s son and daughter-in-law. Tammy mentioned that she had seen a bird fly away from their backyard bird house, but couldn’t tell if it was a blue jay or a bluebird. 

As we stood around talking in the kitchen, out of the corner of my eye through the sliding glass doors I saw the flash of a bird in flight. It was only a flash of color that lasted less than a second, but I was able to process its shade of blue and size, realizing immediately that it was a bluebird.

Impressive, huh?

Then we moved outside to eat breakfast. While we were seated around the table, Sally’s grandson Ryan (who recently graduated from college) brought out a bottle of champagne to make mimosas. When he popped the cork, it rocketed through a gap in a vine-covered fence and landed on the lawn beyond. I was the only one who saw where it went. 

Pretty cool, eh?

OK. So it’s no big deal…but it does suggest that something good is happening inside my head thanks to my computer game playing. 

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S2E36. Dodging Dementia Bullets

Dementia risk-management was not something that was on my mind when I was 20. Or when I was 30, 40, 50 or even 60, for that matter. Had it been, I would have been shit out of luck because the research had not been done yet and so there were no guidelines to work with.

Looking back at my life, though, it appears that I did a pretty good job of dodging high-risk dementia-related behaviors. Of course, I could not have done it intentionally because I didn’t know what those behaviors were, so basically, I lucked out. But as Pippin’s father Charlemagne told him: ‘It’s smarter to be lucky than it’s lucky to be smart!’

Here’s a partial summary of my smart luck. I’ve highlighted risk factors for dementia in bold.

Let me start with something that’s not a behavior at all: my genetic makeup. First and foremost, I was born a male. For reasons that are still not yet fully understood, women are at higher risk for developing dementia.

Secondly, it appears that I did not inherit the dreaded APOE4 gene which is linked to early onset Alzheimer’s. My mother demented at around the age of 83, but her sister was cognitively spry when she died at 94. Nobody on my father’s side lived long enough to find out if there was any dementia lurking there.

Like most boys growing up in the 50s and 60s, I played tackle football with pads after school every day in the fall. I was pretty small for my age, earning the nickname ‘shrimpotz’ in 4th grade, and I was still only 130 pounds when I got to my sophomore year of high school, so I figured playing football was hopeless and switched to running. The lucky thing here is that I was never knocked unconscious or had a concussion. Another risk factor averted. 

Not only did I dodge that bullet, but running became a lifelong habit. I was in the first cohort of joggers to take to the streets, back when it was considered cool for cars and trucks to try to run you off the road. Unknowingly, I had adopted one of the 5 core behaviors for reducing dementia risk…and I did it at a very early age.

I also lucked out when it came to education. I started school in Newark, NJ, where the quality of the education offered had already begun its decline from the system that produced Philip Roth in the 1940s to the one that failed and was taken over by the State of New Jersey in the 1990s. When I was about to enter 4th grade, my parents were able to move us to a town with some of the best schools in the state. I flourished there and wound up getting into Brown University.

All of that was fortuitous because, as it turns out, attending a high quality elementary school and going to college are both protective factors. Again, lucky me!

But it didn’t stop there. When I was 44, I decided to become a psychologist and so I spent the next 6 years in graduate school, first at Marywood University in Scranton, PA, and then at the University of Connecticut. Once again, I didn’t do it to promote my long-term brain health, but we now know that that kind of intense cognitive challenge involving learning new skills and information is also one of the pillars of dementia risk-reduction.

Along those lines, I suppose it also helped that I changed careers every 10 years and that all of those careers were people-oriented.

With its heavy doses of sugar, refined flour, saturated fats, beef and fried foods, the American diet is a notorious contributor to dementia risk. For a long time, I ate with abandon in service to my taste buds, ignoring calories, cholesterol and fat content. Can you say “large pizza with extra cheese, sausage and pepperoni?” 

Fortunately, I did not have a sweet tooth and my metabolism did not lend itself to excessive weight gain. Thus I dodged two more dementia bullets in spite of myself: diabetes and obesity.

My worst period in terms of unhealthy eating was when we were running our B&B. I was the cook, serving up eggs, bacon and breakfast pastries every day. And every day I ate what I was cooking. By the end of that run, though, I realized that I needed to make some changes. There was a history of heart disease on my father’s side (it killed both him and his father when they were around 60), so I figured I better start eating a heart-smart diet. The research for that was plentiful, so I gave up red meat, began using low-fat products, and ate more vegetables, fish and pasta. As fate would have it, all those changes were helpful in maintaining brain health (and constitute another pillar of a brain-healthy lifestyle). I was in my 40s at the time.

I was never a big drinker. In fact, I was a cheap drunk, getting tipsy on just 2 beers. In college, I tried to become a ‘better’ drinker (you can imagine the peer pressure) and even managed to down a 6-pack of Schlitz one night before passing out. But excessive drinking was not in the cards for me. That doesn’t mean that I never got drunk because I did when the occasion merited it. But I never really liked the taste, whether it was beer, wine or hard liquor. Even now, it’s hard for me to drink a few ounces of red wine with dinner, but I do it for the purported brain-health benefits.

On the other hand, I never had any desire or interest in smoking. I hated it ever since I was in grade school and my parents used to light up at the dinner table at the end of the meal. I became an anti-smoking advocate at an early age, so much so, that people were astonished to learn that I had smoked pot! Oh, I suppose I took in my fair share of second-hand smoke (my first wife of 36 years was a smoker), but I think its safe to put this in the ‘dodged a bullet’ column, too.

There are a few other risk factors I haven’t covered here. You can see them all at this link to see how lucky you’ve been:

https://www.nhs.uk/conditions/dementia/dementia-prevention/

Finally, there is one risk factor I haven’t yet dodged, and it’s the biggest one: age. The older you are, the greater your chances of dementing. But dodging that bullet is a good thing, isn’t it?  🙂

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S2E35. The Fog Of Memory

It was the spring of 1986. I had quit my job in Newark, NJ, and we had moved out to Tyler Hill, PA, where we were renovating an 1847 farmhouse with plans to open a B&B by the 4th of July weekend.

I was in one of the bedrooms on the 2nd floor where I was removing more than a century’s worth of floral print wallpapers. The work was slow and painstaking, first soaking small sections in a solution of vinegar and water and then scraping it carefully so as not to gouge the plaster beneath it.

It was also pretty mindless. After a while, I started to replay memories. I was 35 at the time, so my just-ended career in Newark, high school and college years, and growing up were not all that long ago.

I seemed to be watching the movie of my life playing in reverse. The farther back I went, the faster the reel seemed to spin, until I saw my baby pictures in my mind’s eye and the movie ended.

I felt inexplicably exhausted, so I lay down on the floor and closed my eyes…and a feeling of relief swept over me. Suddenly, I felt unburdened by my past and all the emotional baggage that came with it.

I soon realized that all those memories were no longer as close and vibrant as they had been just a few moments before. It was as if I had packed them all into boxes and moved them up to the attic. 

Whatever happened that day was not intentional on my part, but it seems to have repeated itself every 10 years when I switch careers. It’s as if I hold on to a ton of potentially relevant information in case I need it, but then put it into long-term storage as soon as I don’t.

It happened again last year when I ended my 10-year career volunteering for the Democratic Party. No sooner had I quit as chair of the local organization than my memories of a decade’s worth of campaigning became remote. They had joined the previous sixty years worth of boxes in the attic of my mind, in a place that I refer to as ‘ago’ to differentiate it from the here and now. 

I envy people who say they remember events as if they were yesterday. I have no such ability. When I rummage around in one of those boxes, my recollections appear as photographs, not movies. And they are definitely not high-def! Many have shifted perspective, so I have a bird’s eye view instead of my actual eye-witness perspective. 

Many memories have been replaced by memories of the photographs of those events which I’ve viewed over the years. It’s a poor substitute, but it’s all I’ve got at this point.

Although I can’t conjure up strong visual images, I have detailed memories of the stories I’ve told about those long-ago events. My semantic memory (i.e., the facts surrounding events) is much stronger than my visual recollections. Auditory memory is pretty much non-existent.

Occasionally, strong emotional memories will surface. A feeling—sometimes triggered by a smell—will overwhelm me. I can’t always place it, but it’s familiar…and usually warm and pleasant.

I remember myself through a fog. I can still make out the shapes of my past, but they’re distant. I know that all of these things are part of me, but I just can’t see them all that well, even though I can describe them in great detail.

I have no idea whether this is normal or not. I don’t think it’s gotten worse with age. I think I’ve always been like this…but I’m not sure because I don’t think I thought about it when I was younger.

Which makes me wonder where it goes from here. 

I’ve been watching a series of lectures on the ‘Joy of Mathematics’ from TheGreatCourses.com. I remember loving math classes in high school and being good at it. I remember the joy of solving equations. I graduated from Brown just 2 courses short of meeting the requirements for a degree in math.

Yet watching these lectures has shown me that the lion’s share of all that learning and studying is completely gone from my memory. I know: use it or lose it. But it still seems a shame. And it raises the specter of vast stores of memories falling into a black hole from which there is no recall.

That possibility makes even foggy memories look really good by comparison!

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S2E34. Uh-oh: Memory Failure!

(Theodore Ribot, in The Diseases of Memory published in 1881, pointed out that the first characteristic of amnesia in patients with dementia is the loss of memory for recently experienced events with relative preservation of remote events.)

I opened an email from Greg, a classmate at Brown some 50 years ago, that include a link to a recent article in The Guardian titled “Stop drinking, keep reading, look after your hearing: a neurologist’s tips for fighting memory loss and Alzheimer’s.”

I appreciated his thoughtfulness in sending it to me as I am always on the lookout for articles that might generate the inspiration for a blog episode. This article was an interview with Dr. Richard Restak and the occasion was the release of his new book The Complete Guide to Memory: The Science of Strengthening Your Mind.

I googled the book before I even finished reading the article, then downloaded the electronic version so I could scan its contents. A lot of the usual material was covered and I was struck by the fact that here was yet another neurologist covering a lot of the same material that is standard for this type of tome. It didn’t look like there was much that I hadn’t covered in prior posts.

 As I was moving it to the trash, though, I noticed that I had previously downloaded this very book!

Strange, I thought, that I hadn’t recognized the cover art. The name ‘Restak’ seemed familiar, but I couldn’t place it. Thinking logically, I realized that I must have read the book and, therefore, I must have blogged about it. So I scanned the titles of all my posts looking for one in which I might have written a review of the book. Since nothing jumped out at me, I began opening posts with potentially related titles and soon found it. It was S2E28: Working Memory Workout? published on July 15th.

That was only a month ago…and my memory of reading that book had all but evaporated!

What a kick in the pants! Here I was doing daily workouts to improve brain performance and I just had a major fail of episodic memory, the kind of memory malfunction that Ribot described back in 1881.

Episodic memory is our memory of what happens to us: what we do and what we experience. How could I not remember reading this book just a few weeks ago when I had obviously spent a lot of time reading it, thinking about it, and finally writing about it?

Forming an episodic memory has three stages. First you have to pay attention to the event. Basically, if it didn’t make much of an impression when you first experienced it, it’s unlikely that you will recall it later on. 

Second, you need to encode it into memory. You do this by thinking about it, processing it, replaying it, and linking it to other experiences so it fits into a framework for remembering. 

Finally, you need to be able to retrieve it. Recall memory is when you can retrieve it from your memory banks without any assistance. Recognition memory is when you need cues or hints in order to find it. Unsurprisingly, recognition is easier than recall. In either case, though, the memory must have been encoded for you to unearth it later on, with or without a little help from your friends.

So what had happened to cause my memory failure? I clearly had paid attention to the book and processed it more than enough to guarantee encoding. It would be easy to conclude that this was therefore a retrieval error…but maybe not. Why did it not come rushing back to me after seeing multiple cues, including the cover and table of contents? Alternatively, the breakdown could have been caused by a failure in any one or in any combination of the three functions.

I did a quick web search of articles about episodic memory and came across one that suggested you could improve it by watching a movie and then listing as many of the scenes as you could remember. It seemed to me that this could also serve as a reasonable test of your ability to recall episodic memories, so I tried it with a movie I had just watched the night before: ‘Hud’ starring Paul Newman.

I waited 5 days to give my brain a chance to consolidate the memory and, perhaps, even time enough to forget a little about it before attempting the task. 

Now, obviously, I don’t know how many scenes there were nor how many scenes a brain-healthy 71-year old would remember, but I came up with 43.

I’ve got to believe that that’s pretty good. I’m pretty sure I didn’t miss much, so I’m going to put off worrying about any possible episodic memory failures for the time being.

But it is a little scary to see how it might sneak up on you.

__________

S2E33. How To Keep Your Brain Young

I stumbled across a book referenced in an article I was reading and was intrigued by the description of the author: “Professor Kerryn Phelps AM, Australia’s most trusted GP.”

Interesting! A book about brain health by a general practitioner and not a neurologist or neuropsychologist? A consumer of research instead of a creator of research? And from Australia? Because of these anomalies, I wondered if her perspective would differ from everything else I’ve been reading written by Americans with more traditional backgrounds…so I read her book, How To Keep Your Brain Young which was published last September.

Some differences were immediately apparent, such as the spelling of words like ‘foetus’ and ‘coeliac disease.’ When citing research studies, she tends to reference where the work was done instead of the authors’ names, so you come across things like, ‘in a study done at the University of Sydney…’ She seemed to prefer citing work done in Australia, and that was layered on top of references to Australian epidemiological studies and policies of Australian public health agencies. All in all, it was refreshing to see the view from down under.

The most striking thing about this book, though, is the range of topics covered. Although any book about brain health will necessarily cover dementia-related topics, Professor Phelps goes above and beyond in cataloguing the wide variety of things that can affect one’s brain health over one’s lifetime. You might expect a cradle-to-grave approach, but she goes beyond that, not just to pre-natal concerns, but all the way to pre-conception factors that might affect the brain-in-waiting!

Her thoroughness is carried throughout the book with an attention to detail that could only be rooted in the curiosity of someone who found every fact about the brain to be enormously fascinating. She begins with a description of the various brain structures, their functions and the neurotransmitters that drive the system. I have to admit that if I was not already well-versed in those topics, I would have found it very difficult to follow. It’s not that she uses a lot of technical jargon, but that she presents the information in a rapid, unadorned format. ‘Just the facts, ma’am,’ as Sergeant Joe Friday used to say. Her writing is unembellished. There are few anecdotes and personal reflections. There is no poetry in her prose. She writes like a GP speaks: ‘Here’s what the tests show and here’s what you can do about it. I’ve written you a prescription.’

Nonetheless, it’s riveting and breathtaking in its scope. There are short chapters about virtually all the things that can affect your brain in a lifetime, including alcohol, medications, chemotherapy, smoking, anesthesia, gluten, glucose, blood pressure, street drugs, menopause, stress, depression, your gut biome, stroke, brain injury and brain cancer. Factors that don’t merit their own chapters are covered in the chapter on dementia. Oddly, though, she doesn’t address air pollution, toxic chemicals or pesticides.

I thought the best line of the book came in her summary of the effect of using methamphetamines. After detailing all the different ways it kills neurons and affects brain function, she dryly remarks that ‘it really doesn’t have a lot going for it.’

After detailing what proper brain function looks like and inventorying all the things that can go wrong, she settles into a discussion of the things you can do to protect your most valuable organ throughout your lifespan, or as she puts it, ‘how to keep your brain young.’ There are chapters dedicated to cognitive challenge, exercise, diet, supplements, social connectedness, relationships, sleep and mind-body therapies. She also includes a chapter on the brain-enhancing properties of pets, which is something I hadn’t come across anywhere else.

Professor Phelps closes the book with a lifetime prescription for protecting your brain and preserving its performance. It comes down to avoiding brain injury, exercising, optimizing your diet, controlling your blood sugar, managing cholesterol, improving your gut health, controlling your blood pressure, building and maintaining social networks, sleeping soundly, stimulating your mind, taking care of your emotions, being cautious with prescribed medications, avoiding illicit drug use, not overusing alcohol, never smoking, and considering using supplements and herbs.

It seems like a lot until you realize that you’ve got a whole lifetime to figure it out. Obviously, the earlier you start, the better off you’ll be. Nonetheless, the research says that benefits will accrue no matter when you engage.

So, to answer my initial question, the view from down under is pretty much the same as it is from here in West Chester, PA!

__________

S2E31. Sweet Dreams Are Made Of This

When I was growing up, my mother valued her children’s sleep above all other bodily functions. When I was 12, I used that to my advantage when I wanted to play hooky from Hebrew school by staying up late the night before and then pretending not to wake up the next morning when she called me.

In college, a had a fierce bout of depression and found myself sleeping 12-16 hours every day. My therapist told me it was a defense mechanism whereby I tried to escape from reality. It sounded plausible at the time.

I used to wake up most nights at 3am. My best guess was that it was a little bit of residual trauma from when I was 6 or 7 and I was startled awake by the phone ringing. It was the hospital calling to tell us that my grandmother had died. My mother jumped out of her bed, wailing and crying hysterically. I glanced at the clock in my room and saw that it was 3am. Just recently, I learned that about 35% of us habitually wake up at 3am…and a related trauma is not a prerequisite at all.

In my early 30s, when I was the executive director of a performing arts center, I used to doze off in my office every afternoon. I fought it for a long time in the belief that I shouldn’t  be sleeping on the job, but then I decided, screw it! As soon as I’d start to get drowsy, I would buzz my secretary and ask her to hold my calls, lean back in my chair and nod off.

My afternoon napping habit never left me. When my first wife and I ran a B&B in northeastern Pennsylvania, I would retreat to the rope hammock hung between a pair of birch trees or lie down on the porch swing on most days in the late spring, summer and early fall. Those were the best naps of my life!

Fifteen years later, as the staff psychologist on an inpatient behavioral health unit, I took my nap a little earlier to coincide with my lunch break. Without my asking, our director sent out a notice that staff should not disturb Dr. Braffman during lunch unless there was an emergency and a patient was in crisis. Now that’s how you value nap time!

In graduate school, I learned about the 4 phases of sleep. Later studies revealed that you cycle through these phases 4-6 times every night, and that you can dream at any time, not just during REM sleep. 

New research published last month reported that there is a noradrenaline cycle that wakes you up as many as 100 times during the night. The awakenings are measured in milliseconds, so you are unaware of the vast majority of them.

Although we appear quiescent while we sleep, there’s actually a lot of important business going on under the hood. It’s the time when we consolidate memories and new learning and replenish our available stores of vital neurotransmitters. If you don’t sleep well or long enough, you’re going to have cognitive problems the next day, e.g., brain fog and you’ll be prone to making a lot of mistakes.

Another critical function of sleep is to clean up the chemical detritus left over from your brain’s daily activities. There is a whole separate network in your head that performs this task, running in parallel with the neural networks with which we are all so familiar. It’s called the brain’s glymphatic system.

It’s hypothesized that your brain’s ability to clean up the daily messes that it makes plays a critical role in preventing dementia. One way this might work would be by removing beta amyloid that is created as part of an immune response like a fever. 

What I haven’t been able to find anywhere in the literature, though, is a description of the magnitude of this cleaning power. Can your brain completely clean house every day? Is there enough residual power to clean up festering messes that overwhelmed the system on earlier occasions? In other words, is it destiny that our brains eventually be overrun with chemical garbage? Or can we chip away at accumulations of waste products until all our neural pathways are functioning again? Or is breaking even on a daily basis the most we can hope for?

We don’t know the answer to those questions yet, but we do know that somewhere between 7-9 hours of restful sleep on a regular basis helps tremendously. And naps are good for you, too (thank you, lord!), so long as you don’t overdo it to the point where they start to affect your nighttime slumber.

The impact of consistently high-quality sleep on your brain’s health can not be overstated. If you aren’t sleeping well (i.e., less than 6 hours each night), you might want to consider implementing some behavioral changes now that will reduce your risk of dementia by 30-50% later on.

To sleep better, lay off the alcohol in the evening and no more caffeine after 12 noon. Set a fixed schedule for going to bed and waking up. Stow your electronic devices about an hour before bedtime. Make a list of all the things you want to do the next day so you don’t lie awake thinking about them. You might want to do a meditation/relaxation/deep breathing exercise just before bedtime. Make sure your bedroom is dark and the temperature is somewhere in the 60s.

If you do all of these things and still have trouble sleeping, it will be well worth your while to get evaluated. There are a range of products out there—both natural and pharmaceutical—that can offer you support, if you need it.

Pleasant dreams!

__________

S2E28. Working Memory Workout?

A majority of the mistakes and cognitive errors that I have documented in this blog involve failures of working memory. Working memory is where we hold information online while we manipulate it and/or consider what to do with it. It’s where we hear our internal voice. It’s the central cog in our executive functioning network.

Consequently, it’s not pretty when you start to experience declines in your working memory abilities which, as it so happens, are usually the first to go as we get older.

So I was intrigued by an article in The New York Times last week that reviewed a new book (The Complete Guide to Memory: The Science of Strengthening Your Mind) by neuroscientist Dr. Richard Restak in which he asserts that exercising your working memory can forestall its decline and possibly even restore prior losses. The article covers his 7 key recommendations and you can read it here.

Regular readers of this blog know me well enough to figure out that I downloaded the book and read it this week. It reviews all the usual types of memory and he adds a few new ones of his own construction. He pays more attention to brain structures than most books of this type, but he keeps his narrative breezy and conversational, including examples ‘ripped from the headlines,’ as they say.

He recounts the usual litany of techniques you can use to better remember lists, but I was most intrigued by his lengthy discussion of working memory and exercises you can do to actually strengthen it.

One such exercise was to name all of the United States presidents in chronological order, beginning with FDR. Then do it in reverse order. Then do it alphabetically. Then do it in reverse alphabetical order. If you want to try this, I’ll give you a hint: there are 15 of them.

It took me a little while one sleepless night to master this task. As I did so, I felt like I could actually see the places where my working memory let me down and where answers were swimming nearby but just out of awareness.

He recommended making other lists that you can manipulate in similar ways, and to practice organizing them in your mind every day. 

He also recommended daily practice with what is known as the ‘N-back task.’ The easy-to-do-at-home version of this only requires a deck of playing cards. First, you select two cards that will be your ‘trigger’ cards, say a ten and a three. Then you turn over the cards one by one, look at them, and place them face down in a pile. When one of your trigger cards appears, you have to name the card that preceded it. This is the ‘1-back’ version of the task. After you’ve mastered it, you can make it more difficult by trying to name the card that was two cards before the current card, or ‘2-back.’ 

I immediately pulled out a deck of cards and tried it…and failed miserably at the 2-back version. I did alright with the 1-back version, actually having the most difficulty remembering which were my 2 trigger cards!

This piqued my interest in working memory tasks and so I googled it. I discovered quite a number of sites offering (for a subscription fee) computerized versions of a wide variety of working memory tasks. 

I tried a number of them and quickly discovered how limited my working memory is. I was especially bad at tasks that required me to remember visual images. In fact, I noticed that I retained virtually no memory of the images and had to resort to semantic memory to complete the task, i.e., naming the images that had flashed on the screen and remembering the names, not the pictures.

Neuropsychological tests are very good at isolating and identifying your weaknesses, and these were no exception.

Dr. Restak talked about my condition in his book. It’s called ‘hypophantasia’ which is the inability to retain fleeting visual images in your mind’s eye. Conversely, people who are exceptionally adept at doing this have ‘hyperphantasia.’ My first wife was such a person. She could walk through someone’s house once and later draw a diagram of all the rooms on every floor…to scale! Most of us have abilities that fall somewhere along this spectrum from hyper- to hypophantasia.

This experience alarmed me enough to want to initiate a structured workout routine to try to improve (or at least slow the deterioration) of my working memory. My recollection, though, was that—Dr. Restak’s exhortations notwithstanding—the research is mixed about whether computer games and tasks can actually improve your cognitive abilities. In most cases, it appears that you can get better at the computerized task, but that it doesn’t generalize to improve your ability to perform other tasks of daily living. What was I to do?

Right on cue, I received an email from one of my college roommates, Tom, with an article from The Boston Globe about several large-scale, age-related cognitive studies that are being launched in New England. Among the variables being tested are brain training techniques. The program offered by a company called BrainHQ will be used in these studies.

Well, if it’s good enough for the researchers, then it’s good enough for me! So I went to www.BrainHQ.com and subscribed for a year for $96.00. My intention is to do a 1-hour workout each day…if the frustration from getting too many wrong answers doesn’t overwhelm me.  

Wish me luck!

__________

S2E27. And The Diagnosis Is…

For the last year and a half now, I’ve been attempting to faithfully record the types of cognitive errors I notice myself making. At the same time, I’ve been researching the differences between normal aging, mild cognitive impairment, and dementia. So it’s about time I made the call and diagnosed myself, don’t you think?

Making a diagnosis like this isn’t a 1-time thing nor is it an all-or-nothing thing. It’s a snapshot of where I stand today. It’s not predictive of where I will be a year from now, or ten years from now. It’s more like an annual check-up than it is a definitive conclusion.

Before the ‘big reveal,’ though, I thought I’d summarize the range of mistakes I’ve previously documented in this blog. Here you go:

S1E2. Short-Term Memory Peek-A-Boo: walking into a room and forgetting why I went there; being able to hold fewer items in short-term memory (e.g., a 10-digit telephone number) than before.

S1E4. Mistakes On The Journey: doing things without intending to; tip-of-the-tongue word-finding problems; saying a word that isn’t the one I intended; not checking things after I’ve completed them so I don’t catch the errors I’ve made.

S1E5. Testy & Edgy: irritability; lowered frustration tolerance.

S1E6. Did I Do That?: Not remembering doing something right after I did it.

S1E8. Splotchy Thinking: more examples of doing unintended things; more examples of not remembering recent events.

S1E15. Vivid Memories That Aren’t: clear recollections of past events that turn out to be false.

S1E16. The Name Game: Not remembering the names of people I knew well years ago.

S1E18. 2 Runs, 4 Hits, 1 Error: Errors made in social situations.

S1E20. Dear Diary…: Errors in completing complex tasks.

S1E22. Making Coffee Isn’t Hard…Is It?: More problems with complex tasks and routines.

S1E24. Scary & Scarier: Breakdowns in implementing well-learned routines.

S1E28. Potholes On Open Highways: a variety of mistakes including memory, word-finding, and getting distracted.

S1E33. Poor Judgment: exactly what the title says!

S1E35. Mini-Miscues: A collage of errors, including visuo-spatial challenges.

S1E43. No Comment: Talking less in social situations.

S2E7. More Mistakes On The Journey: a grab bag of recent errors.

S2E12. When Your Fact-Checker Doesn’t: problems with executive function and meta-cognition.

S2E18. Subtle Symptoms?: Things that aren’t really problems now, but could become problematic if they worsen. 

(You can read all of these episodes by going to the home page and scrolling down: www.MistakesOnTheJourneyToNowhere.com.)

Reviewing these episodes in order to write this post was pretty sobering. It seemed really bad at the time and I remember being nervous about all the ways I was failing. But I don’t feel that way anymore, even though I recognize that I am still committing most of these categories of errors. What changed?

For one thing, I realized that none of the mistakes that were dogging me had serious consequences. When playing schoolyard basketball, we used to say ‘No blood, no foul’ and these cognitive ‘fouls’ aren’t drawing any ‘blood.’

Secondly, I think I’ve become used to committing this range of errors. They were pretty shocking when I first focused my attention on them, but now, not so much. When I do a mental belly flop I’m more likely to react with a ‘Meh’ than an ‘OMG!’

Finally, I’ve gotten better at compensating for a wide variety of them. In most cases, the duration of a screw-up is very short (measured in just a few seconds) and quickly corrected.

So here’s my bottom line as of July 8, 2022 as I’m just a few days short of 71½:

I definitely don’t have dementia. This is primarily based on the fact that none of the errors I’m committing have serious consequences or affect my ability to live independently.

For the same reason, I don’t think I meet the criteria for a mild cognitive impairment, either: there are no noteworthy consequences to my miscues. Even Sally, who is uniquely adept at spotting my screw-ups, would agree that they are mainly trivial in nature.

By process of elimination, then, it would appear that what I’ve been documenting is normal aging. Not only do my errors fall within a harmless range, but I’m maintaining pretty good executive functioning (e.g., writing this blog every week) and I am still able to find creative solutions to problems. 

So that’s the diagnosis I’m going with for now: normal aging. And if I’m correct about that, then it’s both reassuring and terrifying to know that one’s brain circuits can misfire so frequently and you still get to call yourself ‘normal!’ 

__________

S2E26. Losing My Mind

“Every day is new now, with little remembrance of the day before, but with enough memory retained to know there was a yesterday. This is a new way to live and it takes getting used to.”

Thomas DeBaggio, author of the above quote, was diagnosed with early onset Alzheimer’s in 1997 at the age of 57. His book detailing the progression of the illness (Losing My Mind: An Intimate Look At Life With Alzheimer’s) was published in 2000. He went on to write another book in 2002 chronicling his life with dementia, and became a tireless advocate for Alzheimer’s research. He passed away in 2012.

Up until now, all of my posts have focused upon discerning the difference between normal age-related errors we all make and the more problematic mistakes associated with the onset of dementia, as well as preventative measures we can adopt to try to dodge the illness which affects about half of those who make it beyond the age of 85.

Reading this book last week, however, was my first road trip into the world of life with dementia…and it was sobering. 

The book is presented as a braid of three interwoven threads. Fortunately for us, DeBaggio’s first love was writing. He was a journalist before settling into his career growing and selling herbs, which also led to his writing about that experience.

The book is not written in chapters. Instead, paragraphs alternate between the three threads. It’s a surprisingly effective technique that captures the essence of the relentlessly vanishing world in which he lived.

The first thread is his biography. Reading it, I wondered if he wanted to leave a trail he could follow to find himself once his memory of his own personhood failed him. A noble effort, for certain, but doomed to failure as the disease progresses inexorably through its mind-sucking stages which would ultimately rob him of the ability to understand that the story he had penned years before was about him. 

The second thread is a description of his current status as it unfolds over the course of his first three years living with Alzheimer’s. At this point, he still has the introspective awareness to be able to recognize when he is making a mistake or losing a cognitive capacity or experiencing something new and unfamiliar. It is here that I am most thankful for his literary skills…which makes it all the more painful to travel with him as he loses access to his words and to the thoughts that he can’t pin down and retain:

“There is a dullness in my brain now to allow me to stare into silence without an idea or thought breaking the stillness.”

Juxtaposed against his past and his present (and looming future) is a summary of his research into Alzheimer’s disease circa 1999. He details the state of the research with excerpts from scholarly publications. It soon becomes frustratingly apparent that there has been very little progress in the past 22 years.

I’m glad I read this book as it helped better define for me the seamless spectrum that runs from the errors of normal aging to indications of cognitive decline to the early experience of dementia. It’s the transition from making errors that are irritating but readily resolved to awareness of problematic thinking that has real-time consequences to the loss of control of your inner dialogue.

Thankfully, I’m still in pretty good shape. When I woke up Thursday morning thinking about how I would end this episode, I was able to table my ideas and return to them after breakfast without any problem. 

My thoughts don’t simmer in a quantum soup where they live lives measured in nanoseconds and their very existence is always uncertain. 

My computer’s spell-check isn’t working overtime to try to figure out what it is I really meant to type.

I’m nowhere near traveling DeBaggio’s path, yet I am grateful to him for illuminating the way.

__________

S2E25. The 10 Warning Signs of Alzheimer’s

I’ve been blogging for a year and a half now and, surprisingly enough, have yet to delve into the early symptoms of dementia in their entirety. I’ll correct that oversight below, but before I do, I’d like to add a little perspective.

When you go through the list below, I think you’ll agree with me that there has already been a significant cognitive decline by the time you experience those kinds of problems. Given that we have no treatment that can reverse the effects of dementia, the primary value of diagnosis at that point would seem to be to initiate the transition to some form of assisted living, whether it be in a facility or via support provided by your family.

But there is another really good reason for getting checked out. It’s very possible that the cognitive mistakes you are making have a cause other than dementia. In particular, depression, sleep disturbance, stress and medication interactions can all generate symptoms that mimic dementia. There is great value, then, in ruling out these other causes before you start to fret over beginning your long goodbye.

Having said that, I hearken back to my original intent in writing this blog which was to try to identify indicators that you were slipping well before you get to the debilitated state described in the ‘warning signs’ below. My hope was that perhaps an extra year or two of awareness would give you time to make lifestyle changes that might slow the progression of the illness. What I’m searching for is cognitive errors (my ‘mistakes on the journey’) that are more worrisome than ‘normal aging’ yet not as debilitating as a ‘warning sign.’

As for now, it appears that dementia-related errors are (1) more frequent and (2) more disruptive than those found in normal aging. It’s a fine line, indeed.

With that in mind, I joined a webinar this past Tuesday presented by the Alzheimer’s Association (www.alz.org) titled ’10 Warning Signs of Alzheimer’s’ in hopes of hearing about more subtle indicators of an approaching dementia. 

Spoiler alert: I was disappointed. The material covered was no different than that already posted on their website and, in fact, utilized the same slides. So rather than provide a summary of what I learned, it makes more sense for me to just present the information directly from their website, as I really don’t have anything to add. These are the best guidelines we as laypeople have to differentiate normal aging from dementia. The take-home message is this: If someone you know is exhibiting one or more of these symptoms, it’s probably time for a full diagnostic evaluation.

Here are the 10 warning signs:

1. Memory loss that disrupts daily life.

One of the most common signs of Alzheimer’s disease, especially in the early stage, is forgetting recently learned information. Others include forgetting important dates or events, asking the same questions over and over, and increasingly needing to rely on memory aids (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own.

What’s a typical age-related change?
Sometimes forgetting names or appointments, but remembering them later.

2. Challenges in planning or solving problems.

Some people living with dementia may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before.

What’s a typical age-related change?
Making occasional errors when managing finances or household bills.

3. Difficulty completing familiar tasks.

People with Alzheimer’s often find it hard to complete daily tasks. Sometimes they may have trouble driving to a familiar location, organizing a grocery list or remembering the rules of a favorite game.

What’s a typical age-related change?
Occasionally needing help to use microwave settings or to record a TV show.

4. Confusion with time or place.

People living with Alzheimer’s can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there.

What’s a typical age-related change?
Getting confused about the day of the week but figuring it out later.

5. Trouble understanding visual images and spatial relationships.

For some people, having vision problems is a sign of Alzheimer’s. This may lead to difficulty with balance or trouble reading. They may also have problems judging distance and determining color or contrast, causing issues with driving.

What’s a typical age-related change?
Vision changes related to cataracts.

6. New problems with words in speaking or writing.

People living with Alzheimer’s may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have trouble naming a familiar object or use the wrong name (e.g., calling a “watch” a “hand-clock”).

What’s a typical age-related change?
Sometimes having trouble finding the right word.

7. Misplacing things and losing the ability to retrace steps.

A person living with Alzheimer’s disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. He or she may accuse others of stealing, especially as the disease progresses.

What’s a typical age-related change?
Misplacing things from time to time and retracing steps to find them.

8. Decreased or poor judgment.

Individuals may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money or pay less attention to grooming or keeping themselves clean.

What’s a typical age-related change?
Making a bad decision or mistake once in a while, like neglecting to change the oil in the car.

9. Withdrawal from work or social activities.

A person living with Alzheimer’s disease may experience changes in the ability to hold or follow a conversation. As a result, he or she may withdraw from hobbies, social activities or other engagements. They may have trouble keeping up with a favorite team or activity.

What’s a typical age-related change?
Sometimes feeling uninterested in family or social obligations.

10. Changes in mood and personality.

Individuals living with Alzheimer’s may experience mood and personality changes. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, with friends or when out of their comfort zone. 

What’s a typical age-related change?
Developing very specific ways of doing things and becoming irritable when a routine is disrupted.

If these are the 10 criteria by which we are to measure our cognitive health, then I passed my 71½-year check-up with flying colors!

The only item that is close to raising a warning flag is #9: Withdrawal from work or social activities. As Sally has pointed out, I’m not as talkative as I used to be and now have a tendency not to participate in conversations. But it’s not because I’m not following along or can’t find the words or put together a sentence. I would describe myself in those situations as being comfortable and attentive, albeit not actively engaged. To the extent that my silence might represent a precursor to the development of poverty of thought, though, it’s worth keeping on eye on.

So I’ll take my current mental status as a win…and continue to search for earlier warning signs of dementia.

__________

S2E22. An Abundance Of Caution

Every few days, it seems, a public figure issues a statement saying that although they are fully vaccinated, they just tested positive for COVID. And, although they are asymptomatic at this time, out of “an abundance of caution” they will quarantine for five days.

I just love the phrase “an abundance of caution.” Is that like a gaggle of geese? Or a congress of baboons? In any event, I appreciate the sentiment.

It is out of an abundance of caution, then, that I am switching to organic toiletries: soap, shampoo, hair conditioner, toothpaste, deodorant and shaving cream. The links between these products and dementia are weak at best, but I figure it can’t hurt, so why not?

Toothpaste

Gum disease and gingivitis are both risk factors for dementia. Daily brushing, therefore, is important. As the old Crest carton and tv ad reminded us: ‘…when used in a conscientiously applied program of oral hygiene and regular professional care.’

The primary concern about toothpaste seems to be the presence of fluoride. From what I can gather, though, the best documented effects involve embryonic neurodevelopment and young children. Deposits have also been found post-mortem in the brains of those with Alzheimer’s, but no correlational or causal links have been proposed.

Other ingredients in toothpaste (e.g., artificial sweeteners, artificial coloring, parabens, propylene glycol) might harm you in various ways, but my concern here is brain health. But…out of an abundance of caution…I made the switch. 

It appears that a solution of equal parts baking soda and water will work just fine as a daily toothpaste and it’s as inexpensive as it gets. Alternatively, there are a variety of organic toothpastes available online, although most are on the pricey side.

Shampoo and hair conditioner

Did you know that there are emissary veins in your scalp that provide a conduit into your brain? Their presence means that what you rub into your scalp has the potential to get into your brain…and that’s cause for concern.

A few chemicals in the United States have been banned from use in hair dyes for this reason, but there are many others that are suspect but for which there are inadequate studies to establish the danger. The European Union, on the other hand, has banned some 1,300 chemicals from cosmetics.

Since we massage shampoo and hair conditioner into our scalps on a regular basis, and the potential exists for it to be absorbed into our brains, then I think it makes sense to pay attention to what we’re using.

I used Pert shampoo with conditioner for years. It always burned my eyes, but I didn’t think anything about it. After all, at an early age we were taught to close our eyes when shampooing. Now, though, I figure that that isn’t such a good thing after all, and so I tried organic products and…lo and behold…no more eye irritation!

Soap

I’ve been using Zest for as long as I can remember, and, just like with my shampoo, the fumes burned my eyes. That was enough to get me to try an organic milled soap. And just like with the shampoo, the burning disappeared.

One theory about Alzheimer’s posits that an ineffective immune system can be responsible for the disease. The thinking behind it is somewhat counter-intuitive: we are so germ-conscious that we sanitize ourselves to the extent that our bodies don’t learn how to fight off a range of bacteria, and it is our under-developed immune systems that fail us when it comes to preventing dementia caused by bacteria.

One of the recommendations that this suggests is to stop using anti-bacterial soap. Fascinating!

In addition, chemicals can be absorbed through our skin, some of which can cross the blood-brain barrier, so it makes sense to pay attention to the ingredients in your soap…out of an abundance of caution!

Deodorant

The suspect chemicals to be avoided in deodorants are parabens, triclosan, phthalates, propylene glycol and aluminum. Their effects are linked to cancer more than dementia, but as long as we’re protecting ourselves, we might as well go all in.

It turns out I was already using a safe deodorant: unscented Arm & Hammer Essentials, so no need to change.

Shaving soap

The ill effects of the chemicals that might be found in shaving soaps are generally not too severe except for aerosols which may contain carcinogens. But just like with deodorant, we’ve come this far, so we might as well finish the job. In this case, too, I was already using a natural, unscented shaving soap.

So for me, it wasn’t that hard to make the switch to natural toiletries. The fact that I only use 6 items certainly helped! Did I really have to do it? No. Will it decrease my likelihood of getting dementia by a significant degree? Probably not. But out of an abundance of caution, I did it anyway.  😀

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S2E21. A Brain Healthy Bibliography

Over the course of the last year and a half, I’ve relied upon a wide variety of resources to help me prepare these blog posts. At times I’ve identified them and provided links; at other times, not so much. To remedy that, I thought I’d dedicate this episode to putting all of those resources at your fingertips. There are movies, videos, lectures, websites and books in the following list, just in case you feel compelled to take a deeper dive into the data:

Movies:

‘The Father’ starring Anthony Hopkins

‘Still Alice’ starring Julianne Moore

Books:

The End of Alzheimer’s by Dr. Dale Bredesin (see S1E34)

Remember: The Science of Memory and the Art of Forgetting by Lisa Genova (see S2E4)

In Love: A Memoir of Love and Loss by Amy Bloom (see S2E16)

Lecture Series:

The Aging Brain from The Great Courses (see S2E9, S2E10, S2E11)

Video:

Can Alzheimer’s Be Stopped? – PBS NOVA

Determined: Fighting Alzheimer’s – PBS NOVA

What You Can Do To Prevent Alzheimer’s – Ted Talk with Lisa Genova

Links:

Alzheimer’s Association

Being Patient

WebMD (search ‘dementia’, ‘Alzheimer’s,’ and ‘aging’)

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S2E20. Brain-Healthy Menu Plan

I’ve written often about your diet’s effect on your brain’s health, but it occurred to me that I haven’t yet put all the pieces together to demonstrate that it’s possible to incorporate this kind of diet into a daily routine. I’ll try to do that now.

One of the things that has always bothered me about diet recommendations is the idea that you have to have X many servings of various foods every day or week. I just don’t have the patience to measure things out to see if I’ve got enough to meet the criteria for a ‘serving,’ nor do I possess the discipline to keep track of all of those servings to see if I’ve met the goal. 

Working that hard can take all the joy out of eating!

Instead, I’ve developed a practical approach (some would call it a rationalization!) toward eating. Here are the 3 key points:

1. You can only eat but so much in a day or a week, so eat when you’re hungry and eat things you like that fit your diet plan. I have faith that your body will figure out how to maximize the benefit from the selection you offer it as long as you provide it with a buffet that covers all the basic areas, like Omega3 fats, antioxidants, etc. A little of something good is better than none at all, and it’s probably good enough when you just can’t work the recommended volumes into your plan.

2. Except for #3 below, everything you put in your mouth should provide some nutrient that is protective of your brain.

3. There is no such thing as cheating. So what if you eat something you shouldn’t every so often? What’s the big deal? Maintaining brain health is a long-term project that plays out over decades. The more days I eat all the right things, the better off I am. But it’s not fatal if I have a piece of cake or a hamburger once in a while. It might set my project back a day or two, but that’s not so terrible and it’s more than offset by the soul-satisfying lift I get from eating something that’s taboo. Bottom line: your eating lifestyle should be guilt free!

Let me offer one disclaimer before showing you what I eat:

I’m not recommending that you adopt my diet. I’m just trying to demonstrate that a brain-healthy diet is do-able. Only you can decide what will work for you: what times of the day, how often, and what you like to eat. So I’m not going to give you a ‘meal plan,’ per se. It’s more like an outline to help get you started. 

The diet that emerged for me was the result of my researching brain health in order to write this blog. As I learned about foods that contained important nutrients and compounds, I tried to add them to my diet. Having eaten this way for nearly a year now, I don’t remember what foods provide what benefits, but I can tell you that everything I swallow has a purpose based on the research.

Finally, before showing you what I eat, it’s important to show you what I don’t eat: products with added sugars of any kind, rice, grains (except for oats), dairy (except for kefir), refined flour, bread, fried foods, white potatoes, beef and pork. It sounds pretty restrictive, but it’s actually not all that bad.

Oh yeah…I almost forgot…the goal is to use all organic ingredients.

Here’s what my diet looks like:

Morning Tea: I try to do a 14-hour overnight fast each day, so I stop eating at 7:30pm the night before and have breakfast at 9:30am the next morning. Since I wake up hungry, though, I have 2 cups of tea at around 8:00am to hold me over. Decaf green tea is preferred, but I don’t like the taste all that much, so I mix ½ tablespoon of green tea leaves with an equal amount of mint leaves and then add ½ teaspoon of mixed turmeric, cumin, cinnamon, ginger and black pepper.

Breakfast: It’s the same thing every day: homemade granola with fruit. And it never gets old! It’s now my favorite meal. I linger over and savor every mouthful. Here are the ingredients: oats, chopped walnuts, pecans and almonds, turmeric, ginger, cumin, cinnamon, nutmeg, cocoa, flaked coconut, flax seed, chia seed, oat bran, figs, prunes, apples, raspberries, blueberries, strawberries, and grapes, with flax milk.

(I added oats to the mix after I wrote ‘A Granola Ritual’ because I wanted help in lowering my LDL (bad) cholesterol.)

As you can see, I pack a ton of brain-healthy goodies into this one meal. 

Lunch: Well…not really. I get hungry between noon and 2:00pm, but I don’t prepare anything that could legitimately be called ‘lunch.’ More accurately, I nosh…usually standing up. I know, I know…I should sit down when I eat…but I’m hungry!

I hope this doesn’t gross you out, but my go-to noshes are pickled herring, homemade sauerkraut and seaweed salad. Hummus with vegetables, guacamole, and a few mouthfuls of dinner leftovers are also on the noshing menu. So are oranges and almonds.

Post-workout hydration: 1 pint pomegranate juice made with 1 part juice and 2 parts filtered water.

Dinner: One of the joys of adopting this food lifestyle is trying out new recipes…and being surprised that things taste as good as they do! Here is a list of the items that have become staples of my evening meals: salmon, chicken, shrimp, eggs, kale, quinoa, roasted vegetables (eggplant, acorn squash, sweet potato, Brussels sprouts, carrots), mackerel salad with celery, grapes and walnuts, spinach, asparagus, salad (spring mix, grape tomatoes, onions, sweet peppers (red, yellow, orange & green), mushrooms, anchovies, avocado, parsley, olive oil, balsamic vinegar, lemon juice), red lentil pasta, and 4 ounces of organic pinot noir.

Although garlic isn’t mentioned above, it, too, is a staple. You’re not doing it right if you’re not mincing garlic every day!

Dessert: This is the same every night: a half cup of homemade banana-strawberry kefir with a quarter cup of oat milk, a few dashes of cinnamon and nutmeg, and some stevia to make it sweet enough to pass as a dessert.

Bon appetit!

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S2E16. Dementia & Suicide

Tell the truth: you’ve thought about what you would do if you were ever diagnosed with dementia, haven’t you?

You’re not alone.

The topic came up again this past week when Sally and I watched a PBS NOVA episode about long-term Alzheimer’s research being done at the University of Wisconsin. One of the cases presented was a 73-year old woman with end stage dementia. She couldn’t talk or feed herself and her muscles constantly twitched and cramped. The story line followed her husband and children as they tried their best to make her last days comfortable.

“Don’t ever let me get like that…”

Sally didn’t need to finish the thought. We’ve talked about it before (S1E13), but we’ve never really come up with a plan.

This week, thanks to a new book written by Amy Bloom titled In Love, I learned that there is a path forward. The book is a memoir about her husband’s decision to suicide after being diagnosed with Alzheimer’s.

The path leads to Zurich, Switzerland, where there is a non-profit company, Dignitas, that will work with you. What makes Switzerland’s approach different from assisted suicide available in America is the conditions under which you are eligible to be helped.

In the 10 states in the U.S. that have some form of assisted suicide, the eligibility requirements are intentionally excruciatingly narrow. You’ll need to be diagnosed with a terminal illness with less than 6 months to live AND you’ll have to have all your faculties about you, be able to rationally discuss your decision, prove you are not depressed, and be physically able to self-administer your own lethal dose when the time comes. 

That pretty much rules out anyone with dementia. If you still have your wits about you, no doctor will certify that you are within 6 months of death.

Clearly, the notion of a right to death with dignity for those with dementia has not yet reached our shores.

In Switzerland, though, they’ve eased the restrictions by eliminating the 6-month life expectancy condition. You still have to be diagnosed with a terminal illness (which dementia is) and you still have to be mentally and physically competent to implement the plan (i.e., drink the sodium pentobarbital solution) on your own. That’s why they call it ‘attended’ suicide over there instead of ‘assisted.’ The final act must be yours and yours alone.

Reading about that process, though, shook up my thinking. In my previous imaginings (it seems wrong to call them ‘fantasies’) about a post-diagnosis suicide, I envisioned milking my good days for as long as I could and then pulling the plug when I stopped being me (however I might define that). From another point of view, if I were the one to assist Sally after her diagnosis, the timing would be when she was no longer herself and had lost the ability to marvel at the world of children and ask questions about everything.

In either case, the timing would be tricky, as there is no paper-and-pencil test one can administer to determine that the time has come. You just know it. At that moment, it should be a pretty clear moral choice, especially if you are (as I am) unencumbered by any religious prohibitions against ending a life in this situation.

In Amy Bloom’s case, however, her husband Brian makes the decision to suicide almost immediately after learning his diagnosis. In hindsight, it is clear that he has been symptomatic for several years, but he is still quite capable of enjoying a good meal at a restaurant, traveling and fishing, and he is cognitively strong enough to meet the criteria for mental competence.

That’s pretty brave. Although his journey on the road to nowhere is clear, he is still very much Brian, both to himself and to Amy. There is no waiting, there is no ‘making sure,’ there is no milking the last drop of pleasure from life.

It’s going to take me a little while to wrap my head around that.

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S2E15. My COVID-19 Detour

I suppose I had been lulled into a false sense of security by all the public figures who have announced that, although fully vaccinated and boosted like me, they had contracted COVID and were either asymptomatic or experiencing only mild symptoms. 

When we got to Minneapolis last weekend, mask-wearing was optional in  both the hotel and the arena. Only a very few people were wearing them at either location…and that number did not include me. The first game was Friday night and by Monday morning I had a mild sore throat. So mild, in fact, that I didn’t even consider it was COVID-related, as the simpler explanation was that I had done a lot of yelling at the games.

Masks were required on Minneapolis public transit, at the airport, on planes, and during the Uber ride home.

On Tuesday morning, when I weighed myself on my fancy scale that records not only my weight but a dozen other biometric markers, I was surprised to see that my pulse had shot up to 86 beats/minute from its usual range of 55-65. That was odd and, I thought, bore watching.

I did all the things I normally do on Tuesdays and Wednesday (in this case, days  4 & 5 post exposure), only mildly inconvenienced by a sore throat and some noticeable body ache, but no fever (97.6). I was sticking to the yelling-irritated-my-throat hypothesis.

On Thursday night (day 6), we were scheduled to go out with some friends and so we self-tested at home. Both Sally and I were negative. With no reason to be concerned, we went out.

The next night, though, (Friday, day 7), I had a bear of a night trying to sleep. My sore throat worsened, my temperature rose to 99.6, and I had muscle pain in my back. I’d never had that kind of discomfort with either a sore throat or fever before. That sent me to the google to check on COVID symptoms and there it was: muscle ache was a symptom along with sore throat and fever. (I later learned that it is common for symptoms to worsen 5-7 days after they first appear. Apparently, I was on schedule!)

Since we were supposed to go out on Saturday night (day 8), too, we re-tested. This time, I generated a pretty pink positive line. Damn it to hell!

The good news was that Sally’s test was negative.

Right on cue, I developed the signature COVID cough. Now there, my friends, is a symptom brewed in the Devil’s own basement! It’s relentless. A sea of phlegm gurgles just beneath every breath you try to take. The constant coughing grates at your raw throat, making it scream over and over again. It gets to the point where you fear your next breath. It’s no way to spend an hour, much less a day or more.

I started a regimen of aspirin and cough suppressants. In doing so, though, we discovered that all of our flu/cold remedies were hopelessly past their expiration dates. The bottle of spray I use for sore throat pain, for example, had expired 11 years ago! Sally set about re-stocking our medicine chest with currently active remedies.

I wrote to my primary care physician to see if I needed to do anything else and I emailed the COVID reporting form to the Chester County Health Department.

I shared the news on Facebook. Thank goodness for real and virtual friends and family! The speedy recovery wishes were overwhelming, along with suggestion about how to treat it. Here’s a summary:

  1. Get better.
  2. Get better fast.
  3. Drink lots of liquids and get lots of bed rest.
  4. Take lemon juice with honey and cayenne pepper.
  5. Homemade chicken soup.
  6. Open the windows in the apartment for ventilation.
  7. Buy and use a pulse oximeter.
  8. Ask my doctor for one of several antivirals now available.
  9. Nebulizing saline with hydrogen peroxide.

To the everlasting credit of all those who care about me and who I care about in return, please note that there was not a single recommendation to try Ivermectin or hydroxychloroquine.

My physician responded and suggested I go with #3 above, OTC products to treat symptoms, and a 5-day quarantine. She did not offer anything from #8.

Upon waking up Monday morning (day 10), I was delighted to see that my cough was gone. What a joy it was just to be able to take a deep breath! My pulse rate had also returned to a more normal level, so it seemed I might have turned the corner.

Thankfully, too, I never lost my sense of smell or taste, and my appetite was good. The biggest problem was getting things past my inflamed throat.

My throat was causing another big problem: a major communications breakdown.

I could talk with effort but could not project my voice at all. Sally’s difficulty in hearing me was compounded by the muffling effects of the KN95 masks we were both wearing all the time. Those masks also prevented any attempts at lip-reading. Bottom line: communication was farcical if not hopeless, even with Sally wearing her hearing aides. At one point, we seriously considered texting each other even though we were sitting only about 10 feet apart in the living room!

My brain fog lifted on Tuesday morning (day 11). I don’t think my temperature ever broke 100, but the mental dullness felt equivalent to a fever of about 102. I was glad to be able to think clearly and write again.

That was pretty much it. My pulse oximeter arrived on Tuesday afternoon and my oxygen level was at a healthy 96. Temperature was a normal-for-me 97. I took a shower and felt 1000% better.

On Wednesday, we tested again. Sally was negative but I was still positive. That was a huge disappointment, to say the least!

I’m feeling fine, though, with no symptoms, so I’ll continue to isolate and wear my mask and we’ll test again on Friday.

Looking back, if this was what a mild case of COVID feels like, then I’m eternally grateful for the vaccinations and booster that kept it from being the real thing.

The good news is that I escaped my close encounter with COVID.

The bad news is that I suspect that the week of COVID brain fog  inflammation has nudged up my risk of developing a dementia sometime down the road.

For now, though, I’m just happy to be able to take a deep breath again!

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S2E14. Do Something Different

In terms of cognitive challenges to keep your brain healthy, games and puzzles are fun, but they don’t provide any added brain benefit. The more you engage in them, the better you get at doing them…but that doesn’t help preserve the abilities you need to live independently, like memory and executive functioning.

The recommendation, then, is to do something different to challenge yourself: learn a new language or learn how to play an instrument or go on a trip.

Go on a trip? You don’t have to ask me twice!

The NCAA Women’s Basketball Tournament was played over the course of the last month. I’ve been a fan of the University of Connecticut Huskies since I was a graduate student there from 1996-2001, and Sally caught the fever from me.

So three weekends ago, we made the 4 hour drive up to Storrs, CT, where the first 2 rounds were played on campus. When the Lady Huskies won those games, I went online to get tickets for the next 2 games which were being played in Bridgeport, CT, the following weekend. And when they won those 2 games we made the decision to do something we’d never done before: go to the Final Four in Minneapolis, MN!

This is where the cognitive challenge came in. We had 72 hours to figure out how to get tickets, book a flight, and get a hotel room. We started on the drive home from Bridgeport with me driving and Sally googling hotel rooms.

She found a hotel that was 3 blocks from the arena, so we booked it. When we got home, I searched for tickets online and learned that TicketMaster runs a brisk scalping business. I didn’t want to go all that way (about 1,000 miles) to sit in the nosebleed seats and watch the game on the giant monitor, so I took a deep breath and bought lower-level tickets for a price I never imagined I would pay for any event.

Finally, I went to the American Airlines site to book a flight and, hopefully, use my 65,000 frequent flyer miles. Not only were the available flights at lousy times, but they told me I needed to purchase an additional 200,000 miles at a cost of over $3,000 to get the seats!

That sent me over to Travelocity where I found non-stop flights between Philadelphia and Minneapolis at reasonable times and at an affordable $500 for the round-trip.

Planning done!

Last Friday, we took an Uber to the airport, arriving in plenty of time. After boarding the flight, though, we learned that there was a mechanical problem and we’d have to de-plane while they fixed it. That put us 2 hours behind schedule, so when we arrived in Minneapolis, we took a taxi to the hotel instead of taking the tram as we had originally planned.

We checked in and immediately left for the arena where the 2 semifinal games were being played. UCONN was in the 2nd game and we defeated Stanford. On to the championship game!

The next morning (Saturday), we were having breakfast in the hotel when an older woman approached us and asked if we wanted to buy her tickets for the final. She was a Stanford fan and she and her husband were going back to California instead of going to the game on Sunday. The tickets were in the first row behind the team bench!

Having paid as much as we did for our seats, my first reaction was: “Not interested.” But then I thought about it. First row! So I went over to talk with her and her husband. They wanted half of what they paid for the tickets which they bought directly from Stanford at face value. What the hell…you only live once!

Now we had to figure out how to consummate the transaction. I didn’t have any cash and the tickets were only accessible on a cell phone (apparently they don’t print tickets anymore. Who knew?).

I recalled seeing a ‘transfer tickets’ feature on the app we had to use to buy the tickets, so I knew how she could deliver the tickets to me. Luckily, she had a Venmo account and I was able to make the payment to her that way. 

The transaction was completed in less than 5 minutes. It must have been a sight, though, watching these 70+ strangers figure out the technology to make it work.

But I wasn’t done yet. I went back up to the room and went to the TicketMaster site to see if I could sell my original tickets and recoup a little of what I had paid, or at least get back what I just spent to upgrade my seats.

It is possible to sell your tickets there, but apparently you had to register with a bank account to do so, and I hadn’t done that. Damn!

But wait…I recalled seeing a ‘sell tickets’ menu button on the mobile ticket app and so back I went. Yup…there it was! 

Placing the tickets up for sale was easy enough, but how to price them was the challenging part. It was only about 32 hours until game time, so I needed to get this right. I figured that a lot of fans of the semifinal losers (Stanford and Louisville) would be trying to sell their tickets just like the couple we had just met. And there wouldn’t be a lot of demand for tickets since only people in or within a few hours drive of Minneapolis were likely buyers. So instead of going for a killing, I took a safer path and offered the pair for $500 (we had paid $300 for the first-row upgrade).

In about 2 hours, I received an email notification that the tickets had been sold!

On Sunday afternoon, we took a bus to the Minneapolis Institute of Art. It’s a beautiful facility and we spent our time in the Impressionism and Modern Art galleries. Directionally challenged as we are, finding the exit was an adventure, but we kept meandering until we got there…to discover that it was snowing outside! So instead of walking back to the bus stop, we called an Uber.

That night at the arena, the seats were great! The UCONN pep band was to our right, the cheerleaders directly in front of us and the team bench was on our left. It would have been perfect if we hadn’t gotten clobbered by South Carolina 64-49.  😦

The next day we took the tram from downtown to the airport. The connections were a little tricky, but we muddled our way through it. The flight was on time and we got an Uber from the airport. We were home by 7:30pm.

Once I finished licking my wounds from the defeat, I got around to thinking about all the cognitive challenges that this adventure entailed. Going to new places, orienting yourself, and figuring out how to get from point A to point B were at the top of the list. Then there was the task of mastering new technologies. And most of all, you have to react to a lot of unique decision-making inflection points. These are the things that are generalizable and help you preserve and grow vital brain circuits. 

And best of all, when all is said and done (and unlike doing Wordle, jigsaw puzzles and crosswords), you have a great story to tell when it’s over!

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S2E13. Your Brain On Red Wine

I’ve always felt inadequate around wine drinkers. They ooze with sophistication as they immerse themselves in the complex flavors and aromas of the pampered liquid. They seem to possess a breeding, class and erudition that I lack.

It’s not like I haven’t tried to develop a taste for wine. I have.

Like most college students experimenting with pot, I tried to get into drinking wine to go along with it. Back then, you started with the fruit-punchy Bali Hai and worked your way up to Spanada and Mateus, avoiding Thunderbird and Ripple which were reserved for the old winos in the park. Then you graduated to real wine. It was part of your education.

But I flunked that course. For me, a sip of wine meant explosions of noxious tastes around the edges of my tongue. If my taste buds could have surrendered to stop the assault, they would have. And people thought this stuff was good?

Over the decades, I periodically made attempts to learn how to drink and, more importantly, like wine. I attended tastings and could swirl and sniff with the best of them, but the assault on my tongue continued. Oh, once in a while I came across something that was tolerable. And there was that one time when a friend (and wine connoisseur) sprung for a $150 bottle that was actually good. Alas…the experience was never to be repeated!

Fast forward to this past year when I discovered that drinking red wine is part of the Mediterranean Diet and, drunk in moderation, can reduce your risk of dementia. I was able to incorporate just about every other brain-healthy recommendation I came across into my diet, but not that one. One article suggested that if you don’t like wine, you can substitute 5 ounces of pomegranate juice, and so that’s the path I took, mixing the juice with 10 ounces of water and drinking it for my post-workout, cool-down hydration.

But that left me feeling somehow inadequate, as if I weren’t really implementing the plan. I’m supposed to be drinking wine, so I decided to give it another try.

I started with a google search for which red wine provided the most brain benefit and learned that it was pinot noir: “This is the healthiest red wine due to its high concentration of resveratrol, an antioxidant compound that lowers bad cholesterol and high blood pressure. Some studies also suggest that it can improve brain health, kill cancer cells, and increase insulin sensitivity.”

The recommendation comes with an asterisk, though. Let’s not forget that red wine is about 12% alcohol…and alcohol is very bad for your brain. The suggestion, then, is that you limit your intake to 1 glass (5 ounces) daily.

That seemed do-able at first, but it turns out that it’s really problematic for me. You see, I’m a cheap drunk (always have been!) and it doesn’t take much at all to get me tipsy. The first time I ever got buzzed was at the end of my freshman year in high school and all I had was half a can of Colt45 Malt Liquor!

So the 5 ounce guideline might be ok for most people, but I’ve got to believe that you need to stay on the sober side of tipsy if you want to get the resveratrol benefits without getting slammed by a bigger alcohol effect. 

Overcoming my inadequacy was not going to be easy!

I started my quest by ordering the house pinot noir whenever we went out for dinner. No, I didn’t come across anything I liked and, yes, I got buzzed on one glass.  😦

Anybody know how many ounces of wine restaurants serve in a glass of wine? Whatever it is, it’s too much for me.

Next, I asked my sister-in-law Phoebe (who, among other things, is the family expert on fine wines) for some recommendations. The first bottle I tried wasn’t bad…but it also wasn’t something I would look forward to drinking every night. I just opened the second bottle last night and it’s a little bit better, so I’m going in the right direction.

I need to play with the dosing a little more, too. I measured out 5 ounces, sipped it slowly through dinner, but could still feel the alcohol. I’ll drop it down to 4 ounces tomorrow night and see what happens, and then maybe start sipping an hour before dinner time to spread out the alcohol’s effect. 

I think I’ll ask Phoebe for another suggestion, too, as I’m encouraged enough to think there might be something out there I will enjoy. 

Overcoming my lifetime wine inadequacy could actually be within reach!

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