“I’m a whole lot better than I was two years ago. I haven’t felt lost this year. In fact, I feel like the old me.” This is Dr. David Compton in our most recent conversation.
“When I was diagnosed, I was thinking, ‘I’m going to get worse’. I thought I was doomed. Well…screw that.”
Two years ago, David said he’d been diagnosed with an early form of Alzheimer’s disease, but now he says more specifically it is a condition called MCI, or mild cognitive impairment, which can put one at an increased risk for Alzheimer’s or other dementia. (For those unfamiliar with MCI, the term “mild” can be misleading.) If you’ve been reading my blog you may remember David’s two previous conversations, one a year ago and the other two years ago in the spring of 2016, not long after he was forced to step aside from his 30-year practice in family medicine.
This most recent conversation is refreshing. David’s energy, focus, and coherence surprised me. “My words and thoughts no longer are a scramble,” he says. “Most times they are clear and make sense to me.”
I won’t repeat our two previous conversations, but to draw a quick connection: David and I grew up in the same small Tennessee town, Cookeville. We knew each other but weren’t “buddies”—he’s nine years younger than me. His older sister Susan and my younger sister Alice were good friends. David, 63, now lives outside Knoxville; his family practice was in Oak Ridge.
David points to a couple of catalysts for his change in outlook. First, his geriatric medical specialist last August prescribed Aricept, which can help delay the onset of dementia symptoms in some people. (This is the only med he’s taking.)
The other was the “pointing-the-bone story your friend in Australia tells.” I’d sent David a set of tapes in which the Anglican Canon Jim Glennon shares his experiences from decades in the healing ministry. I also describe this story in my book A Path Revealed (p. 83) and in an earlier blog post. In this story, Canon Glennon described a longstanding practice among Australia’s Aboriginal tribes. If a man broke a taboo, the tribal doctor came to him, pulled the leg bone of a bird from a bag, and pointed it at the man. Thus, ‘pointing the bone.’ And that means, Canon Glennon said, “that because the man has broken a tribal taboo, he is going to die. There are documented cases of him falling down dead at once. He will almost certainly die within a few days because he believes he’s going to die.”
And the point of this story? “We all have faith,” Canon Glennon continued. “And if you believe that you’ve got a disease that’s fatal, that’s your faith. You believe you’re going to die.”
Many diagnosed with MCI eventually slip into Alzheimer’s or another dementia, but not all do. “That’s me,” David says. “I believe I’m going to get better, or at least not worse.”
Belief, positive or negative, can be a powerful cognitive exercise, he says. “Believing that you’re going to get better can lay down positive neural pathways in your brain. But you’ve got to believe it; you’ve got to be intentional.” It’s important, he adds, to understand how these pathways are developed.
Since his diagnosis in 2015, David has scoured the medical journals regarding MCI, Alzheimer’s, and other dementia. “There’s still a lot we don’t know.” He’s also studied cognitive development and the practice of “laying down neural pathways” through cognitive exercises.
For example, he says, “Activism helps me cognitively. My soul is activism; it always has been.”
He ticks off a few activities he’s involved in: volunteering weekly in an urban kitchen; meeting new friends at environmental and political rallies; going to lectures; supporting others in his support group.
“A commitment to something greater than yourself is energizing. “This is a major reason why I got into family practice—I wanted to help.”
“I’ve been reading a lot of American history lately, and I believe we are at a dramatically critical point in our history,” says this family doctor-turned-activist, who in junior high became intrigued with Henry David Thoreau and his writings on civil disobedience.
Now you, dear reader, may not be ready to step into marches and civil disobedience as David says he is, but the point he’s making is this: It’s vital to discover what energizes you and do it, if at all possible. Find your passion and jump in. It can be a powerful cognitive exercise.
Nonetheless, David says he’s always looking to keep himself in check, to not pump stress into his life through over-committing or obsessive behavior. “I still get upset real easy over little things and have to reel myself back in. I still have my bad days and have to work out of them.”
“Every little thing I do each day is a cognitive exercise. While trying to go to war with this situation or illness, I’m aware that I’ll have off days. But with that in mind, I must stay true to the course.”
He ticks off some of his own positive cognitive exercises: regular physical exercise, such as walking; attending lectures; reading essays and journals; meeting new friends at rallies; regular conferences with his cognitive therapist and geriatric specialist; working weekly in an urban kitchen; photography; planning and cooking family meals.
Two years ago he was walking five miles a day, but arthritis has forced him to cut back. Nonetheless, “I still get 30-40,000 steps in a week.”
“I’m convinced that if you don’t put in the work, you’re not going to get better.”
“Stress damages,” he says. “Wrong diet damages; accepting your fate damages; sitting at home watching TV damages; feeling sorry for yourself damages.”
David lists other Do’s and Don’ts drawn from his years of experience as a doctor and from working with his cognitive therapist and geriatric specialist. These may be of value in your own efforts, either as one diagnosed with a dementia or as a care partner...
- Stay on a routine without obsessing over it. “Getting off my routine confuses me, which makes me depressed. So BALANCE is important.”
- If someone with MCI or early onset Alzheimer's can find a support group of like- minded (pun intended, he says) people, get in that group and stay with them. Support each other!!
- Control health issues like blood pressure, blood sugar, sleep apnea, anxiety, and depression. All are related to early cognitive decline if not controlled.
- Commit but don’t over-commit. Don’t obsess.
- Work regularly with a counselor or cognitive therapist as much as you’re financially able; set up a program together and then do it.
- Change your inner dialogue: “I’m going to get better, not worse.”
- Immerse yourself into a fun, stress-free hobby, such as photography, art, woodcarving, writing, or music.
- Don’t isolate yourself; get involved with your family and friends. Make new friends.
- Realize everything you do is a cognitive exercise. Lay down positive neural pathways; avoid the negatives.
- Avoid stressful situations.
- Be courageous as a community of caregivers and patients.
- It’s a marathon, not a sprint. “There will be failures but I must keep trying to find the things I can do and do them.”
David emphasizes that his protocol is not anyone else’s. His ideas may be helpful to others, he says, but it’s imperative for others to work out their own programs with their neurologist/gerontologist and therapist/counselor. He says he likes to share his thoughts publicly as a mirror for his own feedback as well as a way of encouraging others.
“I’m having a good year right now. What will next year bring? I don’t know, but I’m not focused on that. I’m focused on following the protocol we’ve developed, and enjoying my activities while enjoying my family and friends.”
Thank you, Dr. Compton. I’m sure many will find good information and hope from your experience, both professional and personal.
PS1 My book A Path Revealed: How Hope, Love, and Joy Found Us Deep in a Maze Called Alzheimer’s can be ordered from any bookstore or found on Amazon.
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PS3 I’m sticking this 65-cent Alzheimer’s fundraising stamp on all my mail. It was introduced Nov. 30, 2017. Through its first four months 2,196,087 stamps have been sold to raise $280,486.21 for Alzheimer’s research; these net proceeds go to the National Institutes of Health. To see how using these stamps one-by-one can add up, the cancer fundraising stamp has to date raised almost $90-million for research. Join me and thousands of others and Help Stamp Out Alzheimer’s.