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   More Than Memory: Coping With The Other Ills Of Alzheimer's   
      
      
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   June 24, 20178:01 AM ET   
   Heard on All Things Considered   
   REBECCA HERSHER   
      
   Greg O'Brien was diagnosed with early-onset Alzheimer's disease eight years   
   ago. He has written about his experiences with the disease.   
   Amanda Kowalski for NPR   
   The first problem with the airplane bathroom was its location.   
      
   It was March. Greg O'Brien and his wife, Mary Catherine, were flying back to   
   Boston from Los Angeles, sitting in economy seats in the middle of the plane.   
   "We're halfway, probably over Chicago," Greg remembers, "and Mary Catherine   
   said, 'Go to the    
   bathroom.' "   
      
   "It just sounded like my mother," Greg says. So I said 'no.' "   
      
   Mary Catherine persisted, urging her husband of 40 years to use the restroom.   
   People started looking at them. "It was kind of funny," says Greg.   
      
   Mary Catherine was more alarmed than amused. Greg has early-onset Alzheimer's,   
   which makes it increasingly hard for him to keep track of thoughts and   
   feelings over the course of minutes or even seconds. It's easy to get into a   
   situation where you feel    
   like you need to use the bathroom, but then forget. And they had already been   
   on the plane for hours.   
      
   Finally, Greg started toward the restroom at the back of the plane, only to   
   find the aisle was blocked by an attendant serving drinks. Mary Catherine   
   gestured to him. "Use the one in first class!"   
      
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   At that point, on top of the mild anxiety most people feel when they slip into   
   first class to use the restroom, Greg was feeling overwhelmed by the geography   
   of the plane. He pulled back the curtain dividing the seating sections.   
      
   "This flight attendant looks at me like she has no use for me. I just said   
   'Look, I really have to go the bathroom,' and she says 'OK, just go.' "   
      
   Before Greg had Alzheimer's, he would have discreetly made his way up the   
   aisle, used the bathroom and gone back to his seat. Now, no part of that was   
   possible. He had no idea where the bathroom was. Even after the crew member   
   pointed to the front of the    
   plane, he was still confused.   
      
   There were two doors.   
      
   He moved down the aisle, buying time, feeling the flight attendant watching   
   him. The middle door was larger. He put his hand on it.   
      
   Immediately, he knew it was wrong – he had touched the cockpit door. The   
   flight attendant was at his side. He apologized. She asked him to please step   
   away from the door. "I'm sorry," Greg told her. "I have a problem. I got some   
   Alzheimer's.   
      
   "I didn't get to pee," he says now. "But I think I was lucky nothing bad   
   happened."   
      
      
   Greg unwinds a hose while doing some yardwork. Along with his failing memory,   
   Greg has been experiencing secondary symptoms including paranoia, depression   
   and slow healing.   
   Amanda Kowalski for NPR   
   Eight years after he was diagnosed with early-onset Alzheimer's disease, the   
   67-year-old's memory is failing slowly and irreversibly. But, increasingly, it   
   is his other symptoms that interrupt his day-to-day life as a writer, father,   
   husband and now    
   grandfather.   
      
   Some symptoms he is struggling with have largely unknown mechanisms. His   
   depressed immune system, for example, is likely related to his Alzheimer's   
   disease, but researchers are still unsure exactly how. Same with the exact   
   relationship between the    
   Alzheimer's and the numbness he feels in his hands and feet.   
      
   But many of the symptoms he experiences have clear links to the disease —   
   things like rage, paranoia, depression and incontinence.   
      
   And he thinks that a lot of people who are open about some Alzheimer's   
   symptoms are uncomfortable talking about things like incontinence. He makes an   
   extra effort to be open about his symptoms and joke about the parts of his   
   life that are still funny. "   
   You'll never see me with tan pants. I always have an extra pair of pants in   
   the car," he says, laughing a little. "I'm not trying to gross anyone out, but   
   that's my life today."   
      
   "You don't die of Alzheimer's," Greg says. "You die of everything else. But   
   first, you live with it all. Alzheimer's is not your grandfather's disease."   
      
      
   Greg and his wife, Mary Catherine, recently celebrated their 40th wedding   
   anniversary. Both say the disease has changed their marriage.   
   Amanda Kowalski for NPR   
   Prescription Side Effects   
      
   "I refuse to take this one because it makes me loopy," Greg explains, standing   
   at his kitchen sink pointing at one of the pill bottles lined up on the   
   windowsill.   
      
   He reaches for another bottle. "I call these ones my smart pills," he says,   
   struggling with the childproof top. "These goddamn things," he grunts, the   
   water running into the sink. He extracts a pill and tosses it into his mouth,   
   dipping his head to drink    
   from the faucet.   
      
   He smiles. "Not always the best manners, I know."   
      
   Although there is no drug to slow or stop the inevitable progression of   
   Alzheimer's, people like Greg, who was diagnosed with the early-onset form of   
   the disease, often take multiple drugs to treat the symptoms. Greg has   
   prescriptions for four drugs he's    
   supposed to take every day: two to combat dementia and other cognitive   
   symptoms, and two antidepressants, Celexa and trazodone.   
      
   Trazodone is the one Greg refuses to take. Along with the second   
   antidepressant, it's meant to help him deal with the depression and suicidal   
   thoughts that he has been experiencing on and off since he was diagnosed.   
      
      
   Greg's son Conor helps his dad organize medications. Greg takes multiple drugs   
   to treat the symptoms of Alzheimer's.   
   Amanda Kowalski for NPR   
   "In Alzheimer's disease, you're not just affecting the ability to remember   
   things and learn things, but you're also affecting parts of the brain that   
   control mood," says Rudy Tanzi, an Alzheimer's researcher and assistant   
   professor at Harvard Medical    
   School. He says Alzheimer's affects the frontal lobe of the brain, which is   
   involved in the ability to show restraint.   
      
   As the frontal lobe degenerates, it becomes easier to give into desires and   
   fear. Many people get depressed, angry and anxious.   
      
   Celexa and other so-called mood stabilizers can help reduce that stress,   
   agitation and depression. But research has also shown that such drugs can make   
   it more difficult to think and focus, which in turn makes it difficult to do   
   things like write.   
      
      
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