I can't get this to post on blog. It says document is empty. Probably my laptop. This is my solution.
I haven't done the past history yet, but in the interest of saving me work when I do get to it, I will post new results as they come in from now on.
MRI BRAIN WITHOUT CONTRAST 1/13/05 12:54 pm Union General Hospital, Blairsville
Routine sagittal, axial and coronal images of the brain were obtained supplemented with FLAIR axial images.
CONCLUSION: Moderately advanced cerebral atrophy. Chronic ischemic change involving the periventricular white matter. Empty sella is noted as well as pan chronic sinusitis. The greatest involving ethmoid and maxillary sinuses, as well as thinkening of the turbinates likely inflammatory in nature.
He has an appointment with neurologist in March. He will make an appointment with his local doctor to discuss these results, since they are greek to us.
Subscribe to:
Post Comments (Atom)
9 comments:
Cerebral Atrophy - some potential causes listed here:
http://www.ninds.nih.gov/disorders/cerebral_atrophy/cerebral_atrophy.htm
Chronic ischemic change involving the periventricular white matter.
White matter ischemia is pretty common over 60 (30%+ of healthy brains?) http://spinwarp.ucsd.edu/NeuroWeb/Text/br-840.htm
Empty Cella - probably connected to the pituitary problem from before:
http://www.ninds.nih.gov/disorders/emptysella/emptysella.htm
thickening of the turbinates
The turbinates are three bony projections in each nostril. They, along with the septum, are the major components of the nasal passages. Enlargement of these can contribute to chronic nasal obstruction.
Thank you dear boy. I have started work on the list now.
Something to consider:
Most of these observations seem to me to be related to the sinuses. Is it possible that the dizzyness is actually a symptom of sinus problems? If so, perhaps it would be easier and quicker to get an appointment with an ENT doc while waiting for March to roll around. Maybe it would turn out that a course of antibiotics clears the whole thing up!
On a lighter note, Pert has mastered solitaire and says he can predict the next card up. So I moved him to Freecell, which has 32000 diff games. That was a day or so ago. NOw he tells me he can win every one of those too as he knows the formula. I can't play the MInesweeper and it is too ramdom anyway. Any suggestions for Pert's entertainment and stimulation on the computer would be appreciated. He also gets his e-mail, when he's in the mood. Now I have put the electric typwriter in the living room, using the same strategy we used with the computer I hope he will get dextrous enough at typing that he will send e-mails too. He looked at the typewriter today and I told him what it was. It isn't plugged in yet though. Don't want to rush the process.
Make sure he keeps doing crossword puzzles; very good for the brain. We should all do more of them.
I don't know if there is a computer friendly one out there (typing may be more annoying than fun in xwords), but keeping the books around is good.
When Pert got home from shopping, lunching, getting Glena's prescription, taking them to visit Bonnie, he hit the couch like a fish. He feels so bad I called the neurologist and got them to move the March 14th appointment to tomorrow at 2 something. Let you know.
UPDATE IN CURRENT TIME
Saw the neurologist, Grace A. Gilgenest MD, yesterday. I told her how much worse Pert was, how tired he got, all his symptoms and their (ex)acerbations. His lack of facial expression, interest. energy. Shuffling walk.
Hw sat there looking interested, not sloppering, not yawning, smiling, and when she asked him to walk he walked almost like a normal person. I kept telling her this was not the man who lived at home.
He had already had an MRA of head and neck which showed no lesions, plaque, abnormalities. He had an EMG along with the tests for neuropathy before, which bore watching, she said.
She agreeing that he is worse, suggests choosing from one of two courses.
1. Running more tests here and then going to MAYO in Jacksonville, where she has a friend who specializes more in the area with Pert's symptoms and no diagnosis.
2.Going there first, because they would repeat all the tests anyway.
We chose to go there first. She will call and talk to her friend today and get us an appointment and send the info she has to him. He is Zbigniew Wszosek MD at Mayo in Jacksonville.
She switched Pert from Prozac to Effexor and said, when queried, that it was possible for people to present somatically--physical symptoms--from depression. She did not suggest that this was so tho.
Said Effexor was a better drug in this case and would be more likely to stimulate and energise than Prozac.
She asked WHY he couldn't play golf, told him to wear good shoes at home rather than slippers. ( He had said the reason he shuffled at home was because he wore slippers and the heels dragged.) She replied, "Don't confuse the issue. Wear shoes." When she told him to stand up--from the firm upright chair he was sitting in, he started to push himself up using the wooden arms of the chair. She said don't use the arms! So he didn't, and got up just fine. She is not a coddler and is direct. I like her and her bedside manner.
P & I had a long talk today about keeping one's brain stimulated and being interested in things and learning new things and pastimes and doing physical stuff even when it is very hard. As long as one doesn't injure onself or others. Pert is going to the golf course tomorrow to give it a try.
I watched her talk to him like I used to talk to patients who were of the Yes, but, variety and realized I should encourage activity, not enable. Regardless of how it looks and sounds, you will get just as feeble and imobilized and bedridden eventually if you sit in a chair all day because it makes you dizzy to get up.
I, of course, was encouraged and heartened after the visit, just to be going to someone who might diagnose. Pert, on the other hand, was mildly encouraged, but felt it had always been so bad in the past...
She did not rule out Wilson's, but said it usually causes severe trembling and that the Wilson's patients weren't "with the program" mentally as he was. They will test for taht at Mayo along with the other stuff.
She said circulatory or pulmonary, since he passed the stress test with flying colors and had a 61% ejection from the heart valves,(which seemed impressive to her, said it was probably better than hers) wouldn't cause these neuro symptoms. Her office will call to let us know when the appointment is. We take all the MRIs, MRA, Ultrasounds, the films, so Wszoxek can visually-as opposed to reading the radiologist's report-- compare them himself. Later and thanks for all input and assistance. YOU all help a lot.
I can't remember where the current updates go, but I guess it doesn't matter. As you know P went to neurologist Gilgenast on the 2nd FEb. She referred to A guy at MAYO, Jacksonville. Mayo called on the 16th to say it would be at least 7 months till he could get in. He is on the waiting list. He left a message with Gilgenest's secretary on the 17th asking what to do. He called her today, the secretary, she hadn't got instructions yet. Matter pending. I will post when I know anything else. The appreisor came today.
PS: Can you say dead end? blind alley? stone wall? lying down drumming your heels against the floor frustration?
Post a Comment