Re: We need to beware of self-diagnosis and groupthink!

March 24, 2006

It was me (Imogene) that was worrying about Risperdal.

I am not diagnosing my husband.

I am gathering all the symptoms he has, and that others have likewise talked

about.

I am learning all I can, and have questioned Risperdal for a severely poor

risk patient that has had two open heart surgeries. We have been down a very

long road, and I sure don't want him to be in the 4% group that die from

Risperdal. If others can take the medicine, more power to them.

As Geri would say, " With all due respect, " I gather information to learn,

and to help our doctor, not to diagnose.

Imogene

In a message dated 3/24/2006 7:29:15 PM Central Standard Time,

gthroop1@... writes:

Are we starting to engage in self-diagnosis and groupthink? I have been

reading many of the posts talking about how bad Risperdal is for DLB patients.

Many others have been adding complaints about muscle stiffness or rigidity

and problems swallowing, blaming Risperdal for causing these problems.

Some of you may want to read the brochure published by the Lewy Body Dementia

Association. Under the symptoms column in the brochure, it lists

Parkinsonian (motor) symptoms of Dementia With Lewy Bodies as â€“ muscle

stiffness and

rigidity. These are features of the illness. As caregivers, we have to

recognize and cope with the symptoms of the illness.

An article on Dementia with Lewy Bodies, by E. Galvin, MD, Assistant

Professor, Neurology, Washington University School of Medicine, lists the

clinical symptoms of DLB as being, among other things, â€œExtrapyramidal

(Parkinsonian) signs (typically Bradykinesia, rigidity and postural

instabilityâ€¦â€

One of the nationâ€™s foremost Dementia With Lewy Bodies authorities is Dr.

A. Crystal, MD, Professor, Department of Neurology and Pathology, State

University of New York Downstate. Dr. Crystal states that one of the

clinical features that helps distinguish DLB from Alzheimerâ€™s is Parkinsonian

motor

features. He also states that extrapyramidal features (typically

Bradykinesia, rigidity and postural instability) appear relatively early in DLB

patients. Dr. Crystal also lists swallowing problems in patients with severe

DLB

disease. He states as far as medication goes, Acetylcholinesterase inhibitors

should usually be tried first. He says most experts recommend atypical

neuroleptics such as risperidone (risperdal), Olanzapine, or Clozapine, but

avoid

standard neuroleptics such as Haloperidol (haldol) because of neuroleptic

sensitivity.

Iâ€™m sure we all know and agree that the typical or standard neuroleptic

drugs are unacceptable for use in DLB patients, but we need to be careful not

to

diagnosis and criticize medications which may beneficial to some patients

and remember we are caregivers, not physicians. I rely on the advice of our

experienced neurologist who understands DLB and effective medications.

---------------------------------

New Yahoo! Messenger with Voice. Call regular phones from your PC and save

big.

[Non-text portions of this message have been removed]

Welcome to LBDcaregivers.

March 24, 2006

That concern is overshadowed for me by the fact that physicians have

diagnosed my father incorrectly on several issues and severly

weakened him with prescription

drugs that had known side effects as they relate to dementia.

The discussions I have observed here in just a short period of time

would have

prevented one of those episodes from occurring.

I recently read where the percentage of people in the US that visit a

physician and receive

the proper diagnosis and treatment stands around 52%. With something

more obscure such as LBD, I can only imagine the numbers. We need to

educate ourselves and stay involved, even if only as an untrained

observer.

An example of that is my father's persistent runny nose. PDD

with possible LBD and after 15 months of care taking and research,

dozens of doctors visits where I stayed involved and repeatedly

brought up his

runny nose, and I learn about it here for the first time.

" Do no harm " is the side of error we

fall on while discussing possible side effects of a drug.

March 24, 2006

You are really correct in your assessment. A

psychiatrist, who should have known something about

LBD, gave my husband several neuroleptic drugs that

worsened his condition very much. Also, I had

complained for a long time about his runny nose, lack

of sense of smell for years, and his recent being cold

all the time. He also had the Lewy lean, which I

think I described to the doctor as well as questioning

myself if he might have LBD, only to be told he

didn't. I learned from this site and the LBD site

that these are symptoms of LBD. His doctor even

seemed amazed that I had heard of LBD when I first

approached him with it, as he said probably 50 percent

of the doctors wouldn't even know what it was. So,

the doctors do need some education, as well as the

nursing homes, because lots of them don't even know

what it is either.

--- Rick wrote:

> That concern is overshadowed for me by the fact that

> physicians have

> diagnosed my father incorrectly on several issues

> and severly

> weakened him with prescription

> drugs that had known side effects as they relate to

> dementia.

>

> The discussions I have observed here in just a short

> period of time

> would have

> prevented one of those episodes from occurring.

>

> I recently read where the percentage of people in

> the US that visit a

> physician and receive

> the proper diagnosis and treatment stands around

> 52%. With something

> more obscure such as LBD, I can only imagine the

> numbers. We need to

> educate ourselves and stay involved, even if only as

> an untrained

> observer.

>

> An example of that is my father's persistent runny

> nose. PDD

> with possible LBD and after 15 months of care taking

> and research,

> dozens of doctors visits where I stayed involved and

> repeatedly

> brought up his

> runny nose, and I learn about it here for the first

> time.

>

> " Do no harm " is the side of error we

> fall on while discussing possible side effects of a

> drug.

>

__________________________________________________

March 25, 2006

This comment below is what set many of us off. We don't mean to sound

unkind, as we are all struggling with learning about LBD, and coping with LO

who

have it, with very little help from the medical field, as so many Doctors are

not even up on the disease. I worried about Risperdal because of my husband's

heart. I know it helps with hallucinations. Thank goodness for that. But, are

we going to kill the patient while getting rid of his hallucinations? That

was my worry.

I am sorry if I stressed you, but I do believe many of us are stressed, and

voicing our input, fears, concerns, and knowledge from observing, etc. We are

sharing a very bad situation, and we all care for each other. So, if I

misunstood you, then I am sorry.

Imogene

In a message dated 3/25/2006 9:12:19 AM Central Standard Time,

gthroop1@... writes:

Gerald Throop wrote:

Are we starting to engage in self-diagnosis and groupthink? I have been

reading many of the posts talking about how bad Risperdal is for DLB patients.

March 25, 2006

I am one of those who feel that Risperidol was a bad choice for my

mother. My bringing it up on this board is a warning. Had I NOT

stepped in and had those drugs removed from my mother - she would not

be here today. There's no doubt in my mind that my mother was one of

those who are not only extremely sensitive to drugs in general, but

to anti-psychotics especially.

She was on Risperidol for just 3 weeks. The change in her at that

time was not just LBD it was what the drugs were doing to her system.

Her stable point has changed due to (in my opinion) having no anti-

psychotics in her system. There is no doubt that my mother has a

different 'stable point' today vs. before the biopsy while she was

just on a small amount of Seroquil. Every visit since 3/17 has been

better and better. (Yesterday's visit: When I asked mom how she was

doing - her response. " I'm bored. " She is now out of the jeri

chair in a regular, smaller wheelchair. She continues to be the pride

& joy of the PT room.)

Should anti-psychotics work for others - wonderful! But my purpose is

putting a warning out there for others who may feel that anti-

psychotics would work for their LO b/c it's worked for other LOs -

and my experience may help others realize that anti-psychotics is not

a good thing for everyone.

I wish I had learned about LBD before mom's stay in the hospital back

in October - at the time I was relying on the experts. The experts

had diagnosed my mother time & time again with a wrong diagnosis

(Dementia due to alcohol, AD, Binswengers, AD + Binswengers,

Vascular Dementia). And it wasn't until little ole me suggested LBD

before the experts felt it was a possibility. I never heard the words

LBD out of their mouths - and we've been to see at least 20 (some

specialists, some not). I learned about LBD by googling online for

days... My first stop was www.lewybodyjournal.org (my response, HEY

that sounds like my mom), then LBDA.org, then here. And FINALLY there

was light at the end of the tunnel...

So, I hope my posts haven't scared others. I hope my posts only gave

them another side to antipsychotic meds. Something else to think

about. And they learn about the side effects of the antipsychotics

before their LO receives the meds. I didn't - but as it turned out -

I was correct in my gutt reaction to remove the meds from mom.

; loving daughter of Maureen of Boston, MA; finally diagnosed

with LBD on 2/06 after also being diagnosed with everything from AD

to Vascular Dementia caused by mini strokes to Binswengers...; was

victim to rapid progression from Risperidone (or combination of

Risperidone with other drugs OR possibly received another " bad drug "

when she was observed/tested in a hospital in 10/05); in a NH since

11/05.

>

> Are we starting to engage in self-diagnosis and groupthink? I have

been reading many of the posts talking about how bad Risperdal is for

DLB patients. Many others have been adding complaints about muscle

stiffness or rigidity and problems swallowing, blaming Risperdal for

causing these problems.

> Some of you may want to read the brochure published by the Lewy

Body Dementia Association. Under the symptoms column in the

brochure, it lists Parkinsonian (motor) symptoms of Dementia With

Lewy Bodies as – muscle stiffness and rigidity. These are features

of the illness. As caregivers, we have to recognize and cope with

the symptoms of the illness.

>

> An article on Dementia with Lewy Bodies, by E.

Galvin, MD, Assistant Professor, Neurology, Washington University

School of Medicine, lists the clinical symptoms of DLB as being,

among other things, " Extrapyramidal (Parkinsonian) signs (typically

Bradykinesia, rigidity and postural instability… "

>

> One of the nation's foremost Dementia With Lewy

Bodies authorities is Dr. A. Crystal, MD, Professor,

Department of Neurology and Pathology, State University of New York

Downstate. Dr. Crystal states that one of the clinical features that

helps distinguish DLB from Alzheimer's is Parkinsonian motor

features. He also states that extrapyramidal features (typically

Bradykinesia, rigidity and postural instability) appear relatively

early in DLB patients. Dr. Crystal also lists swallowing problems in

patients with severe DLB disease. He states as far as medication

goes, Acetylcholinesterase inhibitors should usually be tried first.

He says most experts recommend atypical neuroleptics such as

risperidone (risperdal), Olanzapine, or Clozapine, but avoid standard

neuroleptics such as Haloperidol (haldol) because of neuroleptic

sensitivity.

>

> I'm sure we all know and agree that the typical or

standard neuroleptic drugs are unacceptable for use in DLB patients,

but we need to be careful not to diagnosis and criticize medications

which may beneficial to some patients and remember we are caregivers,

not physicians. I rely on the advice of our experienced neurologist

who understands DLB and effective medications.

>

> ---------------------------------

> New Yahoo! Messenger with Voice. Call regular phones from your PC

and save big.

>

March 25, 2006

In the recent postings responding to me, there appears to be a lot of unresolved

frustration and anger at the disease, which sometimes gets displaced. I'll bet

99% of us have had to give input to a physician before our LO was diagnosed

correctly with DLB. This is not what I was talking about, because I was in the

same boat.

I thought l made it clear in my original post (below) that I was

referring to drugs in general and risperdal in particular, when I referred to

the Lewy Body Dementia Association's brochure and also quoted from 2 nationally

recognized DLB experts concerning muscle rigidity, balance problems and

swallowing problems. (See Below). There have been many complaints in postings,

linking risperdal with muscle rigidity, balance problems, swallowing problems

and other related problems, when in fact this may or may not be the case.

Fluctuations in the symptoms are a common feature of DLB and could be mistaken

for a reaction to medication.

My MIL had muscle rigidity, balance problems and other symptoms common to

DLB before she took risperdal and 9 years later, she still has these same

symptoms. The risperdal didn't cause the problems and it didn't make them

better. That's not the purpose of the medication. The risperdal is meant to

relieve hallucinations and delusions and that's exactly what it does for her.

With it, we can deliver normal care and she can communicate with others. She no

longer lives in a world of fear and suspicion.

The problems I talked about originally, (See Below) are common problems

with DLB patients which CAN result from the disease. We can warn newcomers

about drug dangers, but we shouldn't scare them by making blanket statements

concerning specific medications. That's why you need a KNOWLEDGEABLE physician,

preferably a neurologist.

Please don't kill the messenger, I've got too much caregiving left to deliver!

Gerald Throop wrote:

Are we starting to engage in self-diagnosis and groupthink? I have been

reading many of the posts talking about how bad Risperdal is for DLB patients.

Many others have been adding complaints about muscle stiffness or rigidity and

problems swallowing, blaming Risperdal for causing these problems.

Some of you may want to read the brochure published by the Lewy Body Dementia

Association. Under the symptoms column in the brochure, it lists Parkinsonian

(motor) symptoms of Dementia With Lewy Bodies as – muscle stiffness and

rigidity. These are features of the illness. As caregivers, we have to

recognize and cope with the symptoms of the illness.

An article on Dementia with Lewy Bodies, by E. Galvin, MD,

Assistant Professor, Neurology, Washington University School of Medicine, lists

the clinical symptoms of DLB as being, among other things, “Extrapyramidal

(Parkinsonian) signs (typically Bradykinesia, rigidity and postural

instability…”

One of the nation’s foremost Dementia With Lewy Bodies authorities

is Dr. A. Crystal, MD, Professor, Department of Neurology and Pathology,

State University of New York Downstate. Dr. Crystal states that one of the

clinical features that helps distinguish DLB from Alzheimer’s is Parkinsonian

motor features. He also states that extrapyramidal features (typically

Bradykinesia, rigidity and postural instability) appear relatively early in DLB

patients. Dr. Crystal also lists swallowing problems in patients with severe

DLB disease. He states as far as medication goes, Acetylcholinesterase

inhibitors should usually be tried first. He says most experts recommend

atypical neuroleptics such as risperidone (risperdal), Olanzapine, or Clozapine,

but avoid standard neuroleptics such as Haloperidol (haldol) because of

neuroleptic sensitivity.

I’m sure we all know and agree that the typical or standard

neuroleptic drugs are unacceptable for use in DLB patients, but we need to be

careful not to diagnosis and criticize medications which may beneficial to some

patients and remember we are caregivers, not physicians. I rely on the advice

of our experienced neurologist who understands DLB and effective medications.

---------------------------------

New Yahoo! Messenger with Voice. Call regular phones from your PC and save big.

March 25, 2006

Gerald:

Not to try and " shoot the messenger " but my Mother's very qualified Geriatrician

took my Mother off risperdal that the doctor at her senior's residence put her

on. He substituted Seroquel because in his opinion although risperdal does a

great job of alliviating the hallucinations and paranoia it can aggrevate or

make worse the rigidity. Seroquel does the same job for the hallucinations and

paranoia but is not as hard on the muscles and joints. This was his opinion and

I believe I have shared this with the group.

from Cresswell ON

Long distance CG to Margaret (Mum) aged 76

Lives at The Briton House, Memory Floor, Toronto

DX Early Onset AD & PD approx. 2002

DX LBD 01/2005

Current Meds: Seroquel, Aricept, LD ASA, Levothyroxin, Calcium Suppl.

Was on: Sinemet, Excelon

Was given Risperdal in NH for a few weeks (Feb '05)

Haldol several times in Hospital Jan 05

---------------------------------

Make free worldwide PC-to-PC calls. Try the new Yahoo! Canada Messenger with

Voice

March 25, 2006

Hi Imogene,

I certainly understand why you are concerned because your husband has a

heart condition. I have very severe heart problems myself and I am being

treated by wonderful doctors at the University of Michigan.

Because your husband has heart problems and DLB, he needs comprehensive

treatment. He needs a cardiologist and a neurologist working together to

safeguard him from medication mistakes, which I'm sure you have.

My MIL has had this disease for many, many years, most of them

undiagnosed. We have had to deal, through the years, with doctors, nurses,

social workers, therapists, lawyers and judges who were completely uneducated

about DLB. Believe me, we know how frustrating it is. However, it seems now is

the time to get busy educating the public about DLB, including the health care

system. We can be grateful that there are doctors at Mayo Clinic, New York

University and the advisory doctors on the board of the Lewy Body Dementia

Association who are busy every day educating other physicians about DLB. I

hope your husband does well with such concerned care as you are giving him.

This comment below is what set many of us off. We don't mean to sound

unkind, as we are all struggling with learning about LBD, and coping with LO

who

have it, with very little help from the medical field, as so many Doctors are

not even up on the disease. I worried about Risperdal because of my husband's

heart. I know it helps with hallucinations. Thank goodness for that. But, are

we going to kill the patient while getting rid of his hallucinations? That

was my worry.

I am sorry if I stressed you, but I do believe many of us are stressed, and

voicing our input, fears, concerns, and knowledge from observing, etc. We are

sharing a very bad situation, and we all care for each other. So, if I

misunstood you, then I am sorry.

Imogene

In a message dated 3/25/2006 9:12:19 AM Central Standard Time,

gthroop1@... writes:

Gerald Throop wrote:

Are we starting to engage in self-diagnosis and groupthink? I have been

reading many of the posts talking about how bad Risperdal is for DLB patients.

March 25, 2006

I agree . My experience is the same as yours and I was glad to get the

group to help me when MDs couldn't.

Donna R

Do you want to read more about Lewy Body? You can also read the Thistle, the

LBD Newsletter. Just click on:

http://www.lewybodydementia.org

Re: We need to beware of self-diagnosis and groupthink!

March 26, 2006

Thank you again for the LBD newsletter site. I have made enough copies to

make a small book. We want to learn and understand this disease, and this is a

very good, informative, site.

Thanks again,

Imogene

Caregiver for my True Texas Gentleman husband of 35 years. He has AD and

possibly LBD, is Taking Aricept and Risperdal. Age 72 in May.

In a message dated 3/26/2006 1:11:48 AM Central Standard Time,

twomido@... writes:

I agree . My experience is the same as yours and I was glad to get

the group to help me when MDs couldn't.

Donna R

Do you want to read more about Lewy Body? You can also read the Thistle, the

LBD Newsletter. Just click on:

http://www.lewybodydementia.org

March 26, 2006

I agree, , we are all in this together. I think others feels this way

too, but we don't, or can't, express ourselves as well as we would like. So we

can go on and smile, and keep on learning together.

I really appreciate this List.

Imogene

Caregiver for my True Texas Gentleman husband of 35 years. He has AD and

possibly LBD, is Taking Aricept and Risperdal. Age 72 in May.

In a message dated 3/26/2006 12:16:37 PM Central Standard Time,

mckendrsusan@... writes:

I just want to say that I agee that we shouldn't make blanket

statements about certain drugs, etc. However, Gerald, I believe you

are doing the same thing - making a somewhat blanket statement that

the drugs do NOT cause the rigidity, etc and that it is the

disease. Please read the PDR of all these drugs and you will find

that most, if not all of these, have a tendency to make some of

these symptoms worse, and also, to start some of these symptoms

because of an individual's reaction to them. Many of them do cause

neuroleptic response, which also caused rigidity which the person

may never have had before.

There are so many interactions and unknown things, I think as a

group we are all just saying that we need to do our research and

become knowledgable and any time a new symptoms comes up to question

what might be causing it. It isn't always the disease, by far.

I'm sure we all agree that we need a very knowledgable physician, of

any type, I don't care, who also does their reading and research.

Unfortunately, there are not a large number out there when it comes

to LBD and even PD. They all think they know everything about PD,

I've seen many mistakes happen by just those people, including

neurologists.

It is up to us to safeguard our LOs, no matter how we go about it.

I've been on some other lists where I have stopped going due to a

little bickering going on, I hope this list is not going down that

path. We all have too many stressors in our lives to have our

statements misinterpreted which can occur very easily with email.

We all have the same goal in mind here!!

I've been on lists before where bickering got started up

L

BDcaregivers , Skrabek wrote:

>

> Gerald:

>

> Not to try and " shoot the messenger " but my Mother's very

qualified Geriatrician took my Mother off risperdal that the doctor

at her senior's residence put her on. He substituted Seroquel

because in his opinion although risperdal does a great job of

alliviating the hallucinations and paranoia it can aggrevate or make

worse the rigidity. Seroquel does the same job for the

hallucinations and paranoia but is not as hard on the muscles and

joints. This was his opinion and I believe I have shared this with

the group.

>

> from Cresswell ON

> Long distance CG to Margaret (Mum) aged 76

> Lives at The Briton House, Memory Floor, Toronto

> DX Early Onset AD & PD approx. 2002

> DX LBD 01/2005

> Current Meds: Seroquel, Aricept, LD ASA, Levothyroxin, Calcium

Suppl.

> Was on: Sinemet, Excelon

> Was given Risperdal in NH for a few weeks (Feb '05)

> Haldol several times in Hospital Jan 05

>

> ---------------------------------

> Make free worldwide PC-to-PC calls. Try the new Yahoo! Canada

Messenger with Voice

>

> [Non-text portions of this message have been removed]

>

Welcome to LBDcaregivers.

March 26, 2006

Well said, Imogene.

>

> It was me (Imogene) that was worrying about Risperdal.

>

> I am not diagnosing my husband.

>

> I am gathering all the symptoms he has, and that others have

likewise talked

> about.

> I am learning all I can, and have questioned Risperdal for a

severely poor

> risk patient that has had two open heart surgeries. We have been

down a very

> long road, and I sure don't want him to be in the 4% group that

die from

> Risperdal. If others can take the medicine, more power to them.

>

> As Geri would say, " With all due respect, " I gather information

to learn,

> and to help our doctor, not to diagnose.

> Imogene

>

> In a message dated 3/24/2006 7:29:15 PM Central Standard Time,

> gthroop1@... writes:

>

> Are we starting to engage in self-diagnosis and groupthink? I

have been

> reading many of the posts talking about how bad Risperdal is for

DLB patients.

> Many others have been adding complaints about muscle stiffness or

rigidity

> and problems swallowing, blaming Risperdal for causing these

problems.

> Some of you may want to read the brochure published by the Lewy

Body Dementia

> Association. Under the symptoms column in the brochure, it

lists

> Parkinsonian (motor) symptoms of Dementia With Lewy Bodies as â€ "

muscle stiffness and

> rigidity. These are features of the illness. As caregivers, we

have to

> recognize and cope with the symptoms of the illness.

>

> An article on Dementia with Lewy Bodies, by E. Galvin, MD,

Assistant

> Professor, Neurology, Washington University School of Medicine,

lists the

> clinical symptoms of DLB as being, among other things,

â€œExtrapyramidal

> (Parkinsonian) signs (typically Bradykinesia, rigidity and

postural instabilityâ€¦â€

>

> One of the nationâ€™s foremost Dementia With Lewy Bodies

authorities is Dr.

> A. Crystal, MD, Professor, Department of Neurology and

Pathology, State

> University of New York Downstate. Dr. Crystal states that one of

the

> clinical features that helps distinguish DLB from Alzheimerâ€™s

is Parkinsonian motor

> features. He also states that extrapyramidal features (typically

> Bradykinesia, rigidity and postural instability) appear

relatively early in DLB

> patients. Dr. Crystal also lists swallowing problems in patients

with severe DLB

> disease. He states as far as medication goes,

Acetylcholinesterase inhibitors

> should usually be tried first. He says most experts recommend

atypical

> neuroleptics such as risperidone (risperdal), Olanzapine, or

Clozapine, but avoid

> standard neuroleptics such as Haloperidol (haldol) because of

neuroleptic

> sensitivity.

>

> Iâ€™m sure we all know and agree that the typical or standard

neuroleptic

> drugs are unacceptable for use in DLB patients, but we need to

be careful not to

> diagnosis and criticize medications which may beneficial to some

patients

> and remember we are caregivers, not physicians. I rely on the

advice of our

> experienced neurologist who understands DLB and effective

medications.

>

> ---------------------------------

> New Yahoo! Messenger with Voice. Call regular phones from your PC

and save

> big.

>

> [Non-text portions of this message have been removed]

>

> Welcome to LBDcaregivers.

>

March 26, 2006

I agree, Rick, it took forever for the doctors to figure out what my

mom had, and there have been numerous physician errors since then,

in treatment as well as with some prescribed meds. I'm usually the

one pointing out problems to the doctors and how to fix them,

including my mother coming off a number of meds and dropping the

dose of ones she needed to stay on, and it was all my suggestions to

the doctor who being a nh doctor should know all this stuff by now.

As a result, my mother has been great for more than a month now. We

took her out of hospice yesterday and put her back into physical

therapy since she is now able to walk more again.

We are not saying any of this stuff for sure or that it works for

everyone the same, but it does help to have information and be

somewhat skeptical and questioning - we are our LO best advocate.

>

> That concern is overshadowed for me by the fact that physicians

have

> diagnosed my father incorrectly on several issues and severly

> weakened him with prescription

> drugs that had known side effects as they relate to dementia.

>

> The discussions I have observed here in just a short period of

time

> would have

> prevented one of those episodes from occurring.

>

> I recently read where the percentage of people in the US that

visit a

> physician and receive

> the proper diagnosis and treatment stands around 52%. With

something

> more obscure such as LBD, I can only imagine the numbers. We need

to

> educate ourselves and stay involved, even if only as an untrained

> observer.

>

> An example of that is my father's persistent runny nose. PDD

> with possible LBD and after 15 months of care taking and research,

> dozens of doctors visits where I stayed involved and repeatedly

> brought up his

> runny nose, and I learn about it here for the first time.

>

> " Do no harm " is the side of error we

> fall on while discussing possible side effects of a drug.

>

March 26, 2006