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If you're new to this blog and want some context for it, read this post from the day I announced my Alzheimer's disease and this post about the day I announced I had lost it. For more info, visit my website with my autobiography and all blog entries in chronological order for easier reading to catch up. There's also a sermon on the spiritual lessons I've learned through this journey through my damaged mind.

Saturday, January 25, 2014

The Forward Lean

Washington DC
We had four inches of snow in Washington on Tuesday evening, not much, actually, but enough to bring the city to a halt.  Record-breaking cold weather, down into the teens and even single digits, has accompanied the snow, so it has stuck around for a while.  True, we would hardly have noticed this weather when we lived in northeastern Minnesota, but it brings up a longing for the winters there.  My memories of cross-country skiing through the forest near our house are among my happiest.

The city was beautiful, however.  Marja and I stretched our regular evening walk to about an hour, enjoying the snow hats on the front-lawn bushes, the empty streets, the wind swirling down the main corridor of our local business area, one house with Christmas-tree lights still on the pine tree in its front yard, and the occasional person struggling against the wind and the cold.  When the temperature is this low, the snow gets crunchy underfoot, evoking memories of walks in Finnish winters where we also lived for awhile.  When it’s this cold, the snow is no longer slippery, nice for an old man whose balance ain’t what it used to be.  It was absolutely glorious to be out in the quiet city.

As we walked, however, I noticed that I kept leaning forward.  Marja noticed it to.  We always walk quickly to get the exercise as well as our nightly togetherness, but Tuesday evening, I almost couldn’t help speeding up.  Unintentionally I kept leaning forward, and legs seemed to be hurrying up to catch up to my upper body, which  seemed to be dragging my legs along.  I stepped off a curb and almost tumbled forward into the street.  I didn’t fall but only because Marja and I often hold hands, as much for balance as for tenderness.

Before I was aware of my cognitive decline, I would hardly have noted an isolated instance like this.  With my impairment, however, my medical mind switched on, and I thought immediately about Parkinson’s disease.  One of its signs is a “festinating gait,” which is one image I have from medical school: a guy pulled faster and faster by his upper body.  Parkinson’s is often a cause of dementia, too.  Naturally, I googled it when we got home.  It turns out, however, that my gait didn’t really meet the criteria to be festinating.  I’d forgotten the other elements it comprises: stooped position; short, shuffling stride; absence of an arm swing; difficulty starting and stopping; and so on.  It also turns out that a festinating gait doesn’t show up until late in Parkinson’s when many other symptoms would have become obvious. 

The mental jump to thinking about my impairment is understandable, I suppose.  My diagnosis is uncertain, different diseases have different prognoses, and I’m a doctor with a natural curiosity. 

But I also wonder if it’s an unhealthy preoccupation with the future.  In the months following my diagnosis, I felt a wonderful freedom from concern about the future.  I lived more in the present, more in tune to others and the world in general.  It was wonderful.  Some of that remains.  On the other hand, I find myself now, twelve months later, a little less in tune with the others, more often pre-occupied with past and future.  Is this thinking about Parkinson’s a “preoccupation” or something less neurotic? 

I don’t feel worried about the future, mostly interested in it.  It’s a mental challenge to put together all of my symptoms and test results, and wonder about the different futures.  So I don’t really feel worried.  In any case, this is my present moment.  Wondering about what’s happening now, even wondering about my future is what I’m doing in this present moment.  And the present moment is where I want to live.


  1. Anonymous1/26/2014

    Hi, and thanks again for your articles. I can see why one would want a 'definitive' answer about one's situation. It would help to plan, predict, assess costs--not just financial--etc.

    As for 'being in the moment' issues: For me, I'm assessing my "five year cognitive plan" each week/month. --What can I do/continue to do/begin to do for the next five years, given my "arc" of aging crossing my "arc" of some 26-year accident-related cognitive impairment. I can continue to volunteer with college student tutoring, some coaching, and being an 'academic resource' for different projects. But I keep feeling I should have a major "project"--a book, a play, some workbooks on 'formulas' for adapting to aging health"--rather than these day-by-day things. Yet, I'm actually 'happy' day to day, in the moment, so to speak. [Given the statistic of 1 person out of 2 who hits the 85-year mark being subject to dementia (if I have my "info" correct), this gives me 5 years of 'okay cognition' and then a continuation of a curve 'downward' to 85 after another 5 years.] So for me it's a question of "one long-term project" for 5 years OR being 'in the moment' of assisting students sporadically and being happy with it as well. For some people these wouldn't be "either-or" issues, but because of energy and memory issues, they are for me.

    So I'm trying to "predict" within my parameters, but it's difficult.[Retired higher ed administrator, Sodium]

    1. I love the way you're assessing your five year cognitive plan, but let write something that may be obvious. It's apparently true that by age 85 something over 40% of people have Alzheimer's. But that includes all the people who already had signs of it five or ten years before. For an 80-year old who has no significant cognitive symptoms, the likelihood of having Alzheimer's at 85 would be considerably lower. (I'm just reasoning deductively; I don't know the actual statistic.)

  2. Anonymous1/26/2014

    I wish that there was a "like" button available. I am always appreciative of your sharing and wish there was a way to indicate that when I really don't have anything to add in the way of commentary...

  3. Your ability to be interested rather than worried indicates to me a certain detachment. I have no idea if that is good or not.

  4. Like :)

    ...especially your description of an evening walk in Washington DC.

  5. I just found your blog via an article about the peanut butter test for Alzheimer's . I could tell by reading just this one post of yours that you probably do not have Alzheimer's. I have spent the past ten years researching vascular dementia as my mom passed away from it in November. We struggled to get the correct diagnosis, because she did not fit the mold for Alzheimer's. She was extremely intelligent, as you are, and so her cognitive decline was subtle at first, and irregular all along. She had six very good years after her diagnosis and then some hard ones. She maintained her sense of humor and awareness almost until the end, and she recognized us all, was able to laugh and eat chocolate, some very important things! I wish you the best of luck as you travel this path, and pray for treatments that can help you. I will be following you on this blog!


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