Attention CCF-MD mdf re: answer to previous question...can't post a reply...

  Please refer to post from Dee posted on 12/29 and replied to on 12/31  the subject of the post is "Decreasing Mental Function"  I tried to post a follow up question but the computer wouldn't let me, so I'll try this way!  First let me say I appreciate your quick and thorough response to my post.  I have to admit, though I have tried to justify these cognitive problems as being due to stress or overwork or simply aging, in the back of my mind I have constantly retained a small amount of worry.  I really didn't believe I was old enough to have these problems...in fact, I worried if I was having this many problems at 41 I couldn't imagine how much worse it might get in the years to come!  When I forgot my address, that was the very last straw.  I have found many doctors don't seem to take these transient problems seriously, preferring to deal with obvious acute ailments, especially in a woman of my age, for whom many problems are obviously relatively unlikely.  I also have to admit that the high ANA coupled
  with these recent problems has me worried...in addition to the right arm problems I also have right sided hyperreflexia, which seemed to worry the doctor immensely at first but then no follow up was done following the normal CT scan.  I have also had a couple of falls since then and all my doctor said was to be careful.  As for the possibility of depression, I have had a history of depression, usually following a situation that is likely to trigger depression (the loss of my father, a move away from family and friends just 10 days after giving birth plus with a 18 month old, and the worst and most dangerous depressive episode following the breakup of my marriage....I do not "feel" I am currently depressed, but am certainly willing to address that issue should that be found to be the root of my problem.  I am glad you mentioned that you would not consider that as a diagnosis until other things are ruled out....I have seen a pattern from many doctors of automatically assuming a patient (particularly female,
  and especially if they live a high stress life) with any mysterious medical symptoms is suffering from depression.  I even had that problem when my daughter was very ill and could not walk...rather than trying to investigate a cause for her very serious pain and weakness, the doctors automatically assumed she was experiencing psychiatric problems...it took a psychiatrist to convince the doctors she was suffering from a physical problem...the first time Graves Disease at age 8 and the second time lupus or an associated autoimmune illness at age 12).
  I am very interested in being evaluated by Cleveland Clinic, both the neurology department and the rheumatology department (and maybe even cardiology since I have had a lot of problems with tachycardia and arrhythmias...one cardiologist told me following an exercise stress test the arrhythmias were a dangerous type and could lead to sudden death and I would need life long treatment, yet when we moved the new cardiologist did a new echo and said the arrhythmia was benign and needed no treatment...he refused to repeat the exercise stress test as being unnecessary....yet whenever I experience exacerbations of the arrthymia and tachycardia I can't help but remember what the previous cardiologist said).  I would certainly like answers to my ailments.  I am on an awful lot of medications for someone as young as I am.  Absolutely the last straw was forgetting my address....and I have to say I am tired of other people making fun of me because of my verbal mistakes.  I also have a rough time with carpal tunnel
  syndrome which I assume a neurologist could evaluate the same time as they evaluate the other neurological type symptoms.
  Certainly, I am not panicked by any of this....the symptoms have come on gradually (except for the right arm stuff).  The negative CT scan reassured me somewhat...although originally my doc asked the ER to do a contrast CT scan and they did a noncontrast scan.
  I live in Florida, and I think I have heard of Cleveland Clinic operating some facilities out of Florida.  I am based in Central Florida, am I right in hearing a clinic is going to open soon in Naples?  That is not far at all from where I live, only about an hour and a half.  Could the new facility in Naples do everything the home facility in Cleveland could  and will they have the following departments:  rheumatology, neurology, and cardiology.  Could all these appointments be coordinated within a single day or couple of days...to minimize hotel bills or travel?  Would this more local facility give the same quality care as the highly renowned Cleveland Ohio facility that I understand is your base?  If Cleveland OH is better, we are traveling to West Virginia and perhaps Canada in July....a short visit through Cleveland could possibly be arranged...and I do have some relatives not too far from Cleveland.  Please advise me on which options are preferable, and also an idea of the urgency.  Because of my other
  medical problems, and asthma that has been very unstable this year...and because my daughter has been having many medical problems this year probably lupus related....we seem to spend a lot of time (and money!) in various doctor's offices.  Also, will the Florida facility operate a pediatric rheumatology department.  With my daughter's positive antidsDNA and her other symptoms, I would like some answers as to whether or not she has a second autoimmune illness (she has had Graves' Disease since age 8).  Although I have many restrictions on insurance for the children, as they are on an HMO....fortunately my insurance is much less restrictive and I am relative free to go to whatever doctors I want...the only authorizations I ever need is prior to admission to a hospital.  So I am fairly ok in going whereever I want to go.
  I have the 800 number for the Cleveland facility....is there a number to call for the Florida facillity?  Where I live is in the Tampa Bay area...are there any other facilities close by?
  Thank you for your time and effort.  I'm glad that my "worry" is reasonable, and that someone besides myself feels I need to get evaluated.  I believe you provide an invaluable service to the community of internet users.
  Dee
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A lot of questions I can't answer, but here goes . . .
The main CCF (Cleveland) generally is able to coordinate all appointments in a day or so, particularly if you are able to make the arrangements well in advance. We are accustomed to seeing people from quite far away, so that is a commonplace thing. It's all taken care of by the appointment person you call.
I assume that CCF Ft Lauderdale and/or Naples may do similar practice with the appointment coordination. But I can't say for sure.
I bet if you call the operator at CCF Cleveland at 800 223-2273 and ask her/him what the 800 number is for the Ft Lauderdale or Naples clinic, you may get the information you want.
The best way to find out if CCF FL has pedi rheum as well as other sub-specialists is to call the Fort Lauderdale clinic directly. They are the right people to ask about coordinated appointments.
I don't think I'd wait 6 months to get evaluated. Get this checked out sooner than that. If it's still a mystery as spring approaches, and if you have been found to have nothing particularly sinister, then you may use us in Cleveland as a backup in July. But that shouldn't be the first investigation.
I have no personal experience with the neurologists in Fort Lauderdale, but I assume the CCF-FL would hire competent clinicians. I just don't know the scope of the operation there.
I hope this helps. CCF MD mdf.