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Can RAS inhibitors reverse or treat vascular dementia?
Jim32
Posted: Sunday, April 18, 2021 1:47 AM
Joined: 3/28/2021
Posts: 28


My mother is 80 years old. 

Since 2018, she has been seeing her deceased husband (my father), her deceased parents, and her deceased sister in her own home. In other words, she has been having hallucinations. 

A CT scan of the head, without contrast, was performed on my mother 3 weeks ago. According to the result of this CT scan, "severe cerebral white matter microvascular ischemic changes" can be seen. 

These microvascular ischemic changes and the hallucinations of deceased relatives led my mother's doctors to conclude that my mother probably has vascular dementia.

According to the following websites, microvascular ischemic changes in the brain can be reversed or treated by RAS (renin-angiotensin system) inhibitors:

https://pubmed.ncbi.nlm.nih.gov/23971689/

https://academic.oup.com/ndt/article/26/2/430/1894767

Does anyone know anything about RAS inhibitors being used to reverse or treat microvascular ischemic changes in the brain or vascular dementia? 

What are some examples of medications that are RAS inhibitors? Can RAS inhibitors be obtained at a pharmacy? Or are RAS inhibitors available only in a hospital setting?

Thank you for any information.

 


Lane Simonian
Posted: Sunday, April 18, 2021 11:00 AM
Joined: 12/12/2011
Posts: 5001


Welcome here, Jim.  I am sorry to hear that your mother has vascular dementia and about her hallucinations.

I have been studying Alzheimer's for seventeen years as a non-scientists.  I had three relatives with the disease.  I am much less familiar with vascular dementia, although there can be some overlap between the two diseases.

RAS (renin-angiotensin inhibitors) may reduce the risk for vascular dementia by lowering hypertension.  They may be less effective in treating vascular dementia once considerable oxidative damage has already been done.  

There are a number of antioxidant treatments that look promising for the treatment of Alzheimer's disease (the most effective may be panax ginseng and essential oils via aromtherapy) that potentially may also help with vascular dementia.  

https://scienceline.org/2011/03/lavender-and-old-lace/ (especially comment by Julie Diehl)


Iris L.
Posted: Sunday, April 18, 2021 7:18 PM
Joined: 12/15/2011
Posts: 17587


Thanks for the reminder and posting the article, Lane.  I have these microlesions.  My neurologist warned me in 2008 to keep my blood pressure down.  That was great advice!  

Iris


Jim32
Posted: Sunday, April 18, 2021 8:34 PM
Joined: 3/28/2021
Posts: 28


Lane Simonian wrote: 

There are a number of antioxidant treatments that look promising for the treatment of Alzheimer's disease (the most effective may be panax ginseng and essential oils via aromtherapy) that potentially may also help with vascular dementia.  

https://scienceline.org/2011/03/lavender-and-old-lace/ (especially comment by Julie Diehl)

Hi, Lane. Thank you very much for your response.

Let me provide some more information on my mom. 

Her hallucinations began 3 years ago, and I've been warning her primary doctor about the hallucinations for the past 3 years. However, he dismissed my warnings. During this time, my mom and I were living together in the same home.

Recently, she had a mental episode, and she was taken to a hospital for an evaluation. A CT scan showed that she had "severe cerebral white matter microvascular ischemic changes". That CT scan and her hallucinations led the hospital's doctors to conclude that she had vascular dementia.

Two weeks ago, she went to a nursing home. Since her arrival at the nursing home, she has been taking Aricept (1 10-mg pill, at bedtime). The purpose of the Aricept is to slow down her memory loss (or something like that). 

I'm not sure how effective the Aricept is going to be. I was told that the Aricept has to be started at the very beginning of a person's dementia, and, as I have explained, her dementia has already been around for several years.

I have Lion's Mane mushrooms here at home. I don't know whether the mushrooms will work any better than the Aricept will. If I want her to take the mushrooms, I think that some staff member at the nursing home would have to approve.

What is your opinion on Aricept vs. Lion's Mane mushrooms?

I see in your profile that your mother had Alzheimer's and that her memory was helped by aromatherapy. If I want my mother to have panax ginseng and/or aromatherapy, I think that some nursing-home staff member would have to approve that, too.

 


Lane Simonian
Posted: Sunday, April 18, 2021 11:25 PM
Joined: 12/12/2011
Posts: 5001



Thank you for the additional information, Jim (and thank you Iris).

For Alzheimer's disease, Aricept does indeed work best when given early.  For early Alzheimer's disease,  Aricept usually leads to cognitive improvement for a period of around six months, then its benefits begin to wane.  At two years, it works a little better than placebo.

Aricept appears to have a similar effect on vascular dementia and perhaps ischemic stroke.  It may not work or be contraindicated in some other forms of dementia (such as frontotemporal lobe dementia).  

Lion's Mane mushrooms may very well help in the treatment of Alzheimer's disease, but no clinical trial data is available yet (to the best of my knowledge).  The following study combining Chinese herbs (including panax ginseng) with conventional Alzheimer's therapies (such as Aricept) may be instructive.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5729264/

If you want to and are able to get permission to use aromatherapy, the more relaxing essential oils such as lavendar, sweet orange, rose, patchouli, and lemon balm might worked best for your mothers.

Years ago I gave a talk at the local library on aromatherapy, and about a month later one of the atendees called me to tell me the memory care facility had allowed for the use of aromatherapy and that his wife had told him that she loved him for the first time in over the year.

This is my favorite video on the potential for aromatherapy in the treatment of Alzheimer's disease and probably other forms of dementia as well.

https://www.youtube.com/watch?v=sKN3DGxl06o

 

 


Jim32
Posted: Tuesday, April 20, 2021 5:49 PM
Joined: 3/28/2021
Posts: 28


Well, I spoke to the social worker who is in charge of my mother's memory-care unit at the nursing home.

The social worker herself likes aromatherapy. She and her family use it. However, aromatherapy is not yet available at the nursing home. The social worker hopes to make it available in the future.

As for Chinese herbs, the social worker and I agreed that I would email to her your link about Chinese herbs and Aricept. She would share the link with my mother's medical team at the nursing home. However, the social worker said that, if my mother is allowed to use Chinese herbs, I would have to procure them for my mother wherever the herbs are sold. 

 

 


HowDoYouDeal
Posted: Tuesday, April 20, 2021 8:33 PM
Joined: 2/17/2019
Posts: 380


If you want to use something as simple as lavender, nursing home staff may consider a lavender scented bath gel or a body lotion. Johnson and Johnson makes a bedtime bubblebath and lotion.

When that ran out, I added a few drops of lavender to regular Johnson & Johnson lotion.  However, I am one of those Shoot first, ask questions later type people....

If you want her to have anything other than what the nursing home provides, you'd need to bring it to her yourself, daily.

That's really interesting about Lion's Mane.

 

Four Sigmatic Mushroom Coffee K-Cups, Organic and Fair Trade Coffee with Lions Mane, Chaga, & Mushroom Powder, Focus & Imm...

Best of luck.

 

 


Lane Simonian
Posted: Tuesday, April 20, 2021 9:56 PM
Joined: 12/12/2011
Posts: 5001


I am somewhat heartened that the social worker is open to these forms of treatments, even though much of it falls back on you.  It is also good that she shared the Chinese herb plus conventional therapy link with the medical team.

It is hard to sort out which Chinese herbs may work the best.  I always go back to panax ginseng because of a couple of  very promising studies and because panax ginseng contains multiple compounds that likely help with cognition (and perhaps also with behavior in the case of heat processed ginseng--panax ginseng steamed at higher temperatures).  

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3659550/

https://pubmed.ncbi.nlm.nih.gov/22780999/

Panax ginseng is fairly easy to get ahold of at least in capsule form, but I am not sure about concentrations and quality of different brands.  There is a supplier of heat processed ginseng in the United States, but it is quite expensive.


Jim32
Posted: Friday, April 23, 2021 12:35 AM
Joined: 3/28/2021
Posts: 28


Lane Simonian wrote:

Panax ginseng is fairly easy to get ahold of at least in capsule form, but I am not sure about concentrations and quality of different brands.  There is a supplier of heat processed ginseng in the United States, but it is quite expensive.

Who is the supplier? Does the supplier have a website?


Lane Simonian
Posted: Friday, April 23, 2021 10:32 AM
Joined: 12/12/2011
Posts: 5001


There used to be a supplier out of Long Beach, California, but I am not finding it now.  It appears that Ginseng Science is now directly selling their product (sun/heat processed ginseng) via Amazon.  This can be found by typing in ginseng science sun ginseng through Google.

There is another product called Feru-guard (ferulic acid in rice bran oil and Angelica archangelica; ginseng also contains ferulic acid) that is supposed to help with behavioral problems in dementia.

https://pubmed.ncbi.nlm.nih.gov/21272180/

The Oregeon Health and Science University did a study last year on Feru-guard for Alzheimer's disease, vascular dementia, and mixed dementias, but I don't think they have released the results yet.

https://pubmed.ncbi.nlm.nih.gov/21272180/

Glovia is the name of the company producing it.


Jim32
Posted: Friday, April 23, 2021 7:28 PM
Joined: 3/28/2021
Posts: 28


Lane Simonian wrote:

It is hard to sort out which Chinese herbs may work the best.  I always go back to panax ginseng because of a couple of  very promising studies and because panax ginseng contains multiple compounds that likely help with cognition (and perhaps also with behavior in the case of heat processed ginseng--panax ginseng steamed at higher temperatures).  

I'm a little confused. 

Panax ginseng helps with cognition only, and heat-processed ginseng helps with cognition AND behavior?

Or, Panax ginseng helps with cognition only, and heat-processed ginseng helps with behavior only?

If the latter is true, and if a patient needs help with both cognition AND behavior, then is the patient supposed to take BOTH panax ginseng and heat-processed ginseng?


Lane Simonian
Posted: Saturday, April 24, 2021 4:29 PM
Joined: 12/12/2011
Posts: 5001


This is a very good question.  In one clinical trial, panax ginseng helped improve and then stabilize cognition over a two year period, but had no effect on behavior.  But when panax ginseng was heated at higher temperatures (heat processed ginseng or sun ginseng) participants receiving the highest dose (4.5 grams per day) saw improvements in both cognition and behavior.  The theory is that steaming at higher temperatures increases the antioxidant capacity of panax ginseng.
Jim32
Posted: Saturday, April 24, 2021 5:07 PM
Joined: 3/28/2021
Posts: 28


Lane Simonian wrote:
This is a very good question.  In one clinical trial, panax ginseng helped improve and then stabilize cognition over a two year period, but had no effect on behavior.  But when panax ginseng was heated at higher temperatures (heat processed ginseng or sun ginseng) participants receiving the highest dose (4.5 grams per day) saw improvements in both cognition and behavior.  The theory is that steaming at higher temperatures increases the antioxidant capacity of panax ginseng.
 
 
That sun ginseng is, indeed, very expensive. But, then again, I am more concerned about my mother's cognitive abilities than I am concerned about her behavior. My mother engaged in less-than-ideal behavior even before she got dementia. So, I can live with less-than-ideal behavior.

Question: In order to derive benefits from ginseng (cognitive benefits from panax ginseng, or cognitive AND behavioral benefits from sun ginseng), would the ginseng have to be taken with Aricept? Or does the ginseng alone suffice?

You showed me a study that showed that Aricept + ginseng is better than Aricept alone. But what about ginseng alone?

 


Lane Simonian
Posted: Sunday, April 25, 2021 9:16 AM
Joined: 12/12/2011
Posts: 5001


A critical question to which the answer is the ginseng along would suffice.  The benefits of Aricept last about six months; the benefits of ginseng last two years or more (Korean red ginseng is a form of panax ginseng).

A 24-week randomized open-label study with Korean red ginseng (KRG) showed cognitive benefits in patients with Alzheimer’s disease. To further determine long-term effect of KRG, the subjects were recruited to be followed up to 2 yr. Cognitive function was evaluated every 12 wk using the Alzheimer’s Disease Assessment Scale (ADAS) and the Korean version of the Mini Mental Status Examination (K-MMSE) with the maintaining dose of 4.5 g or 9.0 g KRG per d. At 24 wk, there had been a significant improvement in KRG-treated groups. In the long-term evaluation of the efficacy of KRG after 24 wk, the improved MMSE score remained without significant decline at the 48th and 96th wk. ADAS-cog showed similar findings. Maximum improvement was found around week 24. In conclusion, the effect of KRG on cognitive functions was sustained for 2 yr follow-up, indicating feasible efficacies of long-term follow-up for Alzheimer’s disease.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3659550/



Jim32
Posted: Tuesday, April 27, 2021 10:23 PM
Joined: 3/28/2021
Posts: 28


Well, I've had some conversations with the social worker in charge of my mom's memory-care unit at the nursing home.

Here is what the social worker said about aromatherapy:

Aromatherapy consists of rubbing oils upon the patient. The oils are ingestible. So, there have to be safeguards to make sure that a dementia patient does not ingest the oils. The nursing home has to come up with policies/safeguards before the patients can be allowed to have aromatherapy.

As for Chinese herbs and Lion's Mane mushrooms, the social worker said the following:

The nursing home's nurse practitioner disapproves of Chinese herbs and Lion's Mane mushrooms. These two products have not been approved by the FDA [the Food and Drug Administration of the United States Government], and the nurse practitioner is not familiar with the products' side effects. 

Regarding the herbs and the mushrooms, the social worker added the following statement: The nursing home is not in the business of treating dementia because dementia can not be treated. (Personally, I think that this statement is very harsh.)

Right now, I am trying to find, for my mom, an assisted-living facility with memory care. I'm trying to find one that will allow aromatherapy and/or Chinese herbs.

I am concerned that no facility will allow my mom to have aromatherapy or the herbs, and that the only way in which my mom will have the aromatherapy or the herbs is to live at home with me and some at-home caregiver(s).

 


Lane Simonian
Posted: Wednesday, April 28, 2021 9:53 AM
Joined: 12/12/2011
Posts: 5001


Oh man, I am not sure where to start or what to say.

I disagree with quite a bit of what the social worker said.  The most effective way to deliver essential oils for someone with dementia is through direct inhalation rather than through topical applications (mixed with carrier oils to prevent the burning of the skin).  Ingesting most essential oils is very dangerous, although I am not sure how easily it would be to unscrew the cap and puts the drops in their mouth. In any case, supervision would be necessary.

Herbs and other natural products are not approved by the FDA, so that is kind of a non-starter.  The long-term use of ginseng has not been evaluated; it may either raise or lower blood pressure at different time periods of use and it may cause stomach upset in some people.  To the best of my knowledge, though, no severe side effects have been registered to date.

Some memory care facilities either proactively use or allow for aromatherapy but I am not sure how common this is. 

To a certain degree, dementia can be treated.  That is one of the great myths about dementia.

On a positive note, I found this recent trial for lion's mane (for Alzheimer's disease, though).

Conclusion: Three 350 mg/g EAHE [lion's mane] capsules intervention for 49 weeks demonstrated higher CASI, MMSE, and IADL scores and achieved a better contrast sensitivity in patients with mild AD when compared to the placebo group, suggesting that EAHE is safe, well-tolerated, and may be important in achieving neurocognitive benefits. 

https://www.frontiersin.org/articles/10.3389/fnagi.2020.00155/full


Jim32
Posted: Saturday, May 1, 2021 8:49 PM
Joined: 3/28/2021
Posts: 28


Well, I have an update on my attempts to get aromatherapy and Chinese herbs for my mother.

Medicare will stop paying for my mom's stay at the nursing home in a few weeks. Because an assisted-living facility with memory care is cheaper than the nursing home, and because the nursing home's social worker believes that my mom can function in such an assisted-living facility, my mom will probably be moving into such a facility in a few weeks.

There is an assisted-living facility with memory care that provides aromatherapy to its patients. The therapy is provided as follows:

-----------------------------------------

The patients experience aromatherapy in a common room.

Hot hand towels are soaked in containers that contains citrus and other essential oils.

The patients wash their hands with the hot hand towels.

The aromatherapy occurs every day before lunch and dinner, and whenever aromatherapy appears on the activities calendar (5 - 10 times per month).

Some patients have lung issues. So, there are no diffusers in the common room. So, there is no inhalation.

-----------------------------------------

Also, this facility will allow my mother to have Chinese herbs, under the following conditions:

-----------------------------------------

Even though the herbs are over-the-counter, the herbs can still be prescribed by a doctor.

If the herbs are not prescribed by a doctor, then the following would occur: I would sign a negotiated-risk contract (a waiver) that would release the facility from any responsibility for the herbs, and I would administer the herbs to my mom myself.

If the herbs are prescribed by a doctor, then the facility's staff members would administer the herbs, and there would be no need for a waiver.

-----------------------------------------

I will still look into other assisted-living facilities, but it appears that this facility is a lot more open-minded about aromatherapy and Chinese herbs than the nursing home is.

 


Jim32
Posted: Saturday, May 1, 2021 9:18 PM
Joined: 3/28/2021
Posts: 28


Lane Simonian wrote:


 On a positive note, I found this recent trial for lion's mane (for Alzheimer's disease, though).

Conclusion: Three 350 mg/g EAHE [lion's mane] capsules intervention for 49 weeks demonstrated higher CASI, MMSE, and IADL scores and achieved a better contrast sensitivity in patients with mild AD when compared to the placebo group, suggesting that EAHE is safe, well-tolerated, and may be important in achieving neurocognitive benefits. 

https://www.frontiersin.org/articles/10.3389/fnagi.2020.00155/full

 

It seems that all of the studies or clinical trials that you have mentioned in this discussion thread, were done in Asia. 

Are there any studies or trials of Chinese herbs or Lion's Mane mushrooms being done in the United States? My mother and I live in Chicago. Are there any studies or trials being done in Chicago?

 


Lane Simonian
Posted: Saturday, May 1, 2021 10:54 PM
Joined: 12/12/2011
Posts: 5001


I think this is good.  I wonder if the assisted living facility would allow you to do direct inhalation therapy (perhaps with a waiver).  A diffuser is not needed.  You can have your mother smell a couple of essential oils each morning under each nostril for a few seconds each.  Rosemary, clove, bay laurel, and lemon balm are good for cognition, although some of these oils may incease anxiety in some people.  

I am not aware at this time of any clinical trials being run for panax ginseng or other Chinese herbs in the  United States.  I will keep looking for such trials, though.

Hopefully, your mother will respond well to these treatments.  


Jim32
Posted: Sunday, May 2, 2021 10:34 PM
Joined: 3/28/2021
Posts: 28


Lane Simonian wrote:

I think this is good.  I wonder if the assisted living facility would allow you to do direct inhalation therapy (perhaps with a waiver).  A diffuser is not needed.  You can have your mother smell a couple of essential oils each morning under each nostril for a few seconds each.  Rosemary, clove, bay laurel, and lemon balm are good for cognition, although some of these oils may incease anxiety in some people.  

 

I'm a little confused about something. If my mother is washing her hands with a towel that has been soaked in essential oils, then won't my mother be inhaling the essential oils anyway?

As for anxiety, she already has plenty of anxiety. I hope that whatever aromatherapy she gets will improve her cognition without increasing her anxiety.


Lane Simonian
Posted: Monday, May 3, 2021 9:49 AM
Joined: 12/12/2011
Posts: 5001


This is a good point.  Having a towel soaked in essential oils would still be direct inhalation aromatherapy, although at a further distance (some of the essential oil may enter through the skin, so topical aromatherapy as well).  The distance may not matter though because in one study where the essential oils were put on a bib the results were quite good.

https://news.ecu.edu/2005/10/18/ecu-therapist-studies-links-between-scent-and-memory/

I am assuming that they will be mixing the essential oil with some kind of carrier oil because several essential oils really sting when applied to the skin neat.

What oils are used makes a big difference in terms of their effect on anxiety.  Lavender, rose, lemon balm, sweet orange, and patchouli reduce mild anxiety at least.  Clove is one to generally avoid for anxiety. Some link this to the past use of clove in dental offices, but it may be more than that.

Through reports from memory care facilities and through this site, several people have chronicled their experiences with aromatherapy, most of which has been positive.


Bunny314
Posted: Monday, May 17, 2021 2:12 PM
Joined: 8/22/2020
Posts: 4


Does anyone have any data on the use of DXM apart from Nuedexta being used for behavioral issues in Subcortical Vascular Dem.  My wife's Psych in a nursing facility setting just upped her depakote dosage.  I have no expectation of finding a cure. I would like to find a way to help my wife be more comfortable, less terrified etc. Suspect you've all been there.

 


Jim32
Posted: Saturday, May 29, 2021 8:01 PM
Joined: 3/28/2021
Posts: 28


Lane Simonian wrote:

A critical question to which the answer is the ginseng along would suffice.  The benefits of Aricept last about six months; the benefits of ginseng last two years or more (Korean red ginseng is a form of panax ginseng).

A 24-week randomized open-label study with Korean red ginseng (KRG) showed cognitive benefits in patients with Alzheimer’s disease. To further determine long-term effect of KRG, the subjects were recruited to be followed up to 2 yr. Cognitive function was evaluated every 12 wk using the Alzheimer’s Disease Assessment Scale (ADAS) and the Korean version of the Mini Mental Status Examination (K-MMSE) with the maintaining dose of 4.5 g or 9.0 g KRG per d. At 24 wk, there had been a significant improvement in KRG-treated groups. In the long-term evaluation of the efficacy of KRG after 24 wk, the improved MMSE score remained without significant decline at the 48th and 96th wk. ADAS-cog showed similar findings. Maximum improvement was found around week 24. In conclusion, the effect of KRG on cognitive functions was sustained for 2 yr follow-up, indicating feasible efficacies of long-term follow-up for Alzheimer’s disease.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3659550/

 

----------------------------------------------------------------------------------------

Jim32's post starts here.

 

It has been a while since I posted to this thread. I will have an update on my mother later. 

But first, I have a question about the proper daily dosage of panax ginseng.

The study mentioned above, indicates that the patients took 4.5 grams or 9.0 grams of Korean red ginseng per day. So, if my mother were to take panax ginseng, would she have to take 4.5 grams or 9.0 grams per day?

 

Looking at the panax ginseng products that are currently available on the market, I found the following products:

https://nutriflair.com/products/korean-red-panax-ginseng-1500mg-120-vegan-capsules

1600-mg capsules

 

 

https://www.iherb.com/pr/Now-Foods-Panax-Ginseng-500-mg-250-Veg-Capsules/717

500-mg capsules

 

For the 1600-mg product, 4.5 grams would be about 3 capsules, and 9.0 grams would be about 5 or 6 capsules.

For the 500-mg product, 4.5 grams would be 9 capsules, and 9.0 grams would be 18 capsules.

So, if my mother is taking the 1600-mg product, would she have to take 3 or 6 capsules per day? 

And, if my mother is taking the 500-mg product, would she have to take 9 or 18 capsules per day? 


Lane Simonian
Posted: Sunday, May 30, 2021 4:46 PM
Joined: 12/12/2011
Posts: 5001


There was basically no difference in the trial between the 4.5 gram dose and the 9 gram dose, so the 4.5 gram dose is probably best (fewer chance of any negative side effects: jitteriness, rise in blood pressue, stomach upset, for instance).  Taking 1600mg three times a day would help reduce the number of capsules taken.  

I hope that your mother is doing all right, Jim.  I look forward to later updates.


Jim32
Posted: Sunday, May 30, 2021 10:39 PM
Joined: 3/28/2021
Posts: 28


OK. As promised, here is an update on my mother. Unfortunately, things are not good.

                                                                                                                                                            My mother was on track to be discharged from her nursing home to an assisted-living facility with memory care. 

However, about 3 weeks ago, she was experiencing pain and was taken to a hospital.

It was discovered that she had a urinary tract infection (UTI) and a broken left hip from a fall.

She got antibiotics for the UTI, and she had surgery with general anesthesia for the hip fracture.  

I wasn't sure how the surgery would affect her dementia. However, the orthopaedic surgeon said that she would be immobile for a shorter period of time with the surgery than without the surgery. So, I agreed to the surgery.

The surgeon said that, physically, the surgery went as well as the surgery could have gone. However, it seems that the general anesthesia may have accelerated her dementia.

                                                                                                                                                          She has been getting physical with nurses. She has been agitated, saying that she needs to go home to take care of her 5-year-old son (I'm in my mid-40s).

When physical therapists have come to her room for physical therapy, she has refused to get out of bed and walk. However, she has tried to get out of bed and walk around, with the nurse present in the room and with physical therapists NOT present in the room. The nurse said that the nurse could not allow my mother to walk around in the nurse's presence, without the presence of physical therapists, because, if my mother fell on the nurse's watch, then the nurse would get the blame. 

So, I agreed to the surgery so that my mother could be more mobile, but the hospital staff get angry when she *is* more mobile. (LOL)

She has been placed into and out of restraints. She has been given the anti-psychotic medication Haldol.

About a week ago, I was told that she had contracted a little pneumonia in her left lung. She received antibiotics via an IV, and the situation was never life-threatening. Unfortunately, she frequently tried to rip out the IV and had to be kept in restraints.

I visited her a few days ago. Because she thinks that her son is 5 years old, and because I look like an adult, she did not believe that I was her son, and she said that she had never seen me before. She spent much of the visit insulting me.

Also, she is now incontinent. The hospital staff keep asking her whether she needs to go to the bathroom, and she always says "no". But she keeps urinating and pooping into her bed. 

                                                                                                                                                          The nursing home where she was before coming to the hospital, will not accept her back unless she can stay off the restraints for 24 hours. But she can not stay off the restraints for that long.

Meanwhile, a hospital care manager says that my mother can not stay in the hospital, and the care manager wants her to live with me in the home we own together (with 24-7 care from private caregivers). But I do not want my mother in the home because I am afraid that her incontinence will stink up the place, and because 24-7 care will cost $20000 per month. That $20000 is just for the caregivers. We would still have to buy food for my mother.

So, right now, my mother is in "no man's land", with neither the hospital. nor the nursing home, nor myself wanting her.

And, of course, the hospital's care manager said "no" to aromatherapy and Chinese herbs. The hospital staff will overmedicate her with Lipitor, depakote, Ativan, and Haldol (which can cause heart problems), but they won't give her herbs or aromatherapy. And when I told the care manager that my mother was being overmedicated and that so many medications could be contributing to her bad behavior, the manager told me that she and her colleagues were the medical experts and that they knew better than I did.

The nursing home's social worker suggested that perhaps my mother can be transported to an assisted-living facility with memory care directly from the hospital, bypassing the nursing home. In this situation, home-health aides paid for by Medicare would give my mother physical therapy at the assisted-living facility, physical therapy that she would have gotten at the nursing home. However, getting the assisted-living facility to accept my mother with restraints will be a long-shot.

 

 


Jim32
Posted: Monday, May 31, 2021 1:23 AM
Joined: 3/28/2021
Posts: 28


In an earlier post, I mentioned the following products:

https://nutriflair.com/products/korean-red-panax-ginseng-1500mg-120-vegan-capsules

1600-mg capsules

                                                                                                                                                    https://www.iherb.com/pr/Now-Foods-Panax-Ginseng-500-mg-250-Veg-Capsules/717

500-mg capsules

 

I have read that the best Korean Red Ginseng product is Cheong Kwan Jang from the Korea Ginseng Corporation, and that all other products are inferior. Is this true?

The above products are not Cheong Kwan Jang, but they are cheap.

                                                                                                                                                      Meanwhile, Cheong Kwan Jang products are very expensive. Here are two such products:

https://www.kgcus.com/default/extract-50g.html

https://www.kgcus.com/default/extract-everytime-30-pouches.html

                    

Also, as mentioned in earlier posts, the following study showed that Korean Red Ginseng can improve the cognition of dementia patients for 2 years:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3659550/                                    

                                                                                                                                                        Look at the "Acknowledgements" section of the description of the study. The study was funded by the Korea Ginseng Corporation, which makes the so-called best Korean Red Ginseng product. 


Lane Simonian
Posted: Monday, May 31, 2021 6:46 PM
Joined: 12/12/2011
Posts: 5001


I took a deep breathe reading about your mother (and your) situation.  None of this is probably going to help much, but anesthesia can worsen dementia and some anti-anxiety medications (such as Ativan) can actually increase anxiety in some people.  I always find it ironic that the dictum to do no harm is so often applied to botanical treatments but not to powerful medications which can have very negative side effects.  It is not always possible to remove all these medications, but in many cases it is possible to remove many of them and in some cases all of them.

I don't think the Korean red ginseng study was biased given the number of other studies on panax ginseg for Alzheimer's disease, but the Korean ginseng corporation touting its own product was biased.  I probably should not promote any particular company, but you can search "best Korean red ginseng capsules."

I am not sure what the possible options are for your mother's care.  The various medical systems put people in a bind, and it is very difficult to find ones way out of them.  I hope that some good placement can be found for your mother.


Lane Simonian
Posted: Monday, May 31, 2021 6:58 PM
Joined: 12/12/2011
Posts: 5001


I looked at some of the reviews for NutriFlair.  Most people were taking it as an energy booster.  One person did note a rapid rise in blood pressure although this can potentially occur with any ginseng product.  I am not a ginseng extract expert, but this appears to be a good product (I wish they would breakdown the components beyond ginsenosides, but I think most ginseng capsules just list ginsenosides as the active ingredient).  
Jim32
Posted: Monday, May 31, 2021 10:33 PM
Joined: 3/28/2021
Posts: 28


Lane Simonian wrote:

I don't think the Korean red ginseng study was biased given the number of other studies on panax ginseg for Alzheimer's disease, but the Korean ginseng corporation touting its own product was biased.  I probably should not promote any particular company, but you can search "best Korean red ginseng capsules."

----------------------------------------------------------------------------------------

Jim32's post starts here.

It was the following Amazon review that said that Korea Ginseng Corporation's product is the best product:

https://www.amazon.com/gp/customer-reviews/R1N2OWSHP5N155

                                                                                                                                                      I did search "best Korean red ginseng capsules", and I found the following article:  https://barbend.com/best-ginseng-supplements/ 

The article says that the best product is NatureBell Panax Ginseng. But this product has 15% ginsenosides and is very powerful (maybe too powerful for my mother?). Also, the capsule is too large and hard to swallow, and my mother would not like that.

                                                                                                                                                      So, bottom line, if I'm choosing a Korean Red Ginseng product for my mother, do I go with just any product? Are all products created equal? Or should I read the reviews and the ingredient list of each individual product and decide from that? 

 

 

 


Jim32
Posted: Monday, May 31, 2021 10:53 PM
Joined: 3/28/2021
Posts: 28


Lane Simonian wrote:

... some anti-anxiety medications (such as Ativan) can actually increase anxiety in some people.  

----------------------------------------------------------------------------------------

Jim32's post starts here.

Anti-anxiety medications can also cause dementia in the first place.

Look at the following study:

https://www.health.harvard.edu/mind-and-mood/two-types-of-drugs-you-may-want-to-avoid-for-the-sake-of-your-brain

According to this study, a person who takes a benzodiazepine (tranquilizer) for more than 6 months is at a much higher risk of dementia than a person who does not take benzodiazepines at all. The risk is highest for the benzodiazepine called diazepam.

Well, guess what? From 2011 to 2019, my mother's primary doctor prescribed her diazepam. This diazepam may have caused my mother's dementia.

 


Lane Simonian
Posted: Monday, May 31, 2021 11:16 PM
Joined: 12/12/2011
Posts: 5001


Both benzodiazepines and benzodiazepine withdraw can contribute to dementia (thank you for the very good article).  One of the great unexplored areas of Alzheimer's research is what types of medications can contribute to dementia.  There may be a lot of opposition to this kind of research.
Lane Simonian
Posted: Monday, May 31, 2021 11:20 PM
Joined: 12/12/2011
Posts: 5001


Not all ginseng products are the same (different concentrations of compounds and sometimes differences in purity), but the hard part is figuring out which ones are the best.  I would not spend hours on this, but it might be worth reading a few reviews from different sources.

This type of information is probably not listed on labels, but the higher the polyphenolic concentrations (things like ferulic acid, vanillic acid, syringic acid, and p-coumaric acid) the better.