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?

3 comments:

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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: https://curetoalzheimer.blogspot.com/ or contact him through charantova@gmail.com.

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.