Tag Archives: treatment

My Battle With Opiates

October 11, 2016 by
Photography by Bill Sitzmann

I’ve had problems with a variety of drugs, but my story hit rock bottom with opiate addiction.

I was always a very straight-and-narrow kid growing up in West Omaha. I obtained my pilot’s license when I was 17, and I was very active in sports and fitness. I graduated with a 4.17 GPA, and maintained a 4.0 in my first year studying at the University of Nebraska at Omaha.

Toward the end of high school, I did the typical partying with friends: drinking at friends’ houses when their parents were away, maybe smoking a little marijuana. But I never felt I had lost control. My father was a functioning alcoholic, so, you could say I was somewhat predisposed to the disease of addiction. But what did I know?

So-called hard drugs caught me the summer after high school. First came ecstasy pills. I remember the first time I “rolled,” I was in my basement with a couple friends who were more experienced with drugs. “I hope this feeling would never end,” I remember saying. My friend looked at me and just shook her head as if feeling sorry for a little kid. The next day, I felt the worst depression I had ever experienced. It scared me. But, I kept taking the pills, chasing that feeling, only for a slightly less satisfying high as my body acclimated to the drug. After a summer of taking ecstasy two to three times a week, the depression stuck with me. I couldn’t seem to have fun without being high.

As I went into my first year of college, I started trying cocaine and opiates. A lot of my acquaintances—I say acquaintances because none of those people are in my life now that I am sober—were doing things like oxycodone, hydrocodone, morphine, and other prescribed narcotics. These prescriptions are relatively easy to get your hands on. There are plenty of other drugs that are synthetic forms of opium and heroin, too.

By my third year of college, I was spending $50-$150 per day to support my habit. Looking back, I don’t know how I could afford it.

Over the next two years my use of opiates grew more and more frequent. At first, I was able to hide my habit from everyone in my life. I can’t even remember how many times I was high in class or in the library working on homework. At the time, I felt in control. When I look back, I realize I was developing quite a few character defects: lying, manipulation, cheating, and stealing. Eventually it got to the point where I wouldn’t even do schoolwork without some sort of drug to aid me.

By my third year of college, I was spending $50­-$150 per day to support my habit. Looking back, I don’t know how I could afford it. I had a good job and minimal bills. I knew when the people I got my drugs from had a prescriptions refilled better than they did. I always figured out a way. Because without the opiates, I felt restless; I couldn’t sleep; I was simply miserable. It got to a point where I needed help. I couldn’t keep going on like that. After checking into a methadone clinic, I soon admitted to my mom and sister how bad I had gotten.

The methadone clinic was another horrible experience for me in the end. The $13 per day I spent bought me another opiate—meant to wean me off of my addiction to pills—that got me arguably higher than those prescription opiates I had been taking. Because of the high dosage, I was nodding off throughout the day. So, I made a decision to quit cold turkey. Relapse followed with a new sort of high, and a new low.

I didn’t sleep for two weeks, I was so restless I wanted to cut my legs off. I couldn’t sit still, I was tired, irritable, depressed, etc.

 After about two weeks, I shot up the pills for the first time. I remember it very clearly: I just gave in. I didn’t like life without drugs anymore. I told myself being sober wasn’t worth it. I was in the back seat of my friend’s car. We were with someone who used an IV, and she handed me my own syringe. She told me it was mine. I actually thought to myself. “What a kind gesture of her to give me my very own syringe.” Of course I had no idea how to cook down the pill we had to a point where we could shoot it up. But I paid close attention when she did it for me, tied me off, and injected it into my vein. My heart was racing. I fell in love.

It didn’t take long for me to become an expert. I had a box of 100 syringes under my bed along with all the cleaning supplies necessary to do it “responsibly.” Within about two months, my arms were beaten black and blue, I had lost about 20 pounds, and I was constantly feeling horrible. The only time I felt normal was when I was high. It was getting harder to find pills, though. There were days where I would skip class, drive around for eight or more hours with people I didn’t know just to get one pill or a few hits of incredibly overpriced heroin. Then again, there were times when it was easy to find, but never when I was dope-sick and desperate. It was a miserable lifestyle, a nightmare. One time I even drove to Denver and spent three days there just to get cheaper heroin. Aside from visiting the Garden of the Gods in Colorado Springs, I didn’t do anything other than shoot up heroin the entire time I was there by myself.

When I started the IV drugs I spiraled out of control really quickly. I went to a different clinic to get on Suboxone, a newer drug for opiate addiction. It made it so I couldn’t get high on opiates and so I wouldn’t have withdrawals. At first, I even shot that up just to feel a little high. I hated not being able to feel happy or excited. I was on Suboxone for two years. During that time, I converted my opiate addiction into an IV cocaine addiction with a side of alcoholism. Thankfully, I was able to stop taking Suboxone, but it was the hardest thing I have ever done. I didn’t sleep for two weeks, I was so restless I wanted to cut my legs off. I couldn’t sit still, I was tired, irritable, depressed, etc. I went into a drinking binge, not leaving my apartment for days at one point. I almost wished I had never got on Suboxone in the first place, but it served one purpose: It got me away from all my opiate connections.

The story of my addiction is not glamorous. In fact, there is a lot that I don’t remember too clearly. There is a lot that I’d rather forget. Addiction is not an easy thing to put on a timeline (which they asked me to do during both of my treatment center stays). Addicts don’t exactly have a structured lifestyle. It’s a roller coaster, complicated, and devastating. It’s taken me three years of trying to get to the point I am at with my sobriety.

battlewithopiates1Every day the disease of addiction whispers in my ear, rationalizing and scheming ways in which I could get high or drunk. Isolation is what it wants, so my defense is fellowship. The character defects that fed my addiction are still with me— I am an egomaniac with low self-esteem who copes by trying to control the world around me—but I work every day to address these problems. I’ve destroyed and rebuilt relationships with my family and friends. I have squashed my loved ones’ hopes over and over again, yet my family still stands behind me. Their support is what sustains my recovery. They know that I could relapse, that my fight is not over.

Sam requested omission of his last name at the advice of his Narcotics Anonymous and Alcoholics Anonymous sponsor. He participates regularly in Narcotics Anonymous and Alcoholics Anonymous meetings. Visit omahaaa.org for more information.

For more information about how Omaha fits into the nationwide opiate abuse epidemic, read: https://omahamagazine.com/2016/10/dying-for-opiates-in-omaha/ 

ADHD

September 24, 2013 by

One of the most common neurobehavioral disorders found among children is Attention-Deficit/Hyperactivity Disorder (ADHD), according to the Centers for Disease Control and Prevention (CDC). And rates are on the rise.

Dr. Ashley Harlow, psychologist at Children’s Hospital & Medical Center, believes that this spike in diagnoses is due to a combination of factors. “Parents, teachers, and [health care] providers are more aware of the signs and symptoms and, therefore, are investigating this diagnosis as a possibility,” he says.

Because ADHD is so prevalent, there is concern that children are being misdiagnosed.

Misdiagnosis can go many ways, explains Dr. Harlow. “I think misdiagnosis is a problem, although I think it is important to consider misdiagnosis as both diagnosing another condition as ADHD and diagnosing ADHD as another condition.

“I see kids who have been diagnosed with ADHD because they do not like their teacher, they do not listen to their parents, or they do not follow through on what their parents tell them to do,” says Dr. Harlow. “These behaviors do not necessarily indicate ADHD.”

Also complicating the issue are instances where children have ADHD and are instead diagnosed with another disorder, like Autism Spectrum Disorder, or when high-school and college students use ADHD medication to support studying. “In these cases of students seeking study aids, misdiagnosis might occur because of misrepresentation of the symptoms by the patient,” adds Dr. Harlow.

Dr. Harlow says that visible signs of ADHD can include behaviors like “difficulty sitting still in the classroom, disorganization in completing homework or turning it in, making careless mistakes, staring off into space, interacting with peers in immature ways, or starting chores but not finishing them.”

Many children may demonstrate these behaviors, so Dr. Harlow advises careful consideration before jumping to conclusions. “[Health care] providers, in consultation with families, work to determine if enough symptoms are present and impairment is at a level to warrant a clinical diagnosis.”

The CDC states that “children with ADHD do not grow out of these behaviors. The symptoms continue and can cause difficulty at school, at home, or with friends.” Therefore, it is important to treat children who are afflicted with ADHD.

Treatment of ADHD focuses on reducing the impact of the symptoms, not eliminating them. “It is important to remember that ADHD is a neurologically based disorder, and so improving behavior likely means learning to manage symptoms rather than removing the symptoms entirely,” explains Dr. Harlow.

He recommends a combination of medical and behavioral health interventions, including setting up the environment (classroom or home) to be predictable and organized for the child and to make consequences immediate and consistent.

Children’s Hospital & Medical Center offers free parent education sessions related to topics surrounding ADHD. For more information, visit ChildrensOmaha.org/BehavioralHealth.

Q&A: Valeria Orlandini

August 27, 2013 by
Photography by Bill Sitzmann

Valeria Orlandini has made a career of preserving works on paper and photographic materials, many of which are proudly displayed in fine homes and museums worldwide. Ensuring that the rich stories, family memories, and important lessons they convey live on for future generations is a job she takes very seriously.

Q: Tell us about your work as a preservation specialist. Who are your clients? 

A: Orlandini Art Conservation was established in 2004 to provide the highest quality conservation treatment and preservation services for a broad range of paper-based objects: historic manuscripts, prints, printed documents, watercolors, drawings, paintings in all media, collages, contemporary works, pastels, and posters, as well as parchment, ivory, and photographic materials. Regardless of whether you’re a discerning collector or a family seeking to preserve precious documents, my goal is to provide all clients with the same exacting standards required by major art and archival institutions. My clients are mid- to high-end collectors and custodians of artistic and valuable and irreplaceable historic materials from holdings in museums, archives, libraries, private owners, and corporate businesses. I work in a wide range of projects and budgets.

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Q: Where did you receive your education and training in art and art conservation?

A: I hold a B.F.A. from the National School of Fine Arts in Buenos Aires; a M.F.A. from the National School of Fine Arts in Buenos Aires; and graduated in 2002 with a M.S. and a Certificate in Art Conservation in Paper and Library Science at the University of Delaware/Winterthur Museum Art Conservation Program in Newark, Del.

Q: When did you first discover your love of history? Why are you so passionate about preserving it?

A: I have always been an art and history geek! I grew up with artists in my family, and as a child I would dig for old artifacts at my grandparents’ homes. I think that from that very early age, I became aware of how real history can be. Also, I come from a family of collectors and art and architecture lovers. Just about every member of my family collects old artifacts and memorabilia of previous generations. I grew up with a real sense of the importance of the past.

Every day, the vision of artists, the identity of people, and the very evidence of history all threaten to disappear. Left alone, old buildings will crumble, the Declaration of Independence will disintegrate, and the photographed faces of battle-weary Civil War soldiers will fade away, among other artifacts. The cultural patrimony, so painstakingly created over thousands of years, is surprisingly ephemeral with the ravages of time and the indifference of a disposable modern culture its biggest enemies.

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Q: How does your work interplay with home interiors and historic home preservation? 

A: As a collections conservator, I work very closely with interior designers, architects, engineers, and maintenance personnel to secure the building envelope where we protect objects from extremes and fluctuations in exterior temperature and moisture as well as light, dust, and gaseous contaminants. We frequently assess and measure temperature and relative humidity characteristics of air surrounding collections, as well as patterns of use and handling protocols. The conservation mission recognizes the need to preserve the unique character of both historic structures and artifacts. No two collections are identical.

Q: What have been some of your most interesting past projects?

A: While working in a number of studios and labs, I’ve had the privilege to treat an array of fascinating objects: Old Master paintings; Japanese woodblock prints from the Edo Period; ancient Korean rubbings and manuscripts; original newsprints from various American cities upon Abraham Lincoln’s assassination from April 1865; John James Audubon’s “Birds of America” folios; original documents of the Founding Fathers; and many others.

Most notably in 2010-11, I participated in the conservation treatment of the Thomas Jefferson Bible Project at the National Museum of American History, at the Smithsonian Institution. I worked with a team of conservators and scientists, conducting materials analysis, assessing aqueous stabilization treatment options, considering appropriate micro- and macro-environmental conditions, and a variety of other tests to help preserve this national treasure.

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Q: What projects have you worked with since moving here?

A: I have treated several objects from the Durham Museum. This museum stands as a magnificent reminder of a bygone era and allows generations to come together to learn, to share, and to remember.

Also, a very rewarding project that I carried out last fall was the treatment of an original Wright Brothers Patent Document [No. 821,393] for the “flying machine,” circa 1903-06 that was brought to my care from a private collector in Iowa. This was a really interesting study piece about the history of aviation and contains five original signatures hand-inscribed in iron gall ink by the Wright Brothers: Orville (1871-1948) and Wilbur (1867-1912), witnesses, and attorney.

Q: What advice would you give those looking to preserve family heirlooms? 

A: The American Institute of Conservation and Historic and Artistic Works (AIC) has developed guides for caring for your treasures at conservation-us.org. There’s also a book by Heritage Preservation entitled Caring for Your Family Treasures that can provide folks practical advice and easy-to-use guidelines on how to polish silver and furniture without diminishing their value, as well as creating safe display conditions for artworks, ceramics, dolls, quilts, books, photographs, and other treasured collections. These are tips with clear and understandable information on how to care for beloved family treasures.

Skin Repair After Sun Damage

July 22, 2013 by

The damage is done. You have been told for years to wear a hat and sunscreen (minimum SPF 30) and to stay out of direct sunlight between the hours of 10 a.m. and 2 p.m. But, again, the sun wrapped you up in its relaxing warmth, and now you’re burnt to a crisp.

You can almost feel the crows feet forming around your eyes and the deep creases folding into your forehead. Is there anything you can do to lessen the damage? Justin G. Madson, M.D., Ph.D., dermatologist at Midwest Dermatology Clinic, P.C., gives practical advice on remedies for both serious and mild sunburns.

If you have a serious sunburn, you need to see your doctor immediately. “Signs of serious sunburn are blistering, a rash, excessive itching immediately following sun exposure, fever, or an infection that results from scratching or an open blister,” says Dr. Madson.

“Excessive pain is also a sign that it is time to see a doctor, especially if it cannot be controlled by over-the-counter pain relievers. Your dermatologist can prescribe treatments for these symptoms, including prescription cortisone creams, antihistamines, and pain relievers.”

For milder burns, try a couple home remedies. “Sooth the area with a cold, wet cloth for 10-15 minutes. This takes the heat out of the skin,” says Dr. Madson. A cool bath and moisturizing lotion can also be helpful. However, “avoid lotions that contain petrolatum [i.e. Vaseline], as these ointments form a barrier that traps the heat within the sunburned skin.

“Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help with moderate pain,” says Dr. Madson. After trying some of these immediate remedies, it is a good idea to let your skin heal on its own. “Leave blisters alone. They are nature’s Band-Aids and protect newly healing skin from dirt and bacteria on the surface of the skin. The outer layers of your skin are there to protect what is underneath. Allow nature to shed the skin when it is no longer needed.”

If you are on vacation and cannot avoid the sun, “apply sunscreen SPF 30+ liberally to all areas of the skin and wear long-sleeve, sun-protective clothing. The sun’s damaging rays can penetrate clothing, so it’s necessary to double your efforts,” says Dr. Madson. “Make sure the fabric is a little loose. Tight fabric stretches, letting in more light. And try to plan vacation activities outside during morning, late afternoon, and evening hours when the harmful rays are not as strong.

“There is a long list of skin conditions caused by long-term sun exposure, the most serious of which is skin cancer. It’s a serious, invasive cancer that spreads to vital organs in the body if not diagnosed and treated early. And sun exposure, especially sunburn, is the leading cause,” says Dr. Madson.

Next time you cozy into the lawn chair on a sunny summer afternoon, remember this statistic from Dr. Madson: “Studies show that your risk of developing melanoma doubles after five sunburns in your lifetime. That’s why sun protection is so important.”

Surprising Fact: “We get more sun damage through the car window than previously thought. A new study found that 53 percent of skin cancers occur on the left side of the body as opposed to the middle or right side. That is attributed to the many miles we put behind the wheel and the increased sun exposure. Whether the window is rolled down or up, you are at risk—windshield glass only protects us from UVB rays. We get a steady dose of UVA while driving (or as a passenger). Reflective factors, such as snow or water, also increase dangers of ultraviolet light,” says Dr. Madson.

Tan Without Damaging Your Skin

May 25, 2013 by
Photography by Bill Sitzmann

When Coco Chanel returned from a luxurious vacation in 1929, she declared “The 1929 girl must be tanned,” starting a beauty revolution that changed the sun-kissed look from being a sign of working-class status to chic, wealthy fashionista. Surprisingly, this trend has stuck around for nearly 85 years and has only grown as a desired beauty trait among women (not to mention its growth as a major cash-cow for the beauty industry).

The problem is more and more women are getting skin cancer while trying to achieve this look, even those in their early 20s who should barely have had time to damage their skin. With too much natural sun exposure, as well as tanning booth UV exposure, this beautiful look seems a little too dangerous. But as it’s the time of year again for swimsuits, women are lining up to get that perfect tan.

So how can we get the bronzed look without actually harming our skin?

If you’re attempting your own self-tanning experience, try Here Comes the Sun™ ($28), one of the many Philosophy skin care products available at Sephora in Village Pointe Shopping Center. According to Sephora’s website, “This self-tanner provides a sun-inspired golden glow within hours of application while an amino acid complex helps firm and tone for smooth, healthy-looking skin. The oil-free, streak-free formula is easy to apply for even, mistake-proof coverage. Skip the sun, and go for the glow.”

Cheaper options—like Jergens Natural Glow, L’Oreal Sublime Bronze, or Sally Hansen Airbrush Leg—usually range from $7-15 and are available at Walgreens, Target, or Walmart. But always read the product reviews first! While these products will save you money, they can sometimes spread unevenly or leave your hands, arms, knees, ankles, and feet looking too brown or awkwardly orange. A few minutes of online reading can be the difference between countless hours of frustrated scrubbing in the shower and a thrifty, beautiful glow.

If you don’t trust your own handiwork to get the desired effect, most local tanning salons have spray-on tanning available. Best of Omaha® winner Ashley Lynn’s Tanning, which has 11 locations in Omaha, is known for its “sunless tan” spray-on tanning.

A “sunless tan” at Ashley Lynn’s only takes a few minutes. Clients can go fully nude or wear swimsuits. Single sessions cost $30, but the tanning salon currently has a $39 special for three sessions.

“We use the VersaSpa spray tan booth,” says Dana Morinelli, director of marketing with Ashley Lynn’s. “There’s a clear treatment and a bronzer treatment. The bronzer is topical. [It] washes off so you can see it right away. Both are composed of skin-firming agents to give you long-lasting color.” Morinelli adds that the color in the clear treatment develops four to eight hours after the session, and both treatments usually last about five to seven days, depending on skin type and daily skin care routines.

Though the bronzer treatment isn’t recommended if you’re getting a quick spray-on tan during your lunch break before heading back to the office, Morinelli assures that the treatments are water-soluble, so clothes won’t be stained.

“If you’re looking for quick color with fewer sessions, then [sunless tan] is perfect. It’s completely cosmetic, and it gives you that immediate tan,” says Morinelli.

Smoking Cessation Aids

March 25, 2013 by
Photography by Bill Sitzmann

The old saying “third time’s the charm” didn’t work so well for Laura Adams when it came to quitting smoking.

“Every time I quit, I’d be good for about six months,” she says. “Then I’d get stressed about something and decide to have just one. Well, once you start up again, it’s all over. It’s an all-or-nothing thing.”

Adams is not in the minority. Most smokers will try quitting multiple times before they are successful. There’s a lot more to smoking than meets the eye, say local smoking cessation experts. “There’s an addiction to nicotine, the actual habit, and the emotional dependence that all need to be addressed,” says Laura Krajicek, a smoking cessation coordinator for Nebraska Methodist Health System.

A smoker for more than 20 years, smoking had become a crutch for Adams. “It helped me deal with daily stresses,” she explains. “When I had a cigarette, that was my relaxation time, my ‘me time.’ Coffee, cigarettes, and break time all went together. It was hard to have one without the other.”

Adams knew that it wasn’t a “pretty habit,” nor one she was proud of. With a campus-wide no smoking policy at her place of employment, Alegent Creighton Health Immanuel Medical Center, Adams would have to “sneak” to an off-site parking lot to smoke. To mask the nasty smoke odor, she would slip on a different coat, pull her hair back in a ponytail, wash her hands, and coat herself with body spray before returning to the office. “It was an embarrassing addiction,” she recalls.

“When I had a cigarette, that was my relaxation time, my ‘me time.’” – Laura Adams, former smoker

When Adams learned about Alegent Creighton Health’s smoking cessation program, Tobacco Free U, she decided this might be the extra push she needed to help her quit for good. The program focuses on the use of group or individual counseling in combination with a smoking cessation aid such as nicotine patches, nicotine gum, or medications.

According to the Cochrane Review, an internationally recognized reviewer of health care and research, combining counseling and medication improves quit rates by as much as 70 to 100 percent compared to minimal intervention or no treatment.

“Success rates rise drastically when you combine the two,” says Lisa Fuchs, a certified tobacco treatment specialist at Alegent Creighton Health. The counseling portion helps people tackle the behavioral addiction, and the smoking cessation aids help with the nicotine addiction.

Which smoking cessation aid is recommended depends on how heavy a smoker, health conditions, as well as what seems to be the best fit for that person’s lifestyle, notes Fuchs. These aids are most successful in individuals who have been counseled on how to use them appropriately. The most common aids include:

Nicotine patch – The patch is a long-acting therapy that delivers a steady dose of nicotine over a 24-hour period and is designed to curb a person’s cravings for nicotine. This may be appropriate for very heavy smokers. The dosage is gradually lowered to wean a person off the nicotine habit.

Nicotine gum or lozenges – Gum and lozenges are short-acting therapies that deliver smaller doses of nicotine and can be taken as needed to curb the nicotine urge. Tom Klingemann, certified tobacco treatment specialist at The Nebraska Medical Center, recommends that smokers schedule the doses so that they maintain a steady state of nicotine in the body to avoid the nicotine cravings and temptation to smoke. In general, he is opposed to short-acting nicotine replacement therapies because “they keep people looking for a chemical fix even though they may not be smoking anymore.” They are also very expensive, and most people trying to quit can’t afford the $40 a week price tag they would cost if used appropriately.

e-cigarettes – These work by heating up a liquid nicotine substance that is inhaled as vapor. The product is not regulated by the Food and Drug Administration (FDA) and many still have a lot of chemicals that may not be any healthier than actual smoking, notes Klingemann. “These are not intended to help people quit but keep them addicted to nicotine,” he says.

Medications – The two primary prescription medications used for smoking cessation include Zyban and Chantix, with Chantix being the preferred of the two, says Fuchs. “Zyban is an anti-depressant and may be recommended for a person with mild depression to help with moodiness as well as decreasing cravings and withdrawals,” notes Fuchs. It is believed to work by enhancing your mood and decreasing agitation related to trying to quit.

Chantix is a newer drug and works by binding to nicotine receptors in the brain and blocking them so that nicotine can no longer activate those receptors, causing a person to get less satisfaction from smoking. At the same time, it also triggers a small release of dopamine, the reward neurotransmitter in the brain. It appears to be safe and quite effective, notes Klingemann. Krijicek says that her clients have seen the most success with this aid.

“Success rates rise drastically when you combine [counseling and medication].” – Lisa Fuchs, certified tobacco treatment specialist at Alegent Creighton Health

Adams used Chantix, which she said helped curb her nicotine urges. But what helped the most, she says, was to change the habits that she associated with smoking. For instance, instead of coffee and cigarettes in the morning, she reached for coffee and orange juice. Because she normally smoked while driving, she changed the route she drove to work. She also replaced the time she would have spent smoking with more positive habits like walking her dogs, running, bicycling, and swimming.

“Once I quit, I started making healthier decisions in other parts of my life as well,” she says. “I started eating better, drinking less caffeine, and exercising more. I feel better now.”

“For 90 percent of smokers, the addiction is behavioral,” notes Klingemann. “It’s all of the other stuff that drives the smoking addiction. Until you start changing your behaviors and routines, it’s really hard to quit.”

From Patients to Caregivers

February 25, 2013 by
Photography by Bill Sitzmann

Margaret Ludwick spends her days sitting in a wheelchair at a senior care center in Elkhorn. She never speaks. The only expressive motion involves her hands—she constantly puts her long, tapered fingers together like a church steeple. Her big blue eyes stare straight ahead but focus on nothing. No one can reach her anymore, not her daughters, not her husband.

Alzheimer’s, the most common form of dementia in adults 65 and over, robs even the most intelligent people of their brain and eventually destroys their body. There is no cure. There is no pill to prevent it. There’s not even a test to definitively diagnose it. Effective treatments have proven as elusive as the disease, itself.

“We do have medications that may help with symptoms in some patients, especially in the early stages of Alzheimer’s,” says Dr. Daniel Murman, a specialist in geriatric neurology at The Nebraska Medical Center. “But they don’t truly slow down the disease process.”

According to researchers, the number of Americans living with Alzheimer’s will triple in the next 40 years, which means 13.8 million will have the disease by 2050 (Chicago Health and Aging Project research as reported by nbcnews.com).

Awareness of symptoms is crucial for early intervention.

“Memory loss and changes in behavior are not a normal part of aging,” stresses Deborah Conley, a clinical nurse specialist in gerontology at Methodist Health Systems who teaches other nurses and caregivers about Alzheimer’s. “I would urge family members to take [their loved one] to a family physician first, seek as much information as possible, and start making your plans.” An assessment that includes the person’s medical history, brain imaging, and a neurological exam can result in a diagnosis that’s about 85 percent accurate for Alzheimer’s.

Ludwick, a registered nurse, who worked at Immanuel Hospital for years, never received an extensive workup.

 “I would urge family members to take [their loved one] to a family physician first, seek as much information as possible, and start making your plans.” – Deborah Conley, clinical nurse specialist in gerontology at Methodist Health Systems

“I first noticed something was wrong about 15 years ago, when Mom was 70,” explains Ludwick’s daughter, Jean Jetter of Omaha. “It was the day I moved into my new house. Mom put things in odd places, like a box labeled ‘kitchen’ would wind up in the bedroom. And she stood smack in the middle of the doorway as the movers tried to carry large pieces of furniture inside, and she just stared at them.”

As Ludwick’s behavior grew worse, Jetter begged her father, Thomas, to get her mother help.

“He didn’t want to hear it. He kept saying, ‘This will get better.’ He had medical and financial Power of Attorney. Dad worked full-time, and she was home alone. This went on for eight years.”

Ludwick’s steady decline rendered her unable to fix a meal or even peel a banana. She lost control of bodily functions. After she was found wandering the neighborhood on several occasions, Jetter was finally able to call Adult Protective Services and get her mother into an adult daycare program. After breaking a hip two years ago, Ludwick arrived at the Life Care Center of Elkhorn.

“This is such a sad, but not unfamiliar case,” says Conley, who began working with Alzheimer’s patients in the mid-’70s. “Even in 2013, people do not know what to do, where to turn.”

Dr. Murman adds, “There is still a stigma attached to Alzheimer’s. People don’t like to hear the ‘A’ word. But it’s much better to be open and specific about it.”

A specific diagnosis may rule out Alzheimer’s.

“Depression can mimic the symptoms of Alzheimer’s…symptoms like mistrust, hallucinations, apathy, social isolation,” explains Dr. Arun Sharma, a geriatric psychiatrist with Alegent Creighton Health. “But we can treat that. We can treat depression.”

Dr. Sharma helped establish a 22-bed, short-term residential facility called Heritage Center at Immanuel Hospital to better diagnose the reasons for a person’s memory loss. Once a patient is stabilized and receives a proper care plan, they can return home. The more doctors learn, the faster a cure will come.

“I see something exciting in the next five to 10 years,” says Dr. Sharma. “If we identify and isolate the protein believed responsible for Alzheimer’s, perhaps we can do a blood test to catch the disease early.”

 “There is still a stigma attached to Alzheimer’s. People don’t like to hear the ‘A’ word. But it’s much better to be open and specific about it.” – Dr. Daniel Murman, specialist in geriatric neurology at The Nebraska Medical Center

But what about a cure? With 78 million Baby Boomers coming down the pike—10,000 of them turning 65 each day—this country faces an epidemic. And what about the psychological, financial, and emotional toll on the caregivers, who are very often family members? They, too, feel isolated.

“It was an impossible situation for me. I couldn’t get her the help she needed,” says Jetter, who bore the brunt of the family crisis since her married sister lives in Dallas. “Now that Mom is at [the nursing home], I can take a breather and concentrate on Dad, who also has mental issues.”

In recent weeks, her father, Thomas, has been admitted as a permanent resident of Life Care Center of Elkhorn as well.

What about her own family?

“I have no one. No husband, no boyfriend. I mean, what boyfriend would put up with all this?” asks Jean, who’s been shuttling between one parent and the other for years, all the while trying to run her own business. The situation has obviously taken a huge personal toll.

Conley has two words for anyone facing similar circumstances: Alzheimer’s Association. The Midlands chapter has support groups, tons of information, and can gently guide the adult child or spouse. They even have a 24/7 hotline: 800-272-3900.

For anyone dealing with Alzheimer’s, that number could become a lifeline.

Bipolar Disease

November 25, 2012 by

“My husband didn’t know if he was going to come home to Cruella Deville or Dolly Levi from Hello Dolly.” That’s how Jane Pauley, broadcast journalist and former co-host of the TV morning show Today, described her battle with bi-polar disease in a interview on Healthy Minds, produced by New York Public Radio. “Who knows what provokes it, but it was like a swarm of bees that wants a target,” she says.

Being diagnosed with bipolar disease was a shock, recalls Pauley, but getting a diagnosis and subsequent treatment, however, allowed her to regain some normalcy in her life again.

Bipolar disease is a serious mental illness that is associated with extreme mood swings from mania to depression. “It is one of the most serious illnesses we deal with because of the disruptive nature of the disease,” says Sharon Hammer, M.D., psychiatrist at the University of Nebraska Medical Center (UNMC). “It is more serous than depression or schizophrenia because it can lead to risky behaviors, such as drug and alcohol abuse, damaged relationships, and suicide. And because of the impulsive nature of the disease, there is often no time to intervene.”

The average onset of bipolar disease tends to occur in older teenagers and young adults ages 20 to 25 years old. “Many women may start to experience symptoms of depression in their teenage years followed by their first manic episode in college,” says Hammer. “This is a very risky time because the college years are often mixed with stress, sleep deprivation, and alcohol use, which are all triggers for episodes.”

“It is one of the most serious illnesses we deal with because of the disruptive nature of the disease.” – Sharon Hammer, M.D., psychiatrist at UNMC

Women with bipolar disease typically spend about 80 percent of the time in depression and 20 percent in mania. Episodes of mania are characterized by abnormal elevated moods that include irritability, being easily agitated, impulsivity, racing thoughts, and insomnia.

Many women tend to be in denial and don’t start taking it seriously until they have children, notes Hammer. Even then, it is often misdiagnosed as depression or anxiety due to the extended depressive states associated with the condition, and the fact that women are twice as likely to have depression than men. In fact, bipolar disease is the most under-diagnosed mental illness and the most challenging to diagnose, notes Hammer.

Misdiagnosis can create more problems because medications used for depression and anxiety are different than those used to treat bipolar disease and can make the condition worse.

In addition, untreated bipolar disease tends to gain momentum and become more malignant with time, says P.J. Malin, M.D., a psychiatrist with Alegent Creighton Clinic and an associate professor of psychiatry at Creighton University School of Medicine. “It can be very disruptive to other parts of your life. Approximately 60 percent of people with bipolar disease will develop substance abuse problems, and it carries a 15 to 20 percent suicide rate.

“Early treatment of the disease can help prevent the disease from getting more aggressive. Untreated bipolar disease, on the other hand, lowers one’s life expectancy by 10 years.”

If you are being treated for depression and are not responding to depression medications or you are experiencing negative or an unusual response, it is important to communicate this with your provider, adds Malin.

“Early treatment of the disease can help prevent the disease from getting more aggressive.” – P.J. Malin, M.D., psychiatrist with Alegent Creighton Clinic

You can also do your own test by taking the Mood Disorders Questionnaire (MDQ) online, which provides fairly accurate results and can help you and your clinician determine whether you are bipolar, notes Hammer.

Environmental factors and heredity appear to be the major risk factors for bipolar disease, says Malin. “There are different theories as to how the environment plays a role, but they include: obstetric complications, intra-utero viral infections, use of hallucinogenic drugs, and traumatic life events, such as the death of family or friends or abuse.”

Treatment typically involves a combination of medications and counseling that may be necessary over a person’s lifetime. “Counseling is huge for long-term success and stabilization,” says Robin Houser, a counselor for Nebraska Methodist Hospital’s employee assistance program, Bestcare EAP. “Bipolar disease is a lifetime problem, and counseling can help people learn coping techniques and avoid unhealthy thinking and unhealthy patterns of behavior. A lot of people think that once they have become stabilized that they don’t need medications or counseling anymore, but that’s when we’ll start seeing imbalances and manic episodes occur again.”

Women with bipolar disease are very sensitive to stress, lack of sleep, and environmental and seasonal changes, all of which can trigger an episode, notes Hammer. Practicing healthy lifestyle habits like getting regular exercise, adequate sleep, managing stress, and light therapy during the winter months can help keep the disease stabilized.

 “Counseling is huge for long-term success and stabilization.” – Robin Houser, counselor for Nebraska Methodist Hospital

Postpartum is also a common time to experience recurrences, probably because of sleep deprivation, says Hammer. There are medications that are safe to use during pregnancy, which are important to take to prevent a relapse. If a woman stops her medications during pregnancy, it can take up to six months to get the symptoms under control again, says Hammer.

“Newer medications as a whole have fewer side effects,” she says, “but it’s important that you are matched with the medication that works best for you and has the fewest side effects.

“Patients who are being followed and treated by a trained health care professional can function vey well and live a normal life.”