New Doc, Different Take on Things

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New Doc, Different Take on Things

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Saw the new neurologist today. I had been nervous as to how that was going to go over. She was great actually. Had gone over the prior neuro's notes and studied the case before meeting with us. Explained the evolution that got us to where Mom is now. Ordered some PT, a barium swallow test with speech and an MRI (it has been over 3 years since the first one).

Original neuro diagnosed PPA-logopenic in 2014 with an underlying Alzheimer's component. BUT this one (and we walked through the old MRI scans) pointed out why she didn't think that was correct.For example that MRI showed no shrinkage in the area of the brain where Alzheimer's has its impact. None. The majority of the shrinkage is in the frontal temporal area which yes, is where PPA and other FTD villains reside. BUT when you dig deeper into the layers of the MRI you find some significant shrinkage in the basal area.

She believes it started as PPA-nonfluent (PNFA) as that variant matches her initial symptoms more closely than logopenic (original diagnosis) and which has now evolved to where corticobasal syndrome is the primary condition due to the rigidity of the right side of her body, the tremors and in scanning through the MRI you can see significant deterioration of the basal area even back in February 2014.

The corticobasal explains the rigidity of her right side, primarily her right arm and the stiffness of that hand which prevents her from being able to use it effectively. Hopefully the PT will help loosen that up somewhat. Won't "fix it" but should help and slow any further progression.

We still have all of the aphasia issues that aren't going away of course - still can't talk or write and reading is going downhill. And a ton of anxiety. She actually had the resident take Mom out for a walk to "check her gait" so she could talk to me without Mom freaking out. I appreciated that.

We're taking her off of Aricept and putting her on a low dose of Zoloft. Recommended adding melatonin later on for coping with the sundowning if needed. Holy crap the outburst THAT caused. Whenever any doctor has mentioned a medication for the anxiety she has gone off. The stigma of depression/anxiety is apparently means more to her than actually having something help.

If there is ANY peace that results from the med change I'll take it.


Hoping for some peace a la Purrcy's the Zen of Purr

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8 Comments

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Lark

Med change? Did you mention a med change and you will take it! Me, too! I'm with you. Just as a mention, cause I am not a doctor (shock and awe). My husband was placed on Seroquel to help with sleep. He has FTD and the symptoms of the movement related stuff. Unknown to me, Seroquel can help with the symptoms and slow down the process. I say \"can\" because, well, you know why. Seroquel does help him to relax but his tremors stopped for the most part and several other body symptoms improved. It is not a cure and I had no idea until he started taking it. It does make him groggy. I have seen it mentioned in some of the literature I have read and my husband's doctor said he was already aware of the possible positive impact when taking Seroquel. It is not a cure. Thank you for sharing.

CatKBorn

Her EKG tests have all been good, there's no history of heart disease but thanks for the info, that possibility wasn't mentioned.

jan

Glad you have a workable diagnosis and hope these medication and lifestyle changes will help you both.

Goldie

How nice you have the right diagnosis this time! Let us know if the new meds work. When we changed meds for my mom, it made a huge difference!