Alzheimer’s at 45

Imagine for a moment that in the space of 8 months – less time than it takes to have a baby, for example – you suddenly find that you can’t remember all the things that everyone your age (45) remembers without effort. Sure, you noticed minor lapses over the previous few years, but at first you just figured this must be what its like to arrive at middle age. Everyone forgets stuff as they get older, right?. But unlike your friends, things get worse. You find that – almost subconsciously at first – you mask your strange memory problems with attention-diverting strategies like beaming a bright smile at everyone you meet, maintaining a cheerful demeanor as much as possible. You’re always ready to laugh, which usually puts attention on someone else. And, most important, you begin keeping quiet as much as possible.

picks2_tax_gr.gifOver time, ever-widening gaps appeared in your act. Sometimes you laugh and by the looks people give you it wasn’t the right time for it. Fewer and fewer conversations make complete sense, but you follow along with a big smile, trying to look involved. You find yourself more and more frequently brought into your manager’s office to explain strange oversights at your cashier’s job. One day, you rush from your department store job in tears – dismissed after one particularly egregious error. An error you still don’t really understand. It isn’t long until you’ve lost your apartment, and with no job you’ve suddenly become homeless. Friends are few, family is far, and soon you spend most nights at the downtown Salvation Army, looking for a place to sleep.

Things have become so bad that you can’t really remember who your family is anymore. Was it here in town where your parent’s live? Maybe that was back in Iowa. Or maye that was just a movie. It gets worse…one day you realize that your thighs feel warm; you look down to see that someone has spilled soup or water or some sort of liquid on your pants. But the smell is terrible and nobody is around that might have caused the problem. Of course, maybe someone was with you just a minute ago but remembering things like this has been so tricky lately that you can’t be sure what happened. But that smell…it’s…really bad. You can’t think of words you might have used to describe the smell – like pungent – anymore. Gone are the days when you might have used words like dank or acrid. Certainly, from the time you were about 5 years old, you would have simply described it as the smell of urine. But even that escapes you sometimes.

You find yourself more and more isolated. Occasionally – you don’t realize it happens monthly – a nice lady gives you money from somewhere. You also don’t realize that these times correlate with sudden attention from people who might be your friends. Not wanting to offend a friendship – and still laboring under the belief that your smile and interested gaze hide your confusion – you consent to “lending” most of your money. You consent to many other things as you shuffle through the gray concrete of the city, cast in cold shadows and forgotten humanity. Often, the most precious things are taken from you with or without your consent…and all the while you are just trying to figure out if that grunting man smelling of sweat and alcohol and needles was your friend. Maybe you knew each other. Maybe this is how he always is with you. Maybe it was alright…you had an arrangement or something. Back then. Back when you could remember.

Somehow you end up in a hospital. The doctors kindly ask horrible questions that drive to the heart of your secret, “Can you count backward from 100 by 7’s?” Or, “Who is the president of the United States?” The worst questions are the ones you know are the easiest…”What is the name of your mom and dad?” because those answers should come quick. You know the answers should come instantly, but they don’t. Desperately, you begin to make up answers. But then they ask the same questions again and you can’t remember what you first said. You’re getting trapped; you can tell the secret is out. A doctor says something about how you scored an 11 out of 30 on a mental exam. You have to do better than 20 to be normal, he says.

pick2.jpgOver the next few days, as the doctor describes what your problem is, you have the doctor continually repeat his words, so you can understand what he is telling you. He says the problem is something called Pick’s Disease, as best they can tell. He says it’s like Alzheimers, but often attacks younger people. The problem is in the front of your brain. You don’t have as much brain as most people have. You have things called “pick bodies” in that area. There isn’t anything to fix it. The doctor tells you that he found a nursing home you can go to where you’ll be safer. Away from your “friends.” Then he says something about how your problem has a “short course”.

“Good!” You say. “Then everything can go back to normal?”

“No.” He replies, carefully. Sadly. “It just gets worse and worse. You probably have only about 3 years to live. Maybe much less. I’m very sorry.”

Ironically, you never seem to have trouble remembering that.

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