welcome to the organic green doctor blog

i am a family physician who was diagnosed with
early mild cognitive impairment(mci) amnestic type on december 21, 2010
this is a precursor to alzheimers disease
because of this diagnosis i have opted to stop practicing medicine
this blog will be about my journey with this disease
please feel free to follow me along this path
i will continue blogging on organic gardening, green living,
solar power, rainwater collection, and healthy living
i will blog on these plus other things noted to be interesting

Wednesday, January 22, 2020

my story revisited 33-disability memory testing

Image result for organicgreendoctor
when i was diagnosed with mild cognitive impariment i was placed on short term disability since with that diagnosis and being on the alzheimers drug aricept (donepezil) put me in a situation where i could not practice medicine anymore

the clinic where i worked provided a long term disability insurance coverage that provided you with 60% of your income
the premiums were paid with after tax dollars so when you receive the benefits they are income tax free

also in the insurance policy was the requirement that you be able to practice medicine as a fully functioning family physician
i could have been a ditch digger or construcition worker but with this policy i had to be able to do my old job
which i couldnt do anymore

the short term policy lasted 90 days then the long term policy kicked in and lasted until you reach 65 years old

the problem was the long term company said i had to have a neuropsychological evaluation from a neuropsychologist on their list
you have to wait 9 months before we will do it
we are not going to pay you from 3 months to that 9 months plus time period
i will admit they did back pay me months later but i had to use my own money during that time

now my initial memory testing my neuropsychological exam for the adni2 lasted almost 3 hours
it was tiring
it was frustrating as i had trouble doing it correctly

i also was put on aricept (donepezil) to slow things down which looking back now it probably has since here i am 9 years later writing this my story revisited blog with my last memory testing in december being normal

the problem was they werent looking at that first test i had done
instead would put me through an 8 hour neuropsychological exam

the research center did send records to the examining doctor so he could see where i was when this all started 9 months earlier

the exam was tiring
they would test for an hour
the doctor would look at it
do more testing
this was repeated off and on all day long with a short lunch break

they even did the mmpi exam looking to see if i had a personalitiy disorder or other psychological diagnosis

i had to wait several weeks before i got my results form the insurance company
i finally got my long term disability almost a year later and got back pay and was able to receive it tax free

later they sent me notification that they were going to hire a lawyer to get me on social security disability
i thought i dont care about doing that
in the fine print of the insurance documents it says basically
if you dont let us do this you lose your money

that my friends was an experience
i thought of all those folks who needed to be on social security disability but couldnt get on it
now alzheimers disease is one that gets fast tracked

more on that later

it was interesting as i reread these blogs there was a paragraph where i realized the aricept may only give me about 3 years benefit
well it looks like its 9 years of benefit so far

also i had noticed an erosion of my math skills which interestingly isnt noticeable to me now 9 years later

below are two blogs one the day before the exam and the other the next day

the hardest part of all of these evaluations i have had and will
have in the future is not the mris or pet scans or the blood
draws or even the spinal tap
its the neuropsychological exams
ive had 4 now in the last year
its like taking an exam where no one can get a hundred
then the parts of the exam on short term memory frustrates me
as it reminds me that yes you do have a problem even though
you arent always noticing it

well today i have to get an 8 hour one required by my disability
they want an independent neuropsychological exam
before they make a decision on my case
(my policy was written so that if i cant do my job as a
family physician then i should be covered)

i dont look forward to doing it today but know it has to be done
i get to do another one for the research study in 2 months
then i will get a long break without having to do them

i did my 8 hour exam yesterday to satisfy the disability insurance
people even though i had a good evaluation done by a reputable
institution (the university of texas medical center memory clinic and
alzheimers research center) which included even more work up
than most people would have been able to get
it wasnt enough for them though so they just wanted to torture
me a little more

all if have to say is the exam sucked
especially on the parts i consistently have problems with
i already know what they are and its frustrating to take them
because you know youll not do well on them

the short term memory problems i have are pretty consistent through
all the tests i have done
i think the aricept may have helped some but it did not help 100%
i also realize that the aricept is short lived in it effectiveness

(usually some one with mild cognitive impairment amnestic with the
apoe 4/apoe4 alzheimers genotype may have about 3 years of
good benefit before it starts to decline)

these short term memory tests that i have problems with are like
if you walk into a school exam totally unprepared and the material
you totally dont understand and you totally bomb the exam
thats what its like
you have to take several just like that
its why i call this the torture test
give me the spinal tap anytime

i also did a mmpi test where you answer over 500 questions
do you hate your mother
do you play with doll
do you hear voices
it is a test for abnormal personality traits
the answer to all of the above questions is no except #2
as i did have 3 sisters so i did play with dolls some
i think i probably came out ok on the mmpi test

overall i still noticed i had problems with short term memory that
has persisted over the last 8 months
some of the tests that were done were chosen to check out what i
had noticed as a problem
i do realize i have lost a significant part of my math skills
much more than i thought
this may have been the most disturbing portion of the whole
8 hours of exams

now i am on my wife shes level when it comes to math

i now get a months break from all this stuff until mid september
when my wife she and i go up to the alzheimers research center to
do a demonstration video how how to do a mental status evaluation
it will be used for medical school and residency educational purposes

it probably should be shown to most primary care providers also

the funding for this project comes from donations from people
like you to the alzheimers research center

i would advise you to look at your disability insurance plans to see how yours works
its nice if you have to use it to have paid for it with after tax dollars
it saved me thousands of dollars by doing it that way

the organicgreen doctor

No comments:

Post a Comment