Why Buddha Never Had Alzheimer's: A Holistic Treatment Approach through Meditation, Yoga, and the Arts
240
Why Buddha Never Had Alzheimer's: A Holistic Treatment Approach through Meditation, Yoga, and the Arts
240Paperback
Overview
It is estimated that 5.4 million people in the U.S. are afflicted with Alzheimer's disease. In its capacity to completely destroy personalities, relationships and daily living, we cannot afford to continue thinking of it as a private disease. Alzheimer's is a family problem—ruthless in its scope and spread. And despite relentless trials and research studies, scientists have not found a drug to control it. Even worse, there isn't even a fully reliable diagnostic test for it. Alzheimer's disease has become a gigantic specter that looms before all of us as we age, and it is advancing unimpeded.
Today we know that contributing factors and symptoms (such as stress and hypertension) can be alleviated with holistic, alternate management approaches—like meditation, yoga, music therapy and virtual reality therapy. Research studies from Harvard Medical School, Johns Hopkins University and Mayo Clinic, among many others, have demonstrated the comprehensive benefits of yoga and meditation on various aspects of the human mind—and when you think about it, that's where Alzheimer's disease develops—in the mind.
But, how can meditation and yoga stop or even reverse the course of Alzheimer's? They set the mind on an inward journey where the risk factors that precipitate the disease are formed. This bridging of the old and new creates an imperative paradigm shift in our perspective toward Alzheimer's disease management. Why Buddha Never Had Alzheimer's is precisely what is needed to cause a drastic and necessary revolution in medical care.
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Product Details
| ISBN-13: | 9780757319945 |
|---|---|
| Publisher: | Health Communications, Incorporated |
| Publication date: | 10/24/2017 |
| Pages: | 240 |
| Sales rank: | 1,117,366 |
| Product dimensions: | 5.50(w) x 8.40(h) x 0.70(d) |
About the Author
Read an Excerpt
CHAPTER 1
ALZHEMER'S DISEASE: WHY WE ARE STILL SCRATCHING THE SURFACE
Gratitude is the memory of the heart.
— Jean Baptiste Massieu
Three ladies lived together, lodged in a plush suite of a senior center facility overlooking the ocean, and found a companionship more destined than designed. Mrs. Terry Behman spoke little, as her solemn expressions overrode her paucity of words. Margaret Mitchel spoke more, and her eyes darted like bullets. Lucy Adams served out of habit. Every dropped spoon was picked up without any fumble; every soiled finger was cleaned, and no spilled water escaped her attention. All three women had one thing in common: they all suffered from Alzheimer's. What prevailed was an unusual confluence of minds where all that mattered was embrace. Details became redundant.
If you review their histories, you would marvel at the present traces left behind. Terry is a retired high school teacher who ran the school with as much élan as she ran her house, with poise, grace, and determination. Margaret was one of America's earliest women pilots. Lucy served her entire life as a nurse. All three minds have now fallen behind. What remains are reflections of their wonderful choices: Terry's restrained expressions; Margaret's piercing eyes, and Lucy's unfailing gift of love and care.
These examples bring out the nature of Alzheimer's: unreliable and unsure. How much of the mind it bites away and how much it chooses to spare seem entirely left to the discretion of its whims. No matter how we try to formalize its ferocity with guidelines and templates, a new version inevitably emerges from right behind the curve.
In valiant yet vain efforts to taste the honey of success, scientists have been smashing one beehive after another, each of them clashing and colliding with the other, producing predictable outcomes from a disease in mindless turmoil.
Let me start with the Department of Psychology at Washington University in St. Louis, Missouri, to provide a better understanding of the endless perspectives scientists have adopted to trace this elusive predator.
Scientists there have examined personality changes in a longitudinal study using a Blessed Dementia scale. Of the 108 participants in the study, 68 received the clinical diagnosis of dementia after their entry into the study. The remaining 40 participants, who died during the study, did not have a clinical diagnosis of dementia. However, when autopsied, 14 of them received a neuropathological diagnosis of Alzheimer's. Based on the eight items of the Blessed Dementia scale, including increased rigidity, increased egocentricity, loss of concern or feelings for others, coarsening of affect, impaired emotional control and responsiveness, growing apathy, and purposeless hyperactivity, the participants' personality changes were measured. According to the results, 47 percent of the converters (those who became demented after joining the study) showed personality changes significantly before the clinical diagnosis of dementia — in sharp contrast to the nondemented group, who exhibited relatively preserved personalities. These changes included growing apathy, increased egocentricity, impaired emotional control, and increased rigidity.
A tempting question instantly emerged from these results: Can we use personality changes as a clinical marker of impending Alzheimer's? Should apathy or nonchalance be viewed as the first faint steps of a losing mind?
But if these are exciting and reasonable concepts, how do I rationalize Lucy's undisturbed care and affection, despite her advanced dementia? How do I overlook Margaret's intact personality expressed through her sharp eyes? Or Terry's restrained emotional quotient? Are they exceptions to the rule, or are we still scratching the surface?
We have opened a Pandora's Box. Numerous theories and hypotheses based on small longitudinal studies with little statistical significances are pouring in from all corners. Among all these impossibly moving targets, some facts remain — that Alzheimer's is an inexorable disease; that it can be varied in its presentation; that it can be slow and gradual or furious and relentless in pace and mood.
Dr. Bharati Sharma was one of those destined to be different and brilliant. An outstanding student in India, she boarded a plane to England at a time when in that part of the world, women in medicine were few and far between. As a member of the Royal College of Obstetrics and Gynecology, she worked with supreme credibility at Queen Charlotte Hospital and Kings Hospital in London before returning to her motherland to become a medical superintendent at a prestigious institute.
Despite her scholarly excellence, Dr. Sharma had little idea that her own mind would sink into Alzheimer's Dementia, grounding a mind that prided itself on taking care of mothers and infants in distress.
A single letter announced the arrival of Alzheimer's. In a letter to her husband, she started off normally, with "My dear husband" but as the letter progressed, quite suddenly and with no heralding sign, she lost her way and stumbled to a halt after a paragraph or two, ending as "Yours affectionately, Mother" A disease in a frenzied pace reversed her own identity in a matter of a few lines. There was no turning back. A doctor turned into a patient who would be need to be taken care of for the next twenty years. All was lost, except tragic remembrances, like when she scrubbed her hands, surgeon style, every time she sat for dinner. Painful reminders that she was once an outstanding doctor.
As of now, we have a grasp of the wide range of clinical manifestations that this disease can present but we have no sense of its timing. This could just be the nature of the beast — protean and whimsical. Future trials and studies would surely throw more light on this conundrum. Apart from memory loss that forms the fulcrum of the disease, impairment of executive functioning is a common presentation. However, this is not set in stone. The shortcomings may range from subtle to prominent, ranging from being less organized to being less motivated, and an individual may exhibit either state in varying magnitude. Yet as the disease progresses, the ability to perform complex tasks becomes seriously challenged.
Other signs and symptoms pour in randomly, almost in callous vengeance.
Dyspraxia, the art of performing learned motor tasks, sets in much later in the disease, long after memory and language have been hit. Can you button your shirt? How do you use a comb? Switch on the fan for me. Can you scoop jelly out of the bottle with a spoon? Open-ended questions or instructions reflect an ability to perform multistep motor activities. But immersed in Alzheimer's, these abilities often falter, leading to dependency, frustration, pain, and compounding emotional agony.
By contrast, sleep disturbances can come early in the disease process, long before the mind has been dented. Fragmented sleep patterns, a quick-in/quick-out pattern of sleep, ending in prolonged periods of solitary nocturnal awakening with inevitable daytime drowsiness. Again, we must resist the temptation to take this early feature as a sign of impending Alzheimer's, for nearly anything disorderly in life can break the natural rhythm of sleep, including the normal, gracious aging of the mind and body.
Seizures, quite like sleep disorders, have a variable foothold in Alzheimer's. They occur in nine to 16 percent of patients and frequently involve the later stages of the disease.
A far more intriguing but unsubstantiated feature of the disease involves the olfactory function — our ability to smell the good, the bad, and the ugly. In a recent article published in Neuropsychiatric Disease Treatment (April, 2016), authors Yong-ming Zou et al. from the Department of Neurology at Tianjin Huanhu Hospital, Tianjin, People's Republic of China, delved deeply into the intricacies and sensitivities of olfactory dysfunction in Alzheimer's. Research and review of almost all scientific studies pointed out that an inability or reduced or distorted ability to smell can occur in the nascent stage of the disease.
Since as early as 1974, forty years of intense research have attempted to use olfactory dysfunction as one of the earliest clinical markers of this disease. The sensitivity of this disorder has been phenomenal, reaching about 100 percent in Alzheimer's. Yet, as with many of these biomarkers, specificity has been weak. In other words, even in a general healthy population, disturbed smell ability has been observed. In a major population-based cross-sectional study published in the Journal of the American Medical Association (JAMA), researchers from the School of Medicine at San Diego State University and the University of California have shown that the prevalence of olfactory dysfunction increases with aging. Statistically, patients who range from eighty to ninety-seven years of age had a 62.5 percent prevalence of olfactory dysfunction.
But the area in which Alzheimer's poses an especially considerable challenge is the "insight" faculty. Reduced insight is a common yet variable feature of this disease. An underestimation of one's own deficits with counter-explanations and alibis, almost as if to preserve one's self-dignity, becomes the most poignant feature of the suffering. Justifiably, the deficits are almost always observed by whomever the sufferer leans on most, which is very often a family member. But again, much like executive functioning, loss of insight is not a guaranteed presentation, and the consequences of these varied features go well beyond the primary disease. Those who manage to hold on to their insight sink into depression. By contrast, once the insight faculty is hurt, behavioral disturbances invariably take center stage in the form of agitation, aggression, wandering, and the psychotic effects of hallucinations, delusions, and — in severe situations — misidentification syndromes.
What increases the complexity is the observation that the simple physiological aging process can uncover all these behavioral disturbances. Dr. Rajkumar Singh, our institute's psychiatrist, who also carries an extensive research background, brought to my attention a study he had co-authored and presented at the 143rd annual meeting of the American Psychiatric Association in New York some years ago.
In that study, forty-five normal, healthy, young volunteers, between the ages of nineteen and thirty-five, were compared to forty-five normal, healthy, elderly individuals, ages sixty to seventy-eight. Both were administered a verbal list-learning task and self-rated scales of affective states to examine the relationship between emotional states and performance on a memory task. What Dr. Singh and his colleagues found was that the elderly group demonstrated strong correlations between poor verbal recall measures and heightened negative emotional states. In the elderly group compared to their younger counterparts, higher levels of negative emotional states were positively associated with poorer memory.
From a raw emotional point of view, misidentification carries the worst prognosis for the complete breakdown of relationships. The ripple effect eventually touches all — from the sufferer to the caregiver to the whole family.
I had always known Laura as one of the most devoted caregivers I had come across in my twenty-five years of patient care. John, her husband, was in my nursing home with a documented diagnosis of Alzheimer's, along with numerous other co-morbidities, ranging from coronary artery disease to high blood pressure to rampant diabetes that gave him severe peripheral vascular disease, eventually leading to a bilateral, below-the-knee amputation. But he was a sweetheart. Loss of memory, loss of legs — nothing could deter his joviality. He denied and defied all laws of Alzheimer's to show minimal behavioral and psychological symptoms — all except one, as I would discover much later.
After several sessions with both husband and wife, I gradually noticed strange but undeniable discrepancies in the couple's past lives. John vowed that Laura always loved Vivaldi and Chopin. When I approached her separately, Laura had no clue about either of those composers. John lauded Laura's outfits in her heyday, which were always blue, including the rim of the pince-nez she wore. Laura vaguely recollected those details. John named all the countries they had visited, yet Laura had a grounding fear of flights and heights.
I expressed my concerns to Laura, gently addressing issues pertaining to both health and law, for example, how difficult it would be to conduct behavioral and biofeedback sessions if facts did not gel, or how I might need to involve Human Resources if I was not convinced of their relationship. Our meeting was far from an interrogation, but I was persistent. Finally, Laura broke. The story she told was heartbreaking, to say the least, yet reflected how far Alzheimer's can go to derail and damage personalities.
Laura was not Laura, after all. She was John's second wife, Martha. John's first wife, the real Laura, had died of an unexpected cardiac arrhythmia. In the ensuing years, Martha had taken excellent care of a very crestfallen John, and they married and lived on happily — until slowly but surely Alzheimer's took over John's mind.
While memory loss was evident, misidentification became the leading feature. With his distant memory intact, John started seeing Martha as Laura. In extreme situations, he questioned Martha's demeanor and appearance because they did not fit into his construct of the departed Laura. Martha tried her best to battle the trauma until she could no longer sustain it, leading to an extreme, perverse transition when Martha became Laura. This was a new love story — intense, suffering, and deeply agonizing. It required intense counseling to convince Martha that by pretending to be Laura she was not only deepening John's dementia, she was also burning herself out.
*
This brings us to one of the fiercest challenges of Alzheimer's disease: caregiver burnout.
Haidi Behman, one of the brightest neurologists in our facility, had always prided herself on her subspecialty of epilepsy, which had become her passion, both for treating and teaching. About ten years ago, she suddenly encountered a bitter crossroads when she found her mother, Terry, in the kitchen completely clueless about the difference between a crockpot and a rice pot, two utensils she had been using for years. Haidi instantly recognized that something was terribly wrong. A predictable course followed: a quick Mini Mental exam followed by Namenda, a highly touted, brain-saving drug. Nothing happened. Terry did not improve or deteriorate; she simply plateaued. When her husband died, Terry turned completely silent and this may have been symptomatic of depression or worsening dementia.
This entire process changed Haidi from a neurologist to a caregiver, from someone who understood the disease to someone who felt its pain. The journey was rough for mother and daughter, and the stakes in their relationship became higher as the contrasts became starker. The woman who had virtually governed a neurologist now needed to be fed, seated in a reclining chair, and have her diapers changed.
This is Alzheimer's most powerful blow — turning a family into a portrait of sorrow and suffering. It almost justifies the absurdity of dementia and depression being considered as "infectious diseases."
A major landmark study by the Department of Psychiatry and Epidemiology at the University of Pittsburgh squarely addressed this threatening issue. Cross-sectional and longitudinal analyses were carried out involving 1,222 dementia patients and their caregivers to assess dementia patient suffering, caregiver depression, and the use of antidepressant medications. Called the REACH study (Resources for Enhancing Alzheimer's Caregiver Health), this multisite trial sought out various psychosocial interventions to measure their feasibility and the emotional impact on family caregivers living with and caring for patients of dementia.
The results were staggering. But even before we address the overwhelming statistics, we should be asking some fundamental and valid questions:
How do we measure suffering?
Is suffering relative?
Is it a completely personal issue?
How many times have we seen individuals flip out at the drop of a hat, while others remain stoic and nonchalant despite insurmountable hurdles? Or, even more astonishingly, they remain happy and resplendent in their expressions, despite facing incredible odds?
Researchers have argued that measurable universal manifestations of suffering exist, despite personal differences. Physical symptoms, like chronic or acute pain, nausea, and difficulty in breathing; psychological affects, like depression and anxiety; and from a holistic point of view, measures of internal harmony, meaning, and purpose of life, are all tangible and measurable factors.
(Continues…)
Excerpted from "Why Buddha Never Had Alzheimer's"
by .
Copyright © 2017 Shuvendu Sen, MD.
Excerpted by permission of Health Communications, Inc..
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Table of Contents
Acknowledgments vii
Introduction 1
Chapter 1 Alzheimer's Disease: Why We Are Still Scratching the Surface 25
Chapter 2 Drugs, Drugs, Drugs: Modern Medicine's Commodity Fetishism 53
Chapter 3 Meditation: The Science Behind an Endless Art 81
Chapter 4 From Nalanda to Harvard University: Yoga's Breathtaking Journey 121
Chapter 5 Meditation and Yoga: The Building Blocks 151
Chapter 6 Music, Virtual Reality, and Simply a Touch 173
Chapter 7 Medicine and Spirituality: The Missing Link 203
References 225
Index 251