Saturday 20 October 2012

I learn something new everyday

There are more than 200 variations of dementia.  Alzheimer's of course is the most known but Parkinson's is also a type of dementia.  There is Vascular dementia which develops after suffering a stroke and Frontotemporal dementia in which the patient doesn't suffer memory loss rather they display schizophrenic behaviours and depression.  Then there is everything in between and often combinations of symptoms and they vary in each patient and they are simply called dementia.
On this day I met with the Geriatric psychiatrist who has been treating mom and now I'm expert and I know better what to expect.  He told me that mom has a type of dementia called RPD, Rapid Progressing Dementia.  This time last year my mom was still walking, talking, using the phone, eating and eating a lot, she sent me a beautiful card for my birthday and wrote an uplifting saying in it. Now she has apraxia (can't walk or control body movements), dysgraphia (can't write), she's bowel and urinary incontinent, she's aphasic (can't speak properly), she's aphonic (can't hear properly) and she is gradually getting dysphasia (she's slowly losing the ability to swallow).  All these new terms that I learnt apply to my mom.
The psychiatrist also believes, based on mom's history that she has rapid progressing dementia with Lewy bodies.  Lewy bodies are a by product of proteins that we need for normal neurotransmissions of messages to the brain.  When the Lewy bodies are created they attack the cortex of the brain.  That's where all the grey matter is and that's what pretty much controls every body function, emotion, memory, thought and language.  The cortex contains the cerebellum and the cerebrum. It makes up 2/3's of our brain and that's what is being attacked and slowly killing my mother.  He said she meets enough of the Lewy bodies criteria but that they can't determine if they are present until after she has passed and an autopsy is done and the brain tissue examined.  There is nothing that stops it, no medication that will slow it and it also presents differently in each patient.  It's also genetic and tends to run in families.
My grandmother died of cancer.  Really she died of dementia.  Hers was slower in the progression and she spent 6 years living in extended care.  When they diagnosis of cancer came, my grandfather, my mother and my aunts and uncles all decided that it would serve no purpose to torture her with treatments and surgery.  In addition, she was so weakened by the dementia that chances were, she wouldn't survive the treatments or surgery.  So the decision was made to make her as pain-free and as comfortable as possible.  She passed away 2 months later, in her sleep.
Now my mother has dementia only hers, like I mentioned, is rapid progressing dementia with Lewy bodies.  I had to ask what is the prognosis.  The doctor was very honest and told me he has seen RPD cases that get to point where they plateau and patients don't get worse but they don't get better and they live like that for about a year before pneumonia or infection gets them and many just slip into a type of coma and pass away peacefully.  But he also said that based on mom's history she IS end-stage and she could have anywhere from 6 weeks if the progression continues at the rate it has followed in the last 8 months and if it plateau's them maybe a year or slightly more.
At that point realizing that it is hitting the women in my family and coming to the conclusion that I'm next in line I asked him what are the chances that I will develop dementia.  All he could say was "It's very probable". Not the answer I wanted to hear.  But he also said that both my mother and grandmother were on Lithium for many, many years and although it isn't proven, many researchers believe that Lithium and other heavy metals that people are exposed to will contribute to the development of the Lewy bodies and that may be the case in my family.  If that is the case, then the simple fact that I don't take Lithium may be my saving grace. 
So that was the wake up call.  It could be 6 weeks or 6 months or a year.  Regardless I going to lose more and more of my mom in the near future until she is finally gone.  I went and sat with her and I cried again.  My mother has been tortured all of her life by her mind and by her brain and now it's going to torture her to her death.  It's just not fair.
For my dear friends that read this, please someone listen.  If in 25 years I get dementia I don't want my kids or my family or my friends to suffer along with me.  So someone do me a favour and do like chief did at the end of 'One Flew Over the Cuckoo's Nest' and just put a soft pillow over my face.



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