Why so hard to get diagnosed?!?
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Comments
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What medical professionals have you seen or testing have you had?
I wasn’t taken that seriously either until I repeated my request to a neurologist and he gave me a screening for cognitive impairment.Stress can be a cause for cognitive impairment, though.
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Thank you for replying! I feel so alone! I have seen a neurologist for an MRI and a neuropsychologist for a neuropsych eval that the neurologist referred me to and I see a speech therapist for "cognitive rehab" that the neurologist referred me to. Everything was normal on the MRI and neuropsych eval and they are saying the cognitive rehab is for my ADHD difficulties. Those tests were over a year ago and I am noticing that I cannot do my job anymore, so I do not know who to talk to about that.
I do not want to wait until my deficits are measurable conversationally because by that point I should not be doing my current job. The tests they gave me are not sensitive enough for early detection, IMO.
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WelcomeWJordana. You say your neurocognitive testing was normal a year ago. If you believe that there is a significant change in your abilities, after one year there should be some evidence on testing, if you were to be retested.
You say your testing was not sensitive enough for early detection. I hope you had more than a mini-mental exam. A thorough neurocognitive testing takes about four to six hours, depending upon your abilities.
Have you had any verbal or written warnings regarding your work performance? Has your cognitive rehab speech therapist discussed work accommodations?
If you cannot do your work, you might consider taking a short term medical leave of absence pending completion of your medical evaluations.
Were you given blood tests to check for medical causes of memory loss?
Were you evaluated for sleep apnea, which can cause memory loss?
Are you on any medications that can cause memory loss as a side effect?
It does take a lot of time to evaluate memory and cognition because there are so many possible causes that must be searched for and ruled out.
Iris
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Iris- Thank you for responding. Yes, I had a full neuropsych work up. I am self employed so I have no income if I don't work.
I have not had a blood test done for memory problems that I know of, just for hormones, thyroid, and normal panels. What blood tests should I be asking for? I am going to ask for a lumbar puncture.
I already have diagnosed sleep apnea, REM sleep behavior disorder and persistent limb movement disorder and a CPAP.
I am not on any medications that cause memory loss.
I don't drink or do drugs. What do you call the blood test for taus or amyloid?
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Oh and yes, the cognitive rehab is helping me with ideas to make me remember what I need to do like take my medications and know what I am supposed to do each day for work and hygiene,but it is not enough help. Can you hire someone to help you set up your reminders and alarms?
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it’s interesting you say you have REM behavior disorder (RBD):
”RBD is strongly associated with certain neurodegenerative disorders. About 97% of people who have isolated (idiopathic) RBD will have Parkinson’s disease, Lewy body dementia or multiple system atrophy within 14 years of diagnosis.”
I’ve heard this before, but this is from:
https://my.clevelandclinic.org/health/diseases/24465-rem-sleep-behavior-disorder-rbd
You may want to ask specifically about these conditions as well.0 -
Thank you, I will. I have a virtual appt with my GP on the 17th.
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Jordana, there has recently become available blood testing for taught and amyloid. You might want to read about that and ask your neurologist. Keep in mind that abnormal test results can impact your ability to get insurance and in other ways.
KHA brought up an interesting point about RBD. Read as much as you can about this, and then discuss with your neurologist.
Also keep in mind that neurodegenerative disorders generally progress slowly in the beginning, so there may be delays in receiving a firm diagnosis. During this time optimize whatever you can, such as using the CPAP to keep your brain oxygenated during the night while you sleep. Follow the habits of Best Practices, they can help you.
If you had extensive testing from a neuropsychologist, the testing should have been sensitive enough to pick up deficits, especially since you were symptomatic. These tests can help diagnose not only the dementias but depression and other neurologic or psychiatric conditions. Repeat testing after a year can give you more information.
Yes, you can hire someone to help you remember to set your reminders and alarms. But if you are at this point of needing outside help, should you continue to be working? I know you need income, but how are you able to complete your work to satisfaction if you cannot set an alarm? Read about work accommodations at askjan.org and search for all of your issues.
You might also think about taking a break from working in order to get some answers for yourself.
You have a lot to deal with. You can speak with an expert at the Alzheimer's Association. There are Care Consultants who are specialized social workers who are knowledgeable and can provide local resources and help with planning and decision making. You can call the Helpline at 1-800-272-3900 and ask to speak with a Care Consultant.
Iris
Addendum: a member on the Caregiver board reminded me about white matter disease. Read about that. It causes cognitive problems but not Alzheimer's.
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Thank you very much for the thoughts. I have my sleep doctor appt scheduled and decided to take action on some work safety measures as I realized I don't need a doctor's permission to take temporary safety precautions.
I appreciate your help. I will trybto get my REM sleep behavior disorder captured in a in lab sleep study as tge only one I have done was in home and it was only 5 hours of data.
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Yes definitely get a lab sleep study.
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My blood tests and my MRI came back normally, but my PCP did recommend a neuro psych eval. They diagnosed me with MCI, and then a PET scan showed Alzheimer's. I am now waiting on an amyloid PET scan.
What I'm trying to say is even though the original MRI came back normal, I would see if you could get a PET scan. Hopefully your health insurance will cover it.
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@maryannbarnsley If you don't mind my asking, which blood tests did you take that came back normal?
I had the ptau-217 and beta-amyloid ratio blood tests for Alzheimer's come back normal, but I'd thought these blood tests just came out in the past year.
If you had these, I'd also be interested in pursuing a PET scan, as my MRI was also normal.0 -
Reading through this thread sounds similar to my experience. I also work from home. MRI was normal. Just finally have had the full cognitive testing done last month with low to below average scores for everything across the board, including memory loss and clear cognitive impairment. But, I am fine with no progressive Alzheimer's or early dementia. I just feel your frustration. You are not alone.
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Hi
So what are you doing as a result of your test results?
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Hi Iris- I can set an alarm, it is more the idea that I cannot set an alarm about something that I have forgotten to set an alarm for. I can do my job when it involves something immediate that I have a deadline that is on an external reminder.
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This is so hard! I was very happy to know that I had an appointment with my GP coming up and then a cognitive rehab session and then a sleep doctor visit the end of this month. But my GP told me before my appt that my insurance was not valid until February. I thought it was valid Jan - Dec bc I picked a plan and paid for it. NOPE! So I have no insurance this month.
I have been trying to get my taxes done for the last 3 years but when applying for health insurance with a disability they want a lot of documents and paperwork and I cannot get it all done and organized. Executive functioning has gotten worse and worse but because I have ADHD, I was not aware it was worsening.
I called my mom who is taking care of my dad with Alzheimer's and told her I was scared of what was happening to me: blanking out when driving and not knowing how to get somewhere, eating mostly just pomegranates 1 - 2 per day for the last month, starting to lose my temper with my dog and with children, pooped my pants in my car accidentally, cold toes and fingers and cold then hot clothing needs, like when you have the flu and the chills, medical bills piling up from forgetting to pay my health insurance last June, big changes in how gross I am able to tolerate my apartment. She told me that she needs my sister and I to be independent when I told her I am scared and need help.
I called our financial planner and told him what was going on and that I need help and he is going to call my mom and get her to set up a family meeting with a professional of some kind.
I found a geriatric specialist therapist and had first session with her on openpath.org, a counseling website collective. She was great and could not believe how much I am coping with.
When I have had coffee and worked out and have had my ADHD meds and have had a decent night's sleep then I sound and appear perfectly fine. But when you come in my apartment on a Sunday when I am not working and see behind the curtain, I am not doing fine. I guess the good thing is, if I have dementia, then it will get worse and I won't care at some point. I just don't want to neglect
my dog, crash my car or burn my apartment building down in the mean time.
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I was wondering if it too late to get long term care insurance if I already went to the doctor with symptoms? Do you have to apply before you have symptoms or the diagnosis?
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I had read that if you have memory issues on your medical record, long term care insurance is much harder to get or will cost a lot more money.
I don't know if it matters if they have found a cause yet or not.0 -
Have you tried calling the 1 (800) 272-3900 Alzheimer's hotline? They have specialists available 24/7 who can advise you on getting help.
I don't know where you are located, but often, there is a local area on aging that can help you find local resources that can also guide you.
You may also want to make arrangements to get help to care for your dog right now so someone can make sure it is regularly walked/fed; perhaps check on rover.com. You might also be able to find someone on someplace like care.com who can help you and check in on you.0 -
Thank you! I think that is a good idea, along with asking for a lumbar puncture and blood testing. Thank you!
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I cannot find the section with Best Practices in it. Where do I find that or is it just a phrase meaning most of the things you are supposed to do?
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