Tuesday, January 28, 2020

What is Dementia?

I ran across this on Facebook:

"One man turned nursing home design on its head when he created this stunning facility."*

It unsettled me. It's sad, it's hopeful. Mostly it endeared me. I have worked with many people living with dementia. Many times they seem blank, distant, unreachable. Occasionally they are irascible, combative, silly, or rude. They can be hilarious and good-natured. They can grope, throw food, or repeat the same word for hours.

They can stare at you like you are the last real person they will ever remember, just because you were there at a particular time.

I have often observed such people to display hallucinations, or speak as if to spirits, or describe the world in detail as it was 50 years ago, but to them it feels like today. I've wondered, "Is she just lucky to have such a pleasant hallucination?" when one has seen many appear to be having pretty frightening delusional experiences.

But then what is "delusional"?

Is it delusional to attempt escape of a fragile and painful body, immobile, perhaps fetid, through the agency of a flight of fancy that seems so real? Or perhaps it's an unsurprising that such a person could find themselves in a fearsome funhouse full of unfamiliar sights and sounds and strangers.

So I read this and found myself really liking the concept. Give in to the delusion. Why fight it? Too often we fight against Nature. There is no winner inasmuch as we all will die. Some believe they will go on to another life...but...why the rush? So much are we tuned into our embodiment of ourselves--our actual bodies--that it becomes hard to imagine actually leaving this mortal life. I feel that way. I like this life. This causes me to wonder if others, whose lives perhaps weren't so lucky, would actually be served by a magical delusion that seems so real.

Except when we interrupt it. Suppress its expression.

There's been a movement in geriatrics that aims at not trying to reorient our memory-challenged elders when they are having a delusion. I've seen this begin to spread in health care, and in fact our own students benefit from this research. So it's getting around. A good idea.

This gives me hope that we are really beginning to put aside our assumptions and lean into Nature. Without that lean we're just regarding things at a distance, struggling with our ignorance, and perhaps robbing people of a sort of restorative humanity they may need in their final days.


* Although I did not verify this story, it's plausible, and seems like a pretty good idea in any case.

Sunday, January 26, 2020

Is The End Of Homeopathy Near?

The short answer is "no."

Over the past couple of years the US Food and Drug Administration has been reviewing the regulations governing homeopathic medicines. Mostly they have been trying to get at the issue of new medicines marketed over-the-counter for consumers.

In general I have been supportive of these regulations, since there is evidence that homeopathic remedies, used improperly, can cause harm. It's like I tell my students:

If it's strong enough to cure you, it's strong enough to kill you.

Well, "kill" might be an overstatement. I've never seen a remedy kill anyone! But I have seen some harms, such as when people repeatedly take high potency remedies that were not carefully prescribed. Dr. Hahnemann himself wrote in the Organon of Medicine that strong remedies in high potency leave their mark on a patient. I have referred earlier to an FDA recall of Zicam because of such problems.

Lately, I've been getting a lot of hysterical email blasts from various homeopathic advocacy groups, and a few emails from patients who are alarmed by these reports, which claim the FDA is trying to gain the authority to recall homeopathic single remedies, which are used in classical homeopathy for complex, constitutional cases, acute problems, and other maladies.

This is not true. For support I'll share this very well written report from the American Association of Homeopathic Pharmacists, here in its entirety in the link. But I'll direct the reader's attention to the crux of the report, as I see it:

"AAHP also believes that the greatest existential threat to the industry today is not FDA but rather manufacturers and distributors marketing products not in compliance with current Good Manufacturing Practices [emphasis mine]."

People who access "natural medicine" are often unaware that the manufacturers of such products still live and work in a capitalist world where the object is to make money. It may be many believe they're also doing good...but, they still have to make payroll! I've talked here many times about Big Pharma and how allopathic drug makers are often corrupt, greedy, and frequently develop drugs that are expensive yet have marginal effectiveness. One must not assume that because a product is herbal or nutritional and outside of the pharmaceutical regulation system, it's "okay." In fact it is because these products are lightly regulated that nefarious intentions can lead to economic opportunism. 

If one wishes to contact the FDA about these draft regulations, one of the best things you can tell them is about the benefits of homeopathic single remedies to your health, and the importance of their continued availability. Expressing support about existing homeopathic medical practice reinforces with them that there's a constituency that values access to homeopathic single remedies.

Be well & stay warm!