Friday, September 24, 2010

Treatment Without Numbers

I know a widely-respected neurologist at a prestigious, teaching hospital who once said,

“Treating dementia is like rearranging the chairs on the deck of the Titanic.”

And he’s not alone in the medical community with this philosophy. I’ve heard many stories of doctors, both neurologists and general practice physicians, who are reluctant to prescribe treatment for Alzheimer’s Disease. They believe that the current drugs available don’t make a difference. They believe the current drugs are not cost effective.

Aricept and Namenda do not cure Alzheimer’s.
They do not stop the progression of the disease.
The cognitive capabilities of everyone who has Alzheimer’s Disease will get worse despite taking these medications.
No one gets out of Alzheimer’s alive.

But what about quality of life? What about the value of making each day a little less foggy, less frustrating, less isolated, less stressful for as long as possible? What about living as fully as possible with whatever time you have?

Do doctors not bother to prescribe calcium channel blockers or statins to elderly patients with heart disease because they’re likely going to die soon anyway? Are patients with cancer denied surgery, chemotherapy, or radiation if it’s known that these treatments will only buy time before the cancer ultimately kills them?

In the diagnosis and treatment of any patient, doctors have been trained to measure and quantify. Cholesterol levels are measured. There is a number. Blood pressure is taken. There’s another number. Patients are given medication, and doctors look to these numbers to evaluate whether the treatment is working. The number changed. The treatment worked.

There is no dementia protein that can be measured in the blood. There is often nothing visible in a brain scan. There is no number physicians can point to that can measure discrete changes in cognition. A doctor can’t put a patient with Alzheimer’s on Aricept or Namenda and then in six months say, “Things look great. We see a 25% decline in the accumulation of amyloid beta in your brain.” Or, “Wonderful. Your glutamatergic neurotransmission is up significantly.”

But just because there’s no numerical index of biological improvement that can currently be measured, it doesn’t mean the improvement isn’t there.

We’re all on the Titanic. We’re all going to die. For those of you with Alzheimer’s disease who are taking an Acetylcholinesterase Inhibitor (Aricept, Exelon, Reminyl) and/or Namenda, do you feel like you’re just pointlessly rearranging the deck chairs?

Tell us what you notice about your capabilities and mental health while on these medications. What value do these drugs have for you? Caregivers, tell us what you notice.

What do we know without knowing any numbers?


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Stephanie Warner said...

This is a great write up, I was also a victim, having Alzheimer's disease for many years. My journey and diagnosis with Alzheimer's disease began when I was 58 years old. My medical condition was heart broken. The first thing I did was get myself informed. I was subjected to different medications including Donepezil, galantamine, by my doctors for treatment without the assurance of having a positive improvement. Despite my visit to several doctors my health wasn't getting better. Also I keep thinking there has to be another alternative to address this, using herbal remedy, this information reinforced my original gut feelings that I should not give up. I decided to look for another option to help my condition. I’ve made many lifelong friends when I was looking for a natural cure for my ailment. To say it gets better is an understatement. I find hope in the darkest of days when I saw a testimony of people talking about Dr. Charanjit's herbal product. I started having series of thoughts, thereafter I ordered his product and started using it, to give the Alzheimer's disease an aggressive approach, the symptoms progressively got better.
Luckily, everything seemed to be okay after a few weeks of starting the herbs, this was a pleasant surprise. I promised myself that I would stay strong. You sit living in fear of the reality what you may face, never really knowing what will happen until it does. I am indebted and decided to always share my experience.
If you have same problem and ready to give a try check out his blog: or contact him through

Jaqulin Farnandez said...

It must have been so hard for you to cope up with the situation. I can feel your pain since my brother was also diagnosed with it. But we took diagnosis & alzheimer's treatment and By the grace of god his health has improved.

Carrie Kayla Reynolds said...

In my own case it was just over four years ago when my Mum began to sound different on the phone. She lived back East with my siblings and my husband and I were living on the West coast and in phone calls it became apparent that my Mum's voice no longer had the same tones of excitement and humor that she used to; and instead it was very flat. At the same time she began to tell us about a situation at work that just didn't seem possible; she was complaining that a group of fellow workers were conspiring to get her. Although Mum had much academic success as a teenager, her behavior had become increasingly odd during the past years. She quit seeing her friends and no longer seemed to care about her appearance or social pursuits. She began wearing the same clothes each day and seldom bathed. She lived with several family members but rarely spoke to any of us. Obviously this whole story seemed very unbelievable and we sensed something was wrong but had no clue as to what it could be. We recommended that my Mum quit her job and look for something else - as we began to wonder if she had a "mental breakdown" and would get better once out of the stressful job situation.
In the case of Mum, she was having persecurtory delusions, auditory hallucinations and negative symptoms that had lasted for at least Three years. All of these symptoms fit with a diagnosis of Dementia. Her story reflects a common case, in which a high-functioning young adult goes through a major decline in day-to-day skills. Although family and friends may feel this is a loss of the person they knew, the illness can be treated and a good outcome is possible as it all got better when we started using a herbal medicine for her through Aparajita.
My recommendation to people who are either wondering if they have DEmentia or wondering if a friend or loved one has Dementia should contact I think one of our key problems was that we didn't do this in the early days of my Mum's illness as we never thought of a natural alternative for her.