A Look Back Part 3

I wasn’t quite sure what to expect when I arrived in January for the Neuropsychological Exam. Remember at this point, the reason for the tests were to pinpoint if there were any memory or cognitive issues based on the 2011 stroke. Discussions about Alzheimer’s disease before this test were dismissed immediately. I was told to allow 3-4 hours for the tests. If you are interested, the tests included variations of the Wechsler Memory tests, WASI, Rey Complex Figure, Verbal Fluency, DKEFS, Boston Naming, Hooper Visual Organization, Stroop Word and Color, Symbol Digit Modality, along with Judgment Questions.

It was noteworthy that when in college, I did an IQ test as part of a Psychology course and scored in the superior range. Is there a correlation between intelligence and Alzheimer’s? I am not a medical professional, however, I did find research about childhood low IQ and adult High IQ being at higher risk. Also some European conclusions that there is the possibility that individuals with higher IQ’s may experience a slower progression of the disease. Review the materials carefully, there are more opinions than proven facts. We will come back to this.

Debra and I returned a week later for the results and had a very good session with Dr. Pare, she explained everything in detail. The results of the Neuropsychological testing;  “Intellectual functioning was estimated to be in high average range. Impairments on a visuo-construction task due to poor planning and organizational skills. Weakness was measured on all tests of verbal and visual memory functions. Verbal working memory was lower than expected and verbal speed of information processing slower than expected. Results show multiple areas of weaknesses which are surprising given the limited amount of cerebrovascular changes seen on MRI imagining. A neurodegenerative process needs to be ruled out.”

The conclusion was that there was no correlation between the stroke, given the area affected, and the memory and cognitive deficits I was experiencing. It was real now, I could no longer blame these things on the stroke.  Dr. Pare suspicioned that there was some kind of Neurodegenerative Disease that would need to be identified. Of course the first thing we did when we arrived home was to hit the Internet and found the list of Neurodegenerative Diseases; ALS, Parkinson’s,  Alzheimer’s and Huntington’s for starters. Also Dementia including Frontotemporal and Lewy Bodies (DLB).

At this point I was taking Ambien, Xanax, and a Tylenol PM to sleep at night, I was on Crestor and Trilipix to manage my cholesterol and triglycerides, Diovan for my blood pressure, and Plavix which is a blood thinner to reduce the chance of stroke. I had chronic insomnia, Xanax was required at 1mg at bedtime to quiet my mind so I could get to sleep.

One Friday night in June of 2015, while watching TV, I mentioned to my wife that I did not feel well, I went downstairs and took my blood pressure with my handy wrist cuff from Walgreen’s, and found my blood pressure was 186/126. I couldn’t swallow, was told later that I had difficulty speaking, and was not coherent. I had no memory of the event after taking my blood pressure. My next memory was in the ER looking at my wife and my daughter and being informed that I was brought to the hospital in the squad. It was many months later before the event came back in vivid detail.

It had been a very stressful week, the culmination on Friday night of the weeks stress was evidently all my body could take. Other symptoms were also becoming more evident, suspicious and delusional thoughts along with aggressive and angry behaviors.  I was beginning to think that people were plotting against me at work which would lead to many sleepless nights. I could get agitated or angry at the news, watching sports on TV, to the point of being inappropriately loud and vocal for the occasion which was not my personality. I started to get more vocal at work, not at people, but at events.  This was the week from hell. I had maybe 2 hours a night sleep, and even though I was on BP medicine, I can only guess what my pressure was during the week.

It was concluded that I had either had another TIA or some form of mid-brain vasospasm and I was started on Verapamil. Our medical staff, my wife and I were all very uncomfortable at this point because something was obviously wrong, I had significant short-term memory problems, significant cognitive issues and a TIA or Mid-Brain Stroke was not adding up to the symptoms. This last episode I now believe to be caused by extreme stress which led to a spike in my blood pressure that caused a TIA, fortunately, there were no lasting affects.

To sum up to this point, I think it is important for me to highlight the remnants of the stroke that can be verified. I have difficulty swallowing lukewarm or body temperature fluids such as coffee or soup. Hot is ok, cold is ok, lukewarm not so much. I still drool out of the right side of my mouth and sometimes bite the right side of my tongue while eating. I have occasional night sweats and cold chills. My thermometer acts up occasionally, my body temp may drop to 96 degrees. My new normal is 97.5. I wake up sometimes feeling like I have the flu, shivering but it dissipates after a few hours.

I also want to say that I have great respect for the medical professionals that have cared for me or are caring for me now. Nobody knows you and your own body as well as you. The signs were there, but we were blaming the stoke. The key was knowing when it was time to move to the specialist. The Neurologist’s told me the stroke would not cause memory or cognitive issues and after the Neuropsychological Exam, I knew something was not right and it took me until the episode in June to decide that I needed to do something. Next stop was to see Dr. Daniel Murman, a Professor of Neurological Sciences and the Director of Memory Disorders & Behavioral Neurology Program at the University of Nebraska Medical Center here in Omaha.

 

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