Our Meeting with Dr Brain

It was a week ago that I told my mom that I had set up an appointment to see a neurologist, and how’d that go? Not so well.

Today, which is Monday, is my mom’s day to stay with the kids, but it was also the day of the appointment. I didn’t say anything when she first showed up, but left her and Aitch to do their thing and ran some errands (I’m normally at work, but had the day off). While gone, I psyched myself up to remind her. When I finally did, while she didn’t want to, she said, “If it will make YOU happy…” No, it wasn’t going to make me happy because I knew what it meant.

When Dr. Brain introduced himself and asked why she was there, she shrugged, mute. I then had to explain that there has been some memory lapses and that she repeats herself in her story-telling and questions. I felt like an ass; like I was somehow throwing my mom under the bus or at the least, complaining about her. I tried to explain that we were there to see if was indeed the normal progression of aging or if it was something else we should be aware of.

He then went into a series of questions that I initially thought were rudimentary in nature:

What is today’s date? The 11th. (It’s the 19th, and we had just signed at least four pages of paperwork that required both her signature and today’s date.)

What year is it? 1980. No, that’s not right. *long pause* I don’t know.

Who is the President? Kennedy! (answered almost too quickly and too enthusiastically) Wait, no…. *another long pause* I don’t know.

How many grandchildren do you have? 10. (she has 11)

There were several others including some simple calculations and where she lived. She struggled with the math problems (What is 100 minus seven?), but was able to answer what city, county, state and country she was in. He also had her draw something similar to a Venn diagram, but instead of circles, she was supposed to do hexagons, which were already drawn on the paper. He then asked her to write a sentence at the bottom of the page. She wrote: “Right [sic] a sentence on the bottom.” At least he laughed at that, but he did make her write an original sentence.

Afterwards, he took several seconds to review his notes, including several hash marks he had made in the margins. Her score was 23 out of 30, which he explained as he presented his opinion: beginnings of dementia, which usually means Alzheimer’s. He explained his scoring system and that he’s going to put her on a new medication. He told us what I had already known about the meds and that is they don’t make things better; they just help to keep things from getting significantly worse too soon.

In a year he will test her again (but yes, we will be following up with him much sooner). In a year, her score should be the same if she takes her meds regularly. Without the meds? She might only score a 19, maybe a 20, at the annual exam.

I could tell as I watched my mom’s expression while he described his findings and the medication that she was upset. Her face flushed and for a split second, she even teared up, but my mom, who is quite stoic, quickly reigned it all back in. Dr. Brain noticed it, too, and went on to explain that we were there to help make sure she stays as independent as she is now. She’s able to cook, clean, drive and basically look after herself and make choices for herself. The medication could potentially give her four more additional years before nursing home care may be required.

Dr. Brain was efficient and frank in his examination and delivery of his news, and yet he was still compassionate. It was hard to hear and I can’t imagine what it is was like to be in my mom’s shoes. She’s seen so many of her friends go down this path and never come back. Understandably, she was in a very subdued mood after the appointment and it was soon that she had to leave to head home. For me, I am also feeling deflated. Four years, even under the best of circumstances, is such a short time. My children will be building memories; my mother will lose them.

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19 thoughts on “Our Meeting with Dr Brain”

  1. I feel so much for you; as you may know we have been going through similar things with my MIL. She is still in her own flat but has carers three times a day. She us quite confused at times and given that she doesn’t really remember me,I doubt she’ll be able to work out where our new baby had come from.

  2. I don’t know who my heart hurts more for right now, you or your mom. I’m sorry you have to be going through this. I can’t imagine what must be going through your mom’s mind.

    Have you and your siblings talked about one of you taking on power of attorney for your mom? I know it’s not the most pleasant thing to talk or think about, but maybe this is a good time to do that and also have your mom have some say while she may still be able to participate in these kinds of decisions (goodness, I hated writing that last part…).

  3. I’m so sorry. I’m going through the same thing with my mother and my mother in law. I hope the meds help her in the coming year and she doesn’t decline too quickly.

  4. Oh crap. I didn’t realize that she had reached the point where the year and the president would trip her up. Of course you know that the doc is giving you a general number so don’t hang your hat on that. Each case is different and your mom could be one of the lucky ones that the meds (?ari.cept, nam.enda etc) can actually seem to help for quite some time.

    I am so sorry you are on this road.

  5. I know this sucks ass. But it’s also good to know that you’re being proactive. I can only imagine how hard this is on you. It’s good that there is medication that can help slow it down and it’s good that you guys now have a baseline. Sending hugs your way.

  6. My heart sank as soon as you got to the part about the date, and then kept sinking. I am so grateful to you for writing about this, especially about the part where felt like you were betraying/complaining, and about her reactions, and just about what to expect from the appointment. So many of us are going to go through this, and it’s so valuable to feel a little more prepared.

    1. Thanks Swistle. I guess writing about it is not unlike writing any other difficult event, like infertility, miscarriage, cancer or ADHD. “Better out than in, I always say.”

  7. Alz is a cruel, cruel illness; there’s nothing good to say about it. The drugs are getting better and every minute saved is precious. DH practices elder law – this is his world, on a daily basis. Families are often in complete denial and wait until the last minute to get help, start treatment, start planning for the future (considering nursing home / assisted living / home health, payment options, advanced directives / POAs, etc.) It’s a wonderful thing that you and the family are already planning for the future. Mom has the ability to share what she wants and that, in itself, allows a dignity in life that many don’t get.

  8. Although it seems short in the grand scheme of things (and I agree it is, and that I’d be feeling the same way), four years is still four years more than you could have without medication.

    Here’s hoping she takes the meds regularly and both of you overcome the guilt and sadness that came with the appointment today. As hard as it was, I whole-heartedly believe you did the right thing.

  9. It’s good that there is a medication that can slow the progression. That will give Aitch a chance to cement some memories of Grandma. Doodicus already has his, and can make more.

    I’m sorry this is happening to your mom…

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