Work to increase your brain power as you grow older

Can you rearrange the letters in "NEW DOOR" to form one word? (See answer #1).

Can you answer the following brainteaser?

You are in a room with three light switches that are individually connected to three light bulbs in another room. However, the switches and corresponding light bulbs are not labeled. You can turn on any two switches, but you are allowed to go into the room only once to determine which of the light bulbs are on. How can you correctly determine which switch is connected to each of the three light bulbs (See answer #2)

Perhaps you are wondering about the purpose of these brainteasers.

As some of you know, I learned in 1995 that I have a progressive movement disorder called Parkinson's disease. Let me clarify: I have Parkinson's disease; Parkinson's disease does not have me.

Parkinson's is a slowly progressive neurodegenerative illness typically characterized by tremor, stiffness (rigidity), slowness of movement (bradykinesia) and difficulty with balance (postural instability). As in my case, not all Parkinson's Persons (abbreviated as PP, no pun intended) develop involuntary muscle tremors. Symptoms appear when there is not enough dopamine in the brain. Dopamine is a neurotransmitter that allows neurons to transmit messages between each other and then to muscles, which in turn allow normal movement. For reasons not yet understood, many of these cells die in Parkinson's persons. The remaining cells do not produce enough dopamine to permit normal muscle function.

Understanding disease

At one time in my life, I was blessed with seemingly endless energy. I enjoyed challenging problems and relied upon my store of energy to solve them. However, living with Parkinson's the past 12 years has forced me to adjust my priorities. I still enjoy challenges, but I have learned to accept the fact that my energy has limits. At unpredictable times during the day, my energy level falls, forcing me to take a break. This is partly related to the fact that, as a result of Parkinson's, all voluntary muscle movements take more effort than normal.

It is frequently difficult to get a restful night of sleep. As the effects of medications wear off during the night, muscle stiffness, muscle cramps and distracting paresthesia occur.

(I liken the sensation to the burning sensation you feel in your hands and feet after they become exposed to extreme cold. ) As you might expect, a sleepless night can reduce one's productivity during the day.

Unfortunately, the medication I am taking (carbidopa/levodopa; also known by the trade name "Sinemet"; "Sin" means "without"; "emet" means "vomiting") no longer works smoothly or consistently, even though I take it every two hours. Now it is associated with troublesome side effects. These typically occur when the drug is at therapeutic levels and include periods of jerky, involuntary movements (collectively called dyskinesia and dystonia) that interfere with my normal gait. These side effects often develop in PP's who have been taking carbidopa/levodopa for several years. As you might understand, they can interfere with my mobility. The exaggerated muscle movements also consume more energy than normal, and can result in muscle pain due to overuse.

Every muscle in a PP's body may be affected to varying degrees. For example, when the beneficial effects of the medication wear off, the muscles involved in speech are at times affected and my voice becomes weaker and higher-pitched. This sometimes is misinterpreted as a sign of anxiety. Also, at times I may not clearly enunciate words, particularly those at the end of a long sentence. This may occur due to weakness of my intercostal muscles and weakness of my diaphragm. Simply put, I have not taken in enough air to exhale and complete the sentence. If this occurs, I ask those participating in a discussion to ask me to repeat the words that were muffled.

Sometimes my facial muscles are affected, in that they don't function "automatically" as they did at one time (neurologists call this "facial masking"). Unless I remember to tell myself to "smile," it may appear that I am uninterested or in a bad mood. When I have the opportunity, I explain my situation to those interested, telling them that I still enjoy taking part in conversations. Also, I say that I have chosen to smile on the inside.

Because of side effects to medication, and progression of the physical components of this disorder, after considerable investigation and thought, I elected to undergo a procedure called "deep brain stimulation" last March. It is a two-stage surgical procedure (details are easy to find by searching for "deep brain stimulation" on the Internet).

At first I thought I had made a poor choice, as I had a rough rehabilitation period (one physician labeled me as cachectic; I dropped to 128 pounds). These events were confounded by iatrogenic factors, leading to complete obstruction of my urethra for approximately 16 hours (I can now truly empathize with male dogs and cats with urethral obstruction), followed by the need for an indwelling catheter (ugh!) and transurethral prostatectomy. (Sometime I will have to tell you about my hospital escapade due to a sleep medication.) However, I gradually recovered, aided by the fact that I came to detest daytime TV and by the fact that I passionately missed being a participant in teaching and research.

In May, I returned to full-time effort at the Veterinary Medical Center. How fortunate I am to have the opportunity to be involved with helping others. I can think of no other mission that gives one such a feeling of worth and satisfaction. Let me state it this way: I have the privilege of going to work each day; I don't have to go to work each day.

You may be wondering why I have chosen to pen a Diagnote about my encounter with Parkinson's disease. The reason is to share some information I think you will find valuable.

Some of you may know that some PPs have varying degrees of dementia. I have chosen not to be counted among them. However, I want to do everything I can to minimize any form of dementia, since in order to "first do no harm" to my patients, to my students and to my colleagues, I need to maintain and even increase my cognitive skills.

You might be asking, "How can you choose not to develop dementia?" Read on. Mozart's brain and the fighter pilot are coming to the rescue.

For reasons too numerous for me to share with you in this Diagnote, it is vital that PPs maintain an upbeat, optimistic and pleasant outlook. Helping others often makes it difficult for me to dwell on my own problems. This is sometimes referred to as the "helpers high" (please see the article titled, "Join the 51% club. Benefit from the helper's high." DVM Newsmagazine 33, No.9, p. 20-21, Sept., 2002).

In addition, there is much evidence that, no matter how old we are or whether our brains are healthy or sick, there is great power in positive thinking. However, there can also be great power in negative thinking.

According to Richard Restak M.D., a neuropsychiatrist and author of the book, Mozart's Brain and the Fighter Pilot, positron emission tomography (PET) studies indicate that persons who think sad thoughts versus happy thoughts can change their brain chemistry. I am sure that many readers of DVM Newsmagazine have experienced the physical symptoms associated with anger.

Likewise, if you have a strong conviction that a certain drug will be of benefit to you, that benefit often occurs even though you were given a placebo. Restak provides compelling evidence that it is never too late to change your brain for the better. To a large degree, the amount of benefit that occurs is dependent upon us.

Most of us are familiar with the concept of "use it, or lose it." It applies to muscles, and especially to our brains (e.g. foreign languages, playing an instrument, chess, bridge or golf, etc.). According to Restak, modern technology both helps and hinders the development and maintenance of short- and long-term memory. While the computer benefits us by retrieval and storage of large amounts of information, the storage and rapid retrieval of information may exert a stunting effect on our memory capacity

Restak provides 28 steps that any person can take to improve brainpower. For example, in step 19, he describes how to accept uncertainty and ambiguity.

Veterinary students would especially profit from his suggestions because they find that most diseases described in textbooks are prototype examples rarely observed by practicing veterinarians. In fact, just as no two patients are alike in health, no two are alike in disease.

Here is a challenging puzzle in which you must embrace ambiguity, and think outside the box. How are the following objects related?

A) cannon

B) football

C) gears

D) potatoes

E) shoes

What do you think? First, do these five words share any features in spelling or pronunciation? Are there any objects with which you could associate these objects? What parts do they have in common? What if we add:

F) corn

G) pliers?

(See #3 answer.)

Additional steps to improve the capacity of your brain recommended by Restak incude:

• Learn as much as possible about how your brain works.

• Apply the knowledge of the human brain to organize your ideas.

• Your capacity for learning remains and may increase as you grow older.

• Learn about your brain's motor programs and how to use them.

• Improve your memory by using a memory system.

• Train your powers of logic.

For those of you who want to maintain and even expand their cognitive ability, I highly recommend this book. The ISBN number of Mozart's Brain and the Fighter Pilot is 0-609-604445-7. It was published in 2001 by Harmony Books, New York.

Answers to brainteasers

1. The answer is "ONE WORD."

2. The solution to this puzzle involves breaking out of the mindset that you will immediately go into the room and look at the three bulbs. The puzzle leads you to this assumption with words like "light bulbs," "lights" and "turn on." But what about using your other senses?

What about your sense of "touch" in addition to your sense of sight? The answer is to turn on two switches for 10 to 15 minutes. Then turn one of them off, and immediately go into the room where the light bulbs are located. The switch that you left on controls the light bulb that is still producing light. The switch you turned off controls the light bulb that is warm. The third switch controls the light bulb at room temperature. Then touch the other two bulbs.

3. In this puzzle, the five seemingly unrelated objects have in common the parts of a human's or animal's face. Cannons have mouths; footballs have a nose (as in he made a touchdown by the nose of the ball); gears have teeth; potatoes have eyes; shoes have a tongue; corn has ears; and pliers have a jaw.

Carl Osborne

Dr. Osborne, a diplomate of the American College of Veterinary Internal Medicine, is professor of medicine in the Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Minnesota.