MARIE: I promised to write about Jon’s recent assessment by a neuropsychologist. Well, it was a really thorough affair, over three hours of playing one game after another. There was mental arithmetic to test working memory, Rorschach-like images to test pattern recognition, alphanumerical mazes to test planning and analytical skills, drawing test for visual acuity, odd-one-out tests for logic and reasoning, Q&As to test orientation and understanding, naming games to test language skills, and much more besides. Most tests came in several variants, so Jon would complete a test, go on to something else, and then be returned later to a similar test for confirmation.
I was there, trying to be unobtrusive in the background and following Jon’s every answer. Many were unsurprising: yes, he knows perfectly well who the US President is but no, like many a retired person he’s not entirely sure about today’s date. Yes, he’s very good at pattern recognition (image analysis was a big part of his job) and yes, he’s always been hopeless at mental arithmetic.
However. The tests also clearly show that Jon’s working memory – what people generally call short-term memory – is very poor. His ability to learn and retain new information is also much deteriorated, as is his ability to plan a task and carry out the plan. On the other hand, Jon’s language is possibly better than he thinks – he has complained of frequently being unable to find the right word, but the tests showed that he can when he focuses.
Several times along the way, Jon was told that “this is quite typical for Parkinson’s”, where not just the body but also the thought processes become slow and “stiff”. For instance, Jon had to name as many animals as he could in one minute. He started out in typical Jon-style with aardvark, which I see as a flash of brilliance, but then attempted in vain to continue with one animal staring with a B, one with a C and so on. He soon got stuck, and here comes the Parky bit: he couldn’t seem to shift gears and mentally go “okay, drop that and move on to zoos or farmyards or pet shops or …”. That kind of rigid thinking is very familiar from our everyday life, and probably as frustrating for him to live with as it can be for me to live next to
Of course these issues haven’t arisen overnight. Just like the physical symptoms of Parkinson’s, these cognitive symptoms progress so slowly that it’s quite unnoticeable from one day to the next, but pretty clear from one year to the next. Having the test show up areas of concern is actually a kind of non-event, just confirmation of what we have suspected for a little while.
As Jon said: "My brain is turning to custard, which is ironic as I happen to be a world expert on custard". We are now waiting for the written report with detailed results. Next come follow-up consultations, first with the neurologist to see if further tests are needed and if medication can improve things, and then with the neuropsychologist to hear about home therapies that may help slow the development of symptoms.
More of that next time.
Showing posts with label rigidity. Show all posts
Showing posts with label rigidity. Show all posts
26 October 2011
10 January 2010
Balancing acts
JON: Bah, Humbug to all my readers, and I wish you all the usual messages of despair and hopelessness that accompany the past season of enforced jollity. There, that’s my annual moan over and done with. Here, we celebrate Isaac Newton's birthday (25 December) with a meal of historically appropriate excess and complexity, and we are now sufficiently fortified to man the barricades for the coming year.
Coming soon will be my assessment by the ‘benefit people’ who will determine my level of disability and thus the size of the pension I will receive. I am of course hoping that they will find me entirely decrepit and of no use whatsoever to the world of work. (This, in my opinion, is not far from the truth, but is something I generally try hard to forget.)
However, at roughly the same time I will also need to be re-assessed as to whether I can safely be let loose with that modern murder weapon, the car. Here, of course, I shall try to impress all round with how marvelously well I function despite my little neurological problem. Quite a balancing act, that (such fun with Parkinson’s). As a first step I get to see a neurologist other than my regular, and then if he feels it necessary I get to take more or less a full driving test. When I took the test two years ago I passed with no problems, so I’m hoping all will be well again this time – and am feeling reasonably confident since last time I was suffering unpleasant side effects (mainly tremors) from the medications I was taking, whereas now my motor symptoms are pretty well controlled.
In fact, I imagine that from a distance you would not actually be able to diagnose me – closer up I shake a bit and have the occasional twitch, but it's much, much better than it was. Marie disagrees and thinks my rigidity would tip off anyone with a glancing knowledge of Parkinson’s, though luckily that should not be much of an issue in relation to driving. Anyway, if I can convince myself this is true then I might be able to convince the neurologist that I don’t need to take the driving test.
In fact I do very little driving, but to lose my license would be a pain, both for me (becoming less independent) and for Marie (becoming my constant driver). I’d be happy enough to be my own passenger as my main deficiency on the roads is that I am over-cautious so drive slowly enough to infuriate other motorists.
I’ll start the year with a plea. I have only just worked out how to add a hit counter to this blog, so I have quite a vague idea of how many and/or who is reading it. If you can spare a moment, add a comment or send me a short e-mail, just so that I know there is someone out there in cyber space.
MARIE: I should like to add a small rant to the above. It is of course entirely reasonable that Jon’s driving skills should be regularly assessed as the disease develops, and quite possibly an evaluation every two years is a sensible interval. It’s a fair bit of bother for us since first one has to go to the town hall to get the application form, then to the GP to get his notes on Jon’s condition, then send in the forms and be told to go see a specialist neurologist, then possible take a fresh driving test and then, at last, order the new license.
This all takes quite a bit of time, but one could argue that as Jon is too ill to work, he is not short of time. However, time is not all it costs. There’s a fee for the form, a fee for the neurologist, a fee for the test and a fee for the license, in total running to rather more than 100 euros – every other year. It strikes me as very unfair that the disabled, who have small incomes and no way to improve on them, and who are more dependent on cars than the fully able who can choose to use bikes or public transport instead, should be made to pay this special mobility tax. We are lucky to be reasonably secure financially, but I can imagine the extra expense can be quite a concern to many disabled drivers.
Coming soon will be my assessment by the ‘benefit people’ who will determine my level of disability and thus the size of the pension I will receive. I am of course hoping that they will find me entirely decrepit and of no use whatsoever to the world of work. (This, in my opinion, is not far from the truth, but is something I generally try hard to forget.)
However, at roughly the same time I will also need to be re-assessed as to whether I can safely be let loose with that modern murder weapon, the car. Here, of course, I shall try to impress all round with how marvelously well I function despite my little neurological problem. Quite a balancing act, that (such fun with Parkinson’s). As a first step I get to see a neurologist other than my regular, and then if he feels it necessary I get to take more or less a full driving test. When I took the test two years ago I passed with no problems, so I’m hoping all will be well again this time – and am feeling reasonably confident since last time I was suffering unpleasant side effects (mainly tremors) from the medications I was taking, whereas now my motor symptoms are pretty well controlled.
In fact, I imagine that from a distance you would not actually be able to diagnose me – closer up I shake a bit and have the occasional twitch, but it's much, much better than it was. Marie disagrees and thinks my rigidity would tip off anyone with a glancing knowledge of Parkinson’s, though luckily that should not be much of an issue in relation to driving. Anyway, if I can convince myself this is true then I might be able to convince the neurologist that I don’t need to take the driving test.
In fact I do very little driving, but to lose my license would be a pain, both for me (becoming less independent) and for Marie (becoming my constant driver). I’d be happy enough to be my own passenger as my main deficiency on the roads is that I am over-cautious so drive slowly enough to infuriate other motorists.
I’ll start the year with a plea. I have only just worked out how to add a hit counter to this blog, so I have quite a vague idea of how many and/or who is reading it. If you can spare a moment, add a comment or send me a short e-mail, just so that I know there is someone out there in cyber space.
MARIE: I should like to add a small rant to the above. It is of course entirely reasonable that Jon’s driving skills should be regularly assessed as the disease develops, and quite possibly an evaluation every two years is a sensible interval. It’s a fair bit of bother for us since first one has to go to the town hall to get the application form, then to the GP to get his notes on Jon’s condition, then send in the forms and be told to go see a specialist neurologist, then possible take a fresh driving test and then, at last, order the new license.
This all takes quite a bit of time, but one could argue that as Jon is too ill to work, he is not short of time. However, time is not all it costs. There’s a fee for the form, a fee for the neurologist, a fee for the test and a fee for the license, in total running to rather more than 100 euros – every other year. It strikes me as very unfair that the disabled, who have small incomes and no way to improve on them, and who are more dependent on cars than the fully able who can choose to use bikes or public transport instead, should be made to pay this special mobility tax. We are lucky to be reasonably secure financially, but I can imagine the extra expense can be quite a concern to many disabled drivers.
Subscribe to:
Posts (Atom)
