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Medical Forum / Diseases and Disorders / Alzheimer's / January 2006

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What medical specialty

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Charlie in San Francisco - 29 Dec 2005 21:27 GMT
My wife has shown increasing signs of dementia.  What kind of doctor
should we consult for a diagnosis?

Thanks,

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Charlie in San Francisco

Gwen Love - 29 Dec 2005 22:37 GMT
Charlie, consult a neurologist.
Gwen

> My wife has shown increasing signs of dementia.  What kind of doctor
> should we consult for a diagnosis?
>
> Thanks,
Evelyn Ruut - 29 Dec 2005 23:14 GMT
> My wife has shown increasing signs of dementia.  What kind of doctor
> should we consult for a diagnosis?
>
> Thanks,

Charlie, when my mother in law started showing signs, we took her to her
regular doctor, who prescribed a whole bunch of different tests.   She was
also seen by a psychiatrist who administered a test and determined that
there was definitely some impairment.   She had a Pet scan and a thyroid
test also, if I recall correctly.

Evelyn
Mary_Gordon@tvo.org - 29 Dec 2005 23:36 GMT
We started with the family doctor - after all, there are many health
issues that can affect the mind that should be ruled out, from thyroid
to drug interactions and reactions, pernicious anemia, etc. etc. So the
usual drill is a review of what is going on, history, all current
medications and other health issues, a full physical with assorted
blood tests, perhaps a psychiatric review to check for depression and
other mental/emotional illness.

We then got sent to a psychatrist with a specialty in dementias in the
elderly, who ordered another whack of tests and assessments, including
a brain scan, and a full assessment of the extent and nature of her
deficits. Sometimes, the specialist involved is a neurologist with a
dementia specialty.

It is really important to get proper diagnosis, which essentially means
systematically eliminating everything else it could be - since some
causes are treatable.

M.
So tired - 01 Jan 2006 23:45 GMT
She has the right idea. Start with your doctor and go to the specialist you
need.

Depends on test results. There are alot of things that can cause dementia.

Be sure to have her tested for lead, aluminum, and mercury.

You might concider a allergist. If she often becomes demented a hour or so
after eating you definetly need one.

Tom Warren wrote a book on his research into what doctors to see.

http://www.midnightcafe.com/alzh/

Goodman and Gilman's 1990 eighth edition of the Pharmacological Basis of
Therapeutics says, "With very few exceptions, mercury poisoning is most
often not diagnosed in patients because of the insidious onset of the
affliction, vagueness of early clinical signs, and the medical profession's
unfamiliarity with the disease."
To confuse the issue, other medical conditions cause short term memory loss.
To name a few, these include, diabetes, an electrolyte imbalance,9
malabsorption due to celiac disease, Pyroluria, low stomach acid, and in
particular, cerebral allergic reactions to foods, food colorings, food
additives (particularly MSG and NutraSweet), pharmaceutical medications,
alcoholism and chemical contamination
Justin - 30 Dec 2005 01:00 GMT
My dad is seeing a geriatric psychatrist. Thus far the doctor says there is
some dementia but cannot say what kind. The doc has done an MRI and
question/answer test. He wants to do a PET scan but we were told there is a
Medicare rule that requires the patient to be under the doctor's care for at
least six months before Medicare will pay for the PET.

> My wife has shown increasing signs of dementia.  What kind of doctor
> should we consult for a diagnosis?
>
> Thanks,
carolinasongbird@gmail.com - 30 Dec 2005 16:49 GMT
<snip> He wants to do a PET scan but we were told there is a
Medicare rule that requires the patient to be under the doctor's care
for at
least six months before Medicare will pay for the PET.
<snip>

Question that. My mom had one done (which showed vascular blockages all
over) after seeing her doc for one month. Of course, it was an
internist, not a psychiatrist, which might make a difference. Medicare
paid for it.

Songbird
Justin - 31 Dec 2005 00:52 GMT
The psychiatrist said that for diagnosis of demenia the Medicare process was
as I described. Heck, I don't know anything but what I'm told! I should
investigate these things more but I just don't have the time. My Mom died 8
months ago and my Dad is falling apart physically, emotionally and mentally.
Meanwhile I'm trying to hold down a full time job and care for him. To a
great extent I have to trust what they tell me.

> <snip> He wants to do a PET scan but we were told there is a
> Medicare rule that requires the patient to be under the doctor's care
[quoted text clipped - 8 lines]
>
> Songbird
Dennis P. Harris - 31 Dec 2005 08:49 GMT
> The psychiatrist said that for diagnosis of demenia the Medicare process was
> as I described. Heck, I don't know anything but what I'm told! I should
> investigate these things more but I just don't have the time. My Mom died 8
> months ago and my Dad is falling apart physically, emotionally and mentally.
> Meanwhile I'm trying to hold down a full time job and care for him. To a
> great extent I have to trust what they tell me.

one of the things i learned about being the primary caregiver for
an elderly person is that unless you are lucky enough for your LO
to have a very good primary care doc, you really *do* need to
question almost everything.  

many health care personnel, unfortunately, try to do what's
expedient or what they know best, not necessarily what's in the
patient's or caregiver's best interest.  there are far too many
docs who are not up to date on geriatric care or dementias.

the last 4 years of my mother's life, she had a wonderful doctor
who not only was sensitive to my mother's needs, concerns, and
health, but did a great job of communicating with all her
children (we did ask mom to give written permission to discuss
her health with all her doctors), and was up to date on the most
appropriate treatments for my mother's problems.  

for ten years before then she had the doctor from hell, at least
for a caregiver to deal with, who essentially ran a
10-minute-appointment medicare mill.  the difference was amazing.

even with good docs, i found that i really needed to research
things, by asking pharmacists for data sheets (or checking
online), by going online and checking the rules for programs (my
mother was sometimes caught in the "can't afford it but makes too
much for financial aid" gap).
 
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