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It had seemed a lifetime ago to Adam since he had last been in Peter's office, and the memory of it didn't make him smile. At least this time, Charlie was seated beside him, and not missing somewhere he couldn't find her. The day he learned of Charlie's test, had been one of the hardest of his life. He gripped his wife's hand, and silently thanked God she had agreed to come; Adam didn't know how he would've fared coming here on his own.

"If I remember correctly, it's been a little over a year ago since we last met," Peter smiled, as he settled into his chair behind his desk. "I was hoping you'd eventually contact me. I even left a few messages with Jerome in the hopes that you would."

"We never received your messages," sighed Adam.

"I thought you were trying to avoid me," smiled Peter. "I fully realize that discussing this disease isn't easy, and I've had patients refuse to return my phone calls because they weren't ready to face it yet. In those cases, I stop calling. Before I begin, maybe you'd like to ask the questions that brought you here to my office?"

"I've been reading so many books," began Adam, "and I'm overloaded with information!"

"That's not uncommon," smiled Peter.

"What I'd love to know," Adam summoned his courage, "is there anything we can do to delay the onset of the disease?"

"An excellent question," nodded Peter. "In fact, that's what I wanted to discuss with both of you." The Genetic Counselor pulled out a file with Charlie's name on it and opened it on his desk. "For most people, the first time they hear the words 'Alzheimer's Disease,' they're being diagnosed and are already manifesting symptoms. What makes Charlotte's situation different is that we know it will happen, even though she isn't presently displaying any symptoms at all. This early warning is a useful one, and can be used to her advantage."

"Oh?" asked Adam, leaning forward in his chair with curiosity so intent, it could've bored a hole straight through Peter Webber and into the office chair behind him.

"By addressing AD early, she might increase her chances of delaying onset and slowing it's progression. However," insisted Peter, "I am not trying to offer you false hope. Charlotte's genetic risk factors are so strong, that I don't know of anything that will stop her Alzheimer's Disease from eventually developing. The key here is to delay onset for as long as we can, and to slow its progression once it has begun."

"What can we do?" asked Adam.

Peter leaned back in his chair. "To begin with-- staying active and exercising regularly, maintaining social interactions with others, and engaging in intellectually stimulating activities. I'd also add to that controlling diabetes, lowering cholesterol and homocysteine levels, and lowering high blood pressure, but that's already not a problem for Charlotte. Even so, I highly recommend that her doctor monitor these risk factors."

Adam's face brightened. "You said 'intellectually stimulating activities'?"

"Yes," nodded Peter, "in fact, that's something that can be done even after the onset of AD has already occurred. One study suggests that even in the presence of AD plaques, the more formal education a person has, the better their memory and learning ability. In other words, use it or lose it."

Here, Adam broke out in a beaming smile.

"I guess that means he's going to chain me to the piano!" laughed Charlie. "Adam has been teaching me to play."

"I think that qualifies as an intellectually stimulating activity," smiled Peter. "It's my opinion that the stronger your mind, the greater its ability to compensate for areas of the brain that are in decline. Stay physically and mentally active, and eat healthy.
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