Under the Shadow of Alzheimer's

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What If I End Up Like Her?

Later I thought, for what must have been the thousandth time: What if I end up like her? The thought of being so debilitated that I would need Austen or Eli to dress me was deeply disturbing on many levels. I would never want my sons to be saddled with my care, although surely, if I get Alzheimer's, I will be someone's burden.

If both of your parents have Alzheimer's, you have a 42 percent chance of getting the disease as you age. I'd be lying if I said this statistic doesn't haunt me. I worry preventively, as if the right dose of angst will ward it off. I like to do my worrying aloud, and my favorite audience is my husband. I'm sure Darryl would prefer to hear less about my foreboding and more about what's for dinner. But my parents' Alzheimer's has been looming like a black cloud over me for years, so the dark thoughts are never far from my mind.

I watch anxiously for signs of impending doom. When I'm on the phone while doing e-mail, I occasionally type what I mean to say to the person on the line. I can't multitask like I used to, and I fret that this must be the first sign of dementia. But then I'll reassure myself with the fact that one of my friends forgot to put the top up on her convertible and only remembered three hours into a terrible rainstorm, or that another friend forgot her daughter's birthday. Most people are unconcerned about what this might mean because their parents don't have Alzheimer's. On the other hand, one in five people are expected to get the disease by the time they're 80, regardless of genetics, so maybe they should start worrying.

I don't ever want to be a burden to Darryl or Austen and Eli, so in my daydreams I have concocted a fantastic plan. If and when my luck runs out, I'll take a vacation to a euthanasia-friendly country -- the Netherlands might be nice. First I'll enjoy lots of sightseeing and fine dining (calories be damned at this stage of the game!) followed by a giant dose of morphine, administered by a good-looking Dutch doctor.

But ending it all, I suspect, is not that easy. It must be hard to pick just the right moment, when the bad so outweighs the good. Perhaps, over the years, you'd set aside just the right amount of medication but, suddenly, you'd realize that it has reached its expiration date before you have. How can it not always feel too soon? You'd miss your husband and your children and their milestones, and let's not forget all of your favorite cheeses and, of course, your friends. And won't they miss you if you sign off too soon? No one wants the curtain to fall before the show is over. The problem is, if you have Alzheimer's, by the time life doesn't seem worth living, you're not mentally or physically capable of ending it all.

However, though I can't afford to get sick, I don't exactly get to make that choice. So five years ago I tried to gather enough information to pinpoint my odds more accurately. I consulted a neurologist, shared my family history and concerns, and asked him what I could do. "We can't definitively diagnose Alzheimer's disease, except posthumously," he told me. "But we can follow you and give you an MRI every so often and see if there are any changes in your brain over the years."

I had three questions: "Will it stop me from getting the disease?" "Do you think there will be a cure in the next five years?" "Does insurance cover this?"

No, no, and no. "No, thanks," I said.

"Let me put your mind at ease," he said. "You don't have the demeanor of someone in the earliest stages of Alzheimer's. You have a normal memory for your age, given the amount of stress you're under."

So for now, I live my life no differently, except for taking a few preventive measures. I eat the good brain food -- salmon and leafy green vegetables -- and take all of the proper vitamins. I exercise, read and write daily, and bone up on my French when I can.

Everyone knows that they're going to die one day and unless that day is looming uncomfortably near, it's human nature to put it out of your mind. Do I live each day like it might be my last? Not a chance. I've got obligations and priorities. Secretly, I'd love an excuse to travel the world and buy my dream home. But in the real world, we have to pay the bills and send our kids to college. Life, I've decided, is basically a tragicomedy, so I might as well save my angst for when bad fortune actually strikes.

Continued on page 3:  You Can Reduce Your Risk


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