Journey Through Dementia

Journey Through Dementia

Thursday, August 15, 2013

An Exercise in Futility

When I dropped my mother off at Atria this morning and drove out of the parking lot, I was fighting tears.  I don't know what I expected, but something more than what I got.

We didn't go to the Brain Gymnasium yesterday.  Well, we did, but my mother got very dizzy and said she had to go back to the apartment.  I walked with her, holding onto her because she was kind of staggering.  She's had dizzy spells before, but not since she moved to Atria (or at least not that she has told me).   Ordinarily I would have waited to see if she had more spells, but I am nervous about leaving her alone while we are on vacation and as she had not yet met the doctor I signed her up with, I decided to make an appointment just to make sure everything is OK.

She hates to go to the doctor, so the fact that she agreed to go without an argument told me a lot about how she was feeling.

This morning she wasn't feeling dizzy and so she was angry that we had to go to the doctor.  I swear she turns into a 10 year old at the thought of seeing any medical professional.  Of course I have a warped sense of terror since I worked in medical offices for so long and see nothing terrifying about them.

But she agreed to go.  I chose Dr. S for her because when I went to get her on some doctor's service, he was the only one available who listed "gerontology" as one of his special areas of expertise.

On the intake sheet, she wrote "dizziness and insomnia" for reasons why she was there.  I had previously written him a letter of introduction in which I outlined her memory problems and what had (and had not) been done in San Rafael.   She never took her neuropsych evaluation because at the time they scheduled it, we were in the process of moving her here, so her official diagnosis is still "mild cognitive impairment," which was given her more than a year ago.

Dr. S got into the room and introduced himself to us both, the last time he looked at me throughout the exam.  He asked where my mother had lived before she came to Davis and she laughed and looked at me and said "I don't know, Bev...where did I live?"  She made it sound like a joke, but she really doese not remember where she lived.  He then launched into a story about his family going to Sausalito for a boat class and having to stay in San Rafael and how there was a race going on and so the hotel rooms were going for $600 a night and they stayed at a Motel 6 where they paid $200 a night.  The story went on and on and on.

He finally got to her first complaint and spent an exhaustive amount of time on dizziness and its causes, all in terms that I could see clearly she was not following, though she pretends well.  At some point when he had run the subject to exhaustion, I mentioned that she was also there for insomnia.  He snapped "we'll take things one at a time."  He then went to her last bone density exam, done in 2007 and suggested it might be time for a new one.  She growled that she didn't like tests and he said "Well, I'm just here to suggest; the decision is up to you and I gather your decision is no."

He looked at her diagnosis of "mild cognitive impairment" and said "When you wake up in the morning, you know what day it is and what date it is, don't you?"  She said "oh sure."  I said "You do NOT" and she got angry with me.  Later, when I mentioned the neuropsych evaluation which had not been done, he poo poo'd it and said that was for head trauma and that because she knew the day and date and remembered 4th St. in San Rafael (which he had mentioned and she agreed was a nice street--it's the street she worked on), that she should remember that a little memory loss was inevitable as people age.

He didn't do a THING to check her memory.  Not one thing, but get her to say that she did know the day and date, thought he didn't ASK her the day and date, which she would not have been able to give him.  That's her biggest frustration every week at Brain Gymnasium, not knowing the day and date, to where Michael now writes it down for her each week so she won't be so frustrated.

Dr. S ordered some labs to be done (which she also growled at) and then sent us on our way without even addressing the insomnia, which in the confusion of his trying to explain his four page medical report to her I completely forgot to bring up again..  By her report, she has not slept for about 3-4 nights, lying awake until 5 a.m. and the doctor didn't even address it.

In all honesty, I don't know what I'm expecting.  But something more than this.  He offered her a shingles vaccine, saying that even though she had shingles before, she could still get it again, but she doesn't like shots, so he didn't push it.  He didn't push a bone density exam though she takes no Calcium supplement and her biggest fear is having to use a walker or be in a wheel chair, which would certainly happen if she happened to fall (like maybe when having a dizzy spell) and break a bone.  

He did order labs and I'll get them done, though she's angry at having to go to the lab, especially when she's fasting, so with Jeri coming for the next week, I don't know if I'll do that now or wait until we get back from vacation.

She's very, very nervous about our being gone for 3 weeks.   She must ask me a dozen times a day what will happen to her if something goes wrong while we are away.  I reassure her that the manager will be aware that we're gone, and he will have both Ed's and Ned's phone numbers in case someone needs to be notified.   I have also arranged with my friend Peggy, who lives at Atria, to send her photos while we are on our trip, and she will bring my mother to her apartment and show them to her on her computer.  

And in joking mode, I tell her that if she dies, I will make arrangements for the chef to hang her in the dining room kitchen freezer until I get back.

I wish I felt better about this doctor, but after today, I have a feeling this is not a guy to discuss anything with; it's a guy to order tests and that's about it.

I wonder what he learned in his gerontology class...