The PHP knows its dementia, but neuro won't commit other than " normal aging, possibly with many tia,s and with macular degeneration and emotional issues resulting from various other things. How ha3d need I push for an ADD diagnosis , or should I let it go. In the same vein as Joan,s blog entry " how does he hide it? " ... I am the only one he admits to That he doesn't know where he is at and so on..... He has ( to me , screamed and threatened and ca"led me bad curse words that I can't even say and how long til violence? "Where do I go, oh where do I go from here" ? He is 80 and wev've been married 30 yrs. Should I pursue a diagnosis (a firm one for AD) or go day by day? Please everyone give me your advice. I need it. Thanks.
Is he on dementia drugs? If not you might need a diagnosis. If he is on them, you basically have one.
Frankly there is very little difference between how Alzheimer's works and how cardio-vascular dementia works. My husband has the later, and possibly Alzheimer's as well, because the majority of cardio-vascular dementia patients do have both. There are other dementias where a diagnosis is necessary. But if he is on the drugs, and the drugs are working (more or less) you can stop looking.
Some of them have aggression. Some don't. If he has aggression, he needs drugs for that. You don't need an additional diagnosis to get them.
It was SO hard to get him to the neuro, twice we had to leave and reschedule. Then when we went for the tests he didn't cooperate which wasn't helpful fro the neuro who got tired of DH hassling his reception girls. In thE end I was living in hell for 2 weeks becAuse of that. What about local AAA people coming in? Could their viSits bebefit?
Can you possibly find a different doctor....this one sounds like a real goofball.....He obviously is not interested in getting to the root of your husband's problem. I would also call your Primary Care Physician and tell him what happened at the neurologist. He or she may have someone else you could see.
You need to get some kind of relief for his behaviors....you do not deserve to live in that kind of environment. He probably needs medications....it might make life easier for both of you.
I am so sorry you are dealing with all of this....do you have children or family who could give you some help?
I agree that you should pursue finding another doctor. You need to have a professional help you find your way around the behaviors and to point you in the direction of available help. I assume he would not be able to undergo a neuropsych exam but I know it is a good indicator of cognitive deficit. From there you may be able to get a diagnosis. Good luck and don't give up.
I have to agree that you should get a firm dx. A good neurologist would want to pursue testing, at least an MRI or CT scan to give you some idea of what the future will hold. A good dx will also open the door to the correct meds. Remember the old saying the devil you know is better than the devil you don't. In our case, the dementia devil can take on many different personalities. Check with your local Alz Chapter to see if they can recommend a GOOD Neurologist. Keep us posted. Arms around, Susan
Dementia is not part of normal aging, there has to be a reason for it. Has he had TIA's, is he on meds for that? Yes, that would cause some dementia. Even if it is senility/aging, there are drugs that help with that & certainly something if he is getting violent. I'd find another Neuro. The problem is that there can be a combination of causes, a 'firm' diagnosis may not be possible, but the symptoms can be treated in most cases. And they should be treated while you try to get a better diagnosis.
I'm going to come back in here. My husband did have a CAT scan before the neurologist gave me a diagnosis. If that hasn't been done, or even better a MRI, it should be done. If there is a pacemaker it is going to be a CAT scan. If no pacemaker is involved it should be a MRI and any insurance company should pay for that.
You also need to get both dementia drugs and anti-anxiety drugs for him (and anti-anxiety drugs for yourself if you need them). If the doctor won't give them to you, FIRE him and find another doctor.
You should not be putting up with anger, violence or screaming.
But if the doctor is giving you the drugs you need to manage the disease, you already have a diagnosis that is good enough. It is almost impossible to tell the difference between Alzheimer's and the various forms of Vascular Dementia unless you know the date of the EVENT. If it is TIAs, there is no EVENT, but it could still be Vascular Dementia. What they do to treat these two most common versions of dementia is exactly the same.
GYPSY2- I can only offer my advice based on my own experiences with obtaining an "official diagnosis", and its consequences. In your situation, your neurologist has said "normal aging, possibly with many tia,s and with macular degeneration and emotional issues resulting from various other things", and even if you seek diagnosis for AD, will that really change anything? In your heart, you probably already know, or suspect that he had ad, and by reading the various blogs here, I am sure you can identify many twists and turns of this disease. So is the diagnosis necessary? Will it change medications that are prescribed? Will the diagnosis change the situation? In my case, I have been seeking a diagnosis for 10 years, and after receiving an official one from a PET scan, I have found that the consequences of this are far reaching into areas that I did not consider. Our Blue Cross insurance has recently informed me that it does not cover Mental benefits (and alz falls into that category). Now I am faced with doctors who want to declare her mentally incompetent, and it is now on official record, so it affects real estate, banking, driver's license, insurance, etc. I keep hoping that the diagnosis is wrong, and that it is some other disease that is curable by taking two aspirin, and a shot of pennicilin. I am sure that my dw suffers from other medical issues, but if you combine that with ad, that is the major problem. Now that we have the diagnosis, I regret having it. I lost hope that we could find other causes for her symptoms, and lost hope in ever seeing an improvement. My real hope was improving blood circulation to her brain, and praying that it would reverse some of the symptoms. These are now all useless dreams.
So my advice, Gypsy, is to seek a diagnosis if you really feel you NEED one. Things will not change and it certainly does not hurt to have a diagnosis, but the ending consequences of a diagnosis can affect your attitude, your treatment, and reach into other areas that you had not considered. I would question whether a diagnosis will improve the condition, change the outcome, or change the medications. If you think that this is important to you, then by all means go for it. The first law of medicine is "do no harm", and if the diagnosis adheres to this, then by all means get the diagnosis. If it can cause harm, forget getting diagnosed. A diagnosis does not change the medical issue...it just gives you more knowledge, but not a cure. And sometimes knowledge is a bittersweet thing. I now much prefer to be stupid, than to have all the useless knowledge in the world.
My husband did improve a little with the dementia drugs, but it is possible that the first year we had the diagnosis would have been easier without the diagnosis for both of us.
Phranque--you said this so well. I, too, have not wanted to push the dx anymore, due to it possibly affecting our insurance. So far, with the pcp prescribing the seroquel, and with no dx, it's gone through under the insurance.
Alzheimer's IS a disease, not a symptom. .. I don't recall how long he has had the problems, but considering he is going blind with macular degeration, and has other problems as well, it could be that he does NOT have alzheimer's DISEASE, but rather clinical depression which would cause some of his outbursts.
We have to accept that they DO NOT want to go to the doctor EVER, and if we stay there in the room with them, they WILL act out. Make yourself leave him alone with the testing people, the doctor, etc., and he WILL behave differently, based on MY experience.
They are doctors who treat people with brain issues, - so trust them. I'll ditto the advice someone gave you to FIND ANOTHER DARNED DOCTOR ..and run like heck from the one who is side stepping the issues you deal with.
AND REMEMBER TO LEAVE THE ROOM....Slip them a note and explain why you are doing it. You'll get better test results. - I understand your frustration, and also understand your need to "stay with him". DON"T. Tests results were more on point when I was not there.
Phranque--I'm amazed that your Blue Cross coverage would exclude AD. I've heard of coverage that excludes things like mental health counselling (i.e. seeing a therapist), but AD is a disease that ultimately affects the entire body, not just the brain. If your wife is entitled to social security disability benefits, she should also be entitled to Medicare (after 2 yrs) and that doesn't exclude AD. My husband has Medicare as his primary health insurance, Blue Cross is supplemental.
I thought they passed some law that insurance companies need to cover mental health just like they do physical health, or is that still in the 'talking' phase. Or maybe it is just something in Oregon and Washington. By the way, I would point out that AD is not mental, it is an actual physical disease that involves some mental functions. I would fight it tooth and nail.
I believe you should call your insurance company and recheck this. If you have a definite diagnosis of AD, that is a neurological illness--NOT a mental illness. My husband has FTD and it is an actual terminal illness. There is no cure, there is no treatment and only if he is seen by his psychiatrist does it get billed as a mental health visit (but he has been seeing this doctor for over 10 years as he did have depression from ptsd). Even when he sees his neuropsychologist for the yearly testing, the neuropscyhs office puts it through as a medical procedure--NOT a mental health procedure.
The doctors offices need to be sure to code the vist properly for the insurance company as a medical not mental health problem.
My DH has had BCBS of Michigan as a supplement to his Medicare and as of Jan. 1, will have Blue Advantage Ruby PPO (a Medicare Advantage plan from BCBS of TN) and neither have any kind of exclusion regarding Alz that I can find in all the material they have sent me to read.