Wednesday, July 28, 2010

A Lucid Moment

While visiting the Doctor the other day, Dad was in pretty good spirits and was cracking us up with funny moments (as seen in the video below). The appointment started to drag on because we were talking to the NP for quite a while and Dad started to get antsy. He kept telling Megan "all they want is our money." She had to explain that this was the VA and she showed him the Air Force insignia on the wall and the American Flag in the corner of the waiting room. That calmed him down, but he still thought that they wanted our money.

After the appointment, the nurses tracked down Megan outside and asked if they could come back so that Dad could get some immunizations. They decided to get some lunch first and then go back because Megan was afraid he wouldn't want to go back in the place that is trying to take his money.

When they went back to the VA, they had to wait for a while and from what Megan made it sound like, Dad had a small awakening. I think he suddenly remembered that he was a Dad and he felt this urge to be there for us or help us out. He asked Megan, "Where have I been? Did I go away when you were little? My brain has gone to mush." Megan said she lived with Paula when she was little, and Dad replied, "Oh, Paula." It's a surreal moment when you have to explain to your Dad why he got divorced. He seemed to know that it was kind of his fault and he asked Megan if he was as an asshole. And she nicely replied, "A little bit." And he asked, "Why? Why was I mean?"

This is the closest thing to a serious Father/Daughter talk that we're ever going to have with Dad and it almost brought tears to Megan's eyes. In a disease where we try to hold on to any lucid moment with Dad, Megan was glad for this one.

It was such a heartbreaking conversation and he kept telling Megan how he was so proud of her, and he remembered things about her life - where she lives, her boyfriend. He asked her if Tony was treating her all right. It's definitely one of those real moments that we don't get very often with Dad. I wish I was there to witness it. Hopefully there will be more, but it's quite possible there won't be.

A Clean Bill of Health, Physically

The Doctor's Appointment went well. It seems Dad is still quite healthy except for a slightly elevated glucose level (which is common in patients who have a past of Alcoholism). This was the first time we had been to this particular VA office, and we really liked the Nurse Practitioner, Dr. Reed. Her Mother has Alzheimer's so she is very familiar with the disease and answered all of our questions. She classified Dad as being in the moderate stage, although my Mom and I seem to think he's on the cusp between moderate and the beginning of severe. I kept telling the NP that this was a good day so he's usually worse.

I'm pretty sure Dad has lost more weight since the last Doctor's visit. I think total it's been 10-12 pounds in 2 months. Dr. Reed didn't seem too worried about that when I asked her if we should be. We'll just monitor that I guess.

He's still got that rash and it looks really bad, not to mention it is itching like crazy. We finally got referred to a dermatologist. That is some good news. Hope we don't have to wait too long for the appointment.

We also learned that the elevated glucose level could contribute to some erratic behavior. I said, "I know that Alzheimer's targets the memory and physical coordination, but sometimes it seems that he is acting kind of crazy." She replied that it was sometimes normal in Alzheimer's patients, but it could also be due in part from his elevated glucose. We asked if we should be limiting his consumption of certain foods and she replied, "At this point in his life, I wouldn't worry about limiting anything." Which is exactly how I feel. We've got to let him enjoy the parts of life he has left.

I guess I kind of wanted a more concrete diagnoses of where Dad is at right now. I go back and forth between Dementia and Alzheimer's because Alzheimer's is a specific form of Dementia (which he definitely has) but is really difficult to 100% diagnose. However, through a process of elimination and thorough testing, Doctors today can diagnose to what they refer to as probably Alzheimer's disease with almost 90% accuracy. We're pretty sure that's what he has since it runs in the family and many of his symptoms are pretty specific, but he has never been completely diagnosed with it. The only way that Alzheimer's can be fully diagnosed is after death when a brain scan can be examined for certain microscopic changes caused by the disease.

I've read numerous things about what the brain looks like in an Alzheimer's patient, things like.... the brain shrinks (and kind of shrivels) as the disease progresses because of nerve cell death and tissue loss... ventricles in the brain (large fluid-filled spaces) grow larger which causes the brain to look like it has holes in it - like swiss cheese... Plaques, abnormal clusters of protein fragments, build up between nerve cells and are a prime suspect of cell death and tissue loss in the brain.... gives a tour of the brain in an Alzheimer's patient and it makes my stomach uneasy. It's strange to think that my Dad's brain is shrinking and shriveling... kind of like it is slowly dying.

It also says that the average life span of someone with Alzheimer's is 8 years. But, then it breaks it down a little more...
Mid-moderate Alzheimer's can last from 2-10 years...
Severe Alzheimer's can last from 1-5 years....

There is so much to learn about this disease but still never enough answers.