I don't really know where we are medically or how to find out

Posted by calispike @calispike, Jul 24 2:44pm

I'm 2017 husband had leukemia. Treatment left severe "brain fog" and doctor started him on a moderate dementia medication. About 2020 he developed Adult Onset Hydrocephelys (sp) and had a shunt put in. Since then because of memory decline he has been put on a memory medication by his neurologist, and most recently she doubled it. I just don't know what I'm dealing with but it is getting very stressful. I brought up issues in a neurology appointment and it crushed him. Then it crushed me. We downsized and put everything in storage 3 years ago and he is just now accepting that. He is short with me. Nothing is ever his fault, makes such stupid excuses like a little kid, is very forgetful but in good spirits for the most part of his days. He is also 85 y.o. I took driving from him a year ago because all 4 quarter panels were smashed, the front of the garage had to be replaced, and he got lost in his home town wandering for over an hour.
He has a neurology appt coming up. I'm wondering if I could send ahead some details to the doctor so I don't have to bring them up in the appt.
Sorry for this being so long. It's only the part of what is going on but if questions arise I'll be happy to answer. And I've kept all these situations to myself for so long.
Bless you all for the care you provide to those that desperately need us caregivers🙏

Interested in more discussions like this? Go to the Caregivers: Dementia Support Group.

Profile picture for judimahoney @judimahoney

@calispike
Hi, our only diagnosis came from a Neuropsychologist, since we have no Neurologists in our town (and waited nearly 2 years to see a Neurologist).
Perhaps you live close to one of the Mayo Clinics and he can be tested there.
Take care. 🌹

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@judimahoney
I guess it all got fuzzy when he was referred to the neurologist by his family physician, her thinking it may be Parkinson's. Lots of tests and time to discover the hydrocephalus.
I think any other diagnosis may have gotten lost in the mix.
Ha, I just remembered that the neurologist said depending on how long the spinal fluid was sitting on top of the brain affects how much cognitive recovery there would be.
But he got better and the last year and a half he had been degrading. All they can do is medications I guess.
I think I need to bite the bullet and all at the next appointment what is going on.
Recently I asked my husband if he's noticed the decline and he got pretty upset. Said he was just fine. I said, do you realize you are watching the same shows over and over again. He told me eventually he realizes he seen it before. 🤷

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Profile picture for labrown @labrown

Yes, communicate with your physician through the office portal regarding your concerns. I do it all the time. It’s very helpful and appointments go so much better.

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@labrown
Yes, this is what I need to do.
For my sanity, if nothing else. Thank you!!!

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Because this horrible disease called dementia is more and more prevalent, I'm just wondering why we can't choose in our health directive while we are healthy and of sound mind to choose end of life medical assistance if we ourselves ever get to what I would call a "terminal" state of dementia - because we've all seen the progression and it is so sad to see someone go on and on for years not being able to function at the most basic levels and not knowing who they are or their family, and as we all know, it ain't gonna ever get better. Then, ending up in a wheelchair in a total daze for months, or years before they pass on. I'm wondering if maybe somewhere inside all that blankness they just want to move on... this may sound harsh but I'm talking for myself here.

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Profile picture for oneputt @oneputt

Because this horrible disease called dementia is more and more prevalent, I'm just wondering why we can't choose in our health directive while we are healthy and of sound mind to choose end of life medical assistance if we ourselves ever get to what I would call a "terminal" state of dementia - because we've all seen the progression and it is so sad to see someone go on and on for years not being able to function at the most basic levels and not knowing who they are or their family, and as we all know, it ain't gonna ever get better. Then, ending up in a wheelchair in a total daze for months, or years before they pass on. I'm wondering if maybe somewhere inside all that blankness they just want to move on... this may sound harsh but I'm talking for myself here.

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@oneputt
I understand your thoughts totally.
My husband and I have discussed this as we don’t want to be in a “terminal state of dementia” for years.
In researching states where “end of life care” is available, a doctor has to access that you have an illness where you will pass away in 6-12 months. Well, with dementia/AD, how long someone will live is not easily determined. When the person is at that stage, moving them to a state where this is available would also be a challenge.

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Yes, absolutely, make a plan for getting your comments to the doctor a few days ahead of time in the future. Most of us are on a long journey and if it didn’t work out for this appointment, there will likely be another chance.

What works for me is I write a few things down every month or so, with dates. I note what has changed, things he remembered, what went wrong, what was fun. Then a week or two before the appointment I make the highlights from my “Caregiver’s Journal” into a note to the doctor. I’m able to use the MyChart portal for this but it should work with a paper letter if you can mail it in a few days ahead then call to make sure the office staff got it to the doctor.
My husband’s doctor appreciated the short note in MyChart and thanked me for it. The journal and note idea came to me from a great friend who’s a pastor and former nurse.

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@calispike By now, you've been to the doctors I'm sure since your post was a few weeks back, however, your question about reaching out to the doctor - when I noticed my husband's memory loss, I sent a note in my portal to the primary care doctor. I was told by the office, since my husband is also a patient, the note really had to be done through his portal, since he's the patient. So I went into his portal, and sent the note, letting the doctor know a short list of what was going on. I also told her that I was worried that he might take the boat out, have navigation problems, and/or got lost, etc., I also shared that we had to move out of our house for mold. Could that have contributed to the memory loss? Deferring it possibly to some other medical situation, that, in the chair that day, seemed a bit more palatable for my husband than what later resulted in an MCI diagnosis. I'm sorry your husband was crushed. Sometimes doing something right, feels oh, so wrong, but we love them, and want to at minimum, get a diagnosis of what we're dealing with so we can help treat it early if we can. At least, that's what I kept telling my husband, in the chair that day. This isn't an easy journey, first with the disease itself, and then the denial of our spouse and/or partner who is experiencing the memory loss.
Best, Karla

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Profile picture for judimahoney @judimahoney

Hi @calispike
So many things you mentioned I could have written; such similar behaviors.
I tried to get info to the neurologist ahead of our first visit last week, and his office wouldn't accept them (stating they could get lost in the mail; lame excuse). So, I brought my folder of info with me that I prepared ahead of time, and gave it to his assistant when she was getting my husband ready for his visit. The neurologist left my packet in his office when he came to see us, and had to go back and get my notes (that I'd spent quite awhile prepping for him), just so we could discuss my husband's medical history (I had to say things like, "The answer to that question is in the packet I brought for you."). Insert angry emoji!
To me that felt dismissive, as if he probably hadn't even glanced at the notes before stepping in to see us. I couldn't help but think, why did I bother putting so much effort into this packet of info if he's not even really referring to the helpful info during our visit?
Perhaps I should look at it from another point of view. I know medical personnel are forced to move patients through their visits quite fast, so perhaps the neurologist didn't have time to read all the items I brought.
If you're interested in what I brought along in that packet, read on:

-Neuropsychologist's diagnoses over the past few years, as diagnosis changed from mild cognitive impairment to frontotemporal dementia (FTD)
-MRI results
-C/T scan results
-pTau 217 blood test results (negative)
-Dementia Association's FTD Symptoms & Staging Tool, the FTD-SST (my husband was mostly at one stage and had several symptoms from another stage, and a few random ones from later stages, so guessing the stages they pass through are not clear cut)
-Dementia Association's Dementia Behavioral Assessment Tool (DBAT)
-The Bristol Activities of Daily Living Scale (BADLs)EP Test
-Summary page of noted changes in behavior and health over the past year (taken from anecdotal notes I take whenever I notice something that is 'off' about my husband, a change in his behavior, actions or personality).
Other than that I just sign up for every free class for caregivers, watch every video folks in the know point me to, attend several support groups and log onto this site daily.
All the best to you. 🌺

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@judimahoney You are correct Doctors typically have 7 min per patient to evaluate, diagnose and treat so a one page chronological summary with all the pages attached might have worked better.

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I agree with the above. I like the detail Judi Mahoney took with her to the doctors and the "chronological summary" @calispike mentioned as what I found worked for me, was that well-organized summary with bulleted one-line information that described my husband's changing behaviors. That way the doctor read through it quickly, and I was able to clearly and quickly articulate within the limited office visit time what was taking place with my husband.
Best, Karla

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