Monday, November 24, 2008

Granny's Physical

This week I finally took Granny in for her physical.
It is always interesting to hear her interact with other people. Similar to how it is to listen to your own kids interact with others. What is she going to say in response to that question? Does she know the answer to that?
I hear the vague, content free comments and answers I recall from patients I've worked with in the past.
She is "cute " now. What I mean is that she sounds sweet, tries to be funny, is endearing. I remember saying to other adults in the past, "Your Mom is so cute!".
The thing is, my Mom was not a "cute" type of person. She was the one who was smart, coo and had a fabulous wit. But not "cute". That is not my Mom.
Docs and others are so dense about short term memory impairments. I told him she was having pain in her left shoulder. While he examined her she kept saying, "I don't remember my shoulder bothering me." Directly following that he asked her other questions. How was her stomach? Any difficulty with bowel movements? Any skin lesions? Now why would you ask her and expect her to be a reliable historian when she has no recall of her shoulder bothering her.
He then went ahead with the standard mini-mental exam.
Q: Do you know what year we are in?
A: 2000 something (she had just written twice, 10 minutes earlier with my cuing).

Q: Where do you live?
A: Well, with her (pointing to me). Just temporarily.

Q: Do you know Judy's address?
A: Redwood City. (I said "Good job Mom!")
Q: Do You know the street?
A: No.
Q: Do you know the phone number?
A: No. Well I never call there. (A good point, who calls themselves. But I am 90% sure she also would not have been able to come up with my cell phone.)

Q: Do you know the name of the recently elected President?
A: It was the guy. (I again gave her credit for that. A very good cover of an answer.)

I also know she could not have provided the month or day or approximate time of day.

But she also played with Ki tonight as Ki directed her as the new employee in her make believe restaurant. She snuggled and tickled and chatted with Aj. She played along with Wheel of Fortune, and she still does pretty well. She played fetch with Java 350 times. (Okay, it just felt like it was that often.) She washed, dried and folded laundry. She was worried when she realized I have birthday upon us, that she had no gift. She did the dishes. She did the cross word puzzle from the Chronicle. She played solitaire with her cards.
I once worked with an amazing neuropsychologist and he told me that individuals with dementia who are kept in the same environment and routine can do amazingly well, because it is all so hard wired in.

This is what it is right now. I am not so sad at this moment. Just reporting. A couple weeks ago when I wrote about her I found myself in an abyss. I lost a whole day and ended up cancelling a bunch of clients and exhausted myself crying.
Part of the journey I guess.

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