Feeds:
Posts
Comments

Posts Tagged ‘neurologist’

Alzheimer's is like a one-way sign to nowhere.

Alzheimer's is like a one-way street to nowhere.

When he didn’t remember the water gurgling from the ground on our dream property, I was stunned. Purchased in the late 90s with thoughts of building a country home,  Ken seemed to be without further confusion regarding our future. He still talked about drawing plans as soon as he found someone who could give him the structural details he needed for trusses.  The building site overlooked rolling hills covered with heritage oaks and pine trees extending to a distant lake, and then blending into more misty greens and rolling hills eventually vanishing into the skyline beyond.  Whether we were watching the sunset or just drinking in the magnificence spread before us it was everything we had wanted for our retirement years.  His life-long goal:  to design and build our own home in the country.  Would it still be practical knowing what I suspected?  Only time would tell.

The difficult part about Alzheimer’s is that when you don’t remember something, you don’t remember that you don’t remember. Years ago, Ken vowed he was not going to have the end of his life be like that of his parents.  I have since wondered if he was aware of his forgetfulness – his confusion — aware of how often he had seen the gurgling water which fed the pond.  If he suspected, in the least little way, was he concerned about what might lay ahead for the two of us?  Or could it have been his procrastinating nature, or, as he claimed, was it the difficulty in finding someone to build trusses which caused several years delay in his settling down and actually drawing the house plans.  These kinds of questions can never be answered.

Ken was of the old school of engineering where everyone still used a slide rule, tee squares and a bulky drafting machine. With the computer age looming over the horizon, his firm was just getting acquainted with the practicality of introducing this new “intelligence” into the business.  Desk-size models they were not; their first computer purchase was the size of a king-size freezer chest.  Furthermore, computer-assisted drawings (CADs) to replace the drafting department would be a thing for the up-and-coming generation of engineers, and Ken would be retired before computers became a “must have” in many businesses. No matter; whatever it was that motivated him to get started on the project, his finally doing so came as a pleasant surprise. Could the possibility of finding a truss builder just 60 miles away have given him a jump start?  A new resolve to stop procrastinating, or did he feel a sense of urgency that time was running out?  Nevertheless, he finished the drawings for our proposed building even though it was several years after the water gurgling incident.  His ability to pick up his tools of the trade and accomplish the tedious work of creating accurate drawings was a bit of a reprieve for me (and a novelty to the planning department who were used to seeing only CADs).  Nevertheless, I was more than pleased.  Perhaps we could go forward after all. Yet, I had to acknowledge my observations.   It wasn’t as if there were no more memory-loss incidents.  There were many which I doubt he noticed – or did he?  Troubled, I once said to him, “I worry when you forget things.”  His usual answer was flippant, “I only remember what’s important.”

He made an appointment with our insurance agent whose office was on a familiar street, yet Ken couldn’t find it.  Even parking the car and walking to follow a sequence of numbers he couldn’t find the address.  It was my guess the number he was looking for was across the street and he had forgotten about odd and even numbering, so he returned home.  I also began drawing maps for him to visit friends who lived nearby.  He missed luncheon dates with volunteer committees because he couldn’t find the restaurant although I reminded him we had been there. “There are too many places to eat in that shopping center,” he complained, “so I gave up.”

I felt stymied, and what was there for me to say?  Should I remind him that it appeared he was heading down the same path his parents had traveled?  Was he aware of his own forgetting – his confusion – or was he in denial?  I recognized the signs and most of the time I chose not to remind him and we didn’t talk about it – at least not in depth.  I just continued to allow it to happen.  Isn’t that’s a silly statement?  I wasn’t allowing anything.  There was nothing I could do to stop it.

In January of 2004 we paid our first visit to the neurologist.  I explained what I had observed and added I was trying to avoid the “A” word.  He prescribed Aricept and agreed that, for a while, we could avoid the “A” word and see what happened during the next 12 months.  The following January the doctor told us that Ken did, indeed, have Alzheimer’s. Slowly, our life began to move in another direction, one we never would have chosen: a turbulent, unchartered one-way street to nowhere.

Photo courtesy of http://www.flickr.com/photos/cbroders/5632294511/.

Read Full Post »

risks ahead

There are many risks ahead for both caregivers and victims of Alzheimer's.

“Everyone is different,” said my friend, Madalyn, whenever I tried to compare Ken with her husband, Darwin, whose body succumbed to death from its own ills even as his brain deteriorated with Alzheimer’s. Darwin developed AD a few years before Ken so I suppose it was natural for me to look for some kind of gage to compare their journeys. What I was to learn, though, is that AD does not follow a precise pattern like the common cold which is usually gone in two weeks – or 14 days – if you take good care of yourself: a solid time frame if there are no complications. I wanted something like that: road signs, directions and distance as my gage so I could be better prepared for what was to come. AD doesn’t work that way. Rather than gages, I got stages: mild, intermediate and severe cognitive loss, and that’s about as good as it gets even though it still doesn’t allow us, caregivers and family, to determine the approximate sickness location until the evidence is blatant. The brain and its deterioration process are still too much of a mystery.

As we watch our loved ones slip further and further into the depths of The Devil’s disease we can only guess – with input from the neurologist — at the three stages, and when they slip from one into the other there is not much of a sign – nothing dramatic – until one day you realize the patient has moved from mild to intermediate, and somewhere down the line to severe. And in observing the changes, I have come to agree with Madalyn. Everyone is different. So is the first tale-tale sign that something may be going wrong with someone we love.

Ken’s mom and dad were our first experience with Alzheimer’s, but as I have mentioned before absolute diagnosis in the late 1970s could only be determined with an autopsy. None of our medical people suggested it be done after they passed, nor did we make the request. However, that was all right because we didn’t need absolute proof; we knew what we had witnessed. An enemy from within had destroyed their brain and it wasn’t as simple as senility or old age. It’s now, in retrospect, that I search my own memory in an effort to recall some of those first signs which may have hinted to what awfulness lay ahead.

UNREASONABLE: In many relationships unreasonable would be a shot in the dark as far as determining a disease such as Alzheimer’s. Ken’s father, Nick, could be a stubborn man, even unreasonable at times, being the patriarch of the family with a lifetime of independence and dogged responsibility, a world traveler, eight years in the Marines, a strong union member, leader and officer he still managed to remain open for discussion. Then he began to change. The episode I remember, which was beyond reason, had to do with the simplicity of watching television during the Summer Olympics somewhere in the mid to late 1970s.

“What are those young women wearing,” he complained while watching the gymnastic performances. “They may as well be naked. You would never see young women from Yugoslavia wearing something like that.”

Tito was still in power at the time, and while Nick hailed from an area which had been part of Austria, it became part of the new state under Tito. Therefore, 60 years after his immigration he considered himself from Yugoslavia, and was proud of the modesty and decorum of the country’s women – not like the shameless women from other nations, including the U.S.A.

“Dad,” protested Ken, “Yugoslavia is participating in this segment of the Olympics and all of the young women are wearing body suits. You’ll see that when Yugoslavia’s team competes.”

“Never!” grumbled Nick. “Our young women would never dress like that.” Seeing was not believing; Yugoslavia’s team appeared in body suits and participated. Nick was unaccepting saying they must be interlopers, not really from his former country. Ken’s further discussion was waved aside as Nick sliced his hand through the air ending Ken’s participation.

Even though the program had moved on to other events, Nick wouldn’t let the lack of modest attire go. Gymnastics were forgotten, but immodesty prevailed in many forms including swim suits. Ken and I talked about it on the way home, remarking how stubborn and set in his ways he was getting, and now he was to the point where no one could tell him anything. Nothing was up for discussion. He knew it all and his word was law. It was only in retrospect and continuing evidence that we had to accept as fact that something was happening to the man we had known so long. His mind was no longer functioning as it once did.

“You don’t know anything.” “Leave that alone.” “Don’t let the boy (our grandson) do that. He’ll get hurt.” “Leave me alone.” “No! I don’t need to shower.” “I don’t have to change my clothes. They’re not dirty.” “Put the lamps on the floor. If we have an earthquake they’ll crash through the window.” “I wear my coat and hat in the house because I might get cold.” “They tricked me so I lost my driver’s license.” No matter how we tried talking with him, Nick became more and more confused and unreasonable.

The diagnosis of AD was ours and arrived at some years following his death. It quickly surpassed what Rose was suffering from, and yet we still didn’t know what it was, nor did we know what to do. Wearing too many clothes, he collapsed on hot days and was taken to the hospital with the paramedics explaining he had become overheated. The doctors determined he was just getting old and demented, suggesting we find a good care facility for him. We did. He died a week later.

Read Full Post »