Neurologists and physicians writing on KevinMD about the brain: dementia and Alzheimer's disease and the biomarkers that now find it early, stroke and what recovery really allows, autism, Parkinson's disease, gait and balance as vital signs, and caring for a spouse or parent with a neurological illness. Three maintained records draw on this archive: Aging and dementia: what physicians say, in their own words, Heart disease: what physicians say, in their own words, and Mental health: what psychiatrists and physicians say, in their own words.
It started with an early morning drive to the golf course on the day before Father’s Day. It was a beautiful spring day in the Southwest, and the Man had it all to himself. However, the second half of the day would belong to others — his wife, his kids, his house, and his job. He was hoping for a quick 18 requiring no mental gymnastics beyond that of a …
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A Father’s Day golf game to remember
The pager beeps early on the first day of my inpatient pediatric neurology service week. The pediatric intensive care unit (PICU) would like us to perform a brain death examination on a young boy before potential organ donation. An apparently healthy boy who had an unexpected clinical course that led to his current state.
As a pediatric neurology resident, I often have difficult conversations with our patients and families, but the …
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A heartbreaking yet heartwarming story of a pediatric neurology resident’s struggle and empathy
Alzheimer’s disease is a devastating illness without effective treatment. Yet it may, in fact, be largely preventable. The first shocking fact to absorb is that the pathogenesis is largely extracranial, though assuredly not entirely so. That clearly defies the conventional pharmacologic wisdom, which has obsessed with amyloid-beta as the offending agent and has approached it by crafting and evaluating antibodies against it. The FDA has even bought into that theory …
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Challenging conventional wisdom: How to reduce the risk of Alzheimer’s disease
It was in 2012 that I started to realize that my wife Jennifer’s memory lapses were a significant sign to be taken seriously. That insight set us on a four-year journey, during which we engaged four neurologists in our quest for an answer. At last, Dr. Brent Fogel at the David Geffen School of Medicine at UCLA diagnosed Jennifer with adult polyglucosan body disease (APBD), an ultra-rare, neurodegenerative disorder characterized …
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A couple’s journey with a rare neurodegenerative disorder
Driving around, searching for children’s Tylenol and a pharmacy that had the antibiotics my son needed, was not how I wanted to spend the holidays. I am not alone – shelves are bare, and antibiotics are in short supply as we head into the new year in the midst of a triple threat of COVID-19, flu, and RSV.
While this drug shortage is incredibly frustrating, at least there is …
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Timely treatment decisions: the promise of surrogate markers
Recent news on actor Chris Hemsworth and his genetic test has been widely covered in the media. The actor said he is taking a break from acting after learning he has a heightened risk of developing Alzheimer’s disease.
I learned this from my teenage son, who read in the news that the Thor star discovered this after undergoing tests as part of his Disney+ documentary series Limitless.
Hemsworth learned that he has …
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In light of Chris Hemsworth’s APOE news: Don’t panic
Close to 6 million adults in the U.S. are currently living with Alzheimer’s disease or a related form of dementia, according to CDC data. And that number will grow as the U.S. population ages. The number of people with Alzheimer’s and related forms of dementia is projected to increase to approximately 14 million over the next 38 years.
Dementia impacts not only the people who develop this condition but also …
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Managing key risk factors may lower your dementia risk
When you begin to pay close attention, you notice how what used to be so easy becomes complicated. When you step back and watch things unfold in front of you, you realize that what once was enough is simply too much. Dementia peels back the layers of our lives, and you begin to understand that less becomes more in the world of dementia.
The signs were there for a long time. …
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Dementia peels back the layers of our lives
A recent study out of England found that walking just under 10,000 steps a day reduces a person’s risk of developing dementia by 50 percent. Pick up the pace to a “brisk” walk (over 40 steps per minute), and that risk goes down even further. Perhaps most strikingly, the authors found that even a low number of daily steps was associated with a reduced risk of dementia.
The walking study …
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Take steps (literally) to prevent dementia
As physicians, we equate terms like “disorder” and “syndrome” with pathology. If a diagnosis is listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM) IV, it’s considered a “problem.” In the case of neurodevelopmental diagnoses, I am becoming increasingly aware that this may not be the case. As a neurodiverse individual with many neurodiverse family members and friends, I believe there is nothing “wrong” with our brains. Different …
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Who are the neurodiverse people in your life?
Doing medical-legal consulting is a great way to use your medical training in a non-clinical field that really helps people. One of the many things we can do is help attorneys refute the question of a pre-existing medical condition. Often opposing counsel will try to lay off accident injuries as not related to the accident or injury in question.
As you may know, medical-legal consulting is a new non-clinical field in …
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How a medical-legal consultant helped refute a possible pre-existing medical condition argument
It was 2:21 a.m., and the pager exploded in my ear like I had forgotten to turn the volume down before plugging in my headphones. The nurses told me your heart rate was getting faster, and your oxygen was dipping lower. When I made it to your room, you were laying in urine because you were too weak to stand. Your breathing was rapid and shallow, like you were caught …
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The art of medicine is born in the unforeseen
May is National Stroke Awareness Month, and I want to share my story of my dad’s journey after his strokes.
Doors open and shut during the early morning hours. I hear the drip dispensing the next dose and some muffled chatter outside the room. Several phones are ringing in all directions, and I listen to alarms going off next door. This means the heart rate is too high.
Snoring beside me, I …
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These wounds will never heal
The baby formula shortage has morphed into a full-blown ongoing crisis. Many stores report that more than half of baby formula products are out of stock. Babies who are six months old or younger should only be fed breast milk or formula. Any substitute may be nutritionally incomplete and may cause babies to have permanent problems in brain development.
What are the essential brain ingredients in the leading baby formulas?
Docosahexaenoic acid …
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The baby formula shortage puts your baby’s brain at risk
This spring, kids will be returning to extra-curricular activities and organized sports in the community, much of which was canceled over the past two years due to the COVID-19 pandemic. As these activities resume, now is a good time to learn what to do in the event of a concussion.
Concussions are one of the most common sports injuries in children and youth. Canadian data show there are nearly …
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What to do when your child suffers a concussion