Meet The Guy Who Will Take You Away From All This

“I can’t socially distance myself from the refrigerator,” my friend Susan wrote on Facebook.

Funny, but true. We’re home. And, we’re snacking. All day long. Even the most disciplined among us can’t keep our hands off that big hunk of steel – and our mouths away from its comforting contents.

What’s more, most of us are moving our bods less than we have in years.

Don’t wait until we get the all-clear to get your body moving more – and your jaws moving less.

That’s what I’m doing and, believe me, I’m not one of those fitness and diet fanatics. Far from it! But I knew I’d better do something to help myself during this insane time.

                 You’ll love Bobby

Learn how to do what I’m doing from Bobby Hoock, a health and fitness coach whom you’ll adore.

Join me and Bobby for a 20-minute get together to hear all about it!

“It’s important now more than ever to build up your strength and stay moving for the health of your heart and lungs, not to mention for the sake of your mental health,” Bobby stressed.

This Wednesday session still has openings (today’s and Friday’s sessions are filled!), so sign up now and guarantee yourself a spot.

If you don’t have the Zoom app, don’t worry. It’s a cinch to download and it’s free! I’ll explain how when we send you a confirmation.

                                                  


Each 20-minute session with Bobby is limited to 8 women. Please sign up here.

 

Facebook Is Overflowing with Misinformation About Coronavirus

An Important Message To My FOFriends, 

Stop Googling “coronavirus” and listen asap to how Dr. Jacques Neelankavil answered questions from the FabOverFifty community on FACEBOOK LIVE this morning. 

Dr. Neelankavil earned his medical degree in 2006 from the UCLA School of Medicine, where he also did his residency and was awarded a fellowship in cardiothoracic anesthesiology. 

“Covid information is confusing and rapidly evolving. I’ll demystify the virus and its impact on society,” Dr. Neelankavil said before going live on Facebook. 

And demystify it he did!  He’s a brilliant doctor. Listen right now. You can go back to the fun stuff on Facebook later.

URGENT: Ask An Infectious Disease MD Your Coronavirus Questions On Facebook Live

Stop Googling “coronavirus” and ask Dr. Aaron Walton – a SUPREMELY QUALIFIED INFECTIOUS DISEASE PHYSICIAN – your questions during a not-to-missed FACEBOOK LIVE on THURSDAY, MARCH 26th at 3 pm EST.

Dr. Walton earned his medical degree in 1999 from Duke University, in Durham, NC, where he also did his residency.

He now practices in Australia where he is a member of the Royal Australian College of Physicians.

Thanks to my dear friend Dr. Matt Williams, a heart surgeon in Philadelphia and a Duke classmate of Dr. Walton, who made the intro!

Write down the time and share with your friends and family.

We Can Finally Afford Personal Training When We Need It Most!

Keeping sane is going to take all our wits during these trying times. Keeping fit may be nearly impossible, what with gyms closed and our limited ability to take vigorous walks. Then there’s our proximity to the kitchen during our self-imposed (and crucial) quarantine. We can be super disciplined and start a daily exercise program, but that’s hard enough when life is relatively normal.

What if I said you could have a certified personal trainer – right at home – who would create a customized exercise program for you. Guide and motivate you. And, you could work out on your own time, for a fraction of the cost of a membership at even a moderately priced gym.

sneaking a chocolate covered graham

That’s just what I’m doing, thanks to Ladder, a brilliant new app created by fitness and tech experts.  And so can you. Ladder gives us real-time virtual access to personal trainers at a super affordable price. And, it gives trainers the chance to grow their businesses when they’ve lost access to the gyms where they work. “We wanted to offer a convenient solution to reversing unhealthy habits,” said Randi Stock,  a Ladder spokeswoman. And, it’s certainly easy to ignore healthy habits during this trying time in all our lives.

MEET YOUR PERSONAL TRAINER TODAY 

It’s simple and quick to be matched with your perfect coach, receive your personalized program and get started.   

STEP 1

Answer eight questions about your personality and fitness, such as Would you rather do something new, something familiar or both? and How would you describe your general health? 

STEP 2

You’ll get a message from your new coach right on the Ladder app, where you get to know each other. My coach, Bobby, asked me about my experience with exercising, my goals, how many days during the week I’d like to dedicate to working out, my diet, injuries, physical limitations and access to exercise equipment.   

                       the body weight squat

Learning that I try to stay away from carbs because I can’t help binging on them, Bobby responded, “Most of the internet tends to make carbs out as ‘evil,’ when they actually can be really good sources of disposable energy!  To lose weight, it all depends on putting out more calories than we take in. Those calories can be carbs, fats, or protein, but at the end of the day it’s calories that matter.” Bobby then asked if I’d be open to recording my meals, which would help me be more conscious about my diet. I said I would. 

By the way, even if you don’t have a single piece of apparatus, your coach will design your custom at-home workout based on your comfort level and whether you want help building strength, increasing mobility or just staying active and healthy. He or she also will make sure the program works with any past injuries or existing health conditions.

 

STEP 3

Your coach will send your workout routine to your iPhone or iPad through the Ladder app, which is formatted beautifully.  Each exercise is slowly and clearly demonstrated on a short (20 seconds max) how-to video, which is accompanied by a concise written description. Your custom routine is created from Ladder’s extensive library of exclusive videos. When you’ve completed each workout, you send your coach a notification so she can see what you’re accomplishing. 

Based on my two weeks of experience, it works best to watch a video, try the exercise, then read the description.  After repeatedly doing the exercises you won’t need the videos or descriptions, but it’s still smart to watch precisely how they’re done once in a while. They’re great reference tools to look at as you go through your workout.

If you’re still not sure how to do an exercise, you can text your coach right on the app, which I did a number of times when I  was starting out. I also sent Bobby short videos of me performing a couple of exercises so he could critique my form.

Bobby is one of about 150 expert trainers across the country who are perfect fits for the Ladder platform. But it doesn’t matter where they’re located since you’ll be working out virtually. What matters is that you’ll be getting a progressive program that really works for you.  That’s worlds better than self-prescribing exercises you think you might need right off of the internet but won’t necessarily help you achieve your goals. 

What’s more, a real person will push and cheer you on so you get and stay motivated. Your Apple watch or a YouTube video can’t offer the crucial human element. And, as you give your trainer feedback, your program will become more and more customized for your level of expertise. “The more feedback you provide, the better your experience will be,” Randi stressed

            one of the exclusive videos from the Ladder library

Feeling pretty sore after I started exercising, for example, I asked Bobby if I should work through it. He suggested a  mobility routine which wouldn’t be overly strenuous but would keep me active and alleviate some of the soreness. It worked! 

“You develop a relationship with your coach, who is invested in your success right along with you. Ladder creates a system of accountability between the two of you,” Randi stressed.  

Bobby and I have established a pretty good daily communication system since we started working together a couple of weeks ago.  We often message in real time. Ladder encourages all trainers to get back to clients within a few hours. 

“Fitness is critical for longevity, especially as you age and your body’s performance starts to  decrease before you even turn 50,” Bobby said. “It’s especially important during this stressful time to keep your body moving and give it exactly what it needs! Ladder lets me customize  workout sessions for every individual and coach them on habits, nutrition, and more through the app! I love tailoring my clients’ routined to their lifestyles and to discover how they can fine-tune their health from all angles!”

I know the exercises are working because my muscles – which were extraordinarily tight  – are now limber. And, the routines are becoming easier. Once I master the round of current workouts, Bobby will send me a new one!  Recording my meals has also helped me stay on the right track.  (Psst: I’m afraid to cheat because I don’t want to tell Bobby, and I’m a bad liar, so I guess being accountable and building up good daily habits are good things.) 

THERE ISN’T A BETTER TIME TO START WORKING OUT WITH YOUR OWN DIGITAL PERSONAL TRAINER AT HOME. 

AND GET TWO WEEKS FREE, EXCLUSIVELY FOR THE FABOVERFIFTY COMMUNITY.

(After that, the cost is phenomenal, as in super reasonable).

Honoring His Treatment Experience After a Leukemia Diagnosis

This post was developed in collaboration with Novartis

During a Sunday phone call 15 years ago, Mitch learned he had leukemia from a doctor who talked so fast, Mitch couldn’t make out his name. His own doctor had told him the day before that his white blood cell count was off on his recent blood tests, and she wanted him to see a specialist right away. She never mentioned leukemia. Being a “broad brushstroke kind of guy,” Mitch didn’t ask questions. He’d learn what was up from the specialist, he thought.

Engaged in his treatment: Actual patient Mitch discusses his journey with CML

When the fast‐talking doctor called, he asked Mitch a litany of questions about his health. “‘Did you ever have this? Did you ever feel that?’” Mitch remembered him asking. When Mitch responded no to all the questions, the doctor said, “That’s great, because with leukemia we tend to think of these things.” He then told Mitch to have a good day and hung up!

“My wife was out with a girlfriend and I was alone,” said Mitch, a small business owner in Biddeford, ME, who was 45 years old at the time. “I was in a mild state of shock. When you hear the word ‘leukemia’, it doesn’t exactly conjure up the idea that this will be fine.” He tried not to dwell on it for the rest of the day. “I’ll know what I’ll be facing when I see the specialist tomorrow,” Mitch remembered thinking. He never learned the identity of fast talker. He just knows that was probably the worst phone call of his life.

“It’s the classic signature of Ph+ CML, and we’ve got to get your white blood cell count down,” the specialist matter-of-factly told Mitch. “You’d be in the hospital if the count was any higher. After that, we’re going to introduce you to a drug that’s been very successful in treating this type of leukemia,” the doctor explained to Mitch.

Ph+ CML are the initials for Philadelphia chromosome–positive chronic myeloid leukemia – a type of blood and bone marrow cancer which is associated with a mutation in the genes called the Philadelphia (Ph) chromosome. This triggers the bone marrow to grow abnormal white blood cells uncontrollably. This form of leukemia is most often diagnosed in people over 60, but can occur in younger adults, as it did with Mitch.

The specialist made it clear that Mitch had a serious illness known as Ph+ CML in chronic phase and needed treatment. Other than feeling “a little tired and out of sorts,” Mitch said he had no other symptoms. “I was working 60 or 70 hours a week. Being tired and feeling out of sorts at times is part and parcel of the whole thing, so I didn’t think anything of it,” Mitch noted.

THE TREATMENT JOURNEY: BUMPY, THEN SMOOTH SAILING

Over the next five years, Mitch’s leukemia was treated with two drugs, and while they kept his white blood cell count in check, he faced unfortunate side effects. Fortunately, another drug – Tasigna® (nilotinib) capsules – had received FDA approval by this time, and patients like Mitch, who endured side effects with other drugs, were having some success with this one. Tasigna can cause side effects, however, such as headache, nausea and potentially other serious outcomes.

Mitch has been taking Tasigna twice a day for the last 10 years, and his white blood cell count is under control. While the experience with Tasigna is different for every patient, Mitch has not reported experiencing side effects “worth mentioning.” After his doctors cautioned him about a potential side effect called QTc prolongation, a serious and possibly life‐threatening heart problem that causes an irregular heartbeat, Mitch is careful to note if he becomes lightheaded, faint or senses an irregular heartbeat.

Mitch is proud of his role in his treatment process for Ph+ CML: Going for blood work every single week, at first, to determine his white blood count and giving bone marrow samples once a month. “It’s like ice core drilling in the Arctic,” Mitch jested. “They use a small core drill to take marrow from my hip.” He takes Tasigna twice a day, 12 hours apart. What’s more, he also can’t eat for two hours before and one hour after his dose.

“It’s my responsibility to honor the process,” Mitch advised. “You really need to be engaged in your treatment. How can I expect the most out of my doctor if I’m not giving it my best? I’m part of a club and I have an obligation to follow the rules. It’s not just about me; it’s about my family. And, it’s about the thousands of people who worked incredibly hard to bring this drug to market, which makes an impact on the lives of thousands every year.”

Mitch hopes his own experience will help others who have been diagnosed with Ph+ CML, which is why he’s excited to be part of an important Tasigna campaign called Your Blood Demands to Be Heard. “If you own your treatment journey every step of the way, as I’ve owned mine, you can have a better chance for success,” he stressed.

Mitch has inspirational overarching advice for anyone recently diagnosed with Ph+ CML: “There’s a great deal of hope, with years and years of research behind this disease. Just make sure to follow your treatment plan to a tee. Every. Single. Day!”


MITCH’S INSIGHTS

This 15‐year veteran of Ph+ CML also offered seven specific strategies on how he successfully incorporated his treatment into his life:

       JUGGLING ON AND OFF DAYS: “You will learn how to predict good days and bad days and operate accordingly. When I became tired, I’d have to be mindful that it wasn’t safe to climb ladders in my job or walk as far and as long as I once did. I knew my clients wanted to see me being engaged and energetic, so I’d reserve those activities for the good days.”

       USING KNOWLEDGE AS POWER: “I made sure to completely understand early on what I needed to do, when I needed to do it, and what was supposed to be happening with my body. Be mindful of side effects. I was probably a little more ignorant than I should have been.”

       SHOWING UP: “Monitoring your blood count is a key part of the process, so when the doctor told me to show up for blood work or other testing, I knew I had to show up.”

      ➠ MINDING THE MEDS: “You might feel so good, you decide to stop taking the meds. But you shouldn’t change your routine without discussing it with your doctor.”

      ➠ LOOKING AT THE BIG PICTURE: “You have to play an active part in your treatment. I’m not engaged in the minutiae, in all the numbers and information the doctors must review, but I always discuss my test results with the doctor or a nurse. I want to know whether everything looks good or whether I had a blip that month. I’m more thumbs up or thumbs down. How am I doing this week and this month? Other patients want to know every number and what it means, but that’s not me.”

      ➠ SETTING THE TIMES FOR TASIGNA: “It might take a while to establish a comfortable routine for taking the medication, since you need it two hours before a meal, and you can’t eat for an hour after the dose. Mornings are super easy for me, since I usually wake up at 6 am and I don’t typically eat breakfast until 8 am. I put the pill on the table next to the bed, pop it in at 6 am and go back to sleep. The timing is more difficult for me in the evening if I’m having dinner with a client or a friend than when I’m home with my wife. It’s not mind‐bending advice, but you have to figure it out on your own.”

      ➠ TRUSTING YOUR DOCS: “It’s more important that I trust the competence and the capability of my doctors and key members of their staff. If that breaks down, I’d look for someone else I can trust. It’s great if you like them, too, but not essential.”

Mitch says his disease is under control, but he’ll likely be on Tasigna for the rest of his life. His blood is tested every six months, and he doesn’t need bone marrow checks at this point, unless something unusual were to show up in his blood. Does he worry? “Heck yeah, every six months it’s like the biggest job interview of my life or waiting to get the biggest contract. I know that Ph+ CML will forever be part of my life, but it doesn’t have to sit at the head of the table. It can sit off to the side just as long as I recognize that it’s there,” he said.

Know your blood count, what the numbers mean, and get a treatment that can help.

To learn more about Tasigna and Mitch’s story, please visit bit.ly/39MghBg.

APPROVED USES

TASIGNA® (nilotinib) capsules is a prescription medicine used to treat:
• Adults with newly diagnosed Philadelphia chromosome–positive (Ph+) chronic myeloid leukemia (CML) in chronic phase

• Adults with Ph+ CML in chronic phase and accelerated phase who no longer benefit from, or did not tolerate, other treatment, including GLEEVEC® (imatinib)

IMPORTANT SAFETY INFORMATION ABOUT TASIGNA® (nilotinib) Capsules

QTc Prolongation and Sudden Death: TASIGNA can cause QTc prolongation, a possibly life‐ threatening heart problem. QTc prolongation causes an irregular heartbeat, which may lead to sudden death. Call your doctor right away if you feel lightheaded, faint, or have an irregular heartbeat while taking TASIGNA. These can be symptoms of QTc prolongation.

• Your doctor should check your heart with a test called an electrocardiogram (ECG)

• Do not take TASIGNA if you have long QTc syndrome or low levels of potassium or magnesium in your blood

• TASIGNA can interact with many medicines and supplements. This may increase your chances for serious and life‐threatening side effects. Do not take any other medicine while taking TASIGNA unless your doctor tells you it is okay to do so

• Food and grapefruit products increase the amount of TASIGNA in your body. This may increase your chances for serious and life‐threatening side effects. Take TASIGNA on an empty stomach

     ° Avoid eating food for at least 2 hours before the dose is taken, and avoid eating food for at least 1 hour after the dose is taken

     ° Avoid grapefruit, grapefruit juice, and any supplement containing grapefruit extract while taking TASIGNA

TASIGNA can cause serious side effects that can even lead to death. During treatment with TASIGNA your doctor will do tests to check for side effects. These tests will check your heart, blood cells (white blood cells, red blood cells, and platelets), electrolytes (potassium, magnesium), cholesterol, blood sugar, and pancreas and liver function. Your doctor may have you stop TASIGNA for some time or lower your dose if you have side effects. You should follow your doctor’s instructions. Serious side effects include:

• Low Blood Counts: Low blood counts are common with TASIGNA but can also be severe. Your doctor will check your blood counts regularly during treatment with TASIGNA. Call your doctor right away if you have symptoms of low blood counts including:

     ° Fever, chills, or other signs of infection

     ° Unexplained bleeding or bruising

     ° Shortness of breath

     ° Unexplained weakness

• Decreased Blood Flow to the Legs, Heart, or Brain: People who have recently been diagnosed with Ph+ CML and take TASIGNA may develop decreased blood flow to the legs, heart, or brain. Get medical help right away if you suddenly develop any of the following symptoms:

     ° Chest pain or discomfort

     ° Numbness or weakness

     ° Problems walking or speaking

     ° Leg pain or your leg feels cold

     ° Change in the skin color of your leg

• Pancreas Inflammation (Pancreatitis): Call your doctor if you have symptoms including sudden stomach area pain with nausea and vomiting

• Liver Problems: TASIGNA can increase your risk of liver problems. People who have had liver problems in the past may be at risk for getting liver problems with TASIGNA. Call your doctor, or get medical help right away if you develop any symptoms of liver problems including stomach area (abdominal) pain, yellow skin/eyes, and dark‐colored urine

• Tumor Lysis Syndrome (TLS): TLS is caused by a fast breakdown of cancer cells. Your doctor may do blood tests to check you for TLS. TLS can cause you to have kidney failure (with the need for dialysis treatment) and/or an abnormal heartbeat

• Bleeding Problems: Serious bleeding problems and death have happened during treatment with TASIGNA. Call your doctor right away if you develop signs and symptoms of bleeding such as uncontrolled bleeding, changes in eyesight, unconsciousness, sudden headache, or sudden confusion about your surroundings

• Total Gastrectomy: Tell your doctor if you have had a surgical procedure involving the removal of the entire stomach (total gastrectomy). Your doctor may need to change your dose

• Lactose: Tell your doctor if you have a severe problem with lactose (milk sugar) or other sugars. TASIGNA capsules contain lactose. Most people who have mild or moderate lactose intolerance can take TASIGNA

• Fluid Retention: Your body may hold too much fluid (fluid retention). Symptoms of fluid retention include shortness of breath, rapid weight gain, and swelling

• Abnormal Growth or Development in Children: Effects on growth and development have happened in children with chronic phase Ph+ CML during treatment with TASIGNA. Some children and adolescents who take TASIGNA may have slower than normal growth

• Pregnancy and Breastfeeding: TASIGNA should not be used during pregnancy since it may harm an unborn baby. If you become pregnant, think you may be pregnant, or are planning to become pregnant, tell your doctor right away. If you are able to become pregnant, your doctor should perform a pregnancy test before you start TASIGNA. Effective birth control should be used during treatment and for at least 14 days after your last TASIGNA dose. Do not breastfeed during treatment with TASIGNA and for at least 14 days after the final dose

• Treatment‐Free Remission in Adults: Your doctor will monitor your CML during treatment with TASIGNA to see if you are in remission. After at least 3 years of treatment with TASIGNA, your doctor may do certain tests to determine if you continue to be in remission. Based on your test results, your doctor will decide if you are eligible to try stopping treatment with TASIGNA. This is called treatment‐free remission (TFR)

     ° Your doctor will carefully monitor your CML during and after you stop taking TASIGNA. If your test results show your CML is no longer in remission, your doctor will restart TASIGNA treatment

     ° It is important that your doctor does frequent monitoring to find out if you need to restart your TASIGNA treatment. Follow your doctor’s instructions about restarting TASIGNA if you are no longer in TFR

• Drug Interactions: TASIGNA can interact with many medicines and supplements. This may increase your chances for serious and life‐threatening side effects. Tell your doctor about all the medicines you take including prescription and over‐the‐counter medicines, vitamins, and herbal supplements

If you need to take antacids (medicines to treat heartburn) do not take them at the same time that you take TASIGNA. If you take:

     ° A medicine to block the amount of acid produced in the stomach (H2 blocker): Take these medicines about 10 hours before you take TASIGNA or about 2 hours after you take TASIGNA

     ° An antacid that contains aluminum hydroxide, magnesium hydroxide,and simethicone to reduce the amount of acid in the stomach: Take these medicines about 2 hours before or about 2 hours after you take TASIGNA

• Common Side Effects in Adults and Children Include:

    • Nausea          • Diarrhea            • Rash             • Cough

    • Headache      • Constipation      • Tiredness      • Muscle and joint pain

    • Itching            • Vomiting            • Fever             • Night sweats

    • Runny or stuffy nose, sneezing, sore throat

• Side Effects in Adults Attempting TFR: If you and your doctor decide that you can stop taking TASIGNA and try TFR, you may have more muscle and bone (musculoskeletal) symptoms than before you stopped treatment. Symptoms may include muscle pain, bone pain, arm and leg pain, spinal pain, and joint pain

Tell your doctor if you have any side effect that bothers you or does not go away. These are not all of the possible side effects of TASIGNA. For more information, ask your doctor or pharmacist.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1‐800‐FDA‐1088.

Please see the full Prescribing Information, including the Boxed WARNING, and the TASIGNA Medication Guide.

References

1. American Cancer Society. Chronic Myeloid Leukemia (CML), About Chronic Myeloid Leukemia. 22 February 2016. Available at: https://www.cancer.org/content/dam/CRC/PDF/Public/8684.00.pdf. Accessed November 2019

2. Tasigna [prescribing information]. East Hanover, NJ: Novartis Pharmaceuticals Corp; 2019

Faithfully Observing Her Treatment Experience After a Leukemia Diagnosis

This post was developed in collaboration with Novartis

Staying positive and determined: Actual patient Virginia embraces compliance with her CML treatment

Virginia was in her late 40s when she began getting upset stomachs on and off throughout the week. Active and health conscious–her nieces and nephews call her “nuts and berries”–Virginia thought she might be perimenopausal. “When I asked my older sister if my stomach problem could be related, she said, ‘Sometimes, but everyone is different,’” Virginia recalled. After a couple of months, it got to the point where she could eat only half her meal because her stomach was burning pretty intensely, and she felt nauseous.

Between jobs, Virginia had insurance but didn’t have a primary care doctor, so she took herself to the ER in a hospital near her home in Southern California. There she learned her white blood cell count, normally around 10K, had shot up to 700K, and her spleen had enlarged to over four times its normal size. With that came the news that Virginia had Philadelphia chromosome–positive chronic myeloid leukemia in chronic phase, or Ph+ CML, which is a cancer of cells in the blood and bone marrow that starts with a gene mutation called the Philadelphia (Ph) chromosome. This triggers the bone marrow to grow abnormal white blood cells uncontrollably. A form of leukemia most often diagnosed in people over 60, it can occur in younger adults, as it did with Virginia.

“My spleen had been taking on all of the cancer, which is very uncommon, and it extended from the top of my rib cage to my groin. It was laying on top of my stomach and my intestines, which was impacting my digestion. I was lucky it didn’t erupt,” Virginia said. It took 10 days of intense chemotherapy to get her white blood cell count to a place where she could be released from the hospital. “I was devastated. I was scared. I had no idea about my future,” Virginia remembered.

“When the ER oncologist walked into the room and told me that CML is slower growing and easier to treat than some other forms of cancer, I felt a little better,” Virginia said. “‘We’re going to figure this out, and you’re going to be okay,’” said the oncologist, who has remained Virginia’s doctor to this day, nine years later. “We have a total partnership,” Virginia said.

MAKING ‘COMPLIANCE’ COMMONPLACE

Released from the hospital with a treatment plan, Virginia was instructed by her oncologist to make sure to take her medicine and have her blood drawn every three months. “At first, I didn’t understand exactly what the treatment was going to do or the side effects I could have. There’s only so much information you can absorb when you’re newly diagnosed,” Virginia said. “My oncologist didn’t want to expose me to information overload, so she said, ‘Let’s get you stabilized with this routine and see how it goes.’”

“I was on the drug for about four months, which got my numbers within the normal range,” Virginia added, “But the side effects were too great, so my doctor switched me to Tasigna® (nilotinib) capsules, which was a relatively new drug at the time.” Some patients were responding well to it, Virginia’s oncologist told her.

“I had a pretty seamless transition with Tasigna.
Though it can cause side effects for some, such as headache, nausea and potentially other serious outcomes, my numbers kept improving.

It was great to start taking Tasigna,” Virginia remembered feeling.

Virginia has been taking two doses of Tasigna, 12 hours apart, every day for about nine years. Each dose must also be taken two hours before a meal, and patients can’t eat for one hour after the dose. “I had never taken medicine on a strict routine. It was a big‐time shift for me, but my doctor and I made an agreement that I’d be compliant and take the medicine, and I have been,” Virginia explained. “Compliance is a strong word, but I like using it. You have to know you’ll be better off in the long run if you follow the treatment plan to a tee, so I do. I’m grateful that this medication actually exists and that helps me to go with it. Fasting is the hardest part,” Virginia continued.

After her “devastating diagnosis,” Virginia was introduced to a support group of CML survivors who “have walked this road many more years than I have,” she said. They gave her a wealth of good information, as well as strong emotional, practical and financial support. A national patient support group also assigned a volunteer first responder with CML to call Virginia soon after she was diagnosed.

VIRGINIA’S INSIGHTS

Virginia hopes her own experience will help others who have been diagnosed with Ph+ CML, which is why she’s excited to be part of an important Tasigna campaign called Your Blood Demands to Be Heard. “When you take the medicine and have your blood tested on schedule, you’re doing the right thing,” she stressed. A nine‐year veteran of Ph+ CML, Virginia also offered four specific strategies on how she successfully incorporated her disease and its treatment into her life:

      ➠ TIME FOR TASIGNA: “The morning dose is very easy for me because you’re supposed to fast two hours before and an hour after. I take it when I wake up and then wait an hour to eat, and then that dosage is done. Then I take it at 9 pm, two hours after dinner. I just have to be more mindful when I go out to dinner and when I travel between the coasts and have to juggle time zones. I used to set reminders on my phone, but I don’t have to do that anymore.”

     ➠ SUPPORT IS SUPREME: “Find a good support group, even if you don’t feel great, and have a friend, a family member or a caretaker help you get to the doctor, get your blood drawn, take your medicine and take care of yourself, especially during those early days.”

“Support helped me to be compliant. It gave me a place from which to operate and feel safe. When I saw other people doing well, I’d think, ‘I can do that!’ We shared our blood numbers in the support group. The group provided encouragement and accountability. I figured out a way to work with my intimate circle and my support group that allowed me to let the medicine do what it’s supposed to do. I figured out what was going to get in the way of my success, and I deflated those fears and thoughts. There’s nothing like attitude, even if I’m bummed out and having a bad day. I had to get back up and show up again. I chose to do it.”

      ➠ WHERE THERE’S A WILL, THERE’S A WAY: “Besides my positive attitude, the secret to my success is my faith and undying spirit. I eat well. I have fun. I have perspective and a tremendous amount of hope. I got a second chance at life, so I try not to stress out too much. I surround myself with people whom I love and who love me.”

   ➠ NEVER DETERRED BY HER DISEASE: “My legs and large muscle groups would feel lethargic at the beginning, but I’ve been able to get back into a healthy workout routine. I don’t push myself as hard as I once did. I didn’t let my disease prevent me from dancing, playing golf and hiking. I also love to do barre exercise classes.”

Virginia has adjusted to her new normal. Her disease has been under control for a number of years, but she’ll likely be on Tasigna for the rest of her life and will have regular blood tests.

By the way, Virginia is the vice‐president of business development and sales at a startup in the cyber security business. That’s a demanding job, but she’s up to it. “I’ve made some adjustments because of my CML, but I love what I do, which is important to me,” she said.

Know your blood count, what the numbers mean, and get a treatment that can help.

To learn more about Tasigna and Virginia’s story, please visit bit.ly/39MghBg.

APPROVED USES

TASIGNA® (nilotinib) capsules is a prescription medicine used to treat:
• Adults with newly diagnosed Philadelphia chromosome–positive (Ph+) chronic myeloid leukemia (CML) in chronic phase

• Adults with Ph+ CML in chronic phase and accelerated phase who no longer benefit from, or did not tolerate, other treatment, including GLEEVEC® (imatinib)

IMPORTANT SAFETY INFORMATION ABOUT TASIGNA® (nilotinib) Capsules

QTc Prolongation and Sudden Death: TASIGNA can cause QTc prolongation, a possibly life‐ threatening heart problem. QTc prolongation causes an irregular heartbeat, which may lead to sudden death. Call your doctor right away if you feel lightheaded, faint, or have an irregular heartbeat while taking TASIGNA. These can be symptoms of QTc prolongation.

• Your doctor should check your heart with a test called an electrocardiogram (ECG)

• Do not take TASIGNA if you have long QTc syndrome or low levels of potassium or magnesium in your blood

• TASIGNA can interact with many medicines and supplements. This may increase your chances for serious and life‐threatening side effects. Do not take any other medicine while taking TASIGNA unless your doctor tells you it is okay to do so

• Food and grapefruit products increase the amount of TASIGNA in your body. This may increase your chances for serious and life‐threatening side effects. Take TASIGNA on an empty stomach

     ° Avoid eating food for at least 2 hours before the dose is taken, and avoid eating food for at least 1 hour after the dose is taken

     ° Avoid grapefruit, grapefruit juice, and any supplement containing grapefruit extract while taking TASIGNA

TASIGNA can cause serious side effects that can even lead to death. During treatment with TASIGNA your doctor will do tests to check for side effects. These tests will check your heart, blood cells (white blood cells, red blood cells, and platelets), electrolytes (potassium, magnesium), cholesterol, blood sugar, and pancreas and liver function. Your doctor may have you stop TASIGNA for some time or lower your dose if you have side effects. You should follow your doctor’s instructions. Serious side effects include:

• Low Blood Counts: Low blood counts are common with TASIGNA but can also be severe. Your doctor will check your blood counts regularly during treatment with TASIGNA. Call your doctor right away if you have symptoms of low blood counts including:

     ° Fever, chills, or other signs of infection

     ° Unexplained bleeding or bruising

     ° Shortness of breath

     ° Unexplained weakness

• Decreased Blood Flow to the Legs, Heart, or Brain: People who have recently been diagnosed with Ph+ CML and take TASIGNA may develop decreased blood flow to the legs, heart, or brain. Get medical help right away if you suddenly develop any of the following symptoms:

     ° Chest pain or discomfort

     ° Numbness or weakness

     ° Problems walking or speaking

     ° Leg pain or your leg feels cold

     ° Change in the skin color of your leg

• Pancreas Inflammation (Pancreatitis): Call your doctor if you have symptoms including sudden stomach area pain with nausea and vomiting

• Liver Problems: TASIGNA can increase your risk of liver problems. People who have had liver problems in the past may be at risk for getting liver problems with TASIGNA. Call your doctor, or get medical help right away if you develop any symptoms of liver problems including stomach area (abdominal) pain, yellow skin/eyes, and dark‐colored urine

• Tumor Lysis Syndrome (TLS): TLS is caused by a fast breakdown of cancer cells. Your doctor may do blood tests to check you for TLS. TLS can cause you to have kidney failure (with the need for dialysis treatment) and/or an abnormal heartbeat

• Bleeding Problems: Serious bleeding problems and death have happened during treatment with TASIGNA. Call your doctor right away if you develop signs and symptoms of bleeding such as uncontrolled bleeding, changes in eyesight, unconsciousness, sudden headache, or sudden confusion about your surroundings

• Total Gastrectomy: Tell your doctor if you have had a surgical procedure involving the removal of the entire stomach (total gastrectomy). Your doctor may need to change your dose

• Lactose: Tell your doctor if you have a severe problem with lactose (milk sugar) or other sugars. TASIGNA capsules contain lactose. Most people who have mild or moderate lactose intolerance can take TASIGNA

• Fluid Retention: Your body may hold too much fluid (fluid retention). Symptoms of fluid retention include shortness of breath, rapid weight gain, and swelling

• Abnormal Growth or Development in Children: Effects on growth and development have happened in children with chronic phase Ph+ CML during treatment with TASIGNA. Some children and adolescents who take TASIGNA may have slower than normal growth

• Pregnancy and Breastfeeding: TASIGNA should not be used during pregnancy since it may harm an unborn baby. If you become pregnant, think you may be pregnant, or are planning to become pregnant, tell your doctor right away. If you are able to become pregnant, your doctor should perform a pregnancy test before you start TASIGNA. Effective birth control should be used during treatment and for at least 14 days after your last TASIGNA dose. Do not breastfeed during treatment with TASIGNA and for at least 14 days after the final dose

• Treatment‐Free Remission in Adults: Your doctor will monitor your CML during treatment with TASIGNA to see if you are in remission. After at least 3 years of treatment with TASIGNA, your doctor may do certain tests to determine if you continue to be in remission. Based on your test results, your doctor will decide if you are eligible to try stopping treatment with TASIGNA. This is called treatment‐free remission (TFR)

     ° Your doctor will carefully monitor your CML during and after you stop taking TASIGNA. If your test results show your CML is no longer in remission, your doctor will restart TASIGNA treatment

     ° It is important that your doctor does frequent monitoring to find out if you need to restart your TASIGNA treatment. Follow your doctor’s instructions about restarting TASIGNA if you are no longer in TFR

• Drug Interactions: TASIGNA can interact with many medicines and supplements. This may increase your chances for serious and life‐threatening side effects. Tell your doctor about all the medicines you take including prescription and over‐the‐counter medicines, vitamins, and herbal supplements

If you need to take antacids (medicines to treat heartburn) do not take them at the same time that you take TASIGNA. If you take:

     ° A medicine to block the amount of acid produced in the stomach (H2 blocker): Take these medicines about 10 hours before you take TASIGNA or about 2 hours after you take TASIGNA

     ° An antacid that contains aluminum hydroxide, magnesium hydroxide,and simethicone to reduce the amount of acid in the stomach: Take these medicines about 2 hours before or about 2 hours after you take TASIGNA

• Common Side Effects in Adults and Children Include:

    • Nausea          • Diarrhea            • Rash             • Cough

    • Headache      • Constipation      • Tiredness      • Muscle and joint pain

    • Itching            • Vomiting            • Fever             • Night sweats

    • Runny or stuffy nose, sneezing, sore throat

• Side Effects in Adults Attempting TFR: If you and your doctor decide that you can stop taking TASIGNA and try TFR, you may have more muscle and bone (musculoskeletal) symptoms than before you stopped treatment. Symptoms may include muscle pain, bone pain, arm and leg pain, spinal pain, and joint pain

Tell your doctor if you have any side effect that bothers you or does not go away. These are not all of the possible side effects of TASIGNA. For more information, ask your doctor or pharmacist.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1‐800‐FDA‐1088.

Please see the full Prescribing Information, including the Boxed WARNING, and the TASIGNA Medication Guide.

References

1. American Cancer Society. Chronic Myeloid Leukemia (CML), About Chronic Myeloid Leukemia. 22 February 2016. Available at: https://www.cancer.org/content/dam/CRC/PDF/Public/8684.00.pdf. Accessed November 2019

2. Tasigna [prescribing information]. East Hanover, NJ: Novartis Pharmaceuticals Corp; 2019

10 Foolproof Lifestyle Choices to Getting Natural ‘Healthy’ Energy

This is a “sponsored post.” ChromaDex compensated FOF with an advertising sponsorship to write it. Regardless, we only recommend products or services that we believe will be helpful for our readers. All insights and expressed opinions are our own. —Geri Brin

A high powered lawyer at a prestigious firm, my 56-year-old friend Wanda doesn’t feel fully awake until she’s had her first cup of coffee in the morning. She also swears she’d never make it through a long night at the office without guzzling at least one giant mugful.

Coffee might be her quick picker upper, but when Wanda started relying on it throughout the day to give her energy, she realized she wasn’t doing her body any favors. Instead, she felt irritable and anxious, and many nights she couldn’t get to sleep. 

Interestingly, of the 80 percent of adults in the United States who consume caffeine, those between 50-and 64-years old consume the most, according to The Food and Drug Administration. Wanda has plenty of company! 

An overdose of caffeine – think about those sugar-packed drinks in every supermarket across the country –  is no one’s idea of healthy energy. It may get you going in the short term, but have enough of it over the long haul, and it can take its toll on your heartbeat, ability to sleep and nervous system. That’s exactly what Wanda was experiencing. 

Sure, it’s convenient to get a quick shot of energy from a can or a mug when you’re exhausted.  But, it’s far wiser to support your own natural energy levels by incorporating these 10 common sense practices into your daily lifestyle. That way, your body can store energy to call on when you most need it, let’s say during a late night at work or an afternoon at the playground with your toddler grandson.

 


Chronic stress – from a high-pressure job or financial problems, for instance – can cause many types of physical and emotional symptoms, such as tiredness to lack of energy and focus. Determine a way to help reduce your stress, whether it’s seeing a therapist or taking up meditation.

Taking on too much, professionally or personally, can sap your energy. Surely, not every single thing on your “must-do” list has to get done soon, or ever, for that matter. Streamline the list asap! 


Relaxing can provide physical and emotional benefits, such as relieving depression and lowering your heart rate. Laziness is another story. Don’t use energy for days or weeks on end and you’ll actually become more and more fatigued, not to mention raise your health risks. Even if you exercise lightly three days a week for 20 minutes each time, you’ll feel more energized after six weeks, according to a University of Georgia study. Regular exercise delivers oxygen and nutrients to your tissues, boosts strength and endurance, and helps your cardiovascular system to run more efficiently. You’ll probably sleep better, too!  

 

 

We guess you really don’t need another reason to stop smoking, but here it is, anyway: Smoking actually saps your energy by making it harder to sleep. The nicotine in tobacco speeds your heart rate, raises your blood pressure, and stimulates brain-wave activity associated with wakefulness. When you stop smoking, you sleep better and energy returns (provided, of course, you’re not mistreating your body in six other ways). 


While it’s ideal to sleep seven to eight hours a night, sleeping soundly for four hours is far better than tossing and turning for eight. Sleep deprivation has been associated with obesity and related health problems, such as heart disease and diabetes. It can lower your energy level by making you feel fatigued during the day. And, it can impact your immune system, raising your susceptibility to colds and flus and lowering your energy levels for days at a time, according to www.sleepfoundation.org.  

Quality sleep lets your body restore many functions it needs to stay healthy, such as temperature regulation, a strong immune system, steady hormone levels, and good appetite. All of these processes play a role in your energy level. 


Even if your weight is ideal and you exercise regularly, it’s smarter to consume small meals and snacks every few hours than three big meals every day. This gives your brain a steady supply of nutrients and can lower your perception of fatigue, according to Harvard Health Publishing. Foods with a low glycemic index (their sugars are absorbed slowly) may help you avoid the lag in energy that usually occurs after eating quickly absorbed sugars or refined starches. These foods include whole grains, high-fiber vegetables, nuts, and healthy oils such as olive oil. High-carb foods have the highest glycemic indexes. Proteins and fats have glycemic indexes that are almost zero.


 

As we said at the start, caffeine does help increase alertness, but you must drink it judiciously to get its energizing effects. 


 

No denying that a glass of velvety red wine or a super dry vodka martini can make you chill. But avoid drinking at lunch, when the sedative effect is especially strong. And, if you want or need to have energy in the evening, cut out the 5 pm cocktail. Of course, we don’t have to tell you to drink in moderation, do we?

 

Water is the only nutrient that has been shown to enhance performance for all but the most demanding endurance activities. So, unless you’re training for a triathlon, drink it. Not everyone needs eight glasses of water a day, but everyone absolutely needs it for a trillion reasons, including energy. Feeling fatigued is one of the first signs that you’re dehydrated. 



We know, just the thought of sitting in chemistry class again gives you hives. Don’t worry, you don’t have to do that. But please read these few paragraphs about how our bodies make energy, why our energy production naturally ebbs as we age, and a simple thing we can do to help reverse that process.

Dr. Charles Brenner, a Stanford-educated PhD (you’ve got to be impressed with that credential!), has uncovered the pathway between a molecule called nicotinamide riboside (NR), and nicotinamide adenine dinucleotide (NAD), which he argues is the single most important molecule in every single cell of our bodies. 

                 Dr. Charles Brenner

“We all absolutely need NAD,” Dr. Brenner said emphatically. It performs a number of critical functions, such as enabling our cells to convert the fats, proteins and carbohydrates we eat into the energy we need to help us stay in top shape. It also activates sirtuin genes, which regulate cellular aging and the chemical and biological processes that help us maintain healthy and fit lives,  Dr. Brenner reported. 

NR is a form of vitamin B3 that helps our cells to produce NAD. Unfortunately, our levels of NAD substantially decline as our bodies slow down with age. 

Aging is the biggest risk factor for many of the diseases that kill us. Doing cardio and weight-bearing exercises all week, consuming a diet of nutritious whole foods, getting adequate sleep, and staying away from smoking and drinking are all important. “But cells damaged by the inevitable stresses of life, such as aging, look for ways to replenish their NAD, which helps keep them running smoothly,” Dr. Brenner explained.  

An NR supplement actually can reduce the effects of aging on our cells, starting with decreased energy production.

Dr. Brenner is the Chief Scientific Advisor behind TRU NIAGEN®, the only NR supplement directly from ChromaDex, the worldwide patent-holder and innovator behind it. When you take TRU NIAGEN, you’re getting the real benefits of Dr. Brenner’s important discovery, without the side effects of some other supplements.

I’ve been taking TRU NIAGEN® for about three years. I  feel really good, and while I’ve lost some hair as I’ve aged, I  haven’t lost my signature energy. While many claims in the booming nutritional supplement market seem downright absurd, I am living proof that it’s smart to take TRU NIAGEN® since it supports my desire to age the best I can!

 

to age the best you can with Tru Niagen®

Life Line Screening Wanted to Keep Me Healthy. I Didn’t Listen.

Life Line Screening compensated FOF with an advertising sponsorship to write this post. Regardless, I started having its health screenings years before this, and I only recommend products or services that I believe will benefit others. Geri Brin, Founder, faboverfifty.com 

                  Carotid artery screening

I wasn’t overly concerned when the ultrasound test from Life Line Screening revealed mild fatty plaque in the carotid artery on the right side of my neck.  Two carotid arteries–there’s another one on the left side–carry oxygenated blood to the brain, neck and face, but the amount of plaque wasn’t a dire threat to my health, at least not immediately. Uncharacteristically, I dismissed the report recommendation to follow up with my doctor, too preoccupied with launching this website at the time.  That was in 2010. I felt good and had no signs of a problem. My weight was reasonable. I exercised. Didn’t smoke or drink. 

My blasé attitude had troubling consequences. 

By last year, my weight had spun out of control, I was working out less, and a new ultrasound showed a dramatic increase in the plaque. Now the bad stuff was narrowing the right carotid artery somewhere between 59 and 80 percent. That got my attention, even if there wasn’t a single symptom. If a piece of plaque broke off and blocked the blood flow, I could have a stroke. To make matters worse, my cholesterol numbers were dismal. My doctor started me on statin therapy right away to lower my cholesterol, told me to lose weight, and to take low-dose baby aspirin every day. 

I’m 15 pounds lighter today and my cholesterol numbers are excellent, thanks to statins. Another carotid artery scan is scheduled for the end of July, and hopefully the level of plaque hasn’t progressed. “It might even have regressed,” my doctor said. If more plaque shows up, surgery might be necessary to clear it out. Serious surgery! 

Ironically, most doctors won’t recommend a carotid artery ultrasound for asymptomatic patients with no family history of stroke. What’s more, Medicare doesn’t cover the test unless someone has experienced symptoms such as transient ischemic attacks, mini strokes lasting only a few minutes.  Without coverage, it’s costly to have tests like this done at a hospital.  The United States health system isn’t a shining example of how to practice preventive medicine. 

Having no reason to suspect any cardiovascular problems nine years ago, I actually arranged for the first ultrasound through Life Line Screening as a preventive measure. Life Line has provided preventive screening to millions, and at remarkably fair fees, since it began 25 years ago. When the original results showed mild plaque, it should have been fair warning not to let myself go. After all, that’s what preventive health care means. That’s what makes Life Line a smart idea.

The Life Line Screening Difference

When Life Line recently contacted me about introducing its screening service to my FOFriends, I didn’t hesitate. After all, they discovered the plaque in my carotid artery at an early stage, not to mention early bone loss, and suggested that I see my own doctor. Pretty foolish not to heed their advice.  “Every day we find people across the country with significant carotid artery disease,” said Dr. Keith Coffee, Chief Medical Officer at Life Line. 

                  A stroke in the brain

Besides the carotid artery screening for plaque, a Life Line special package offers tests for 1) Peripheral arterial disease, a circulatory condition in which blood vessels narrowed by plaque reduce blood flow to the limbs. P.A.D. usually affects the arteries in the legs, but it also can affect the arteries that carry blood from your heart to your head, arms, kidneys, and stomach 2) Abdominal aortic aneurysma bulging, weakened area in the wall of the aorta, which is the largest artery in the body. Over time, the blood vessel balloons and is at risk for bursting or tearing, which can cause life- threatening bleeding and potentially death. 3) Heart rhythm aka atrial fibrillation or AFib, a quivering or irregular heartbeat that can lead to blood clots, stroke, heart failure and other heart-related complications and 4) Osteoporosisa loss of bone density or mass. 

It’s only $159 for all five screenings.

“We discovered about 62K overall health risks in 2017 alone,” Dr. Coffee said. A team of highly qualified, board-certified radiologists throughout the country, led by a vascular surgeon, reads all ultrasound images as well as the electrocardiograms for AFib. 

“These are screenings, not diagnostic tests,” Dr. Coffee stressed. “We encourage patients to share their results with their doctors so they can together discuss the appropriate treatment, if necessary.” (Remember, that’s what I didn’t do!)  Life Line doesn’t have physicians available who can discuss the test results with patients, and it doesn’t interact with patients’ physicians. They do provide a summary of the results that you can share with your doctor. “We simply provide the incentive for patients to take the right steps for their health,” Dr. Coffee noted. 

If Life Line Screening discovers a life threatening condition, however, such as an aneurysm that’s about to rupture, it will send someone right to the ER and call for an ambulance if they wish.  “Our customers tell us that we’ve possibly saved their lives. We get letters all the time from people who had no symptoms and thought they were just fine, but were at risk for having a large aneurysm about the rupture,” Dr. Coffee said. 

In and Out In 90 Minutes Or Less

    Peripheral arterial disease screening

An average of 50 people a day check into each Life Line location in 60 cities across the country. Teams at the screening sites include at least two ultrasound stenographers who hold certificates in ultrasound technology, and two medical assistants who are cross trained to perform tests including electrocardiograms for heart rhythm, fingerstick blood tests, and peripheral pulses. A nurse practitioner joins most of the teams to see people 65+ years old for Annual Wellness Visits, which are covered under Medicare.

While most people opt for the basic, five-test package I described earlier, many decide to get their cholesterol and glucose checked during the same appointment, Dr. Coffee told me.  Life Line Screening offers 15 preventive screening blood tests, including thyroid function, vitamin D, and hemoglobin A1C for diabetes. It also provides a take-home test for detection of colorectal cancer. A call center with 300 trained employees helps participants decide what tests are right for them, based on their age, risk factors and medical history.

Testing is done in churches, at community centers, fraternal organizations and occasionally in hotel ballrooms.  When Life Line works with affiliates, such as hospitals, anyone with abnormal results is referred back to the hospital. It also offers exclusive screenings for employees of large corporations as part of their healthcare plans. “Our goal is to get people in and out in 60 to 90 minutes, which includes paperwork and waiting time,” Dr. Coffee said. 

                           Results package

A results package arrives in the mail about three weeks after your screening. It reports on every test you took and on your risk for stroke and cardiovascular disease in general, taking into account factors including smoking, high cholesterol and family history. “We give you all the information we can to help you make lifestyle changes and modifications if you need to,” Dr. Coffee explained.  If a major issue such as Afib is discovered, a Life Line representative will call you directly, rather than having you wait for the results package. 

People generally have their first Life Line screenings at 55 years old. “We have patients in their 40s who just want to know where they fit healthwise, or maybe they have a family history of early strokes. And, we have people in their 90s,” Dr. Coffee said. Returning patients account for about half of Life Line’s annual screenings, and close to 90 percent of all patients have their own physicians. 

Please learn from my error: Get preventive screenings once you’re in your mid-fifties, whether or not you have symptoms.  And pay attention to what you learn.

for peace of mind or early detection 

Your Bone Health After 50

FabOverFifty recently polled 100 women from our community to learn about your bone health.

What You Should Know About Dementia and Alzheimer’s, But Were Afraid To Ask!

I met Dr. Michael Serby about 35 years ago, when our toddler boys played together at the local playground. He did research in Alzheimer’s and had a practice in geriatric psychiatry, but those subjects were not uppermost in my mind at the time. Now they are, so I decided to ask Dr. Serby if he’d be willing to do an interview with me about his life’s work. I’m delighted he accepted my invitation, because so many of us have seen Alzheimer’s wreak a horrific toll on family and friends, and are frightened it will hit us, too.
lead

FabOverFifty: What happens to our minds as we age?

Dr. Serby: Some people have long-standing psychiatric problems that started when they were young, or younger, and have become more of a problem. Maybe the frequency of their problems increases. Maybe they don’t have the family they once had to help them.

“Many people have diminishing cognitive function as they get older, that may begin as early as their 50s, but I know one woman who is 106 and is as sharp as can be; not a sign of diminishing cognitive function. So it’s not age, per se, that’s responsible for the development of cognitive change. It’s just more common as you get older.”

How do you define many and what happens what exactly is diminishing cognitive function?

“The majority of people over 50, certainly over 60, will experience some change in their cognitive functioning. They can’t find the right word, for example. They’ll say ‘it’s on the tip of my tongue,’ this kind of thing. That’s considered normal.

Your bones may change with age. Your joints may change with age. Your skin may change with age. Everything changes with age, but if there’s nothing pathological in those areas I mentioned, that’s great. Your memory for words also may show some change, but it’s not significant if it doesn’t affect your daily life, your functioning. You can continue to work as a lawyer or a writer. But some people panic as soon as they can’t think of a word. They’re looking for that first clue that they’re going to get Alzheimer’s. People are being evaluated in dementia centers all the time who are considered ‘normal.’”

caption

How do you know when your ‘diminishing cognitive function’ is out of a range considered ‘normal’?

“You might have trouble planning, with language, with spatial skills.* It’s pretty noticeable, and gets in the way of your daily ability to function, but it hasn’t gotten to the point of dementia When this happens we call it Mild Cognitive Impairment (MCI).”

* Visual-spatial skills are critical for success in solving many tasks in everyday life, such as using a map to guide you through an unfamiliar city (pre-GPS); merging into high-speed traffic, and orienting yourself in your environment, as when you’re learning your way around a new office. Some tasks that require visual-spatial ability include packing for a trip (deciding if a certain box is large enough for the objects you want to put into it) and using mirror images (as when you comb your hair while looking into a mirror).

If you’re diagnosed with MCI, will you automatically get Alzheimer’s?

“About half of patients with MCI will go on to dementia, but many seem to hang there and continue (with MCI), maybe forever.”

Let’s say you and your husband have driven the same route to the mall, hundreds of times over the last 35 years, but one day he forgets which way to turn when you’re at the exit. Is this cause to worry?

“You shouldn’t hang your hat on one episode like that, because there are many possibilities that have nothing to do with dementia. Perhaps the husband didn’t sleep well the night before, and he had an isolated memory lapse; maybe a TIA is beginning, which is common in older people. (Note: A transient ischemic attack is a brief interruption of the blood supply to part of the brain that can result in confusion, temporary memory loss, sudden fatigue, difficulty speaking, vision changes, and poor balance. High blood pressure is a major cause of TIAs, but they also can be caused by issues including diabetes and high cholesterol, according to popular website healthline.com)
couple“If this happens, and the person gets more confused that day, it would suggest that he be seen by a doctor. They might need to get cardiac and neurological exams.

“Alzheimer’s is very slow, but a wife who experiences an incident like you described might say to me: ‘I can tell you exactly when the Alzheimer’s started.’ That’s not true. It’s just when she noticed something because it was so clear cut. You can associate a stroke with a specific event, but not Alzheimer’s. Don’t make any assumptions without an evaluation.”

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