(greeting from neighboring Latvia)

[Bobute]

Aciu labai (thank you) my neighbor:
Hello Norbet. I greatly appreciate the time you have taken to answer mE. Blessings my friend, peace be with you.
I will check with my doctor of course. Since am MRI was not done after the mini stroke, I am not sure how much damage occured. I did lose my ability to speak normal and my taste buds.
My speech was like baby talk, not in full sentences. That lasted a few hours after going to the hospital. Then it just disappeared, gone, I was speaking normal again. I did have an IV runnig , so maybe that was the reason it cleared up.
I was also told I lost my taste buds because of the medication they used. That lasted for well over a year. Nothing had taste of any kind.
I recoverd after about three weeks well enough to drive again. Shaky at first, but able to go to church and run a few errands until my strangth built back up.
The following February I had shingles in my right ear along with loss of swollowing on the right side and an eye that would not close or blink. My face was twisted and I had no balance at all.
Still no MRI. About 6 months , not sure, later the forgetfiulnes, confusion, some anger with moodyness began to appear.
Then my doctor ordered the first MRI with contrast and said I had atrophy and isschemia with dementia. No added meds at the time.
Later with more forgetfulness, confusion, and mood swings a neuro was suggested who began mE on the Aircept after another MRI, no contrast.
After the Ramsey I noticed the changes beginning. Not that much after the stroke that I could tell. Ramsey really seemed to kick it all off. I was not treated soon enough, within 48 hours, so it was a full blown case.
I was too sick to get out of bed. Thought I had the flu and grew weaker each day until finally I discovered my face twisted and the paralysis. I was in a wheel-chair about 3 months, too weak to walk. Wore a patch about 3 months, my eye would not close and lived mostly on liquids because I had trouble swolling.
I feel Ramsey brought it on moreso than the stroke. I understand medi-care will pay for an Alz. test. Is that true and what is the test? How reliable is it?
Blessings again, thank you

Bobute, mE
xoxox

[norbert1]

Bobute,

You asked, “I understand medi-care will pay for an Alz. test. Is that true and what is the test? How reliable is it?”

First, I suspect at the time of your mini stroke, a cat scan was taken. This must be done before anti-clot therapy is begun.

There is no single test to diagnose alzheimers. Diagnosis is a clinical diagnosis, meaning that a diagnosis is made by the doctor based on a confirmation that the results of all tests and observations are consistent with alzheimers. So an MRI is one of the things looked at. Making a diagnosis is more difficult when more than one thing is going on.

The MRI takes a picture of the brain and shows both the external and internal structure. The MRI is also used to look for other conditions that might be the cause of problems, in other words, it is also used to rule out other conditions…. to judge the amount of stroke damage for instance.

The effect of alzheimers that can be seen on MRI is atrophy (shrinkage). Early in the disease, the amount of shrinkage is not great enough to be seen on MRI. Much later in Alzheimers the shrinkage is great enough to see. For the most part, the shrinkage is throughout the brain, but might be more concentrated in some specific regions.

Methods to see Alzheimers plaque or to measure shrinkage of the hippocampus (the memory control structure) during the MRI are currently under development and not yet available for diagnosis.

The Alzheimer test you are probably asking about is a PET scan. This test is similar to a cat scan, but the patient is first injected with radioactive glucose (sugar) By measuring levels of sugar consumption, they get a picture that shows level of functioning in all parts of the brain. (Intensitiy of brain activity shows as different colors, so the image resembles a thermal image.)They will determine whether the pattern from the PET scan corresponds to the suspected type of dementia. This test is more expensive than an MRI. Medicare recently adopted guidelines that allow the use of PET scan when the patient is under age 65, or the doctor is having trouble making a diagnosis. It is considered more accurate than MRI because each type of dementia tends to make a different distinctive pattern in this test.

Neuro Psychlogical testing is a way to use question/answer tests and written exercises to determine level of function of different areas of the brain and corresponding thought processes. It is the old fashioned way to do the same thing as a pet scan. It is also a way to determine percentage of function of various brain functions – to determine if a person has the ability to do certain tasks properly.

Some doctors take spinal fluid samples and look for tau, Beta Amyloid, or homocysteine. These tests have never been validated with testing and there is no agreement of what different levels of these substances mean. (i.e. cutoff points between normal or abnormal, accuracy, and specificity (# of false postitves)).

You talk of the development/worsening of forgetfulness that you experienced. This is probably the most significant issue the doctor is considering. A major factor is probably whether this “forgetfulness” corresponds to the type of memory problem seen in Alzheimers and making sure that there is not another possible cause.

God bless,
Norbert

By the way, my wife is the Latvian in the family. Her parents came over after WWII as displaced persons. She knows some Latvian, but is not really fluent. She tells me that there are a few common words between the two languages, but apparently not very many.
Mes milet tevi = (we love you)