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I don't know about the causes, but this "losing the word" is extremely
common in lupies. Conversations like "Can you bring me the... the... oh
you know what I mean" or "Pass the elephant, please" are all too usual!

Aging is a degenerative process.

Fatigue is a part of Lupus. Sometimes we just have to accept being tired
and lower our expectations of ourselves (without wallowing in it).

I wouldn't want any of that cognitive testing, because here we're
obligated to advise the Ministry of Transportation of new health findings
that might affect our driving. In fact, our doctors are obligated to
report us if they see a serious medical report of cognitive problems.
On the other hand, if yours is severe enough, you might want to
self-"police" yourself not to drive. It's controversial, because many
people on medications (which can make them drowsy or disoriented) drive
anyway, when they're not supposed to.

Been there, done that with all that "counselling" (many years ago).
"digging in the past" is only good if it can motivate you to change how
you perceive yourself and your life. Be prepared to feel worse before you
start to feel better.  Reliving old hurts (or reviving them) isn't for
everyone.  I'm not a psychiatrist or psychologist, but I would think you
have to commit to longterm counselling for that (possibly 2 years or
more). It can also be a learning experience on how to learn to cope with
mood swings (as long as they don't have an organic cause). - I forget if
"mood swings" are considered part of Lupus.  Hormones can do that, but I
forget your age.

I think it's good that you got the MRI (for a baseline) and to make sure
nothing organic is going on in that brain of yours (that needs monitoring
or treatment).  Hope you'll make sure a copy goes into your main medical
file. (or keep a copy yourself).

If the goal of the MRI and the cognitive testing was to find a better
medicine that will help you with depression or mood disorders, then
perhaps it was worthwhile.  Talk to your doctor if you think a med change
might help.

Sounds like he didn't find anything too surprising or worrisome to him.

Hugs
J - not an expert/just my opinion.

Hearing has been closely related to oxidation in the ear .. rust / oxidation /
free radicals ..
They have come so far now as to say any sudden hearing loss must be checked for
elevated iron levels ..

Don't you just hate that when that happens ..

They have shown in A;zheimer patients the cognitive SCORE rises WHEN the blood
is thinned .. allowing the blood to more FREELY .. flow .. less 'viscosity' /
thickness of the blood ..

In Lupus they have shown and TARGETED the levels of iron they have in their ..
skin ..

In lupus they have shown a propensity to excessive hemolysis of red blood cells
..

Poor red blood cell .. viability .. not too 'long lasting' and therefore ..
increased red blood cell destruction and therefore increased iron sequestering
..

Iron buildup leads to increased free radicals / rust and decreased antioxidants
in the body ..

Fatigue is one of the PRESENTING symptoms of someone with iron .. excess ..

Pancreatitis is VERY common in those with lupus .. and .. coincidentally the
treatment used to HALT  pancreatitis is the SAME treatment used to induce ..
thinning of the blood .. hemodilution ..

Who loves ya.
Tom

Without going into all sorts of details - - PCP's, Neurologists,
Rheumatologists, Naturopaths, DO's, and all sorts of Internal mmed.......
got so bad I thought I was totally losing my mind... yes, this is part of my
life as well.... finally have been put on anti-depressant which has made an
enormous difference in my life - - I have one now!!!

wishing you a smooth day and fast relief to a fearful problem

Leslie

I am sorry to hear you are having such a tough time. I am not sure if I can
give you any insight, but I am going to try. I only recently got my master's
degree in Clinical Psychology (specializing in Health Psychology) so I do
know about diagnosis and treatment of some of these things on a
psychological/cognitive side.

I know that Lupus and other related autoimmune disorders have this effect --  
disorientation, word finding difficulties... etc. It is really hard to
pinpoint what is causing it -- the fatigue (which can cause this), the pain
(chronic pain can alter the neurochemicals in our body causing it difficult
to focus; or just the presence of pain in itself can make it difficult to
complete a thought!), and definitely the depression. The patients I have
counseled (in my training I mostly specialized in treating children with
chronic illness, but I did have some depression cases and parents with mood
disorders) had a lot of difficulty focusing, processing directions and
retrieving information from their minds -- this often improved when the
depression improved. I believe I have seen research that suggests that the
region of the brain that is in charge of learning and acquiring new
information is smaller in depressed people (it shrinks with depression), but
that when the depression is alleviated the size goes back to normal. What
medications are you taking? This also could be a major cause of your
symptoms. The frustrating thing is that it is so often a combination of
many, if not all, of these factors that interact with each other.

"Psychomotor slowing" is a fancy way of saying you may be mentally
processing things slower than the average person your age. It is not a word
with a prognosis attached (it doesn't imply a permanent condition), but is a
descriptive psychobabble term that confirms that the neuro-testing shows
that you really are having difficulty processing things cognitively. (It is
a term that says you can do it, it just takes awhile).

I'm not sure what to say on that one. What are your diagnoses to this point?

The neuropsych gave the

Impressions are the same as a diagnosis. But the code is also needed for
insurance.

Do you have any questions about what they mean by mood disorder due to
auto-immune disease? They make a distinction in the DSM-IV (the diagnostic
manual for psychology) between mood disorders and mood disorders caused by a
medical condition. Apparently they believe yours is likely organically
induced from the disease (as well as the stressors of the disease). Are you
on any anti-depressants?

This diagnosis is given when "cognitive dysfunction" is seen on neuro-psych
testing -- which just means that you are performing below the average for
your age group on the testing in some areas and there is evidence of a
medical condition for it, but your symptoms do not rise to the level of the
general cognitive disorders (e.g. delerium, amnestic disorders (severe
memory problems). Mild means you are not far below the average and variable
is implying that in the testing you were most likely inconsistent - fine in
some areas, struggling in others. Did they go over your results in detail?
Letting you know what areas you struggled in most?

Grrrr... it makes me mad that they offerred you little help or solutions. I
think the group is right in the sense that there is a certain amount of
fatigue and mental slowing that you may have to accept - due to the disease
and medications. But if you are going to go through all the work of a nuero
evaluation it frustrates me that the docs didn't do more for you. Did the
report give recommendations? I haven't seen the results and am speaking only
from speculation, so take my comments with this in mind, but it would seem
that a medication consult for this would be helpful. I know it is
frustrating to take one more medication, but there are others out there
besides Paxil than can help alleviate some of the depression and maybe even
help with the fatigue and concentration. If these problems are associated
with depression and causing a cycle it could help break the cycle.

However, I am also biased in that I think no one should go on
anti-depressants without at least going to see a counselor for a little
while. Sounds like you really need someone who specializes in chronic pain
and chronic illness and who uses Cognitive-Behavioral Therapy. It is a much
more present centered, problem-solving focused therapy and teaches things
like visualizations, relaxation, etc... It gives faster relief. Once skills
are learned to control negative thought patterns, physically alleviate pain
by using special techniques, and even just having someone to empathize with
you -- I think it is good to then delve into the "past" if there is stuff
that is affecting the way you deal with your situation in the present. For
example, if you are a perfectionist with a determination to over-achieve and
therefore refuse to accept the limitations of your body then it is likely to
cause depression, which will in turn cause a worsening of symptoms (that
would be me!!!).

I am not sure if this helped, but I thought I would chime in. Sorry if I
told you things you already know. If you want to ask me anything personally
feel free to e-mail me. (lerch_stephanie@hotmail.com) I am sorry you are
feeling so awful. Let me know if there is anything else we can do.

Stephanie