Medical roll call

The last two weeks have been unusually busy, medically speaking, touching cancer, Alzheimer’s and Arthritis.  Marcia started with her six month oncology checkup, three days later we had our quarterly visit to NYC to meet with her neurologist, and the following week, we met with her orthopedic doctor.  Marcia’s cancer story is a happy one.  She’s 2 ½ years cancer-free and every visit we’ve had since her lumpectomy has been a positive one.  I haven’t written about the need for an orthopedic doctor before now.  This is where perspective is evident.  Marcia has Alzheimer’s, breast cancer, spinal stenosis and arthritis in her hips.  Anything that’s treatable doesn’t make the radar screen these days.  Marcia has been going to physical therapy since May and while not totally pain free, she has less discomfort than she did earlier in the year.  Her doctor believes we’ve given PT a fair shot.  This morning Marcia had a minor surgical procedure (steroid injection) that will hopefully alleviate her back pain for a long time.

 

If you’re keeping score, she’s beating cancer and arthritis.  Marcia is a fighter and has overcome one devastating or depressing diagnosis after another.  I wish I could say the same for Alzheimer’s.  To my knowledge, Alzheimer’s is undefeated.  Everyone dies with it, or from it.  Our meeting with her neurologist in New York City was both a good and sad day.  It was a good day because I watched her give her best effort to eat and get dressed with intense concentration. While that may not sound like much, I’m overwhelmed with pride when I watch her keep trying to do things that are increasingly harder to do.  It was a good day because I saw her laugh and smile when we were meeting with Dr. Honig.  By the way, Columbia University is a teaching hospital, so we rarely meet with Dr Honig alone.  Usually he has an intern or a student with him.  This time we were joined by an intern, a fellow and another doctor.  I didn’t mind, and Marcia didn’t appear to mind either.  And she tried so hard to do all the tests she was put through and didn’t seem to mind the crowd observing her.  And it was a good day because Marcia agreed with Dr Honig that she would give Adult Day Centers a try. ……

 

But it was a sad day.  Several times during our 45 minute appointment I felt an overwhelming emotional response to the tests he put her through.  None of the questions he asked her or things he asked her to do are new.  He asks the same questions every time and puts her through pretty much the same drills every time we see him.  And it’s heartbreaking because you don’t have to be a neurologist to see how things are progressively worse.  She can’t repeat “no ifs, ands or buts”.  She didn’t know what day of the week it was, though it may have been more that she just couldn’t say “Thursday”.  She kept putting her finger on the desk and was trying to do a Monday, Tuesday, Wednesday like cadence instead of using words, or so I thought.  Dr Honig asked if she wanted to write it on paper.  She tried, but didn’t really know what to write.  Then he asked her what year it was.  In past blog entries I’ve written that Marcia has known what year it is, but she would say “two-oh-one-three”, with more than just a passing effort, as opposed to” two thousand thirteen”.  This time she wrote “Monday” on the paper.  Finally, he asked her to take “this piece of paper in your right hand, fold it and give it to your husband”.  She took it in her left hand and gave it to me without folding it.  While watching all of these tests make me want to cry, Marcia reacted to each request with only a little frustration about not being able to verbalize her answers.  She used to hate these tests and would get upset because they made her feel “stupid”.   She really doesn’t appear to feel that way anymore.  She listens intently to Dr Honig’s questions and requests and gives her best effort.  And I think she believes she’s doing fine.

 

Marcia’s language skills have noticeably deteriorated since May.  All of us who spend any time with Marcia know this.  Dr. Honig commented not just on diminished verbal ability, he also quickly picked up on her voice changes, in both pitch and volume.  She’s very soft spoken and rarely says more than a word or two.  It’s also clear that while language is the most challenging of her symptoms, just processing information is more difficult and we (family, Dr. Honig) are increasingly concerned about her being alone.

 

We are moving forward with enrolling her in a local Adult Day Center in Somerset County. We’ve completed the medical forms and are planning an “interview” for October 2nd.  We plan to start with one or two days a week and expand as Marcia feels more comfortable.  While this will be just one more significant event in her progression, this one feels better than some of the other milestones, because we know she will be looked after and safe for longer periods of time.