The efficient and friendly office managers,
My tester, with her arms full of flash cards, watches, combs and other professional supplies,
A random ensemble of white-coated professionals, quietly bustling about, making eye-contact with no one,
The patients, sitting docilely in pairs with their caregivers, waiting their turns to find out what the staff has to share, good news or, more likely, bad,
And, ruling the roost, Dr. P, patient and unflappable as ever. He also wears white, as befits his station.
After numerous visits here, this place has come to feel familiar and non-threatening. Jane and I find chairs to wait, but we don’t need to wait long. The tester approaches us, and whisks me away to her now-familiar office….which, yesterday, also happened to be a portal to the Twilight Zone.
What?!?
Twilight Zone?!? You know, the place where reality and unreality meet?
The test itself was not a big deal….a number of the words I had to memorize I still remember from previous versions, which was spooky in itself. Then there was Dr. P, grinning over his computer just like the last time we did this, 8 months ago.
"Uh - oh,” I say. “Something funny happen?” I offer.
Instead of answering, Dr. P gently and respectfully guides me and Jane over to our appointed seats at his desk. Now he is asking us the questions. “Did I hear you mention something about cognitive losses?”
“Oh, yeah, I can’t remember a single thing any more. I’m always losing track of what I’m trying to say. It’s so noticeable!”
“Mr.Yardley, your testing shows otherwise. Your cognitive abilities are showing themselves to be as strong as anytime you have been a patient here.”
"Impossible,” I blurt out.
Jane just shakes her head and rolls her eyes.
“That is so different from what i see every day,” she adds.
Here is how Dr. P sums it up in his notes:
"Mr Yardley underwent repeat neuropsychologic testing today. He scored 28 on the Mini-Mental State Exam compared to 27 when tested in 02/2018. His score on the ADAS was 8 compared to 9 in February.
"ASSESSMENT: Mr Yardley remains remarkably stable on formal neuropsychologic testing in spite of both he and his wife indicating that cognition continues to decline."
So, what does this all mean? are the tests faulty? Hopefully not!! They are a key part of a standard assessment meant to screen for cognitive issues that could indicate dementia. If the tests are randomly unreliable, especially to such an extreme extent as Jane and Dr. P and I experienced, they might lose a lot of their credibility as diagnostic tools.
"Uh - oh,” I say. “Something funny happen?” I offer.
Instead of answering, Dr. P gently and respectfully guides me and Jane over to our appointed seats at his desk. Now he is asking us the questions. “Did I hear you mention something about cognitive losses?”
“Oh, yeah, I can’t remember a single thing any more. I’m always losing track of what I’m trying to say. It’s so noticeable!”
“Mr.Yardley, your testing shows otherwise. Your cognitive abilities are showing themselves to be as strong as anytime you have been a patient here.”
"Impossible,” I blurt out.
Jane just shakes her head and rolls her eyes.
“That is so different from what i see every day,” she adds.
Here is how Dr. P sums it up in his notes:
"Mr Yardley underwent repeat neuropsychologic testing today. He scored 28 on the Mini-Mental State Exam compared to 27 when tested in 02/2018. His score on the ADAS was 8 compared to 9 in February.
"ASSESSMENT: Mr Yardley remains remarkably stable on formal neuropsychologic testing in spite of both he and his wife indicating that cognition continues to decline."
So, what does this all mean? are the tests faulty? Hopefully not!! They are a key part of a standard assessment meant to screen for cognitive issues that could indicate dementia. If the tests are randomly unreliable, especially to such an extreme extent as Jane and Dr. P and I experienced, they might lose a lot of their credibility as diagnostic tools.
Here’s another idea…
A current fad in the dementia community is the importance of keeping your mind sharp, “use it or lose it," keep your brain tuned. This philosophy can take different forms, but basically focuses on respect and proper care and feeding of the brain so it can be the best brain it can be. Just take a look at any issue of AARP (the 50+ national lobbying group and you’ll see that month’s version of exercises to defy aging).
I used to be more skeptical of this kind of thinking…that just changing the fuel mix in our carburetors will turn us into superheroes and keep illness, stress and troubles far away.
Life is more complicated, I’m sure.
Still, I keep the book my son gave me nearby:
A current fad in the dementia community is the importance of keeping your mind sharp, “use it or lose it," keep your brain tuned. This philosophy can take different forms, but basically focuses on respect and proper care and feeding of the brain so it can be the best brain it can be. Just take a look at any issue of AARP (the 50+ national lobbying group and you’ll see that month’s version of exercises to defy aging).
I used to be more skeptical of this kind of thinking…that just changing the fuel mix in our carburetors will turn us into superheroes and keep illness, stress and troubles far away.
Life is more complicated, I’m sure.
Still, I keep the book my son gave me nearby:
The Mammoth Book of Brain Boosters: Give your Brain the Ultimate Workout Every Day of the YEAR !!!!!!!
What helps me the most is keeping myself busy in body and grateful in spirit. Let Alzheimer’s take its unpredictable path through my nervous system.
What will be next?
Another dose of (alleged) “remarkably stable” sounds pretty good…!?
Mnemo just gives me a wink.
I love reading this, Sky! As I was reading, I was thinking "Perhaps writing this blog is contributing to your pretty good cognition." That, and of course the book your son gave you, which sounds like a hoot! Write on, friend!
ReplyDeleteYour companion on the journey toward the unknown, Judy