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Monica19815 Asked November 2019

Any suggestions for questions I should ask the neurologist at my husband's upcoming appointment?

I was able to move my husband's neuro appointment up by 2 weeks. In the spring, my husband's PCP gave him an MMSE during an office visit (due to concerns I was having about some of my husband's recent behavior that I thought was ADD or a vitamin deficiency) and the results of the MMSE resulted in his PCP referring him to a neurologist. We went to the neurologist and she administered a SLUMS exam which indicated mild cognitive impairment of an (as yet) unknown origin. His MRI was normal. His follow up appt. is this week. Can anyone give me some suggestions regarding questions we should ask the neuro? We have just 2: "What is your diagnosis at this time?" and "What can we expect in the future?" We have asked her to rule out ADD, HF Autism and Depression. My husband also has hearing loss that he refuses to address and just found out he needs a new glasses prescription (and he refuses to wear his glasses all the time as he should). I just need to know what this IS and what it IS NOT and would appreciate question suggestions based on your own experiences.

AlvaDeer Nov 2019
Do all of your own research you are able. The types of dementia are VERY different and have VERY different symptoms and patterns. VERY different. Ask what Type he may have if they know. Vascular, Frontal Temporal, Lewy's, Alzheimer's and etc. You have a big learning curve ahead. Take along any symptoms you are able. The refusal to wear his glasses and hearing aid is going to make your job all the more difficult in terms of deciding what is what. Wishing you good luck and hoping you will update us on what an initial neuro consult after MRI looks like.
Monica19815 Nov 2019
His neuro admitted (I had sent her a letter prior to the appt.) that my husband could have adult ADHD, cognitive impairment, Aspberger's....at this point, and with all I told her in my letter as my dear husband would not tell her anything in his first appt, she wants him to have the 4 hour test, and they will also talk with me privately at that time. She also asked a question that surprised me...she asked if my husband's voice was getting softer, which is not normal with hearing issues. I had never thought of it before...but being more observant these past few days the answer is yes. And family over the holidays are going to let me know what they think. She also asked him if he is SURE that no family ever had a cognitive or neurological disease. Husband told her no. When I got home, I Googled the soft voice question and learned that this can be a sign of Parkinson's. A vague memory came to me and I asked my husband...did anyone have Parkinson's in his family? YES. His grandfather did! I immediately emailed the neuro to tell her this additional information and also to tell her that after his appt with her he consulted with a physical therapist because he was getting so stiff it was hard for him to bend over. The PT said he was really surprised at how tight his back, hips and leg muscles were. I have not heard back from the neuro nor have they scheduled his 4 hour test yet. I wonder if any of these things are related. Many of his other symptoms are indicators of Parkinson's....but he does not have any tremors. Again...it is a waiting game.
BarbBrooklyn Nov 2019
What level of support does my husband need right now? Does he need someone around at all times? Can he be left alone at home for a few hours? Overnight?

Can he manage his own medications?

Should he continue to drive?

What are your recommendations as far as remaining at home and isolated or going to a day program or Assisted living?

What lifestyle modifications will he benefit from? (Diet, exercise, devices, at home help)

Are there any meds that you think might help?

What do you see his prognosis as? Would you like to follow up after 6 months or a year?

Can your office staff put these recommendations in writing for us? (So you can point to them and say "the doctor says....)

These are the issues that mom's neurologist addressed after her neuropsych testing showed Mild Cognitive Impairment.
Monica19815 Nov 2019
THANK YOU! Lots of good questions there...I will write down the ones that apply to him right now. IF he does have dementia or something similar he is in the early stage right now.

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