Nobody wants to kill her own mother by accident. Luckily, mine pulled through.
As teachable moments go, this one was huge. I learned that once you or someone you know hits age 65, it's time to learn which drugs can increase the risk of dementia when taken for long periods. And which, for people who already have dementia, can make them psychotic.
I call them the drugs of fog, and I saw firsthand what these seemingly innocuous pills did to my mom. A pill that might make a 20-year-old or a 40-year-old slightly sleepy made my 95-year-old mother, Ceil Zubrod, into someone I had never seen. Known for her easy smile, great style and a crazy-early bedtime, she morphed in less than five hours into a hallucinating, night-walking, screaming basket case, all thanks to one anti-itch prescription pill I gave her for her eczema.
Ignorance is never a great defense, but it's the only one I have. The nightmare began after I gave her that pill at around 9 p.m. as she went to bed. At roughly 2 a.m., she whacked me awake with her flashlight and ordered me to help her pack a suitcase so we could walk to her childhood home in New York, about 1,000 miles from our place in Tampa.
After she tried to flush my underwear down the toilet, I threw on a raincoat and began looking for my car keys to drive to the emergency room. In that minute, she tried to climb over our balcony. Fortunately I happened to look up and pried her hands off the railing. Her face was so tormented I barely recognized her. At the ER, they took blood, did an MRI and - of course, given her age - ordered up a urine test.
When the result came back, the ER doc demanded, "You gave you mother a Benadryl - at her age?" As the exhausted caregiver who'd ingested my share of Benadryl over six decades for occasional allergies, I was clueless because this was not what my mom was taking. The doctor who had prescribed her anti-itch pill never mentioned that it was the equivalent of a giant Benadryl.
And if he had, I wouldn't have understood why that was so terrible.
One of the many secret aspects of aging is that physical symptoms can mutate like aliens, which plays havoc with all we think we know about healing ourselves or our loved ones. For example, once we hit our 70s or 80s, symptoms of urinary tract infection that most women recognize - fever or a burning sensation when urinating - give way to something known throughout Florida - the state with the nation's highest percentage of the elderly - as "acting strange."
During this entire episode I naively assumed my mother might have a really bad urinary tract infection, but Ceil's mercifully well-informed ER doctor understood the possible terrifying side effects of pills that adult children give their aged parents. Which is probably why he acted as if I'd fed my mother rat poison.
"Do not give her ANY more anticholinergics," he practically snarled while signing her discharge papers.
I made him spell it while praying he wouldn't cite me for elder abuse. Once Ceil was asleep in her own bed at our home, I researched what other medications came under that heading.
A Harvard medical health blog told me: "Anticholinergic drugs block the action of acetylcholine. This substance transmits messages in the nervous system. In the brain, acetylcholine is involved in learning and memory. In the rest of the body, it stimulates muscle contractions. Anticholinergic drugs include some antihistamines, tricyclic antidepressants, medications to control overactive bladder, and drugs to relieve the symptoms of Parkinson's disease." And then it pointed to "mounting evidence that anticholinergics aren't drugs to take long-term if you want to keep a clear head, and keep your head clear into old age."
I moved on to actual studies. What was news to me had already been well studied around the world. In England, a 2011 study of 13,400 people age 65 and older found that the use of medication containing anticholinergics was linked to an increase in the risk of cognitive impairment - and mortality within two years.
Similarly, researchers in the United States followed 3,434 people 65 and older for more than seven years. None had dementia or Alzheimer's disease when the study began, and all drugs they took were carefully tracked. The findings of this study were as scary to me as the outcome of the overseas research: Those who took anticholinergic drugs - either over-the-counter or prescription-strength formulations - for an extended period had a greater risk of developing dementia.
Anticholinergics include all kinds of mass-market remedies beyond Benadryl (which is known generically as diphenhydramine), such as Nyquil, Sominex, Advil/Tylenol PM, the bladder-control prescription drugs oxybutynin (Ditropan) and tolterodine (Detrol), and neck and back pain drugs such as Flexeril. These are all worthwhile medications - for younger people.
My 95-year-old mother's accumulation of daily prescriptions were classic textbook material, beginning with pills for overactive bladder that she had taken from age 69 to 94. A doctor had prescribed that medication years before - without her even being incontinent. Why, I recently asked that doctor, and I got this response: "Overactive-bladder issues are common in women over 70. They don't like to talk about it." Actually, my mother never brought it up because it was never a problem. I'm pretty sure she didn't realize what the prescription her doctor renewed faithfully was intended to treat.
Ceil is now down to a single baby aspirin each day. She happily watches her favorite on-demand sports programs - tennis and ice skating - before she goes to sleep. She takes a daily one-mile walk, loves going to a nearby Trader Joe's for flowers and regularly gets a manicure.
So I had been feeling home free after our ER visit until I saw amitriptyline recently on a list of anticholinergics. It had been prescribed as sleeping pill for me, and I had been taking it nightly, and happily, for almost two years. No more.
Back in my hippie days, "you are what you eat" was a mega mantra. (People were far more forgiving of mind-altering drugs.) These days, I'm more inclined to say, "The older you get, the more you need to keep up with anticholinergic research."
The Washington Post
Mon May 08 2017
My 95-year-old mother's accumulation of daily prescriptions were classic textbook material, beginning with pills for overactive bladder that she had taken from age 69 to 94.
Jabatan Pengajian Antarabangsa dan Strategik UM mohon maaf kepada seluruh rakyat Malaysia
Dalam satu kenyataan pada Sabtu, jabatan itu menegaskan pihaknya kesal dan memandang serius terhadap perkara itu.
AWANI 7:45 [27/04/2024] - Siasatan sama ada Tun M salah guna kuasa | Jangkaan persaingan sengit | FFC umum tangguh misi | Mesyuarat khas dua hari
#AWANI745 malam ini bersama Dzulfitri Yusof;
1. Mokhzani dan Mirzan nafi disiasat SPRM
2. Pertandingan empat penjuru, PRK Kuala Kubu Baharu
3. Freedom Flotilla To Gaza ditangguh, delegasi dunia pulang
4. Mesyuarat Khas WEF berlangsung di Arab Saudi, ketika suhu geopolitik semakin panas
1. Mokhzani dan Mirzan nafi disiasat SPRM
2. Pertandingan empat penjuru, PRK Kuala Kubu Baharu
3. Freedom Flotilla To Gaza ditangguh, delegasi dunia pulang
4. Mesyuarat Khas WEF berlangsung di Arab Saudi, ketika suhu geopolitik semakin panas
Piala Thomas: Jangan pandang mudah Malaysia - Antonsen
Walaupun Malaysia membariskan skuad perseorangan kurang 'menyengat', Anders Antonsen masih menjangkakan saingan sengit.
Budak lima tahun cedera jatuh dari tingkat tiga flat
Seorang kanak-kanak perempuan berusia lima tahun cedera selepas dipercayai terjatuh dari tingkat tiga rumahnya di Flat Taman College Height pada Sabtu.
AWANI Ringkas: Kasino di Forest City
Ikuti rangkuman berita utama yang menjadi tumpuan sepanjang hari di Astro AWANI menerusi AWANI Ringkas.
Hamas sudah terima maklum balas Israel mengenai cadangan gencatan senjata
Gesaan dari seluruh dunia untuk satu gencatan senjata semakin meningkat dengan serangan ke atas Gaza kini memasuki bulan ketujuh.
World Economic Forum berbeza dari kelaziman
Lazimnya World Economic Forum (WEF) akan berlangsung setiap musim sejuk di Davos, Switzerland, lokasi lahirnya forum berprestij dunia ini sejak lebih lebih dekad lalu.
Dalam tempoh kira-kira tiga bulan, WEF keluar dari kelazimannya dengan menganjurkan mesyuarat khas dua hari, 28 hingga 29 April 2024 di Riyadh, Arab Saudi.
Ia memberi isyarat, kepentingan kestabilan rantau Asia Barat atau timur tengah ini, bukan perakara main-main.
#AWANI745
Dalam tempoh kira-kira tiga bulan, WEF keluar dari kelazimannya dengan menganjurkan mesyuarat khas dua hari, 28 hingga 29 April 2024 di Riyadh, Arab Saudi.
Ia memberi isyarat, kepentingan kestabilan rantau Asia Barat atau timur tengah ini, bukan perakara main-main.
#AWANI745
Pemain Astro Kem Badminton 2024 berpeluang berlatih di bawah jurulatih BAM
Wan Wah menjelaskan pemain-pemain yang dipilih akan menjalani latihan intensif itu di Akademi Badminton Malaysia (ABM).
#AWANI745
#AWANI745
PRK Kuala Kubu Baharu: Pengundi perlu pilih kestabilan - Fadillah
Fadillah berkata beliau percaya pengundi di kawasan tersebut, boleh membuat keputusan terbaik untuk menentukan calon paling layak untuk mewakili mereka.
Liga Parlimen Al-Quds: Malaysia gesa satu resolusi penyelesaian isu Palestin dapat dicapai
Malaysia antara lain mendesak Pertubuhan Bangsa-Bangsa Bersatu (PBB) meluluskan resolusi menghantar tentera pengaman ke Palestin.
Anak-anak tanya mana ayah mereka - Salma Mentor
Jelas Salma, dia dan suami menerima keputusan mahkamah ini dengan reda.
Kulit bayi tujuh bulan mengelupas dan berdarah selepas keluar hospital
Hospital Sultan Ismail (HSI) Johor Bahru diminta memberi penjelasan terperinci berhubung penyakit kulit seorang bayi berusia tujuh bulan yang semakin teruk.