Cards on the table: I'm frightened.
Over the past year or so, I've been slipping in terms of my day-to-day cognition. I tried ignoring it for a while. Tried justifying it Pishh -- Everyone forgets where he parks his car in a large garage! Tried OTC pharmaceuticals like COQ-10.
Not much progress on any of those fronts.
The most vexing part of what I was going through was the spottiness of it all. Yes, Eileen would tell me before leaving for her office at 7:30 a.m. to put dinner in the oven at 5:00. And I'd wave her off: Sure, hon. Got it! And she'd arrive home at 5:15 to an oven full of nothing.
But I considered that as simply having too much on my plate. In my defense, I'm currently holding down four separate jobs: Two as organist/choir director, one as a content creator for a financial services executive recruiter, and one for a regional lifestyle magazine. In addition to helping with our local dog trainer each Wednesday night.
So I took myself to my local PCP, a nearby Certified Nurse Practitioner who I trust completely. His first-stab thought was ADHD.
ADHD?!?!?! Really?
He explained that ADHD is on a statistical rise with aging Baby Boomers across the nation, driven by influences from any number of influences. We joked about it being blamed on everything from too much Kool-Aid in the 1960s to the effects of Heavy Metal music in the 1980s.
He recommended an appointment with a neurologist. I got a family member's recommendation for one and made the appointment.
In the interim--the time between my initial contact and my onsite appointment date--things started getting worse.
One night, after our dog obedience class, I got lost driving home in the car. This is from a destination less than a mile from our home, to/from which I've commuted just about every Wednesday night for more than 20 years.
So, with great hope that things would get better, I went to the appointment.
It wasn't ideal. The doctor didn't seem very interested in my overall story, just a recitation of symptoms. He did some reflex-testing, left the office for a moment, came back with a prescription, made a follow-up appointment and sent me on my way.
When I pressed him -- Is this dementia? Is this something else? -- he wouldn't commit. "I'm calling it age-related impairment." he said.
Umm... Okay. What does that mean?
No real answer.
I expressed my biggest concern: Yes, I was losing ground on day-to-day cognitive operations. But other pieces of my thinking were just fine. For example, I can continue to play the organ without issue. I can follow Mass, accompanying singing exactly when needed, according to the rubrics of Mass.
How does a guy in mental decline do that?
Also, I continue to tackle the Sunday New York Times crossword puzzle (the toughest of the week), most often completing at least 75 percent of it and occasionally nailing the whole thing.
How was I losing navigation in the car while still being able to come up with name of the first Secretary of the Treasury (Alexander Hamilton for the win)?
I got a shrug. "It's complicated. Not all cognition is the same..."
Umm... Okay...
For the next appointment, I brought in the big guns: I had Eileen come with me.
The procedure with the doctor was pretty much a carbon copy of Visit #1: Quick question on my overall status. Reflex check. Doctor exit. Return with a scrip (he upped the original dosage), G'bye.
Eileen kicked into eagle-eye mode almost immediately, peppering him with questions. He gave her the same brush off -- "Well... It's age-related impairment. There's no much more I can do. What cognition he's lost, he's lost. But the med should help him from declining any further."
And voop, gone.
Neither one of us was satisfied with the care we were getting, so we mutually agreed to find another neurologist.
After combing through websites and periodicals and parsing patient reviews with a microscope, we found another neurologist. She had about every advantage we could want. But her expertise and bedside manner meant that an appointment would be tough to get.
Nonetheless, we waited.
And she turned out to be well worth the wait.
Our initial appointment was about two hours in length, starting with interviews of the both of us. Separately.
We were then united, and some future steps were outlined.
First piece of advice was to ditch the meds Doc #1 had prescribed. "Wholly inappropriate," our new neurologist (newrologist?) said.
Second step is extensive testing. I need bloodwork, a PET scan (radioactive material shows how my brain is functioning).
Act three is an extensive eval, a three-hour "test" of sorts that is supposed to illustrate to her what's working and what's not.
That latter exercise has me rattled; I underwent something similar about 10 years ago (again related to cognition), and it was a horror show.
"I'm going to mention three presidents -- Hoover, Taft, and Carter -- and then we're going to talk about the Theory of Evolution for half an hour. And then I need you to repeat those Presidents..."
And so on. And so on...
Obviously, I did well enough in that years-ago testing to require no further medical intervention. The sad thing is, I cannot remember why I went in the first place. Probably at the urging of my family (as now), but sadly, I can't gather the specifics.
The appoints for my regimen with this new neurologist will unfold over the next few weeks, with the three-hour exam being the last.
Not looking forward to it.
I only hope that when I go, I can actually remember what I'm there for...
