A new course

We visited the neurologist yesterday, and it went pretty well.

The neurologist pretty much agrees with my LBD theory, but he's trying to eliminate some other issues and make sure that its not medication or some other electrolyte or medication issue that's causing his problems.

He was given a MMSE (Mini Mental State Exam) which I'm not sure the doctor knew, but I'm pretty familiar with.

It goes kind of like this:
The Mini-Mental State Exam
Patient___________________________________ Examiner ____________________________ Date____________
Maximum
Score
Orientation
5( ) What is the (year) (season) (date) (day) (month)?
5( ) Where are we (state) (country) (town) (hospital) (floor)?

Registration
3( ) Name 3 objects: 1 second to say each. Then ask the patientall 3 after you have said them. Give 1 point for each correct answer. Then repeat them until he/she learns all 3. Count trials and record. Trials ___________

Attention and Calculation
5( ) Serial 7’s. 1 point for each correct answer. Stop after 5 answers.
Alternatively spell “world” backward.

Recall
3( ) Ask for the 3 objects repeated above. Give 1 point for each correct answer.

Language
2( )Name a pencil and watch.
1( )Repeat the following “No ifs, ands, or buts”
3( )

Follow a 3-stage command:
“Take a paper in your hand, fold it in half, and put it on the floor.”
1( )Read and obey the following: CLOSE YOUR EYES
1( )Write a sentence.
1( )Copy the design shown.
_____

Total Score
ASSESS level of consciousness along a continuum ____________ Alert Drowsy Stupor Coma


According to the neurologist, he scored a 25 out of 30. 23 or below qualifies for cognitive impairment. I think he even gave Mr. C a few points. He attempted the serial 7's exercise, but got absolutely nowhere. The doctor decided that reciting the months of the year in reverse was a substitute and he eventually was able to do that.
I'm not entirely happy that was overlooked. He didn't know the day of the week or the day of the month either. And today, he even told me it was April 7th, 1939 and it was a Wednesday. Later though he did seem to remember that my mom's birthday was yesterday which made today April 24th. He used to be really good with birthdays.

The neurologist decreased his Clonodine, which he said might be causing him to be sleepy during the day. He's getting a half of a pill for a week, then stopping it altogether. We also agreed that since he's had 2 years of Aricept and have not seen any change at all, that we're stopping that and going to try Exelon in a 24 hour patch form. We have a 4.5 mg patch for 4 weeks, then the 9mg patch after that.
He goes back in 6 weeks.

My sister comes to visit tomorrow. She's asking me what he's going to be like. I told her he's just about the same, happier to know she's coming. He seems more resigned and almost happy about staying here, so now I wonder if we really are going to be flying him home and then turning around and coming back. I think either way we're going to be going up north for a few weeks to let him visit his family and clean out his place.

In fact, he seems to even be planning to stay here most of the year, but go home for the summer and possibly live with his brother and sister for those 2 months or so. The summer up there is really SO short, sometimes I almost forget about that myself. It's already nearly summer here and it's not even Memorial Day yet, which amazes me.

He really enjoyed the summery weather today though. According to the weather channel it hit 90. It felt all of that.