Learn to Listen — Opportunity sometimes Knocks Softly

Today’s Suggestions



Ø  Learn to listen.  Opportunity sometimes knocks very softly.


Ø  Never deprive someone of hope; it might be all he or she has.


Ø  Pray not for things, but for wisdom and courage.



OK then. I received the diagnosis of Lewy Body Disease at the University of California San Francisco (UCSF) at the Aging and Memory Center in October 7, 2008. Then………..whoa! What is going on here? I think they have the wrong diagnosis. I know these Docs are smart but maybe they’re making a mistake. But then I didn’t remember much about being evaluated anyhow. Pam, Francine and Stacy — 2 awesome friends like family members) had to keep reminding me what had happened. The Drs. told me that I could no longer drive. WHAT?? You can’t do that to me. Don’t ever take my car from me. Don’t ever tell me I can’t drive. You’re taking away my lifeline…….please, no. And, of course, you can’t go back to work until January 2008. So I just figured I’d have to take several months off and then somehow the ‘rest’ would help and then everything would be just fine. Pam had already been told that I could not ever work again and that I couldn’t practice medicine again. But somehow I didn’t know that. Maybe I forgot. Maybe I wanted to forget. Maybe I went into deep denial. Maybe, maybe, maybe. Finally, it began to sink in little by little. Even though I didn’t remember each and every detail, Pam was patient and kept explaining over and over what the situation was about. But how would we survive? How could we pay the mortgage? How could I ever not practice medicine again? I worked too hard to get that license I told myself. Just maybe, some more time would help and I could still do something as a physician. My options were clear. Either voluntarily surrender my medical license back to the Medical Board of California or to place it in an inactive status. Well guess what? I haven’t been able to do either one yet. My license expires at the end of November of this year. After all this time — 1 year later I am now ready to let it go. I’m feeling real teary right now as I type and as I think about this. It hurts so badly. I feel I’ve lost my life. Why is this being taken from me at such a young age? Now I can’t help people anymore. I know I still can but it has to be in a different way. I’m slowly learning that at least 1 way is to blog. So I feel hopeful but yet am fighting not to cry right now. I already can see how writing all this out is already helping. But the pain is still there. And no. For some reason I’m not angry at anyone for all this. Not even God. I know He allows things to happen if life and then when He closes one door, He opens up another one. We just don’t know why but all this could be a blessing in disguise. How that is I have no idea right now. I know I have to accept my diagnosis and how my life has changed. I am working on it each day. I guess I’ve accepted it more than I thought. How do I know? One of the ways I know is that it’s OK to give up my medical license now. I’ve struggled with whether to surrender it or to place it in ‘inactive’ mode which would allow me to re-activate it later and begin to practice medicine again. Now I know that can’t happen and never will happen (at least not in the traditional approach we all have in our minds). So I’m now getting my paperwork in order to go ahead and turn my license in on a voluntary basis. David, do you realize how grateful you should be that you didn’t cause any harm to any patients? Wow! The good Lord did protect people from any possible errors and mistakes I could have made. Like writing an incorrect prescription, forgetting names of medicines, dosages, etc. I am so fortunate in this regard. Thank you, Lord.


Tomorrow. I’ll pick up and talk about what we suddenly had to do after I left the hospital with my so called ‘death sentence’ diagnosis. No, I know that’s not really the way to look at it. But I have to make some humor for myself.



New Data Highlight Positive Results of Namenda(R) (memantine HCl) Once-Daily Extended-Release Formulation

Results Presented at ICAD 2008 Highlight Significant Improvement in Cognitive Performance and Global Clinical Status in Patients with Alzheimer’s Disease –

CHICAGO, Illinois — PRNewswire-FirstCall — Forest Laboratories, Inc. recently presented positive Phase III data of a once-daily extended-release formulation of Namenda(R) (memantine HCl) at the 2008 Alzheimer’s Association International Conference on Alzheimer’s Disease (ICAD). The study evaluated the efficacy, safety and tolerability of an innovative, proprietary, 28 mg once-daily extended-release formulation of Namenda compared to placebo in outpatients with moderate to severe Alzheimer’s disease already being treated with a cholinesterase inhibitor (donepezil, galantamine or rivastigmine).

In the study, patients treated with once-daily extended-release Namenda experienced significant improvements in cognitive performance and global clinical status compared to those receiving placebo. Patients treated with once-daily extended-release Namenda also experienced significant improvements in verbal fluency and behavioral symptoms as compared to placebo. The results build on preliminary findings announced by Forest in February.

"While there is no cure or existing treatment to prevent Alzheimer’s disease, there are currently-available FDA-approved treatments, such as combination therapy with memantine and a cholinesterase inhibitor, which can alleviate symptoms by providing cognitive, functional, and behavioral benefits," said George Grossberg, MD, Director of Geriatric Psychiatry at Saint Louis University School of Medicine, and the lead investigator who presented the data. "These findings reinforce the safety, tolerability and efficacy of memantine in a newly-developed once-a-day formulation."

Marco Taglietti, MD, Executive Vice President and Chief Medical Officer at Forest added, "With this novel formulation, the efficacy and tolerability of Namenda is delivered in a more convenient, once-daily dose."

About Alzheimer’s Disease

Alzheimer’s disease is a progressive, degenerative disease of the brain and the most common type of dementia. Dementia is used to describe the progressive loss of cognitive, intellectual, or functional abilities. By 2050, the number of individuals age 65 and over with Alzheimer’s disease could range from 11 million to 16 million. Currently, all Alzheimer’s disease medications approved in the US other than Namenda belong to a class of agents called cholinesterase inhibitors.

About Namenda

Namenda (memantine HCl) is the first in a class of medications with a unique mechanism of action that focuses on the glutamate pathway, a target for the treatment of Alzheimer’s disease. Indicated for the treatment of moderate to severe Alzheimer’s disease, the FDA approved Namenda in October 2003 based on three studies of Namenda used alone or in combination with another Alzheimer’s disease drug. At present, the recommended dose of Namenda is 10 mg two times a day (20 mg/day).

Namenda is contraindicated in patients with known hypersensitivity to memantine HCl or any excipients used in the formulation. The most common adverse events reported with Namenda vs placebo (greater than or equal to 5% and higher than placebo) were dizziness, confusion, headache, and constipation. In patients with severe renal impairment, dosage should be reduced.

Until tomorrow………

Dr. David


One Response

  1. Dr Dave: You have graduated from a practitioner to one who can add so much to our lives. Between you and Dr Mitch we are so very fortunate. Thanks you so much for your posts on the messenger board. And of course your blog


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