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Sunday, December 26, 2010

The neurological exam . . .

"You do not have dementia."

Welcome words from a brilliant neurologist, David Kaminska, MD.

I had scheduled an appointment with the Neurology Department of Kaiser Permanente as I had concerns about some memory lapses I have been experiencing. Perhaps nothing all that unusual, given my age (I'm 71), but I wanted to be checked anyway. Reason? My mom had Alzheimer's/Dementia and if I was headed down that horrible road I wanted to know about it and take what I felt were the necessary steps to close that ugly door.

Evelyn's mom had Alzheimers/Dementia too, and she was equally concerned as she also has had some memory lapses occasionally.

The Neurology Department wisely requires someone bring you to the appointment (if you DO have dementia, you should not be driving) so it worked out beautifully. Evelyn sat in on my meeting and got the same benefit as if she had an appointment for herself.

What goes on at these neurological screening appointments for memory issues?

Standard blood pressure/weight exams. Doctor comes in and discusses your medical history. He takes down the family history and enters it into your medical chart. Then he asks you memory test questions:

What is today's date.
"February 18th."
What day is it?
What year is it?
What city are you in presently?
Where are you in that city?
"Kaiser Permanente."

I want you to remember three words:
Apple, Table, Penny.
What are those three words I just gave you?
I answer, "Apple, Table, Penny."

He then tests my muscle tone in both arms, checks my eyes, taps my legs with a rubber hammer, asks me the three words, and I answer "Apple, Table, Penny."

He then gives me a brilliant lecture (well deserved) about my weight and my diabetes. Diabetes, he says, will kill you. You can control it. If you lose 30 lbs there's a good chance your diabetes will go away, totally; same with your hypertension. He went into great detail about proper nutrition, what to eat, what not to eat, what eating habits to follow, which eating habits to avoid. He said eating is 80% of losing weight, exercise 20% (too much exercise can make you hungry . . . and then you eat more). But, he said, I need to do both and right now.

If I don't, the diabetes will kill me, or a heart attack will, or a stroke will . . . and, if I don't take these steps then I could well be headed toward dementia. That is a possibility with all of us, he said, but if we address obesity now and lose the weight, there's a strong chance we can put off such problems until our mid to late 80', perhaps even beyond that date.

Among others, he said to get rid of soda pop (which we don't drink) and Diet sodas (which we do. Correction: Have drunk - we're gonna stop. It's loaded with chemicals and it's always better to go natural). Plenty of water, tea is okay, or coffee. He recommended stopping all breads, all pasta, hit the vegetables and fruits; for breakfast, steel cut oatmeal with fruit (which we have very often), or take a large cup, put frozen peas, beans, corn, whatever in, pour in hot water, drink; that is very filling, very quick, and very filling. (I had never heard of this before and it sounds both delicious and nutritious).

And that is pretty much all there is to an exam.

He allowed as how my habit of multi-tasking (having three or four balls in the air at any one time) was contributing to my habit of sometimes forgetting things; plus, at age 71, one has the normal slight memory loss that comes with older folks (remember, our brain shrinks as we age; normal brain atrophy).

Bottom line . . . I do not have Dementia or Alzheimer's, nor do I have any signs of the early stages of same.

The doctor is a brilliant and handsome young guy and practices what he preaches. He described his breakfasts, lunches and dinners. He's a graduate of USC, spent 10 years as an ER doctor in Hawaii, then went back to school to train as a neurologist.
I'm delighted we got him as our neurologist (just the luck of the draw).

As we left Kaiser and headed for our car, Evelyn said, "I'll be expecting my fee of $250."

"What for," I asked.

"I've been telling you the same thing for years," she said. "That's probably about what Kaiser pays the doctor for that exam." (Cost me $15 co-pay)

And she's right.

This time, however, it's time for me to listen and do what I'm told.

That, my friend, is what a neurological exam for memory loss, dementia, or Alzheimer's is like. Nothing to be afraid of at all. If you decide to seek such an appointment, I hope you are lucky enough to get a neurologist as brilliant as this young man.
We lucked out!

Good luck to you!


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