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Medical Forum / Diseases and Disorders / Alzheimer's / April 2004

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Char - 09 Apr 2004 08:38 GMT
Dear Friends,

This is my second day on the computer in a little more than a month,
so I fell way behind in reading messages.    First, my heartfelt
sympathy to those of you who have lost loved ones.  Seems like there
was a lot of sadness while I was taking a break.

Evelyn, I don't know how you have managed with Ida for so long---I
hope the paperwork goes smoothly for you & that her transition will be
smooth as well.

John is slowly declining a little more all of the time.  Lately, there
have been more obvious things that have come up which makes me realize
his memory is getting worse.  He is still cooking but I have to keep
an eye on everthing to make sure the right burner is on or off  & that
no surprises happen.  He is due for labs & to see his doctor next week
if I can get him to go.  He seems to be going through stubborn spells
off & on again.  He has also  taken to needing more quiet
time----almost every evening now, he wants to be in the living room by
himself to just have quiet time.   Our daughter is living with us
again until she moves back to Va in a few weeks----I think he senses
there is a lot more going on with her moving but he can't get any
thoughts together as to what it might be.

I am going to give all of the information I have about memantine to
John's doctor & try to get it prescribed.  I'm afraid though that it
might make him feel confident enough to want to drive again.  Has
anyone seen verbal improvement with memantine?  John is having a much
harder time talking now----Unless he has really planned what he is
going to say or it's part of everyday phrases, he talks very
slowly---seems like he leaves 5 to 10 seconds between words.

Seems like I am growing a lot more impatient with him lately.  I'm
sure it's related to a lot of other stress that's going on right now,
but I really am starting to feel overwhelmed at times.  Anyway, maybe
after I take care of taxes & some other stuff, I'll find my patience
again!

Always,

Char
Evelyn Ruut - 09 Apr 2004 12:17 GMT
> Dear Friends,
>
[quoted text clipped - 37 lines]
>
> Char

Dear Char,

So good to see you posting again!   I am sorry to hear that John has
apparently gotten a bit worse.   Some have commented that memantine has
given their loved one just enough additional cognition to make them a bit
more feisty and aware of their own problems again.   It is certainly worth
trying, if you ask me.  You can always stop it if it creates any difficulty.

Ida isn't on it as yet, and she gets better days and worse days.   I am
convinced that when she is the least bit tired she has a VERY bad day.   So
we let her sleep late and go to bed very early if need be.   She seems
happiest when just left to lay in bed or sleep on the sofa a lot.    We are
processing the paperwork to get her admitted, but there is a glitch.   She
failed her physical.... a urinary tract infection (UTI).   She is on
antibiotics for it right now.

She also has lost a lot of the weight she had gained back.   She had lost a
lot when we first began to care for her, gained it back the first couple of
years, now she has lost it again.   She simply doesn't want to eat and she
starts refusing her food after a few bites.  We don't force her but coax and
coax and finally if she is really adamant, we give up.

My husband is furious about the physical and the UTI bit holding things up.
He says "what is a nursing home for if not to care for a person who is too
sick to be cared for at home?"   and.... "why can't they take her anyway,
and give her the antibiotics themselves?"  It just doesn't make any sense.

But the truth is that I know she is getting good care here, and we are
coaxing her to eat more and drink more.   I am sure that in a facility they
won't care so much if she is getting enough food or liquids.

It has become quite a hassle to bathe her, and it takes both Peter and I
together to get the job done well.   He gets her into the shower and onto th
e chair, then I do the main wash up, then he comes in, lifts her to wash
where I couldn't reach, and then gets her out of the shower so she doesn't
fall in the process.

Poor Ida just looks confused through it all and keeps saying "OK rinse off
now..." over and over  (just like she used to in the very beginning).   She
is less than comfortable with the new shower arrangements;  I previously had
her so relaxed and comfortable about showering, but now we are SO afraid she
will fall if we let her try to get in or out by herself, so I really need to
have Peter's help.    If she slipped I know I couldn't hold her.

She has gotten very unsteady on her legs and can hardly walk.   She has
fallen from time to time too.  Fortunately we have thick carpeting, and we
usually supervise her well when she wants to go from one place to another.

This is a rotten disease isn't it?
Signature

Regards,
Evelyn

(to reply to me personally, remove 'sox")

Char - 10 Apr 2004 05:27 GMT
Dear Evelyn,

So sorry Ida is so much worse. I read the messages to get caught up
but had no idea she has become so frail.   John has had a couple of
his "frozen moments" where he says the message just doesn't go from
his brain to his legs to walk.  The last time I couldn't even
gradually guide him like I usually do.  He was relying on the walls &
then me to keep going.  It really scared me because I thought he might
fall---I finally got him to his recliner but thought at the time I
should start looking for a walker for the next time.

Always,

Char

> > Dear Friends,
> >
[quoted text clipped - 87 lines]
>
> This is a rotten disease isn't it?
Tumbleweed - 14 Apr 2004 19:37 GMT
<snip>

> My husband is furious about the physical and the UTI bit holding things up.
> He says "what is a nursing home for if not to care for a person who is too
> sick to be cared for at home?"   and.... "why can't they take her anyway,
> and give her the antibiotics themselves?"  It just doesn't make any sense.

I have to agree with him, this seems bizzarre, are you sure you have chosen
the right home? What happens if she gets poorly after she is admitted, do
they ship her back to you?

Signature

Tumbleweed

Remove my socks for email address

Lesanne - 14 Apr 2004 23:29 GMT
I just have to butt in here and say that elderly people almost always have a
trace of white cells in their urine, and if it is asymptomatic it does not
even need to be treated.  This would show up as a "mild" infection in a
urine sample....  with no fever, freqency, or pain on urination.  You can
tell if they have pain on urination even if they are not communicating it,
they will make faces (sometimes subtle) when urinating.  This is maybe the
number one overtreatment with antibiotics for elderly persons.

> <snip>
> >
[quoted text clipped - 7 lines]
> the right home? What happens if she gets poorly after she is admitted, do
> they ship her back to you?
Gwen Love - 09 Apr 2004 21:20 GMT
Char, it's good to see you post again, but sorry your news about John isn't
better.  Do hope you can get him on Memantine because it does seem to help
some people a lot.
Don't be too hard on yourself for being impatient at times.  It is
impossible to do everything just right when dealing with a person who has
any kind of dementia.  You just have to do the best you can, and I know you
do that all the time.  Hope things work out well for your daughter.  John
will probably do better when you two are by yourselves again.  Post when
you have the time.
Gwen

Signature

***************************************************************************
*****
HAM AND EGGS -- A day's work for a chicken, a lifetime commitment
for a pig.
***************************************************************************
*****

| Dear Friends,
|
[quoted text clipped - 37 lines]
|
| Char
Char - 10 Apr 2004 05:33 GMT
Yes, Gwen, you are right about things being better when we are alone.
There's just too much stimulation with her, her phone, & her dog added
to our 3.  Ours are pretty mellow but hers is crazy 90% of the time &
is a pain in the yard---can't help but like him though!  John has told
me that it's better when it's just us----he knows I understand his
moods & don't take offense at him wanting to be left alone.

it is so strange though----he has the lights in the living room on all
day, but when it gets dark, he wants them off!

Always,

Char

> Char, it's good to see you post again, but sorry your news about John isn't
> better.  Do hope you can get him on Memantine because it does seem to help
[quoted text clipped - 48 lines]
> |
> | Char
Trish Knight - 10 Apr 2004 04:28 GMT
> Dear Friends,
>
[quoted text clipped - 37 lines]
>
> Char

Hi Char,
So glad you posted!  I'm sorry to hear John is not doing better.  Have you
ever received a diagnosis of any kind?  I do hope the doctor will see the good
in Memantine, and prescribe it, and that you will have good results with it.

Love,
Trish
Adelle D. Stavis, Esq. - 10 Apr 2004 14:20 GMT
Dear Char,

So great to hear from you! Hope you are enjoying the visit from your
daughter, even with the extra confusion its bringing.

Like Trish said/asked - any closer to a diagnosis? The freezing you just
wrote about sounds like there may be a Parkinson's-like component. It's kind
of a classic Parkinson's symptom.

Signature

Adelle D. Stavis, Esq.

> Dear Friends,
>
[quoted text clipped - 37 lines]
>
> Char
Char - 16 Apr 2004 03:39 GMT
To All,

No label for what he has---I'm tending more towards FLD---picks or
lewey bodies---so little is known about about EOAD it's hard to know
if it's the culprit or not.   Somebody posted not too long ago that a
LO had been diagnosed with Lewey Bodies.  How was that diagnosis made?
My understanding is it takes a brain biospsy which we will not do or,
eventually an autopsy.  Same question with Pick's Disease----how are
they being diagnosed?

Always,

Char

> Dear Char,
>
[quoted text clipped - 46 lines]
> >
> > Char
KD - 16 Apr 2004 18:42 GMT
Hi Char:

It may have been me you read about, my dad was recently diagnosed with Lewy
Body dementia.

From what I've read, you're right, an autopsy on the person's brain is the
only way to be absolutely sure that's what it is. But there are certain
symptoms that come with LBD. For example, it fluctuates. Dad can be all
right for days at a time, then he'll wake up one morning and not recognize
anything about the apartment he's lived in for over two years. Goes and has
a nap, and sometimes wakes up fine again. Also, he sees things in his
apartment, frequently children, and later wonders where they all went when
he walks into a room. Even his wife, he'll sometimes walk into the room and
ask her where she went. When she says she's right there, he says no not you,
the other one.

Falls can also be a symptom, since this seems to be related to Parkinson's
and some people get symptoms of both. Thank God Dad doesn't seem to have the
problem wtih his balance at all, although he did take a fall yesterday,
first time ever. I think that it was just slippery and wet though, anyone
could have fallen.

KD

> To All,
>
[quoted text clipped - 63 lines]
> > >
> > > Char
Darryl - 17 Apr 2004 04:39 GMT
>To All,
>
[quoted text clipped - 5 lines]
>eventually an autopsy.  Same question with Pick's Disease----how are
>they being diagnosed?

Hi again Char,

I seem to recall that John was suffering from symptoms very similar to
my Dad's prior to his death.  You might recall that he was diagnosed
with EOAD at 56 y.o. yet autopsy confirmed DLB at 59.  The only thing
of note on a CT was atrophy specific to the frontal lobe.  His last
MMSE was 27/30 only six months prior to his death.  Clock-drawing was
out the window.  

I've included a list of things you can look for (although you have had
a thorough workup, right?)  You want to be careful with the
neuroleptic (antipsychotic) sensitivity.  Syncope or fainting spells
are unmistakable--I could see one coming a mile away.  The two other
important features in my Dad's case were detailed visual
hallucinations and later a Parkinsonian gait (which may have
ultimately been caused by Haloperidol, a neuroleptic).  

Take care,
Darryl.

1. The central feature is progressive cognitive decline amounting to
dementia; deficits on tests of attention, fronto-cortical skills and
visuospatial ability may be especially significant.

2. Two of the following are required for a probable, and one for a
possible, diagnosis of DLB:
a) Fluctuating cognition with pronounced variations in attention and
alertness.
b) Recurrent visual hallucinations that are typically well formed and
detailed
c) Spontaneous motor features of Parkinsonism.

3. Features supportive of the diagnosis are:
a) Repeated falls
b) Syncope or transient loss of consciousness
c) Neuroleptic hypersensitivity
d) Systematized delusions
e) Hallucinations in other modalities

4. DLB is less likely in the presence of:
a) Stroke disease, revealed by focal neurological signs or brain
imaging
b) Evidence of any other physical or brain illness that may account
for the clinical picture.

>Always,
>
[quoted text clipped - 50 lines]
>> >
>> > Char
 
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