2025-2026 Central Asia Adventure – Tbilisi Georgia
Today’s Huntington’s Disease report is about the progression of the disease as the neurons die off over the years. The Manifest Stage begins 10-15 years before symptoms, with subtle mutant Huntingtin protein accumulation causing 5-10% neuronal loss in the striatum – caudate and putamen. Cognitive changes such as mild memory issues or subtle motor signs such as eye movement delays may appear. Changes in brain structure are detectable via MRI or PET scans. The Early Stage starts with the first physical symptoms through 8 years. Chorea emerges as medium spiny neurons in the striatum decline by 30-50%. Dopamine dysregulation amplifies involuntary movements, while early psychiatric symptoms such as depression & irritability reflect cortical and limbic involvement. The Middle Stage spans 8-15 years after symptom recognition where striatal loss reaches 60-70% and cortical atrophy of 10-20%, worsening coordination, speech, and swallowing. Chorea may peak then decline as rigidity or bradykinesia (slowness) takes over, especially in juvenile HD. Late Stage is 15-20+ Years after symptom start with near-total striatal loss and significant cortical loss of up to 30%, leading to severe disability with mutism, and dementia and 24×7 care. Death often results from complications like pneumonia and other unrelated physical issues.
Hello from Tbilisi, the ninth stop on the trip.
When I woke up in the morning, I had flashes of a dream where I was somehow assistant to the new Pope who was very young. I took him to visit the old Pope and made some room for him to keep his status updates on my whiteboard. Is the non-stop adventure of travel getting to my subconscious?
I met Edward outside at 7am, he already flagged down a taxi to start our quick trip from Batumi to Tbilisi. We were on the platform at 7:10, the train is already there but they won’t let us on… We bought 1st Class ticket but the car is marked Business, hmmm. And as luck would have it there is a screaming child. It’s a great train with large leather chairs, power, free Wifi, and a vending machine with snacks. We arrived at the Tbilisi station right on time – two thumbs up to Georgian Railways! Said goodbye to Edward as he continues his journey, running to the bus station. I set up Google maps, rolled to my hotel about a mile away over bumpy broken sidewalks, very close to a square with a metro station and lots of restaurants, I think I’m going to like it here. Up to the 6th floor in a very scary Soviet elevator. The family hotel business owner Karina knew my name as I walked in, very sweet lady. The room is comfy, bathroom looks great. Large window overlooks the city. Wifi very strong, yay!
I walked to the nearby metro station and checked it out. There’s an extensive metro system here that I definitely want to take advantage of. I decided to try the Big Red tour bus to see an overview of the city. The bus web site says the bus stops at the square, but no detail as to where it stops, and no sign there that I could find. I waited about 20 minutes until one bus came in, looped around and exited the square. WTF? I ran next to it, trying to get it to stop, it finally did. I got on and asked the guide why they didn’t stop. She said I’m supposed to know where to stand. Um yeah no. I paid for the Red loop, plus a full-day minibus tour outside the city tomorrow including a winery. After the bus loop, I got off and walked down to the river and got on the complimentary boat ride. I walked home through town, stopped at a little cafe on a pedestrian street and had an amazing veggie stew, with a lot of eggplant, tomatoes and potatoes.
The next morning I had to go to the minibus tour office so I walked to the metro station, easy tap-in to pay with my phone. Went down the steepest and longest escalator of my life – I felt like I kept tipping forwards so had to lean back and really hold the handrail. The subway car was definitely a remnant from Soviet times. Early as usual, I have 50 minutes until the tour starts. The girl at the desk pointed me across the street to a cafe, had a turkey wrap & strawberry smoothie.
Our minibus pulled out right on time, our guide speaks English and Russian, with a degree in International Relations. She learned English to marry Harry Stiles – true story. She told us that Georgia has the first evidence of winemaking in the world from an 8000 year old clay pot, and hosts more than 500 grape and wine varieties. The high mountain towns around the city are inaccessible in winter, and supplies are sent in by helicopter. She gave us a history lesson saying the capital moved to Tbilisi around the year 500. The King at the time was falcon hunting, his bird caught a pheasant and both birds fell and drowned and boiled in hot sulfur water. Now this is mostly legend but probably has a grain of truth because the name Tbilisi means “warm water”. Tbilisi is known as ‘The City’ in the entire region. It was a strong trading center with streets named after the craft or merchandise for sale like Copper, Cotton etc. Despite the warm and sunny weather prediction in the city, it’s cold and raining here in the mountains and I wore a golf shirt and shorts. First rainy day in a month on the road!
Our first stop was a handicraft store on the side of the highway. Multicolored hanging things look like candles but are actually candy with different grape flavors. The next place was an ancient bread and cheese shack just steps off the highway. Bread cooked with wood from grape vines and fruit tree wood gives it the special flavor – it’s a national secret, don’t tell anyone! The next place was Sighnaghi village considered Georgia’s Little Las Vegas with its own famous instant wedding chapel. Sighnaghi has a 4km wall that protected it from invaders coming from the Caucasus mountains & Dagestan who would conduct raids, kidnap children and sell or enslave them. The defenders used pork BBQs to act as a deterrent against Persian and Ottoman Muslims – that’s thinking outside the box!
The third place was the Dugladze winery. We started with Chacha which is a spirit distilled from grapes like grappa or rakia The winemaker described each wine as we went through the tasting, and all of them come from the same grape but with different aging and fermentation processes. We started with a very young dry white with a light juice flavor, then a 2 year a bit stronger. Semisweet is now starting to taste like wine, but still fruity. Semisweet rose’ with a light ruby color, left for 16 hours with the skins in in the juice. We moved to a semisweet red, drier and tannins starting, then a dry red, with good aromas and full tannins. Kinzmaruli tastes almost like brandy. They don’t add yeast to the fermentation process – it’s natural on the outside of the skin so they don’t harvest after rain. They use a very interesting clay pot system – a large pot is buried in the ground with only the opening at floor level. “Top wine” floats to the top with its higher alcohol level. Going down there is Middle wine, Bottom wine, Lees, Skins, Stems and Seeds. We had an early dinner there, very hungry by 4pm! I tried to get the veggie stew again but they don’t have it so went for the chicken in garlic sauce and bread with cheese inside, and a glass of 2014 Special Reserve wine. I slept all the way home on the bus, chilled to the bone.
My last day of the first visit in Tbilisi was spent walking the streets, guided by a list of suggestions from ChatGPT. Up up up twisty narrow streets to the bottom station of the funicular train to the peak overlooking the city. Bought a ticket, rode to the top. There is an extensive park and carnival booths and rides but everything was closed – low season, weekday and rainy. This is also the top station of the cable car but there’s no way you’re getting me on that. Back to the hotel, so sleepy – had a nap 4pm-6pm. Did a short walk around the nearby blocks, had ravioli at Pastamania. I confirmed with Karina’s husband that I can leave my suitcase here when I go down to Armenia for a week and come back up. Yay!
Next stop: Dilijan Armenia
