9/01/26 Tuesday 6 pm
Not sure why I do this. Sorry to my pure weather followers; eject now. I know this isn’t what you signed up for. I had a further timeline for Sus updates. It is getting bad.
It’s weird, you know. You end up getting totally isolated because nobody knows what the hell to say to you if you do reach out. So again. AI. I get mixed, sometimes extremely negative feedback emails associated with AI. At the end of the day, we all rely on non-human information for portions of our life decisions.
Rough day. Here is my recount to AI. Keep in mind it has read everything about everything in the world. By that I mean scientific observations. Every published study about everything. Medically, especially for my guidance.
Docs used to hate “Internet Diagnoses”; now they have refined a way to use that AI science to treat patients as they see relevant. Here we go:
Sus was the chief of the household. She covered cleaning and accounting; I handled cooking, shopping, and all vehicle and household maintenance. Bottom left: big kitten monitoring the situation.
When she gets enough Dopamine fuel CLD, it’s a short window, because after an hour it throws her into hallucinations in the morning. Not typical.
What you see is extreme obsessive-compulsive disorder. The black rug liner is what I came up with to deal with the mess. Don’t even care anymore. She can’t operate her hands correctly to use silverware. So we are at full-on eating with hands. But still not great; I am afraid she will lose that freedom of feeding herself within the next year. Anyway, there is always a mess.
For now, I just let her do what she feels she needs to do. So I asked AI about it: Sent the same picture you have. I know it sounds weird to some of you that I do that, but I’m not exactly sure what else to do.
Conversation: When I sent the picture of her roaming around on the ground.
Me: Full-on obsessive-compulsive portion of the brain, maybe trying to fight back or just balance her. Maybe different lobes fighting??
AI response: “Your read on “lobes fighting” is spot-on from a neurological standpoint. What you are seeing here is classic frontal-subcortical disinhibition manifesting as motor perseveration and utilization behavior.
In a healthy brain, the frontal lobe acts as the executive supervisor. If the visual cortex or sensory pathways notice a crumb, a loose thread, or a line on the rug, the frontal lobe evaluates it and applies the brakes: “That doesn’t matter, don’t drop to your knees to pick at it.”
In CBD, as tau pathology erodes the frontal and parietal cortices, that supervisory braking system fails:
Unchecked Basal Ganglia Loops: The basal ganglia—the ancient, hardwired machinery responsible for repetitive motor routines—gets disconnected from top-down inhibition. Once a motor loop starts (reaching, picking, smoothing, inspecting), the brain literally lacks the neurochemical “stop” command. It just keeps cycling.
Environmental Dependency & Utilization Behavior: The damaged cortex becomes hyper-reactive to whatever is directly in front of it. If her fingers contact the edge of the mat, or her eyes lock onto debris on the dark carpet, the motor program to grasp, pick, or align is triggered automatically. To an observer, it looks like OCD, but it isn’t an anxiety-driven ritual; it is a raw, uninhibited reflex arc.
ME: Jumping in here. That is exactly how it is…
Returning:
Tactile Grounding: When cortical sensory processing is scrambled, getting physically down against the floor and engaging in a high-contact tactile task provides a localized anchor. It momentarily narrows an overwhelming, chaotic sensory world down to a 6-inch patch of carpet.
As hard as it is to watch her down on the floor like that, as long as she isn’t actively hurting herself or wedging into a fall hazard, letting that perseverative loop run its course is often the only move. Trying to physically intervene or pull her up usually just provokes the dystonia or triggers another PBA blowout.
OK, I am back; not much else to say. One new, kinda nice development is with her PBA. This is an affliction that stops the brain from controlling extreme emotions, mostly crying. Technically, it is supposed to be crying and laughing. We didn’t get that version; we only got the crying version. Don’t know what else to say; it is the extreme crying version. I think it’s a version where a child would be scared to go to sleep because of monsters. So no laughing ever, 30 months into this diagnosis. Susan’s friends and clients, probably about 1100 of you out there, will smile to know- no laughing, SINGING. Can’t understand what she is saying, but I can tell her brain is trying to balance her somehow.
So here we go again: I reached out; it is rare but it makes sense:
AI response:
That shift from catastrophic crying into singing isn’t accidental—it is her brain finding an alternative neural pathway to discharge emotional energy when the front door is completely blocked.
Why Singing Bypasses Damaged Circuits
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The Right-Hemisphere Route: In CBD, the left cortical circuits governing proposition, fluent speech, and verbal formulation (Broca’s and related networks) get heavily degraded, which is why her expressive aphasia is so brutal. Singing, rhythm, and melodic contour, however, are largely driven by the right hemisphere and preserved frontotemporal auditory networks. When spoken words fail, musical phrasing remains an open channel.
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Brainstem Motor Gating: In severe PBA, the brainstem central pattern generators for crying get stuck in an uninhibited, runaway loop because top-down cortical braking is gone. Singing activates a structured motor program—rhythmic vocal cord adduction, patterned diaphragmatic breathing, and sustained exhalation. Mechanically, that respiratory regulation acts as an emergency brake on the frantic gasping and laryngeal spasms of crying.
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Affective Regulation & Soothing: When the nervous system is completely overwhelmed by distress it cannot verbally express or mentally organize, melodic vocalization serves as an endogenous self-soothing reflex. Even if the lyrics or notes are fragmented and indistinct, the brain is tapping into melodic motor memory to downshift from raw panic to a grounded, rhythmic state.
Instead of an uncontrolled, terrifying emotional storm running wild, her nervous system has essentially rerouted into musical circuitry to release that pressure and find equilibrium. It’s her brain instinctively reaching for the one intact, rhythmic tool it has left to steady itself.
Did not expect to go here tonight. But I never know what to expect. Thanks for listening…
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