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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S1E45. Subtle Changes

Just like that…it’s gone! Now you think it; now you don’t. POOF!

It’s quite the magic trick…making thoughts disappear like that. If only I knew how I do it!

Following up on the second blog I posted last December, I’ve noticed that I no longer experience the phenomenon of walking into a room and forgetting why I went there. There’s been a subtle shift. It’s morphed into something a little different.

What happens now is that I completely forget my original intent. For a moment, I don’t even realize I’ve forgotten it. Instead, I’ll do something else that needs doing in that area just as if that had been my purpose. Only after I’ve started that task do I realize that I had another purpose…and then it comes back to me. For example, the other day, I walked into the kitchen and started to unload the dishwasher before I remembered that the reason I went into the kitchen in the first place was to make some tea.

It’s only a fleeting experience, so there is no real down-side to it, and there is the benefit that I get things done that I obviously had deferred. Clearly, though, something has changed.

It reminds me a little of a video I saw about a form of ADHD that is caused by cognitive decline and dementia. It documented the story of a woman who couldn’t get anything done around the house because she was constantly being distracted by other needs before she could complete the previous task…and this went on all day.

Fortunately, what I’m experiencing is nothing like that. I catch on to what’s happening pretty quickly and I complete all the intended tasks…both the original and the newly-discovered.

In a way, it’s an improvement from a year ago. I recall my purpose a lot faster than I used to and without having to sustain a focused effort. But it’s still bothersome that I forget it in the first place.

A more problematic variation of this occurred the other night when we were out to dinner with friends. We were at an Asian restaurant that had a unique style of serving your dinner. They didn’t serve everyone at once. Instead, they served each order as soon as the cooks finished preparing it. As a result, some of us got our main courses first and our appetizers last. Some of us were served quickly and some had a longer wait. If I had to guess, I would say that salads were served the fastest, then came fried foods, and finally noodle dishes that required boiling. And the delivery speed for each was determined by the volume of orders coming in from the other patrons.

We all ordered and soon the food began to arrive. Two of us received our salads first while the others waited. Gradually, more dishes appeared. I was still hungry after I finished my salad and so I tried one of Sally’s chicken wings. Some fried tofu was being passed around and I tried that, too. After a while, I wasn’t hungry anymore.

Finally, the last member of our group was served, but along with his order came a huge bowl of tom yum soup. Nobody claimed it as theirs…until it dawned on me that I had ordered it!

In the half hour between ordering it and its being served, I had completely forgotten all about it. If I had remembered, I never would have sampled all those other dishes.

So that’s the bad news.

The good news is that I’ve noticed an improvement in another domain: remembering names. You might recall that I was having difficulty with that task back in April (“The Name Game”). Now names of people from my past seem to be cropping up in my head without a lot of effort. And when I do try to come up with a name, it seems to be within easy reach.

So what does all this add up to? I’ll be damned if I know!

The promise of a brain-healthy lifestyle is that it will slow the progression of cognitive decline. Around 40% of dementias can be prevented in this way, or so the research suggests. Another way of looking at it is to say that your rate of cognitive atrophy is slowed to the point that you die from other causes before you qualify for a diagnosis of dementia. Don’t get me wrong…I’m not complaining. Dying before you dement is a good thing!

What’s more, the research doesn’t say how long you have to be implementing the 5 Pillars before you see tangible results. Some studies have a 6-month time frame while others measure the impact of lifetime habits. 

And since we don’t know what my cognitive status would have been had I not changed my habits six months ago, we can’t really measure the success/failure of the program.

And so my journey continues… 

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S1E23. Why Am I Writing This?

It was a fair question that my nephew Zach (Sally’s sister Lynn’s son) asked me over cake at the graduation party for my great nephew Nate (Sally’s brother Tad’s daughter Skye’s son). 

I had already explained my motivation back in December in Episode 3: My Life Is Now An Experiment (https://tinyurl.com/4epzfffc), and so it seemed like a good time to reflect back on a half year of blogging to see if I still felt the same about this project.

Zach (a political science professor at Haverford College) had raised the question in the broader context of the meaning (or lack of it) of the things we do and the notion of ‘legacy’ or what will be remembered about us (if anything) two, three or four generations from now.

We had already agreed that not much of what we do in our lifetimes will last very long into the future (to whit: think about what you know about your great grandparents)…but that that didn’t really matter. We do things that have meaning for today…and that’s enough.

My primary reason for writing this blog is to provide data that might be helpful to researchers trying to diagnose and treat age-related cognitive decline and dementia. My hope is that by tracking and reporting my mistakes over the course of a decade, I will leave a record that either describes normal aging or the onset of dementia, and no matter how it turns out, that such a first-hand report will have value.

That assumes an awful lot, though. What are the odds that such a researcher will (1) stumble across my notes, (2) discern a meaningful pattern in what I recorded, and (3) convert that insight into a useful tool for diagnosis or treatment? As Sally is fond of saying in these situations, the likelihood lies “somewhere between zip-a-dee and doo-dah!”

Over these first 6 months, though, one thing I’ve learned about myself is that I also do this—and I’m being brutally honest here—for the clicks. It appears I’m a click junkie!

Each week, I spend money to advertise the new post on Facebook and Google. Whenever someone clicks through to the site, I can see on my WordPress blog dashboard not who they are, but which episodes they read and what country they are from. It’s exciting to know that there are folks all across America who have stopped by, and people from Ireland, Canada, India and Sweden who are frequent readers, too.

It’s comforting when they leave comments describing their own experiences that are similar to mine. They make my journey less lonely and it’s nice to know that I’ve made someone else’s journey a little less lonely, too.

I especially appreciate it when a reader signs up to follow the blog. It’s the ultimate validation for me as a writer: you liked the content enough to want to see more and to have it delivered directly to your inbox every Friday to make sure you don’t miss an episode.

And in the blogosphere, the number of followers you have is the gold standard for measuring success. Success would be nice, but I have a long way to go to achieve it and I don’t really expect it.

Managing the blog (e.g., rooting for content each week, writing a 600+ word episode, converting it to a podcast, refining and implementing the advertising plan, interpreting the results, and interacting with readers) keeps me busy in ways that push my cognitive envelope. In itself, it should provide a measure of protection against decline. But I also find it intriguing to monitor myself so I can catch as many errors as possible, try to better understand what causes them, and to divine what clinical implications (if any) they might have.

It’s work, but it’s fun.

Getting back to Zach’s question, after six months, several reasons for writing this blog have emerged: a desire to help in some small way, the rewards of having my work read and appreciated, and the joy of doing it.

Thanks for asking, Zach!


S1E21. One Hundred Fifty Minutes

I’ve been running—on and off—since I was 14 and a freshman in high school. I wasn’t fast, but I worked hard. I never ran a mile in under 5 minutes, but I did earn my varsity letter running the 2 mile.

In 1966, I was among the first joggers to run in the road. People used to yell ‘Get a horse!’ The more creative among them yelled ‘Get a car!’ In the winter, some would aim at me and I’d have to jump into a snow bank. We’ve come a long way in 55 years, haven’t we?

Over the years, I always felt better when I was running. In my 30s, I tried to run the sub-5 minute mile that had eluded me in high school. I got down to 5:35 and was chagrinned at how difficult it was to run a 75-second quarter mile when I used to run them with the greatest of ease.

In my 40s, my primary care physician sent me for a stress test. I was told that I had a ‘runner’s heart’ with thick walls that had built up over the years. Apparently, heart disease (which runs on my father’s side of the family) was not my biggest risk factor.

On my 50th birthday, I was living in Lexington, North Carolina, while doing my Ph.D. internship at the Hefner VA Medical Center. I was jogging in a park a block from my house when I got the idea of setting a goal for myself: I wanted to be able to jog 2 miles without stopping every year until I was 80. That was considered pretty far-fetched in 2001, but it was a motivator for me. Each year for the past 19 years, I’ve been able to check that box.

In my middle 60s, I was in good enough shape to run 5K events. My best time was 30:50.

Jogging has been my go-to exercise when I need to lose weight or manage my cholesterol. According to the research, it appears that it will help preserve my cognitive abilities, as well.

Of all the things we don’t know about dementia and age-related cognitive decline, one thing we do know is that regular exercise is protective. It may not reverse losses, but it does appear to protect what you have and slow your rate of decline.

The latest guideline I’ve found is to shoot for exercising 150 minutes each week, e.g., 30 minutes/day x 5 days. The criterion for calling it ‘exercise’ seems to be ‘huffing & puffing’ and/or ‘breaking a sweat.’ So it’s nice if you go out for a walk, but it’s better if you step up your pace. The goal appears to be to keep the 400 miles of your brain’s blood vessels open and pumping nourishment to your 86 billion neurons 24/7/365.

COVID-19 really knocked me for a loop. No, I didn’t get it, but it closed the gym where I worked out and I gained 20 pounds. So now I’m starting my comeback. For years, a good weight for me has been 155, but now, at 186, I weigh more than I’ve ever weighed before and, at 70, I know that’s not good. Being overweight and out-of-shape, I need to go at this with caution. 

The apartment complex we just moved into has a fitness center with a treadmill. Since I haven’t yet met my goal of being able to jog 2 miles this year, that’s where I’m starting. I began by just walking the distance. Next I plan on jogging ¼ mile as part of the 2-mile walk, and then raise that to ½ mile when I feel ready…and so on until I’m jogging the whole thing.

Just 5 years ago, a comfortable jog for me was at a 6 mph pace. Now, though, I see that I’ve slowed to 4 mph (15 minutes/mile). Jogging 2 miles will take me 30 minutes. Going 2 miles has me huffing & puffing & sweating, so this workout fits the healthy brain guideline. Now if I can just stay motivated enough to do it 5 days each week…

Post script: On Wednesday I discovered another way I can huff & puff and burn a few extra calories. We live on the 4th floor of our apartment complex. Getting there from the street level takes 3 flights of 19 stairs each. I doubt I’ll ever be able to walk up and down for 30 minutes, but doing it is definitely more heart and brain healthy than taking the elevator.

And then I saw someone much younger than I jogging around the complex. Each lap is probably about ¼ mile. 

It’s nice to know I have options!

S1E15. Vivid Memories That Aren’t

“I’m at Mom’s condo. The police are here. They won’t commit her. Can you please talk to them?”

It was a frantic call from my sister Lorna in Florida. My 83 year-old mother had assaulted her aide and the police had been called. We knew she was dementing, but she refused to move into assisted living. It was only a matter of time before something like this happened.

I vividly recall talking to the officer from the dining room of our B&B, holding the phone to my ear and pacing back and forth only as far as the cord would allow me. Fortunately, we had no guests at the time.

I told him that I was a licensed clinical psychologist and explained why she needed to be committed. He replied that she did not currently appear to be a danger to herself or others and he could not commit her under Florida’s Baker Act. He told me I was a terrible son for not taking better care of her and that if I didn’t make arrangements for her, he would have no alternative but to handcuff her and arrest her for assault. 

I told him to go ahead and arrest her. When he tried to do that, she did exactly what I knew she would do: she punched him. At that point, the police restrained her, brought her to a hospital psychiatric unit and had her committed. She got the help she needed.

Nearly all of what I just recounted is true, all except my vivid memory of having the conversation in the dining room of our B&B. You see, I didn’t become a clinical psychologist until 5 years after we sold the B&B.

Yet I can see this scene in my mind’s eye as clear as day. I see myself holding the phone…and that should have tipped me off that my memory was faulty, because I could not possibly have seen myself at that moment. I might have seen the table, the door out to the side porch, or my wife, but I would not have seen myself. The perspective of my memory was all wrong.

As memory expert Dr. Elizabeth Loftus tells us, “…once you have an experience and you record it in memory, it doesn’t just stick there in some pristine form you know waiting to be played back like a recording device. But rather, new information, new ideas, new thoughts, suggestive information, misinformation can enter people’s conscious awareness and cause a contamination, a distortion, an alteration in memory…”

So mis-remembering is a fairly common occurrence, but I suspect it can become more of a concern as we age, not because we are subject to new information being received, but because our memories become more fluid and permeable, that is to say, more at risk for being contaminated by a nearby memory.

In the case I just described, I tried hard to recall some other important conversation I might have been remembering that had occurred in that location, but I couldn’t. Then I tried to imagine having the conversation in the house were I actually was living in 2003 when this happened…and I couldn’t. So the mystery of this faulty recollection remains unsolved.

But it does bring to mind a similar, more recent experience. Once again, my memory is distinct and clear. We had just moved to Kennett Square and we went to the grand opening of the local Democratic Party campaign headquarters. It was 2012 and we were eager to work for Obama’s re-election.

No sooner had we stepped inside the door than the party chair walked up to us, introduced himself, and asked where we lived. When I told him, he immediately invited me to join the organization as a committee person for our precinct.

Although I don’t see my wife who is standing beside me in this memory, I feel her presence. The problem is that it’s not Sally. It’s my first wife who had passed away two years earlier. 

That’s the kind of porous, mix-and-match memory recall that concerns me. I have no clue if this is meaningful or not in terms of distinguishing normal aging from the alternatives, but I’ll keep an eye on it. One thing is for certain: it’s definitely a mistake on the journey.

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S1E8. Splotchy Thinking

I look at the back of my hand and I see veins running under a splotchy, thin skin. It is the hand of an old man.

I know I am 70. I know this is normal, just as I know that a decline in brain function is normal. Yet I want my brain to look and act the same as it has for the past 50 years. I reject splotchy thinking. I bristle at the errors I am noticing with increasing frequency. Even though this might be normal, I don’t like it.

It happened for the first time the other day. I was putting things away after dinner and I put the butter on the upper shelf of the refrigerator. Only problem is that we keep it in a covered compartment on the refrigerator door. I caught the mistake as soon as I made it, but something tells me that this wasn’t the last time that this will happen.

We don’t have a regular set of dinner dishes. Instead we have an eclectic collection of dinner plates. I was looking for the ones with the colored dots design and couldn’t find them. Did the housecleaners move them? They have their own sense of fengshui and we find all sorts of things have been re-purposed after their visits. Instead of going down that path, though, I asked Sally if she knew where they were. As we talked, I recalled that some plates had chips in them. Did we throw them out? Sally remembered our conversation about throwing them out, but neither of us could say for certain that we did. I’m going with the ‘we threw them out’ theory.

At Sally’s request, I haven’t cut my hair since COVID hit a year ago. It’s now ponytail length and so she gave me one of her hair ties. I used it the other day when I went out and took it off when I returned. Later, when I had to go out again, I couldn’t find it. I looked all over. Sally gave me another one. Later that night, when I undressed for bed, I found the original one. It was on my wrist, hidden by my long-sleeved shirt.

I was walking on the track at the YMCA and I got to thinking about impressionist art. I set about trying to remember who it was that painted scenes of Tahiti. It didn’t come to me easily. I knew it wasn’t Van Gogh, Mary Cassatt or my favorite, Renoir. Not Seurat, Monet or Manet. Not Pissarro. I went through the alphabet to see if that would trigger a name, but that didn’t help. I visualized one of his paintings. I recalled a scene from the movie ‘Goodbye, Columbus’ where Richard Benjamin gives the name to a young black boy in the stacks of the Newark Public Library. It took about 10 laps around the track, but it finally hit me: Gauguin.

When I got home, I googled ‘major impressionist artists’ to see how many artists I knew whose names did not occur to me: Matisse, Cezanne,  Degas, Toulouse-Lautrec. That means I was able to conjure up 8 out of 12. I think that’s a pretty good percentage. Ask me again a year from now.

When I drive somewhere, I take a moment and look around to lock in my location after I park. So far, I haven’t lost the car once!

I turned on the tap in the upstairs bathroom sink, reached into the medicine chest and took out my toothbrush and toothpaste. There was nothing wrong with that…except my intent was to shave, not brush my teeth.

And that, my friends, is what a splotchy brain looks like.

Post script: I think I really dodged a bullet in the tale of the missing dishes. In dementia, it’s very common to fabricate explanations when your memory fails in order to fill in the gaps. A brain, like nature, abhors a vacuum.

Paranoid explanations are quite common. Instead of concluding that I must have thrown them out because they were chipped–even though I don’t recall doing so–I could have decided that the housecleaners stole them. Or that a thief or neighbor had come into the house at night and taken them. If you told me that didn’t make any sense because no one would steal 2 chipped plates when there are plenty of better ones right there for the taking, I would argue with you, confabulate another rationalization, stick to my guns…and wonder why you were being so difficult.

If/when I start doing that, I will have traveled well beyond splotchy on the road to nowhere.

_________________

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S1E6. Did I Do That?

Instead of electric blankets, we have electric sheets. If you’ve never tried them, please do! One of the highlights of our day is getting in bed at night, just to feel that head-to-toe warmth. Sally and I both squeal with pleasure!

But in order to make sure our bed is toasty warm at 11pm, I go upstairs and turn on both sides of the dual-controlled sheets at 6pm. 

(No…that is NOT where I’m going with this. I NEVER forget to turn on the sheets and I don’t need any reminders or accommodations to make certain I do. Clearly, memory is fine when one is highly motivated!)

So each night at 6pm, I walk up the stairs to our bedroom, turn on the sheets on her side of the bed, place her nightshirt under the covers so it will be toasty warm when she puts it on, and then place 2 pillows on top of the covers to weigh them down so they have contact with the sheets.

Then I walk around to my side of the bed and do the same (except I don’t have a nightshirt).

I am about to leave the bedroom when I stop in my tracks. Did I turn on the sheets on my side? I can see the pillows on top of the bed, but from where I stand, I can’t see the control. I have no memory of turning the sheet on. So I go back and check.

It’s on.

I check the control on Sally’s side–just to make sure–and it’s on, as well.

I wouldn’t be writing about this event now if it were not for the fact that the same thing happened the next night, and the night after, too. With the same result each night: I had turned my sheet on, but had no clear memory of it.

This was very different from the experience I described in my second blog entry (https://mistakesonthejourneytonowhere.com/2020/12/12/peek-a-boo/) where I forgot what I intended to do on the way to doing it. Forgetting that I did something after I had already done it, though, was an error of a different magnitude.

There are many aspects of daily life for which we don’t create episodic memories. Things that are rote, routine, automatic, done without thinking and/or repetitive are not worthy of space in our memory bank. Memory is for experiences that are unique, special, emotional, important and/or worthy in one way or another.

I decided to make this activity important to see if that would make a difference. Instead of automatically going through my routine (and allowing my mind to wander where it would while I turned on the sheets), I made a special effort to stay in the moment. When I clicked on the sheet on my side of the bed, I looked at the control. It registered an ‘8’ on its digital display. There was one red light to the left and 3 red lights to the right.

When I walked out of the room, there was no doubt in my mind that I had turned on the sheet. The image of the digital display was clear and vivid.

So, too, the next night and the night after and the night after that.

. . .

A week later, I had cataract surgery which requires using eyedrops for several days during the recovery period. Sally was my nurse, administering the drops 3 times daily. But one day, she wasn’t available and so I did it myself. 

And an hour later, I wasn’t sure that I had…

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S1E2. Short-Term Memory Peek-A-Boo

I’m sitting on the couch in the corner of the living room, the lamp beside me illuminating a jumble of flotsam on the end table below it: my wallet, scratch pad and pen, small spray bottle of eyeglass cleaner and cloth, a bag of almonds, assorted business cards, 3 tv/vcr remotes. As I compose an email, it occurs to me that I’ve been putting off the trip to the grocery store. I click ‘send,’ set the computer aside, and get up to check the refrigerator to see what we need.

I pause in front of Sally’s recliner to ask if she wants anything from the kitchen. She pauses a guided tour from the Barnes Museum, removes one earbud, asks me to repeat the question, and then tells me, ‘Thank you, but no.’

As I pass through the dining room, I notice she’s printed something that is still lying in the tray. I make a note to myself to bring it to her when I return.

I flick on the kitchen light and stop. The question forms itself quickly: Why did I come in here?

—————

Memory. The Big Kahuna. Everyone’s worst nightmare because memory failure is an essential feature of all forms of dementia. It’s the group of errors to which we all pay exquisite attention. Not a day passes on social media when there isn’t a meme referencing the experience of going into a room and forgetting why you went there.

Sound familiar? It’s probably been happening since we were 40, but the increase in frequency draws our attention to it as we get older. You don’t need fancy neuropsychological tests to identify it. It’s just there…and becoming more commonplace…and so we worry…and the memes help us laugh about it and not feel so alone…and then we learn it’s part of normal aging and might not mean anything more…but we still worry.

At least I do…or did.

A little over a year ago, I noticed that when I had these episodes, what I had forgotten would come back to me a few minutes later when I was thinking about something else. It was a comforting to know that the thought wasn’t completely gone…I just hadn’t been able to hold it online in current, short-term memory. It was still there in intermediate memory and I was still able to access it and, more importantly, go do what I had originally set out to do.

(Before going any further, and in the interest of full disclosure, I should tell you that I am not a neuropsychologist, but I did take 2 graduate courses and 3 practicums in neuropsychology en route to my doctorate in Clinical Psychology. Which means I have a sense of what dementia looks like and have some understanding of the basic principles of brain function. Please take what I say with a grain of salt because although I haven’t kept up with the literature, I’m not one to shy away from offering theories, observations and conjectures for discussion!)

It occurred to me that perhaps a circuit here and there had shorted out and that was what was causing periodic breakdowns in my ability to hold something in mind for 30 seconds if I wasn’t actively trying to remember it (e.g., by repeating ‘Check to see if we’re out of milk…Check to see if we’re out of milk’ over and over again as I walked to the refrigerator). If so, then maybe I could grow new connections (brain cells are very good at that!) to provide an alternate pathway around the short circuited area. 

The next time it happened, then, instead of giving up and walking away, I stayed right where I was and consciously tried to recall my purpose. 

It was work. It was effortful. It was successful! 

Over the next few weeks, I discovered that I could reclaim the memory in 15-20 seconds. And it seemed that the more I did this, the more easily I could expose the lost trace the next time it happened. 

I don’t worry too much about that kind of error anymore. It still happens, of course, but I don’t worry about it or get frustrated when it does. I know it will pass momentarily. 

Now I have a new worry. It’s the same kind of thing, but it happens more quickly, within just a couple of seconds.

After looking up an email address to send to someone else, I forget the extension before I finish typing it. Was it ‘@yahoo.com or @comcast.net?’

I can’t keep an entire 10-digit phone number in my head while dialing.

While surfing the net, I get the idea to open a new tab and check out another website, but by the time I open the tab, I’ve forgotten where it was I wanted to go. I end up staring at an empty address bar until I can reclaim my intention from its hiding place just outside of awareness.

So that’s the bad news. The good news is that I’ve come up with accommodations. I copy and paste the email address instead of trying to remember it; I’ll focus on the last 7 numbers because I can quickly press the area code numbers without having to memorize them; I force myself to open the new tab and go to the target site as soon as the idea appears instead of waiting until I’ve finished reading the article that triggered the idea in the first place.

The really good news here is not that I can complete my phone call, etcetera, but that (1) I am aware that I am having the problem, (2) I can problem-solve to find an accommodation, and (3) I use the accommodation going forward. Those are all examples of what’s known as ‘executive function’ and as long as you have that working for you, you’re in relatively good shape. With a modicum of thought and effort, you’ll find your own accommodations, too, and that’s one of the keys to aging successfully.

So that’s where I find myself today: In relatively good shape and playing peek-a-boo with my thoughts.