Transcription
From: A.D. Dirkzwager
Sent: Sunday, 11 December 2022
To: Faysal el Khalil
Subject: From Amsterdam with love
Thank you for your sign of life from Lagos. It's been a while, but in the meantime I've been thinking a lot about you and what it would be like to live in Beirut today.
Are you, May and the family in good health? How do you deal with daily life in Beirut these days?
I imagine it won't be easy. I'm very curious how you are doing in Lebanon? Questions, questions?
Is your home still the apartment in the apartment complex at the Marina? Are the 2022 annual results of the family soft drink company satisfactory now that the year 2022 is almost over?
Thank you for letting me know that there has been a breakthrough in the treatment of Alzheimer's disease. It is a solution for patients with early stages of Alzheimer's. The clinical psychiatrist who diagnosed Vera with Alzheimer's disease told me that when people come to her for an examination to find out whether she/he has Alzheimer's, they have usually already been ill for the past three years, disguised as somewhat forgetful.
Life is a bit complicated now that I have to live Vera's life in addition to my own life. In the household she never puts anything back in its usual place. There's a lot missing, because her short memory can't remember the places where she put her keys, for example, or whatever. But she loves visits and meetings with old friends and acquaintances.
Now allow me to send our Season Greetings for that time with a contemporary appropriate cartoon.
Love from both of us to you both and we often think of the fabulous four days in Beirut in good company: That's YOU and MAY ! Vera & Adriaan
P.S. 1
Think about this quote. Is there an unreasonable leader in Lebanon who can change Lebanon in a reasonable nation ?
"The reasonable man adpts himself to the world; the unreasonable one persists in trying to adapt the world to himself. Therefore all progress depends on the unreasonable man."
G.B.Shaw (1865-1950)
P.S. 2
Vera's short memory fails her. Reading a book is pointless. That means she appreciates my company to pass the time. Besides being "honoris causa" Vera's caretaker, I am also her companion. She also lost her sense of time. For example: Today, Wednesday, Vera asks me what day of the week it is? I reply that it's Wednesday, to which Vera replies: "So it's Wednesday." She tries to keep track of the time using het calendar on the IPhone. She warns me about an upcoming event, but I have to tell her that it is an event from last month.
According to Reisberg's "time line" Vera has passed stage 4. I don't have to help her choosing clothes, because she never changes clothes. Until so far poor Vera's medical bulletin.
Breaking News
It is with great sadness that we have decided to move to Noordwijk near the coast.We bought a "rez de chaussée", ground floor apartment and sold our apartment in the city of Amsterdam. The actual move will not take place until about the end of April, when ownership of the apartment will be transferred.
I am looking forward to move to the apartment in Noordwijk without staircases.
The decline in Alzheimer's goes step by step. What is learned first is the last to leave the brain.
Alzheimer's disease follows a fixes route through the brain. Under the microscope, you can see the first typical Alzheimer's abnormalities in the cerebral cortex of the temporal lobe. etorhinal cortex, in the brains of the deceased. Then you see some abnormalities appear in the hippocampus. At that time there are no symptoms yet, so the deceased never knew that the decease process in the brain had already started. But if the temporal lobe and the hippocampus are heavily affected Alzheimer's disease, short-term memory problems occur.
People don't remember what happend recently, but can still remember fine details of a party at primary school. Finally if Alzheimer's disease affects the other cerebral cortex area's, the patient becomes demented.
No only the microscopic changes, but als the loss of functions follows a fixed pattern during the Alzheimer's process. Here, the skills disappear in exactly the reverse order in which we acquired them during our development.
The sequence is evidenced by stages of the Alzheimer's process, which were numbered by DR Barry Reisberg in New York.
In stage1, nothing is wrong. In stage 2, People can no longer find their belongings.They notice that problems arise at work, but they can often keep it quite hidden.
In stage 3, others alo notice that you cannot longer perform your work. In stage 4, things go wrong with more complex tasks, such as organizing the finances. Next (5) you need help choosing clothes. The (6a) you need help with dressing, (6b) with washing, (6c) problems arise on the toilet with flushing and wiping your buttocks, one becomes incontinent for urine (6d) and for faeces (6e)
In stage (7a), you only speak one to five words a day and then you no longer speak intelligibly words (7b), you can no longer walk (7c), and then you can no longer sit independently (7d). Then (7e) the smile disappears, which everyone was so happy with when you were a baby, and then (7f) you can't lift your head yourself anymore. The patient eventually lies in the fetal position in bed, and if you put a finger in his mouth, he has a sucking reflex. All the way to the new born baby stage.
