sue

my dad's MRI and CT scan show so much damage that, according to his scans, he should be in a persistent vegetative state. whenever he is hospitalized in the local hospital, they have to get the same neurologist to sign off on his care because she is the only one who knows him and can say that these scans are baseline for him (she's sweet, but not too competent). he also has a diagnosis of vascular dementia.

within the last several weeks, he remembered his phone # and the town that he lives in, as well as his birthday, how old he is, and the month of my birthday. he remembered my mom's age and my age as the age that we were when he had his first major stroke over two years ago. these were things that his doctors thought he would never do.

all of his doctors thought he would be dead or in a persistent vegetative state by now. they are very fond of him and are overjoyed that he continues to improve cognitively. he is now aphpasic but as lucid as he was before the first major stroke in 2003 (and with the same personality).

you cannot measure a person or their potential for progress by their MRI.

sandy

Sue,

Put 'aricept' into Google and do a little research, then call your neurologist back and see if Ray would be a candidate to try it. It sure did wonders for my dad's dementia. After it built up in his system---with can take a few months---we could tell when he missed a dose and I credit that drug with helping my dad stay out of a nursing home. He had had a series of TIAs before starting the drug and I'm not sure, but I believe his dementia would have be classified as vascular, too. Aricept won't cure dementia but it can postpone the worst of it by several years. He was also taking several vitamins along with the aricept as per the geriatric phsychiatrist's orders. I understand there is another dementia drug on the market within the last five years, too, that you might search for before calling the doctor back. Don't wait six months to ask him about dementia treatments. If you can find a doctor who specializes in geriatric health....they understand strokes, dementia and drug interactions better than others, in my opinion.

This is a hard time of life Sue, but you'll get through it. You've got to brush up your sense of humor, too. You'll need it to deal with all that is ahead.

Jean

Ray's diagnosis was the result of a series of tests including MRI and MRA, cognitive, brainwave (forgot the initials), and a discussion with a psychologist. I think I would say he has seriously slipped cognitively in the last six months by my observation. It is noticeable now that he answers most questions: "I don't know." whether he later talks about the same issue or not.

It is no good glossing over his defects, from time to time I honestly now that he is losing his memory both short and long term.

There is no question of him going into care, he is only 63 and most is funded for the over 65's so I have a couple of years grace (I hope) but I may have a look at a couple of weeks respite early next year and see what that does. My GP is against respite but he is like that.

Right now I am exhausted at the thought of what lies ahead but Jean, like a rubber ball I just keep bouncing back.

Don't worry, all will eventually make sense, or we will make it into nonsense for our own amusement.

Sue.

sue and jean

there are several dementia medications, such as aricept, reminyl, exelon, and namenda, which are used with patients with vascular or mixed dementia and TBIs as well as with Alzheimer's type dementia, with mixed results. you can google all of these names for references. also, if there is a component of depression along with the dementia, it makes the dementia worse, and it needs to be treated as well, usually with SSRIs or effexor in stroke patients with dementia.

john has improved from a trial of aricept and amantadine as well as nortryptyline along with cymbalta for depression (he refuses to take SSRIs because of sexual side effects and his blood pressure was too high for effexor) and lamictal for his mood lability. his neuropsych will start him on a trial of namenda once he finishes his second round of neuropsych testing. he is also going to cognitive rehab after the testing is completed.

my dad was tested and found to have vascular dementia. he was on antidepressants at the time of the testing which improved his cognitive functioning. he is now on buspar and is actively considering asking for antidepressant meds again, which were stopped after his second stroke (long story).

sue, do you have a neuropsychiatrist who could evaluate Ray and perhaps prescribe a treratment regimen for him? a neuropsychiatrist would be the most qualified person to evaluate him and recommend treatment.

sandy