Tuesday, September 29, 2020

Diagnosis by a Specialist

 

 

Dimensions of Dementia

Shirley Woolaway

Perhaps you’re concerned about a family member or friend’s memory loss, perhaps your own. One way to find out whether it is memory loss or normal aging is to seek out a physician. A family doctor or internist could be your starting place and might use a brief test for memory. But you may be better served with a specialist. For instance, with heart issues you would probably seek out a cardiologist, if cancer, an oncologist. So, if the brain may be an issue, the Alzheimer Association and other experts recommend seeing a neurologist who specializes in dementia issues. Neurologists are M.D.s with a clinical residency and specialized training on various conditions affecting the nervous system: the brain, spinal cord and nerves.

With internet access, it’s easy to find neurologists online, see what their specialties are, and read reviews from patients. There are a number of neurological groups in Naples and Ft. Myers and these might be good places to start. Once an appointment is made you might wonder what kinds of testing you’ll have to undergo. You might feel a little uneasy or fearful about how well you’ll do. I know I did when I first took some of the tests. In fact, I continue to have yearly checks of my memory, and still have some performance anxiety. Maybe it’s a result of all that testing we had in school.

Once in the neurologist’s office there will be the usual forms asking for your medical history, current, and past illnesses, medications, conditions affecting you and other family members. You may be asked about your diet, the use of alcohol, what over-the-counter medications and supplements you take.

The physical exam will include taking your temperature, pulse, blood pressure and checking your heart and lungs. You may be asked for blood or urine samples, in other words, a physical exam like others you’ve probably had.

The neurological exam may include an MRI or CT scan that will help the physician check for strokes, brain tumors, Parkinson’s disease, head trauma, and whether there is fluid accumulation on the brain. The doctor or a medical team member will check your speech, eye movements, reflexes, coordination, muscle tone and strength.

When all that information’s been recorded, the neurologist will want to know about your thinking skills and your ability to solve simple problems. You may be asked where you are, what time it is, the date and be asked to remember a short list of words to feed back later. You may be asked to draw a clock with the correct numbers on it and the hands set to a particular time. In addition, some questions may be asked to detect depression or other conditions that can overlap with dementia issues. For details check out: www.alz.org/alzheimers_disease_steps_to_diagnosis.asp.

A diagnosis may be given at the second appointment. Some conditions are treatable and preventable, for instance, thyroid issues. Or you may be told the memory loss is normal aging. Other conditions are treatable, but currently cannot be prevented, like Parkinson’s or Alzheimer’s disease. If you receive a Mild Cognitive Impairment diagnosis, there is a 40 to 60% chance of it developing into Alzheimer’s disease, and it did in my husband’s case. Medication may be prescribed to treat the symptoms of your condition, such as Aricept, Razadyne and Exelon for Alzheimer’s disease.

Receiving a diagnosis of dementia is heartbreaking. But I found from experience as a caregiver for two family members, it is helpful to know what you’re dealing with. You can become informed on the condition and take the steps needed to live life as fully as possible as long as possible.

Shirley Woolaway has an M. Ed. in counseling and worked in journalism, in business, and as a therapist in Pennsylvania. She has 25 years personal experience with dementia as a caregiver for family members with Alzheimer’s disease, and nine years as the coordinator of an Alzheimer’s Association memory loss/caregiver support group, earlier in Pennsylvania and now on Marco Island. We believe that Shirley’s insights will prove helpful to many of our readers.

For help on all aspects of Alzheimer’s disease and other dementias call the national Alzheimer’s Association confidential, 24/7 helpline at 800-272-3900 or the local Bonita Springs office at 239-405-7008 for care consults and support group information. Also helpful with local educational programs, workshops, and support groups, is the Naples Alzheimer’s Support Network, 239-262-8388.

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