Wednesday, August 5, 2009

August 4th, 2009 Talkin' Shop

One of the great things about Alcoholics Anonymous is the range of people you meet. While I have not yet encountered any fellow AA’s who are also in the ALZ club, to my knowledge, it’s probably just a matter of time. Lots of people think that alcoholism is related to Alzheimer’s, but that doesn’t seem to bear out in actual clinical practice, to my knowledge—and in fact it may not be germane at all. In general, I think that ALZ is not well understood in the medical profession (not clinically speaking within the ALZ specialty certainly, but one gets the sense that the day in, day out, of the Alz specialist may be something of a backwater.) It seems to be a distasteful discussion topic among physicians and other top-flite  medical personnel, probably because it is stigmatized as incurable. In my own experience, I have tried all the major medications for the disease:

Aricept: the first one I tried; made me drowsy and somewhat listless. I felt as if I was going downhill.

Namenda: No change to speak of. But the most heinous aspect of this particular drug is the incredibly stupid name they gave the drug. I mean, think about it for minute…Name Ender…just what you want in an outcome, the loss of identity, the disappearance of self, the decay of memory and function…Please,  someone hire a copywriter! (My ad agency will do the job for a mere 10 percent of sales!)…

Excelon Patch: The difference between the others and the patch is like night and day for me. First of all, it gives me a sense of participation in the regimen—that might sound weird, but I want to be responsible for my own care to the extent I can be. With the patch there is a nice little routine that develops. First of all, you can adhere the patch to any part of your body. Of course, you don’t want to jump in the shower just after you do it, necessarily, but the morning prep regimen quickly becomes a ritual. You’re supposed to change the site of adherence daily, but I haven’t found that to be an issue. Occasionally you get a little bit of skin irritation, but it is minimal. It comes with a small cutter made just for opening the  “Patch Pouch” (sorry, couldn’t resist), and there is something satisfying about using the cutter…it also leaves a trail, of sorts, so if you get confused, the pouch debris can sometimes help you remember whether or not you already opened one.

The only problem with this alternative is the cost. If you are constrained by money, it can be a difficult nut to cover. On the other hand, what’s it worth to continue to function at a normal level? If I were Excelon, I would be addressing the cost issue, but that’s a discussion that is out of my league.

I think the marketing of these drugs needs to be taken up a notch. There is plenty of money in this category, and if the consumer were to be able to participate in their own care decisions and perhaps design a group discount for locking in a “contract” of sorts, the patch might be more available to a wider range of people.

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