Skin: Wrinkles

El Paso Library, Day of the Dead display. October 2016. Credit: Mzuriana.

Goal

Mitigate the quantity and depth of facial wrinkles as I continue to age. 

Summary

Because of a moment of enlightenment a few weeks ago:

1. I realized that even though I've got my share of wrinkles already, it is still a worthwhile exercise to delay or blur new ones. 
2. Diligence in good excellent skincare today is an investment in my future self. 
3. Complacency is my enemy. 

The moment of enlightenment

For decades, I've been diligent about applying moisturizing lotion every morning. Not because of good discipline on my part. Nope. It's because, especially in winter, I can feel the dry discomfort of my skin if I don't lotion up after washing my face. Ergo, I put it on. 

Until a few weeks ago, I was "pretty good" about putting on an anti-wrinkle cream at night and sunscreen during the day. 

When I missed a night with the anti-wrinkle cream, I shrugged and figured I'd do it the next night. Most of the time, this was true. 

I usually remembered to put on sunscreen before I left my place, but it was an ad hoc behavior. I did not put it on automatically every morning regardless of my intent to go out. 

Something happened a few weeks ago that transformed my mindset about consistent use of the anti-wrinkle cream and the sunscreen. 

I had a zoom meeting with a woman in her early 40s. Tracy is originally from South Korea, a country that takes skincare VERY SERIOUSLY. "Glass skin" is the objective of Korean women and men. Tracy connected with me in her parked car, as she'd been out and about running errands.

Tracy asked if I would mind if she wore her pandemic mask during our meeting because: 

• She hadn't had time to go home and replenish her sunscreen, 
• The four-hour window that a sunscreen is good for had expired, and 
• She wanted to protect her face from the sun that entered the car. 

I was gobsmacked. Not because I thought Tracy's behavior was over the top. It was because she had a commitment to a goal and she took the requisite actions to support that commitment. I admired this. 

I immediately made a commitment to myself: "Pretty good" skincare compliance was no longer good enough. I intended to achieve 100% compliance with my skincare practices, such as they were. 

And today, weeks later: So far, so good. 

(I also shared my burning bush encounter with my 40-something daughter, in case she might choose to take anything from it.)

Products

The thing with skincare products is you never really know if they're working, right? Because you don't know what your skin would have looked like if you didn't use the product or what your skin would have looked like if you'd applied a different product. 

Yes, there are those anti-wrinkle ointments that claim to show visible improvement in one's existing lines and crevices. After an ungodly number of weeks, typically. I suppose one can take close-up photos of the before and the after to discern any differences. 

Anyhoo. 

I take a tri-fold product approach to my face.

At night, I apply an anti-wrinkle cream. It's a so-called "deep wrinkle serum." 

In the morning, I apply a:

• Moisturizing lotion; and
• Sunscreen. 

My current go-to lotion is a so-called "crepe corrector." 

 

Other behaviors

Tanning. My father was ahead of his time when he admonished us youngsters to avoid baking in the sun. He'd read the emerging research, back in the day, of its harmful effects on our skin. This was at a time when most white girls in the US wanted a tan, the deeper the better, to exude health and athletic fitness. 

I'd like to say that I took my father's advice to heart, and it was his guidance that made me a shade-seeking girl, but truth be told, I disliked laying out in the sun (or sitting in a sauna) because I didn't like to be sweaty, it was boring, and I had a slight fear, irrational, that I'd involuntarily open my eyes and stare directly into the sun. 

Smoking. Alas, I smoked for most of my adult life. Fortunately, I quit when I turned 50ish. 

Repetitive facial expressions. If accurate, this reinforces my practice of - when I catch myself in my "dead face" (which others call "resting bitch face," a term I dislike)  - setting my facial expression into a smile or, at least, upturning the corners of my mouth instead of allowing them the drop down in their desired default position. This requires me to lift my separate my upper and lower teeth instead of allowing my upper teeth to rest upon the lower. 

There are other behaviors that Monsieur Google cites as wrinkling agents, but because I am dissatisfied with the research (if any) behind these allegations, I don't include them here. 

Face painting on the Day of the Dead. Mesilla, New Mexico. November 2012. Credit: Mzuriana.

Literature: What Old Age is Really Like

 

Tattoo exhibit, Royal Ontario Museum, photo of Fang-od Oggay - June 2016, Toronto

Below are excerpts from: What Old Age Really Looks Like, a 2015 article by novelist and essayist, Ceridwen Dovey, published in The New Yorker. I have made a few structural changes for more visual readability here, such as chunking and bulleting. 

What does it feel like to be old? Not middle-aged, or late-middle-aged, but one of the members of the fastest-growing demographic: the “oldest old,” those aged eighty-five and above? 

This has been the question animating me for a couple of years, as I’ve tried to write a novel from the perspective of a man in his late eighties. ..... 

Somewhere along the way, though, things went wrong. My protagonist became Generic Old Man: crabby, computer illiterate, grieving for his dementia-addled wife. .... I forced on him a new love interest, Eccentric Old Woman: radical, full of energy, a fan of wearing magenta turbans and handing out safe-sex pamphlets outside retirement homes.

In other words, I modelled my characters on the two dominant cultural constructions of old age: the doddering, depressed pensioner and the ageless-in-spirit, quirky oddball. 

After reading the first draft, an editor I respect said to me, “But what else are they, other than old?” ....

... Why did I so blithely assume that I had the right to imagine my way into old age.... when I would approach with extreme caution the task of imagining my way into the interior world of a character of a different gender, race, or class? .... 

The conundrum of who has the authority to write about old age .... 

....  like any fictional representation, old age can be done well or badly ... but there’s less chance of being called out on hackneyed depictions of old age, in part because those in the know—the over-eighty-five-year-olds themselves—haven’t historically had any cultural power.

Stereotypes of old age, whether positive or negative, do real harm in the real world, argues Lynne Segal, the author of “Out of Time: The Pleasures and the Perils of Ageing” (2013). ...

... [In] age critic Margaret Morganroth Gullette’s ... 2004 book, “Aged by Culture[,]” Gullette highlights the limitations of having only two socially accepted narratives of aging: stories of progress or stories of decline. 

Neither [narrative] does justice to the “radical ambiguities” of old age, Segal says. We’re forced either to lament or to celebrate old age, rather than simply “affirm it as a significant part of life.”

Old age is perplexing to imagine in part because the definition of it is notoriously unstable. ... We tend to feel younger as we get older: almost half the respondents aged fifty or more reported feeling at least ten years younger than their actual age, while a third of respondents aged sixty-five or more said that they felt up to nineteen years younger. ....

... Young and middle-aged adults anticipate the “negative benchmarks” associated with aging (such as memory loss, illness, or an end to sexual activity) at much higher levels than the old report experiencing them. However, the elderly also report experiencing fewer of the benefits that younger adults expect old age to bring (such as more time for travel, hobbies, or volunteer work).

These perceptual gaps between generations are large and persistent. Simone de Beauvoir, in her exhaustive study “The Coming of Age” (published in 1970, when she was sixty-two), wrote, “Old age is particularly difficult to assume because we have always regarded it as something alien, a foreign species.” ...

... We age as individuals and as members of particular social contexts, yet the shared experience of old age continues to be overstated. The eighty-two-year-old British novelist Penelope Lively writes that her demographic has “nothing much in common except the accretion of years, a historical context, and a generous range of ailments.” At the same time, though, she warns that aging is such a “commonplace experience” that nobody should “behave as though … uniquely afflicted.”

The actress Juliet Stevenson, who is in her late fifties, recently commented that “as you go through life it gets more and more interesting and complicated, but the parts offered get more and more simple, and less complicated.” ...

... [An example of nuanced writing about an elderly character] is the thirty-seven-year-old Australian author Fiona McFarlane’s 2013 début novel, “The Night Guest.” McFarlane’s protagonist, Ruth, though succumbing to dementia and at the mercy of an unreliable caregiver, is capable of seeing beauty or taking great pleasure in her present—in a sexual encounter, for example—while also deriving equal parts enjoyment and pain from memories of her unusual past. She is neither hilarious nor terrifying. McFarlane says that, while writing Ruth, she thought of her as “an individual who, at seventy-five, is the sum of years of experience, memory, opinion, prejudice, decision-making, and desire.”

But why search for depictions of old age by the young when I should instead be seeking out narratives by natives of old age? I don’t mean the rich body of work by late-middle-aged authors, which tends to be more about the fear of aging than about the experience of old age itself ...,  but literature written by authors aged seventy-five and older.

......  Frank Kermode summed up the problem: “Those who have had actual experience of old age are likely to be dead or very tired or just reluctant to discuss the matter with clever young interlocutors.” Philip Roth, for example, who is now eighty-two, decided to retire from writing at the age of seventy-eight, after the publication of his quartet of “Nemeses” novels, saying in an interview about fiction, “I don’t want to read any more, write any more of it, I don’t even want to talk about it anymore ... I’m tired of all that work. I’m in a different stage of my life.” .....

[Penelope] Lively has also chosen to share her view from old age in a memoir, “Ammonites and Leaping Fish: A Life in Time,” from 2013. This is not a traditional memoir but a meditation on old age and memory. She takes pride in her right to speak of these things. “One of the few advantages of age ... is that you can report on it with a certain authority; you are a native now, and know what goes on here.” She also highlights the importance of the mission: “Our experience is one unknown to most of humanity, over time. We are the pioneers.” She likes the anonymity that old age has given her; it leaves her “free to do what a novelist does anyway, listen and watch, but with the added spice of feeling a little as though I am some observant time-traveller.” ... 

... My to-read list now includes:

• Stories by the ninety-six-year-old Emyr Humphreys; 
• Late work by Doris Lessing, Chinua Achebe, and Seamus Heaney; 
• Poetry by Elaine Feinstein, Dannie Abse, Maureen Duffy, and Ruth Fainlight;
• A new novel by the seventy-three-year-old Erica Jong, “Fear of Dying”; 
• Fiction by William Trevor, David Lodge, Kent Haruf, Toni Morrison, and Kenzaburo Oe; 
• Memoirs by Vivian Gornick, Roger Angell, and Diana Athill. 

Funereal Thoughts: A Joke

 

Sweets, Bowie  Bakery, El Paso, Texas. March 2017. Credit: Mzuriana.

There was a very old man. 

Bedridden, fragile, so weak.

Death stood near. 

One day, he awoke to scrumptious smells emanating from his kitchen. His favorite baked goods! There were also savories. Tiny bacon and swiss cheese quiches! Barbecue pulled pork! Homemade baked beans! 

The fragrances so seduced the old man that he struggled to remove the sheet and blanket that covered his failing body, then he half-fell and half-stepped out of his bed, then carefully, for fear of falling, he lowered himself to the floor. The old man crawled - oh so slowly - from his bed, through his bedroom, down a corridor, and into his dining room, whereupon he spied atop the dining room table, an array of sweets and savories. 

Trembling with both desire and fatigue, the old man crept to the table. 

He arrived. Tremulously, he reached up his arm and grasped hold of a fat pastry. He lifted it shakily, his mouth opening in anticipation of a sweet bite.

His wife loomed suddenly. Her hand slapped his away, and the pastry dropped back onto the table. 

"That's for after the funeral!" 

Environmental Gerontology

 

Gathering for sunset, Grand Canyon. September 2007. Credit: Mzuriana.

A term new to me: Environmental gerontology

From Cappella Living: 

Human beings, no matter what their age, have a basic need to belong and to be part of something (Maslow 1943). Unfortunately, as people age, many find their opportunities for social engagement dwindle. Their support systems get smaller as friends and neighbors pass away or move, or as they begin to experience physical or cognitive challenges that limit their ability to be engaged with the outside community. Put simply, our worlds often begin to shrink as we age. ... 

.... simply being in proximity to other people does not guarantee social engagement.

A drier definition from Environmental Gerontology in Aging in Place: 

Environmental gerontology is a specialization within gerontology that seeks an understanding and interventions to optimize the relationship between aging persons and their physical and social environments. The field emerged in the 1930s during the first studies on behavioral and social gerontology. 

Escapees in Livingston, Texas. November 2019. Credit: Mzuriana

A positive role model

Livingston, Texas, is the headquarters for the Escapees RV  Club, an organization devoted to people who travel in RVs (or other mobile "lodging"). 

The property hosts a large RV campground. 

It is also the home of the affiliated Escapees Care Residency Program . Members of the CARE residency program are people who used to travel full-time in their RVs, but who "can no longer take care of their own or their spouse's needs following an illness, injury, surgery, or the progression of a long-term health situation." Most of the CARE residents are older. 

CARE seems to exemplify the principles of environmental gerontology. CARE's purpose:

"CARE is a place where you will receive professional help for the things you may no longer be able to do. It is not a nursing home. Its goal is to delay or eliminate the need for a nursing home by providing daily meals, scheduling medical appointments and providing transportation to appointments, providing on-duty nurses, secure day rooms, and a comfortable social atmosphere."

The CARE residents live in their RVs in close proximity to a community center on the property. 

This community center has a dining room in which three full meals a day are served from its commercial kitchen. The community center also has an expansive communal room with spaces devoted to a library, conversational seating, a music performance/practice area, and religious service area. 

It's at this community center where the environmental gerontology principles shine. 

• The Livingston property hosts hundreds of RVers all year, and these RVers - some new, some regular visitors - intermingle with the CARE residents at the community center. 
• The traveling RVers can buy meals at the dining room; the travelers sit at the same round tables as the CARE residents. On Saturday mornings, it's also common for folks from the "rooted" Livingston community to come to the dining room to buy breakfast. This is because the Saturday morning breakfast enjoys some renown for its menu items and tastiness. 
• The traveling RVers join in regular music jams with the CARE residents. 
• The traveling RVers hang out in the community center's "living room" and library with the CARE residents. 
• It's all very organic and seamless. 
• The CARE residents see fresh faces almost every day, fresh conversations, fresh stimulations. 

There's nothing contrived or patronizing about the inter-mingling, either. By that, I mean that the travelers did not make a decision to "spend time with the older people" as an act of service. 

Universal design

When I think of environmental gerontology, I also think of universal design. 

I love the term "universal design." 

It's what might have been associated in the past solely with access for those with disabilities. 

But universal design benefits all of us, irrespective of age and abilities. It's as good for parents with tots in strollers as it is for people in wheelchairs, people behind walkers, or people who need balance assists such as grab bars along walls or in shower stalls. 

My own dream of environmental gerontology

For me, I envision a future residence that is within walking distance (or, later, short-distance Uber/Lyft/public transportation) to a grocery store, library, coffee shop, park, cultural venues. 

There is also diversity that surrounds me in:

• Age
• Complexion
• Language
• World views
• Socio-economic status
• Gender
• Cultural and physical pursuits

On GROWING Old

 

Lincoln National Forest, near Cloudcroft, New Mexico. June 2013. Credit: Mzuriana.

It occurred to me the other day

That growing old

Is to 

Flourish

Bloom

Open

Widen

Germinate.

We don't fall old, spill old, tank old, wither old, shrink old, dry old, mold old. We don't describe our evolution as we do structures and geographical features: decay, dissolve, rust, melt, erode or degenerate. 

The verb we use counts for something. 

We grow old. 

A former colleague of mine, Jessica Terrell, wrote this journal entry while on the 2002 American Frontiers: A Public Lands Journey: 

My Favorite Day

… I know that when I return home, friends, and family will be asking “So what was your absolute favorite place on the whole trek?” 

What will I tell them? I will start out by saying that every day inevitably seemed better than the last. “Seemed” is the key word, you must realize. 

If I were to mix up all the days of the trek and do it all over again, each new day would never cease to “seem” better than the one before it! 

So I have come to the conclusion that TODAY will always be my favorite. 

The dawn of each new day has and will continue to reveal to me things that have never before occurred, and never will occur again, whether it be a beautiful cloud formation over a particular mountain, the call of elk on a cool morning in a national forest, or even the way rocks glitter in the brightness of the afternoon sun.

To grow old is to dwell and revel in today, informed by all of my experiences and observations and studies from the past, recent and long ago. 

Jessica did not have the luxury of growing old.  

The Law of Relativity in the Land of Age

 

Gentlemen at Monument Valley, Utah. October 2007. Credit: Mzuriana

From Cappella Living Solutions: 

While ageism is rampant throughout our society, some [elder living] communities have found that ageism is even more pronounced among the older population, a theory that makes sense when considering the definition of ageism coined by psychologist Todd D. Nelson that explains that ageism is “prejudice against our feared future self” (2005).[Emphasis added.]

... Older adults who are fearful of losing cognitive or physical abilities are using the health of those around them to determine their own relative health, which leads to downward contrast comparisons (Loeckenhoff 2016). These are the kind of ageist statements like “At least I’m not blind like Mary,” or “I don’t belong here, these people are old.” ....

The first time I went to a yoga class, the instructor said a very important thing: "Do not compare your level of ability with that of others."

I realized recently that I had fallen into a pattern where I compare what I do or don't do, what I can or can't do, and how old I look or don't look, with an imaginary Everywoman of my cohort. 

While I have not fallen into a downward contrast comparison mode in the sense that I feel superior in any way to others in my age cohort (because, really, it's 100% about me and zero about anyone else), I do seem to have adopted exactly the kind of relative thinking that I deplore in some healthcare providers. 

I seek self-reassurance that I am doing OK. No. That I'm doing better than OK. No. That I'm doing better than the imaginary Everywoman in my cohort. Because "better-than" equals doing well. 

In other words, I have used the average health level of people my age as the yardstick to measure my health. 

Because I am so adept at denial of realities, I must kill these relativity thoughts.

What I would prefer to do is measure my level of health against an age-neutral bar. Otherwise, over time:

1. I might easily become complacent about habits that will keep me as active physically, socially, emotionally, and intellectually as I want to be. 
2. I might forget that any physical, social, emotional, or cognitive fitness I enjoy today could be snatched away from me tomorrow. Where I am relative to another person my age has very little meaning. Except for today. 

Besides, I learned from my 12-step experience that even if the duration of my abstention from my drug of choice is longer than a fellow 12-stepper's, the other 12-stepper might be light years ahead of me in emotional or spiritual maturity. 

Awakenings to My Age

 

Winter berries. Missouri. December 2006. Credit: Mzuriana.

These people are old

Some years back, at an offsite work event, I sat at a round table with women and men who worked in the same large organization as I did, but in different offices. I looked around at my tablemates, most with shimmers of gray in their hair, and the start of crinkling skin and softening jaw lines, and I thought, "Everyone at this table is older." 

..... and in the next moment, this lightning bolt struck me: "Oh my God. I'm about the same age as they are. Jesus." 

Ew! I am not going to date my father!

There was a phase I passed through, as I surveyed potential matches on an online dating site, when I flipped through profile after profile of prospects in my age cohort, that I felt visceral reactions: "Oh my gosh, they look as old as my father! No, no, no!"

It took awhile to understand that my brain was encased in a cocoon of magical thinking. For one, the men didn't even look as old as my father did when he was well into his 70s. They looked the same age as the mental fixed-image I had of my father when he was in his early sixties, probably even younger. Second, I had an internal image of my own self that was younger than I was in reality. Third, I was (am?) just as ageist as many of us. 

It wasn't only the superficial appearance of a prospect in my cohort that I grappled with; it was the fear that the older a man was, the greater the statistical likelihood that he has (or will have, imminently) one of the myriad medical issues visited upon us with age. (As if I were immune to the same.)

I had to change out my mental model of what my "market" looked like. It was neither quick nor easy to accomplish this. 

I also gained more empathy toward men who sought a younger woman. Because they were probably as aghast as I in the beginning: "I'm not going to date my mother!" (And, culturally, they can attract younger women, for a variety of reasons, and they can do so without receiving the smirks that women do when they are with younger men.)

Other people are old

In one of my past lives, I worked with a government agency that has a focus on older adults. I met with  numerous women and men who were in their 70s and older. At that time, I was in my late 40s or early 50s. 

Without exception, every one of the agency's 65+- year old stakeholders I met with referred to others as older or elderly. They never self-identified as old. 

From my position on the age continuum, the distinction intrigued me. But apparently, this is a common phenomenon. 

I remember being on a hike with a group of my women friends, perhaps 15 years ago. One of my friends would have been about the age I am today. We encountered a family on the trail, which included a boy of 10 or so, and his mother. I think he had become somewhat separated from his mom. She called out to him about his precise whereabouts, and he responded to her loudly, so she could hear him, "I'm behind the old lady!" referring to my friend. 

I was deeply shocked. I wondered if my friend had heard this remark. If she had heard it, I wondered how she felt about it. But I never even asked her, because if she hadn't heard it, I would not have wanted her to learn of it. And if she had heard it, I didn't want to remind her of it. The boy, of course, meant no harm. He was just using my friend's outward appearance, in relation to himself, as an easy identifier for his mom. ... And here I am, being ageist yet again because being called "old lady" is evidently so egregious that ... it is somehow too shameful to discuss? 

I find that, now that I'm in my 60s, I have the same sort of thinking as the stakeholders in that government agency. I have not awakened to being old. I am OK with being older. 

But once I hit 70, I think the alarm will go off for sure, right? 

That doesn't mean I'll be willing to disclose my age then. I remember my maternal grandmother telling me one day: "I never wanted to divulge my age. But now that I've turned 80, I want to." 

For now, I'm going to continue to hit the snooze button. 

Ageism and Health Care: An Infographic

 The long-ass infographic below tells it all prettily.

For the most part, I like it for the mere fact that it raises medical-care ageism. 

Alas, it is silent on BEERS. 

Credit: Regis College Online

Brain: When I Didn't Think About It and Now I Do

 

Brains for lunch. Kutaisi, Caucasus Georgia. February 2012. Credit: Mzuriana.

Backstory

I come from intelligent parents. My siblings and I are intelligent people.** 

No hubris here. It's just a fact, as evidenced by life-long assessments by individuals or organizations outside our nuclear family. 

Part of who I am - ever since a startling, single comment by my fourth grade teacher, Mrs. Murray - is the immutable acceptance of my intelligence. 

Did I forget a person, place or thing from earlier in the day, yesterday, last week, last month, last year? Sure. Did I worry even one nanosecond about it? Nope. I didn't even think about it. There was nothing unusual about it. And, in general, did I have a good memory? Yes. As for childhood memories, I've never had the encyclopedic recollection of these that one of my sisters has. So nothing unusual for me there.  

Did I think I was immune from some sort of dementia in the future? Nope. 

My paternal grandfather, in his 80s, developed dementia (I heard), attributed (I believe) to atherosclerosis. One of my paternal aunts had a similar experience in her 80s. I don't know the extent of their dementia, i.e. mild or severe. 

My father was only 75 when he died of pulmonary hypertension and mitral valve regurgitation. It's possible that, had he lived into his 80s, he would also have developed some level of dementia. 

My mother developed dementia at some point in her 80s. (She died at age 91.) It was gradual, and it eventually forced her to let go of:

• Work activities she had heretofore relished, 
• Driving, 
• Playing computer games, 
• Web surfing, 
• Emailing with family members, and 
• Cooking in her kitchen without someone present. 

Some of her personal-care disciplines fell by the wayside, too, such as getting dressed every day, applying lipstick, making her own bed - but I'm unsure how much of this was a function of an impaired cognitive state or learned helplessness because of well-intentioned, but disempowering helpfulness by some family members (i.e. doing things for her that she could have done and always had done for herself). 

My mother also had Type II diabetes, which she invariably pooh-poohed as "nothing," and thus, until very late in the game, she did virtually nothing to manage properly. 

To my knowledge, neither of my maternal grandparents developed dementia. But if they had survived the illnesses that killed them in their mid-80s, it's possible they would have had that experience. 

My powers of denial and discounting

Frankly, I ascribed my mother's cognitive challenges to her cavalier attitude about managing her diabetes, her antipathy toward virtually any sort of physical exercise, and possibly, long-term side effects of her pharmacological salad. 

I "knew" it was likely that I am a candidate for some sort of dementia when I reach my mid-80s or later because of my paternal side's atherosclerosis history, but .......... that's so far away, right? And if I catch the causal agents early enough, to prevent or manage the progress of atherosclerosis, I can perhaps prevent or at least slow the onset or the severity? 

And I've been seeking medical screening that will illuminate any early signs of pathology that lead to dementia! 

Also, I already do most of the things the experts tell us to do! I stopped smoking more than 10 years ago. I'm at a healthy body weight. I get a moderate amount of exercise (could do better here). I drink alcohol on a continuum between "occasionally" and "sometimes." 

My journey into aging has been predicated on an assumption that I would enjoy sustained cognitive health at least into my mid-to-late 80s.  

I did not dismiss the likelihood that I'd be diagnosed with some form of cancer that I'd have to respond to. After all, my mother had cancer three times; my paternal grandmother died in her 50s of cancer; my maternal grandmother died of cancer; my maternal grandfather died of cancer. And, hell, I was a smoker for most of my adult life. I was also obese for much of my adult life. So I'm not universally in denial about my health. 

When everything stopped ... for a moment

This past September, I had just moved to a new apartment in a city new to me in State A. 

The move happened after a 60-day period (June 30 through August 31) in which I, in the second year of COVID times: 

1. Moved out of an apartment in a different city in State A; 
2. Traveled to State B for a couple of weeks to visit with family and friends; 
3. Traveled back to an area new to me in State A; 
4. Traveled to both familiar and new-to-me destinations in State C; 
5. Traveled back to State A for a week to look for apartments in the new-to-me city; 
6. Returned to State B for a couple of weeks to visit with family and friends (and to offer support to my daughter while she had COVID); and
7. Circled back to State A to move in to my new place. 

 To tell you the truth, those two months are pretty much a blur. 

So here's the thing that shook me to the core: 

I teach English online to students, mostly business or academic professionals, all over the world. 

On the morning of September 9, ten days after moving in to my new apartment in my new city, I was in a lesson with one of my students. I shared with her how I'd just moved in to my new place. She asked me what city I was in. 

I didn't know the answer. 

I drew a complete fucking blank. 

Nothing else in my head or my body was different, as far as I know. 

My words came out the way they should. (No garbled sounds or word order weirdness that might indicate a TIA). 

I felt no weirdness in my limbs or facial expression. 

I didn't feel lightheaded or dizzy. 

I said, "just a moment," and I stood up and walked to my apartment door and opened it so I could look in the corridor, confident that this would jog my memory. It did not. 

As I look back now, I think I may have scurried (electronically) to my browser to pull up Google maps to see if that would deliver the information. 

I don't recall now how I recollected my new city, but the important consequences of this incident were:

• Both my student and I felt distressed and worried - OK - alarmed;
• The very foundation of my world shifted.
• After we ended the lesson, I popped two aspirin in case I was about to have a stroke. I looked at my face in the mirror. My mouth didn't droop on one side. My walking was normal. My hand movements normal. 

What the hell happened there?!

On September 17, I had an appointment with my new health care provider. I described what happened and explained my fear of something-something - a TIA? Early sign of dementia? What? 

She gave me a very short cognitive assessment test. She gave me three words to remember, then asked me some other stuff, then came back to the three words, which I did remember. There was no indication of cognitive or memory impairment. 

I was only somewhat soothed, because that weird event earlier in the month was appalling. 

Because this was such an extraordinary event, I talked more to my provider. I said nothing like this had happened before. I did not want to let it go. 

I described other symptoms that had emerged in the last 18 months or so: 

Changes in my sleep patterns - going to bed super early (like between 8:30 and 9:00), being sleepy around the middle of the day, and more recently, an occasional dull headache when I awoke. I wondered about sleep apnea. 

Nothing in the blood or urine work that we did that day revealed anything remarkable. 

I scurried to take more cognitive tests, all online. Results did not indicate anything abnormal. 

Although what happened was a loud clanging alarm bell at first, the sound dimmed. I was addressing it; I was taking the right steps. 

And then ..... 

On December 2, there was another lesson. A different student. 

We were proceeding through an article together. She would read aloud a paragraph and then we'd pause to talk about pronunciation and intonation, vocabulary, and content. We'd pass to the next paragraph. 

At a certain point in the article, I was unsure where we were - which paragraph we'd just finished and thus which one was next. 

In the past, I would have said - without any hesitation other than a sheepish tone - "where are we now?" Because there was nothing abnormal about losing track of one's place in a longish text. But because of the astonishing experience in September, I tried to cover up, which resulted in me staying on the paragraph we'd just read - I had guessed incorrectly where we were. Heheh. 

This alarmed my student, which, in turn, alarmed me. Again - no signs that one reads of a TIA. 

So since then I am acutely sensitive to any memory lapse. The search for a word. The remembering of someone's name from the past. What I did seconds earlier. 

I started watching a youtube channel of someone with Lewy Body Dementia. 

For reassurance, I have searched for situations in which people fear they have dementia, but do not, and I have come up empty. There seems only to be the reverse: People who are unaware they are impaired: Anosognosia.  However, this comes close: Stalked By the Fear That Dementia is Stalking You. 

COVID connection

Something I have noticed in the past year - among my friends and students - is a surprisingly common lament about memory lapses. 

I want to apply this to my own situation, to normalize my situation (if there is even a "situation"), to assuage my fear of some kind of cognitive pathology that will force me to change everything - everything! - I had envisioned in my young-old and middle-old future. 

I almost burst into tears when I read this: It’s not just you – we are all more forgetful during the pandemic, experts say. Here’s how to fix it.  I had read similar articles previously, but this one seemed so much more certain about what might be a shared phenomenon that we can attribute to this COVID era. 

I would also propose that COVID arrived after six years of Trumpian stressors, of ghastly and deadly exhibitions of racism (that continue to unfold), barbaric family separations at the border, and current attempts of White supremacists to further embed racism by banning the teaching of critical race theory, to ban books that address racial truths as told by those who experience those truths, and so on. ......... My point being: We were already stressed before COVID arrived. 

Holding many thoughts

I've caught myself thinking too many lines of thoughts in quick succession. For example, I start to move my body toward the kitchen to get A, but in the briefest span of time before I arrive there, my mind has already moved to a whole other line of thinking, maybe two!, and when I arrive in the kitchen, I forget why I went there. 

Lots of contact, but maybe not the right kind of contact

I've made a conscious effort to initiate and maintain contact with people in my circle, present and past. I live in a new location where I've not made local new friends (thank you, pandemic), so geographic distance precludes face-to-face visits with the old. 

Most of my contact with my friend- and family circle has been via email or text. It occurred to me recently that this is not the same as talking to someone on the phone. Furthermore, one of the advantages of regular real-time (and not text) contact is that we note any changes in each other's speech, judgement, memory, etc. Our real-time present communications help keep us on our toes. 

 I've begun to initiate phone calls in addition to emails or texts. 

Yes, there's also zoom, and I use that a lot with my work, but I've learned there is a counter-intuitive intimacy present via phone that is not on zoom. 

 

Memory impairment in the context of age

To the National Institute of Aging: This was so completely unhelpful: 

"Many people worry about becoming forgetful. They think forgetfulness is the first sign of Alzheimer's disease. But not all people with memory problems have Alzheimer's. Other causes for memory problems can include aging, medical conditions, emotional problems, mild cognitive impairment, or another type of dementia." [Emphasis added.]

"Memory problems can include aging." Not actionable. Not measurable. Dismissive. If it's a natural part of aging, why are they memory "problems"? 

The NIA chart below, however, was helpful - irrespective of age: 

Differences Between Normal Aging and Alzheimer's Disease

Normal Aging	Alzheimer's Disease
Making a bad decision once in a while	Making poor judgments and decisions a lot of the time
Missing a monthly payment	Problems taking care of monthly bills
Forgetting which day it is and remembering it later	Losing track of the date or time of year
Sometimes forgetting which word to use	Trouble having a conversation
Losing things from time to time	Misplacing things often and being unable to find them

Seriously, is it correct to call Column A "normal aging"? How is "normal aging" different from "average memory" or "typical memory" or "healthy memory" or "adult memory"? 

Resources on typical memory

Working Memory: The Engine for Learning

Medical Definition of Memory Span

How Memory Functions

My conclusions

Inconclusive.

**Intelligence does NOT default to healthy life skills at home, at work, and in our communities. It does not rule out learning disabilities (e.g. dyslexia) or ADHD or some other neurodivergence.