Between a viral infection that has knocked me about the last several weeks and preparing for a lecture at the Michigan State University medical school, I haven’t been able to blog. Fortunately, I did feel better enough for a few days last week to take the train/bus combo to Michigan and fulfill my responsibility to give the lecture, but even on the way back I started to feel weak and sleepy again. It’s gotten a little better, but it’s time to see a doctor other than the one looking out at me from the mirror.
I’ve wondered two or three times whether the fogginess and weakness that has accompanied the other flu symptoms is a result of some further damage to my brain. I doubt it, but I can’t help thinking about it. The most likely cause of my cognitive decline is vascular (those little strokes), so—although it’s unlikely—any sudden change in my mental status could signal a sudden worsening of my cognitive decline.
Even without the current fogginess, the impairment seems to be worsening slightly over the past several months. Last week I was trying to make a set of bus reservations. Megabus can certainly make travel inexpensive, but you can only make reservations online. They also make you figure out your own connections if you have to change buses. I was trying to make reservations to travel from here in Washington to New York City then transfer to a bus to Albany NY and make the return trip a week later. I had to:
a) figure out my desired arrival time in Albany,b) figure out the needed departure time from New York to Albany, andc) then go back and figure out the Washington departure time to get to New York on time for the Albany bus.d) Then I needed to reverse the process a week later.
It sounds a little complicated when I write it out like that, but this kind of task has never been difficult for me.
I just couldn’t do it. I would get the day of the week confused, the arrival and departure time in NYC confused, forget when I wanted to leave or when I wanted to get there. Several times I had all four reservations about to finalize but then I double-checked and one of them had the wrong time or even the wrong date. Then even those that were right started to look like they were wrong, and I had to go through the entire process in my head to double-check it. I should have written it all out on paper, I suppose, but I got so frustrated that it didn’t even occur to me. After forty-five minutes, I finally got the trip from Washington to New York right and the trip from Albany back to NYC right, but I couldn’t get the other two. I finally had to ask Marja for help.
Before my cognitive impairment, it would have been humiliating to tell Marja I couldn’t do it, but at least that is no longer true. We both know what the trouble is, so she was happy to finish the task.
Having to hold several related things in my mind while working on each separately is the most frequent manifestation of my cognitive decline these days. Something similar happened trying to compare two almost identical copies of my speech; there’s a not-very-complicated automatic procedure for that exact thing in Microsoft Word, but it took me the longest time to get the correct documents in the right order and then—as I went through the combined document—I kept getting confused about which option from which document was the one I needed.
It frustrates me:
- I can’t tell whether my confusion is really getting worse or it just seems so.
- Almost every time I try to describe something like the ticket episode above, the other person will say, “Well, I’d get confused, too.” I just nod my head.
- And then I remember my intention to let these kind of useless comparisons go. I’m not scared of the future, so why let myself get worked up about minor changes?
In September 2012, when I first received the diagnosis of “almost certain” Alzheimer’s, I would have been extraordinarily grateful to know that in April 2014 I’d be worried about such minor problems as these.
I could just remain grateful and take each day as it’s given.