Mis­tak­enly di­ag­nosed with Alzheimer’s

Baltimore Sun - - COMMENTARY - By Bar­bara Young Bar­bara Young is a psy­chi­a­trist, psy­cho­an­a­lyst, pho­tog­ra­pher and au­thor. Her most re­cent books are “The Per­sona of Ing­mar Bergman: Con­quer­ing Demons through Film” and “Pho­to­graphs Are Me­mories.” Her e-mail is: young­md­bar­bara@gmail.com.

In 2017, I al­most died three times. I had gone to my oph­thal­mol­o­gist for the an­nual ap­point­ment and was asked by my doc­tor: “Did you know you’re blind in the right eye?” Gi­ant cell ar­teri­tis, also called tem­po­ral ar­teri­tis, was con­sid­ered as the cause and was con­firmed fol­low­ing a biopsy of the right tem­po­ral artery.

I was rushed straight from the doc­tor’s of­fice to the E.R. My friend Jill be­came my ad­vo­cate un­til my nephew Har­vey ar­rived from At­lanta. At this point we must rely on Jill’s ac­count of my se­ri­ous col­lapse be­cause my mem­ory had de­serted me. When she came to visit, I was ei­ther asleep or un­con­scious, she said. My face was flushed, and I was “hooked up” to mon­i­tor­ing de­vices. Jill thought I was go­ing to die.

My only me­mories of the 21 days in the hospi­tal are of ly­ing in a nar­row cu­bi­cle. I was started on a high dosage of pred­nisone. This pow­er­ful steroidal an­ti­in­flam­ma­tory drug can cause delir­ium, and in my case it did. My world seemed eerie and fright­en­ing. At times, I felt I was watch­ing a scary movie.

Jill and an­other woman came to dis­cuss their edit­ing of my book of pho­to­graphs. It is hard to be­lieve that as in­ca­pac­i­tated as I was, part of my brain was still func­tion­ing. None­the­less, my mind con­tin­ued to play strange games. Was this the first stop on the way to de­men­tia? My in­ternist ex­plained that the brain is in­jured dur­ing delir­ium, and that the re­sult­ing cog­ni­tive im­pair­ment takes time to clear.

They sent me to a re­ha­bil­i­ta­tion cen­ter to re­gain the strength I had lost in my arms and legs. There I caught a flu that turned into a se­ri­ous case of pneu­mo­nia. In the hospi­tal again, I was hit with one cri­sis af­ter an­other. I de­vel­oped a car­diac ar­rhyth­mia. Sev­eral doc­tors fought all day to save me. Though I don’t re­mem­ber their strug­gle, I must have been sub­lim­i­nally aware of it be­cause that night I thought of my pa­tients and called a col­league ask­ing her if she would take over for me if I died. The next day my heart was nor­mal. When I re­turned to the re­ha­bil­i­ta­tion cen­ter I learned to walk with a walker.

I fi­nally got back to my house, with 24-hour care pro­vided by Trib­ute home care. The kind and skill­ful as­sis­tance of the aides was an im­por­tant fac­tor in my re­cov­ery. My new doc­tor came to my home. She di­ag­nosed me with Alzheimer’s. There are se­ri­ous con­se­quences to this mis­di­ag­no­sis. With Alzheimer’s, pa­tients, rel­a­tives and doc­tors give up all hope of re­cov­ery. With cog­ni­tive im­pair­ment due to delir­ium, how­ever, there is an ex­pec­ta­tion of re­cov­ery once the cause of delir­ium is iden­ti­fied and suc­cess­fully treated. For me, this hap­pened when pred­nisone was very slowly ta­pered, and methotrex­ate grad­u­ally sub­sti­tuted.

I would not be alive to­day had it not been for the lov­ing as­sis­tance and sup­port I re­ceived from my fam­ily, friends and doc­tors.

In Novem­ber, I moved into the friendly com­mu­nity of Sym­phony Manor where I am learn­ing to take care of my­self. I have com­pletely re­cov­ered from the ef­fects of the in­juries to my brain caused by delir­ium. Af­ter hav­ing huge, cof­fee-col­ored cataracts re­moved from both eyes, vi­sion in the left eye is good.

If you or your loved ones are ever caught up in an ill­ness that in­volves se­ri­ous changes in men­tal sta­tus, be sure that your doc­tor can rec­og­nize the dif­fer­ence be­tween per­ma­nently de­ment­ing Alzheimer’s and the tem­po­rary cog­ni­tive changes caused by delir­ium. Many doc­tors can’t.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.