Thanksgiving in Minnesota
I’m finding it difficult to come up with material for this blog. I think it’s a form of writer’s block.
I suspect it has to do with my fixation on the scientifically determined medical diagnosis. For those of you who haven’t been following this blog, all my objective tests for causes, or even for cognitive impairment itself, have been normal, yet I’m still convinced it’s Alzheimer’s:
· I know I’m impaired;
· 80% of all people with cognitive impairment have Alzheimer’s;
· the pattern of my symptoms is typical of Alzheimer’s;
· my medical tests have shown no evidence for any other cause of cognitive impairment;
· therefore, I’m convinced, the likelihood of Alzheimer’s disease is high.
So I’m comfortable referring to my cognitive impairment as Alzheimer’s as long as I can take a few minutes to explain the scientific uncertainty of the diagnosis. But what do I do in a two-minute explanation? How do I refer to myself in a posting here for someone who might be visiting for the first time?
My discomfort, I think, comes from the fact that when I was practicing as a physician, my patients expected me to confirm their diagnosis scientifically. I was certainly aware that medical testing could be in error, so—if the science couldn’t explain their symptoms—I didn’t discount their experience, but my job, nevertheless, was to report the scientific facts. If the science and the patient’s symptoms didn’t agree, my job was to describe the discrepancy (usually at length) and give an opinion, not to make an absolute judgment. So, in those cases, I always felt the longer explanation was always necessary.
Furthermore, honesty is almost an absolute value for me, and saying, “I have Alzheimer’s” when the objective testing suggests otherwise feels misleading. Yet, if I describe my illness in the elevator version as a “subjective cognitive impairment,” almost no one’s going to understand what I’m talking about, so such a description is misleading, too. So, in fact, describing myself as having Alzheimer’s is less misleading. Nevertheless, I’m emotionally uncomfortable without the qualification.
I believe I need to get over my qualms. I will change the introduction to the blog and to my website to reflect the uncertainty, but, despite my discomfort, I’ll include the word “Alzheimer’s” in my two-minute, elevator version.
I hope that getting over my irrational scruples will help break this writer’s block.
I remain grateful for the support so many of you have expressed.
 There are several different groups (formally referred to as “domains) of symptoms of cognitive impairment such as loss of memory (amnestic cognitive impairment); impairment of visual-perceptual skills; difficulties in concentration; general slowing of mental capacities (for example; taking long to do things, trouble following recipes or keeping track of bills); language problems (for instance, word finding), and challenges in executive function (for example, in planning or in solving problems).