Haunting Attrition

As I guided Cindy from one room to another, holding both her hands and slowly backing up in front of her, I noticed her legs for the first time in quite awhile. Even during the summer she usually wears pants because she chills easily. On this hot summer’s day I dressed her in shorts, revealing the disturbing amount that her legs had atrophied.

This haunting image now comes to mind when I do range of motion exercises with Cindy. Her arms put up surprising resistance when I straighten them out, but now I notice her arms have become very thin, if not quite frail. Cindy eats well, essentially the exact same food I do. Granted, I take larger bites, but I also burn up a couple thousand more calories each day. We are not dealing with malnutrition, but the inevitable attrition of Alzheimer’s.

A recent post on an Alzheimer’s forum listed three myths about dementia. The third myth in the post echoed what I’ve shared with you often:

“The third myth that amyloid causes Alzheimer’s disease is under challenge, but its proponents are still hanging on.  Certain forms of amlyoid may contribute to oxidative stress early in Alzheimer’s disease, but they are one of several factors that do so.”

The other two myths portray people with dementia as irreversibly losing memories. Research has shown that new neurons can form later in life and that memories can be recaptured after cognitive decline. Along these same lines, I have commented that “input” seems to be more functional with Cindy than “output.” She still perceives, understands and even remembers many things, but she cannot convey much of that.

Lately I’ve been relating the mind to an interstate highway system, with memories and thoughts being the transported cargo. A tornado can halt transportation by either wiping out the cargo trucks or the bridges. I believe, in contradiction to the two myths, that with dementia the “bridges” are being wiped out more than the cargo of memories and thoughts.

Even if I am wrong with that belief I cannot see the attrition of memories and can at least pretend they are still there. When we hug I witness nothing that proves she has lost the memory of who she is clasping so tightly. The brain is the target of dementia, but at least we cannot observe what is going on with the synapses of the mind. Perhaps it is best not to know, even if it might not be as hopeless as we think.

Though only collateral damage from dementia, the body hides nothing. I do not see an Expedition Woman’s legs or arms, those are forever gone and what remains will atrophy further. Even if attrition of the mind could be halted at this point, restoring the body would be a daunting task. Daunting and haunting.

Last night I had a dream that I was hiking. That’s nothing new these days. Usually my hiking dreams feature only me, no doubt my mind’s attempt to subconsciously debrief the past and prepare for the future. Last night Cindy was with me hiking, at one point competing with me at jogging down a mountain.

That’s a side of Cindy that few outside our family knew. This warm, kind, sweet woman (all true) is quite competitive, in some ways more competitive than me. She took great pride when the Director at her visiting nurse agency referred to her as their “golden girl.” She took great pride in being known as the “Expedition Woman,” even protesting a bit when I once extended that title to our daughter Charissa. She ardently wanted the Triple Crown of hiking, I suspect even more than our hiking friends knew. She would be happy to know that in my dream I could not shake her in our race down the mountain.

What was my subconscious trying to accomplish by including Cindy in my hiking dream? I have no image in my mind of Cindy’s mind; there is no recent MRI scan I might picture. Instead, the image of Cindy’s legs, the shriveled legs of a 10,000+ miler, haunts me now and might for years to come. Perhaps my dreams now seek to alleviate this haunting attrition.