Well I received the report from the Neuro/Psychologist today and I guess I will share them to possibly help others that may be facing this in the future...
Result for word recognition test known to be relatively resistnat to neurological change I was estimated to fall within the above average range!
Moderately impaired on a speeded visual motor test.
Moderately impaired on a Phonological word list generation test.
Difficulty distinguishing target from non-target stimuli.
Grip strength moderately impaired in right hand and severly impaired in left hand.
Finger tapping moderately impaired with left hand and manual dexterity coordination moderately impaired with right hand.
Moderate impairment on concept formation and mental flexibility.
Performance was generally average to above average on tests of basic attention and working memory (holding information in mind while manipulating it), memory tests, some speeded tests assessing visual construction/perception, tests of reasoning (abstract, practical, social), two tests of concept formation, confrontation naming, academic tests of spelling and reading and left hand dexterity/coordination. Low average range on tests of common cultural knowledge, some aspects of memory, a speeded visual motor test, semantic word list generation and right hand finger tapping speed. Although these latter low average scores are not impaired, they may represent a bit of a decline for this woman.
In summary this 45 year old woman with a diagnosis of MS (1993), paratrigeminal neuralgia, osteoarthritis, asthma and pain. On testing, she endorsed a severe level of depressive symptoms. Given her history of MS, pain and fatigue, the etiology of her cognitive problems may be multifaceted. Given her endorsement of a severe level of depressive symptoms, her psychological status may also be contributing to her cognitive picture.
The only good part was at the end of the letter when she said "Thank you for referring this interesting woman to our service." hehe
Seriously, I was advised to seek out psychological assistance (which I have but they don't seem to take me too seriously and think I am more angry than depressed). I was advised to not attempt to multi-task...only work on one thing at a time and don't try to learn new things without minimizing distractions and don't start a new task without finishing the current one. She stated that it didn't seem to her that my pain was under control and that further discussion about options for pain control would be recommended including non-pharmacological ones.
So that in a nutshell is what they have come up with after all that testing...there was no mention that any of these problems could be related to MS so I would imagine that my gp will say that all I need are anti-depressants and a good psychiatrist right? I will see her next Thursday and it will be interesting to hear what she has to say about all of it. I am going to look into buying a small tape recorder this weekend to put in my purse because I don't want to forget anything she has to say...I want it word for word and a recorder is the only way for me. I will let you all know what happens of course!
I think that the impaired grip strenghth, finger tapping, and manual dexterity could be related to MS, and that's just at first glance.
The good part seems to be that it looks like when your pain is under control and your depression/anger is reduced, you will most likely find improvement in your cognitive issues. If not, then maybe they are caused by MS, and would be clinical evidence.
Don't take this as all bad, let's hope that your gp realizes that grip strength and manual dexterity aren't usually depression issues, unless you're so depressed that you can hardly move, which surely ain't our Rena!
I like the idea of a small tape recorder, just as a memory aid.
I am not really looking at this as all bad...I was sure that there was a possibility of it being worse and at least I seem to excel at a few things...hehe
I am thinking that I don't really care what the gp thinks (even if she claims that she does on occasion hehe). I just want her to realize that this Dr. that db see's would be willing to see me and all I need from her is a referral letter and I am not going to wait for it because I was told by the neuro office to get it in a.s.a.p. I am also going to point out that the evil neuro is on the other side of town and is really unreasonable to get to whereas this neuro is at the University Hospital which I can easily reach via a taxi or bus if I have to.
Hubby will go with me to the gp appt. but I think a tape recorder is a good idea for my own use...even if the psychologist said that my short term memory is not bad I can't for the life of me remember half of what a doctor has said once I leave the office. I will keep you up to date as to what is going on.
I'm wondering what does it mean by the use of "endorsement" several times. Does that mean during your appt. you approved of them saying you were depressed? Sometimes the use of a particular word in reports is standard language but seems so weird - an example of that is the word "deny" - such as "the patient denies drug use." "the patient denies other problems that may contribtue.... " It seems like a weird word to use.
I hope you are able to switch to the different neuro and start the process with someone who may really listen to you.
I asked my Internel Medicine Specialist one time if I could tape due to my poor memory, and she said absolutly not!!! She got very belligerent, and said if I turned the tape on she was leaving. So I didn't. But I did leave her. I wish I had just turned on the recorder, and not mentioned it to her. Get my drift?
Well..I got the recorder and it is voice activated and I have no intention of telling my gp that I am going to be taping her. I am have no intention of using it for any legal proceedings...I am just using it to ensure that I have my bases covered. These pills I am on now are really throwing me for a loop...nausea, fatigue (on top of the regular stuff), dizziness...hope my body gets used to it soon cause I can't take much more of this! Anyway, I plan on just having it in my pocket and then it will transcribe it to print through my computer so I will have it word for word in print. I figure that she has screwed me so many times in the past that I have to cover my backside for fear of it happening again.
Shell...I understand that it is documented but I have my doubts as to whether my gp will actually read the document from the psych or not...she seems to see what she wants to see and that is about it if you know what I mean...time will tell and I will be letting you all know what happens on Thursday.
My GP told me that he knew nothing about MS. I have had MS since 1995, and I am glad to have a neurologist, especially one that specializes in MS. Many years ago , I was a Pharmaceutical Rep and I was amazed by the lack of knowledge some of my doctors had about new medications and research. ( It was documented information in the New England Journal of Medicine - I also gave them white papers) I noticed that the older the doctor the less likely they were to try new medications and procedures. The younger doctors were more up to date on new medications, test, procedures.
I have neuropsychological testing scheduled for Wed. the 29th. It is odd. For my Evoked Potentials my dx was demylenating disease. For the nueropsyc it is progressive memory loss. Maybe that is because I forgot how to pump gas. Do you think? Is there any info I should take with me?
Did they give you a form to fill out prior to the testing? I had to fill out a form answering questions about everything from what meds am I currently taking to family medical history to current and past medical diagnosis. If you haven't been given a form you will have to provide this information prior to the testing. You should take a list of all meds you are on currently...any surgeries that you have had in the past, family history. They will be asking lots of questions re past and present situations so be prepared for a long day. At least it was for me...about 8 hours and then I had to go back because I wasn't finished and too tired to continue...it was then a 567 true or false questionaire that took about 2 1/2 hours. I wish you luck with this testing...it is very indepth and hopefully it will give you the answers you are seeking!
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