The Diagnosis

A month ago we went to the VA hospital in Madison for a Neuro-psychology exam. This is a brain function test of executive functions, thinking, making decisions, planning, understanding, language, perception, and ...well, you get the idea.

It was a two hour test that we did on the 14th of last month. I should say, a two hour test that Rich did last month.
I learned in Physical Therapy-Speech last year that issues a person has pre stroke generally become worse post stroke or as the PT gal said, the issues would be greater in general.

We sat down in the room and I mentally thought I was prepared for hearing the two doctors conclusions.
I wasn't.

Cognitive Disorder, specifically Vascular Dementia -- the doctors were quick to say that Dementia means Brain Changes-- the stigma of hearing "You have Dementia" is about as horrid as hearing the word "Cancer".  Perhaps even much worse. Dementia is like saying: You are going to lose your mind.

We have gone down the Cancer Road already so I didn't think anything would actually shock me.

Rich has not just had one stroke. Last year's stroke was just a big bang compared to all the others he has had over the years. In other words, he has had a lot of insidious brain damage over the years.

I had thought perhaps that Rich had Vascular Dementia, but until the words were clearly spoken to me in that room, there was a chance that it wouldn't be that.

I looked over at my husband and wondered how he was taking the news. Hard to tell as he was just listening and watching. The doctors were very good to look us both directly in the eye.

Then they asked a few direct questions. "Val, you are not working correct?" I smiled and said that was correct, I had to quit last year to stay home and take care of Rich.
"We have a treatment plan and some things we believe will be helpful but it is a big commitment."

The question behind the question. 'Will you go running from this room screaming your head off and ditch your husband? Or are you willing to put in time and extreme effort for his therapy and care?'

I replied to them that I was there for the long haul. After all, I'd driven to the UW 5 days a week for over 6 weeks to take Rich to radiation treatments and tried to work on the weekends.

They went over the details of getting appointments with PT, OT, and seeing a Medical Psychologist too. I inquired if that would be that same as the gent we saw during cancer treatments. He was quite helpful. They thought they'd try to schedule us back with him since we had a history already of seeing him during the cancer treatments.

Social workers, OT coming to the house for inspection, testing Rich for safety, OT doing driving tests with Rich...arranging Respite Care.

Discussions of driving, not driving.

And then the bombshell.

"Do you have your POA set up?" the one doctor asks of us.
"Yes," I answer, "we did that quite a while ago."
"Financial and Medical?"
I nodded.
Rich nodded.

They turned and looked at Rich. "We may ask your wife to be your Medical Agent as we are not sure you can make your own health decisions. We will consider Financial POA also."

I could see that Rich was a bit shocked. So I piped up.
"Honey, if they do that, nothing really changes. Right now we are doing all of this together anyway. We sit and do the bills together, we go to appointments together right?"
He nodded. "I could do the checkbook," he said, "but my tremors are so bad. I can't write so Val does it."

There it was, the same thing we went through with his mother. Losing your independence officially. It didn't matter that I've already been doing most of what a Guardian or an Agent for Health/Finances would be doing already. But the 'threat' of having that taken away was downright frightening for him.

The discussion went on to talk about how Speech Therapy would help, meeting with the Med/Psych doctor would help, PT, OT, Social Workers, setting things up.

The goal was to maintain Rich on a plateau provided there wasn't another brain incident or other health incidents.

In one year they would test him again to see if he was able to maintain or...
Well.
Let's just say it out loud. This sort of brain damage doesn't reverse itself.

I'm not asking for sympathy or writing this for shock value.
I may continue writing about this on my other blog called The Long Road.
The Long Road is where I addressed our travels through Cancer.

I hope that I am prepared to travel down this new fork in the road.

Dang it All to ...

Well dang it all to heck and back.

I'm not going to really whine about this too much. Hmmm. Maybe I will. It seems that osteoarthritis has crept into my life. Well at least into my hands.
I of course figured that it wouldn't happen to me.

Stupid me. I sort of knew it would. My Grandmother Pearl had twisted gnarly hands and she barely whispered a word about it. I'd see her gardening, crocheting, sewing, and doing all those normal things with her beat up hands. At the time I admired those well worn hands and said something to her about it.
In all her infinite wisdom that I never learned...she replied, "Oh I don't think you want these hands. Some days they don't do so well."
She said this as she was artfully cleaning a fish with quick skilled movements.

My mom began to suffer the same fate as did her sisters. Arthritis crept up on their hands deforming them and sometimes twisting the joints.

Over the past year or so, my hands began to ache a lot. Certain movements hurt. Grasping things was painful. My left thumb continued to hurt making grasping door knobs a real chore. In fact when we remodeled, I had handles put on the door that I could just push down on.

Opening a jar can be tricky. Using an old fashioned can opener can be a trying feat. Over the winter my hands became worse. I developed Herberden's Nodes on the ends of my fingers. As those nodes develop, the pain is quite intense. I recall my father showing me the tips of his fingers and telling me that once the bump was formed, it stopped hurting, so it wasn't so terribly bad.
Oh, he was not kidding!

So this summer those wonderful little nodes pretty much quit hurting and I was able to get along except for the thumb issue. Sometimes at night, I'd fall asleep with a cold pack wrapped around the left hand. It numbed things enough so I could sleep.
Peeling apples for apple crisp last month made the pain nearly unbearable. So I decided to see how I could process apples without causing myself a lot of pain. Easier to make jelly, juice, and apple sauce than to peel apples.
Plus I got a food mill which helped tremendously.

Brushing the mules out for riding was even a bit difficult, but I decided worth the pain.

I sort of knew what may be going on with the hands. Goodness knows I've seen it in my grandmother, my mom, and my dad. However my fingers are not being deformed much.

So when my doctor and I looked over the hand X-ray results, I was sort of surprised. There it was osteoarthritis in both hands. No fingers were left unscathed.
The left thumb showed degenerative joint 'disease'. Oh. Ick.
Mostly it means that the hands will slowly get a bit worse as I get older.

Now dammit, how did I get older? In my mind I am about 30! I look in the mirror and see that older person looking back at me. She disappears when I take my glasses off. She looks much younger after I take a shower and peer at her in a fogged up mirror.

My doctor recommended that I see Occupational Therapy for exercises to strengthen my left hand and to see how they could suggest non drug like therapies to lessen the aches and pains. I am all for that. Our local clinic has an excellent PT/OT department and they have helped me quite a bit in the past.

How am I going to 'deal' with this? Well, now that I have a name and a cause for the pain, I will not quit doing things or baby my hands. The pain is not indicative of something that will harm me.
It is simply wear and tear. I need to work out how to do some things smarter and need to be aware of the "Use it or Lose it" theory. If I stop doing things with my hands, or I stop being active ... I will be in more pain and more health problems will arise.
If the body stops moving, it will destroy itself.

My doctor said that if the thumb issue got too bad she would send me to a hand specialist to explore injections [eeks!] and perhaps surgery [eek gads! NO!]. She said she had a patient who went through the surgical procedure and the recovery and PT time took about 6 months. No thank you!

This is not earth shattering but it will include some minor changes for me.

Yes, I think my father was correct. Aging is not for sissies.