my story-final answer

MY STORY-FINAL ANSWER
i have the unique opportunity of telling my story as a physician who
has treated alzheimers patients, as a family member who dealt with
close relatives with the disease and now as a patient who may have
been diagnosed early enough that i can give unique observations
on this terrible disease

so its been a long 8 months since i was diagnosed with early mild
cognitive impairment amnestic type thought to be from alzheimers

alzheimers is a diagnosis that can only be 100% made by brain
autopsy when a person dies
i hope to reach as close as possible to 100% while i am alive with
what is available in modern medicine although some of the tests
are only available in research studies

i had to quit practicing medicine which was what i loved to do
i enjoyed going to work every day
i had just got real good at what i do

i will do a three part series every friday for the next three fridays
on my story

today will be on the history of what happened to me
next friday will be all the test results and how they are used
then the third friday will be what all this means for me and for
you

here goes
two years ago i applied for long term care insurance because of my
family history of alzheimers
my mom had severe alzheimers and died from complications of the
disease
she had an infected toe that she and no one else noticed
from that she got gangrene of the leg and died after that
my dad was spared the merciless trip of alzheimers by dying from
a heart attack
looking back he had mild to moderate alzheimers but never was
officially diagnosed (i know this because of a genetic test i had)
a close relative of mine has moderate alzheimers now
he is a year younger than i am
his disease is what worries me the most as i feel like i may be
following down the path he is taking

for the long term care insurance i had to undergo a 30 minute
neuropychological exam by an examing nurse and had no problem
with any of the questions
i eventually got the long term care insurance and plan to maintain it
during my lifetime
if i had waited until all this had happened i would not have been able
to get the long term care insurance today
(nor could i get new health insurance, life insurance, medical
malpractice, or a disabiltiy policy ie im uninsurable)

a year later because of the family history of alzheimers i wanted to
enter an alzheimers research study or see a neurologist to follow
me on a regular basis

i had started to notice problems at this time although they were
quite subtle and not noticeable to patients, family members,
fellow workers or fellow doctors

i had started to have problems with doing prescriptions especially
when having to calculate doses and if the patients prescriptions
got complicated
i compensated by using caution, triple checking everything and
being backed up by the computer, a good nurse and by the pharmacy
i had started to have problems remembering the interactions of
medications but this again was helped with our computer system
and by using standard forms for office visits

i also started to have some problems remembering seeing patients
when they would return for followup visits
i know you cant remember seeing every patient and remember
everything about a visit but
i had several times when i saw patients for illnesses that i should
have remembered but absolutely did not recall seeing them
i found this surreal and very disturbing

but at no time did i put my patients at jeopardy
i became very cautious and did a good job of documenting the visit
when i saw patients

i also had to take a continuing medical education course for my
malpractice insurance to get a 15% discount on my premiums
when i read the material and then took the test i only made a 30%
on the test
i was given credit for taking the test but again i was very disturbed
by my failure to retain the material

this was about the same time i went to see the memory clinic at the
university of texas southwestern medical school in dallas
after talking to the research associate the plan was i would enter a
alzheimers research as a normal control subject

i discussed with the research associate what i was wanting to do
was to be in the alzheimers research study so i could be monitored

if i had or developed a problem i would know
if that happened i would quit practicing medicine for fear of
causing harm to my patients

my wife she and i went to the clinic
we met with the research associate who interviewed  us in
separate rooms-i answered some questions better than my wife
she did
i then under went a complete neurological exam by one of the
staff neurologists
he also interviewed my wife she when i went in for my neuro-
psychological exam

on the 3 hour neuropsychological exam
i did ok on most of the material
however the parts that delt with short term memory was a problem
for me
i knew for sure when i took that exam that i had a problem
this was quite disturbing to me

after the test i discussed it with the research assoicate who told
me oh know everyone says that
i knew i had a problem

on the trip home i discusssed all this with my wife she

that week i dumbed down my practice, slowed down my practice,
referred out any complicated patients, tried to get out of doing
urgent care, and scheduled more time off

a few weeks later i got a call from the research associate who told
me i was turned down for the study because i failed the short term
memory portion of the neuropsychological exam
it was recommended i see a neurologist for an evaluation

next week ill do part two which will be on the neurology visits,
all the test results, and the research study then
in part three i will try to put it all together as to what it means
to me and my wife she and my family and what it may mean
to you in regards to alzheimers disease

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austin walk to end alzheimers at my team page
or support a local walk in your area at www.alz.org/walk/

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the organicgreen doctor