Jan18

My Brain Diary, Part 10

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My Brain Diary, Part 10

So I have seen my neurosurgeon. He is happy. My brain is the right shape, and everything seems to be pretty much where it’s supposed to be. No lesions. The clump of cancer cells left behind out of necessity on my dura has even gotten smaller. He says there’s a possibility that it might even go away – I guess because they aren’t cells from the dura or something like that. I’m not going to complain if they do, no matter what the reason.

What I am complaining about, though, is that I’ve pretty much regressed to the mean – and it’s not a very nice mean.

This is pretty much as well as I’m going to be able to think from now on.

I started off with a substandard memory, and now it’s even worse. Short-term memory is much more impaired than it used to be. . .and that means that forming long-term memories out of those short term memories is impacted as well. There are things that no amount of reminding will come forward. Complete blanks where memories should be. I work hard to remember certain small things, but short of writing them down and carrying the written note with me at all time, they just don’t stay. I constantly have one thing or another to apologize for for forgetting.

One of the memory issues (did I mention this before?) is anomia. That is, I can’t remember words for things. Mostly it’s people’s names and names for objects. Noun loss. Other words will escape me periodically, but this is the most predominant. It works in only one direction, though. Visual input will not produce a word, but hearing or reading a word will create a mental image. So the words are there, I just can’t call them up on demand. When I’m anxious or stressed, it’s worse, and sometimes that makes me more anxious, which makes it worse, and so on, and I have moments of sounding like an idiot. Not cool, brain, not cool.

The other problem is that my medications aren’t working right. My doc wants to try medications that are aimed more at treating bipolar than ADHD, because the Cymbalta/Adderall combination that’s been my favorite over the years is now making me anxious. I stopped the Adderall a few weeks ago, and that helped a lot with the panic, but makes it incredibly difficult for me to concentrate. I have not been able to enjoy reading since stopping it, and I spend a lot of time wandering around the house wondering what I was just about to do. Like, unless I have something in my hand that I can look at that reminds me what I was just about to do, I honest to goodness forget what I was about to do the moment I face a different direction.

I am splitting my Cymbalta so I’m taking 30mg instead of 60, because of the dreams. OMG, the dreams are killin’ me. They are giant, epic affairs worthy of being made into movies. They’re not just in color, but also filled with sounds, smells, flavors, textures, and other sensations, most of them not particularly pleasant. Every morning I’ve awakened feeling exhausted from the stress of the dreams, with my jaw aching and head pounding from clenching and grinding my teeth. Last night I put in a mouth guard to help with this, and was rewarded with a particularly nasty nightmare.

All I can hope is that once the medication issue is resolved, my brain will be static enough that it’ll be resolved with some finality. Until then, I’m nervous about leaving the house (although I’m fine once I finally do) and darn near terrified of using the phone. (Part of that comes from the word loss anxiety. Ugh.)

People tell me that I seem fine. I suppose I appear fine on the outside. I’m much less fine on the inside. I’ll be contacting a neuropsychologist to see if I can learn some strategies for dealing with my new functional issues, and might also need a neurolinguistic speech therapist. We shall see. First, though, I need to work on lowering my expectations to a more realistic level.

Dec26

Treating the Symptoms, and the Placebo Effect

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Treating the Symptoms, and the Placebo Effect

Proponents of various forms of alternative medicine regularly rally under the claim that medicine treats only the symptoms, while their favored modality “treats the whole person.” I’ve long known that this is wrong, and I could enumerate all the reasons why, but only now did it occur to me that there’s an even deeper level to this inaccurate claim that I haven’t seen addressed elsewhere – irony.

I’m not going to try to get into so much detail that it obscures the point (for a change) so I’ll stick to the examples that directly apply to my inspiration. Doctors and scientists who blog cover the overt falsehoods that are relative to their specialties with far greater specificity than I ever could. They can even tell you how each individual CAM treatment doesn’t work and why. I don’t think I need to do that, because I could never attain that level without the education, experience, and dedication that these science-based medicine bloggers have.

Instead, I’m going to draw from my own experience at a forum in which we discuss mental disorders – ADHD in particular, but also its other delightful companions and complications – where alternative treatments are accorded an undeserved level of respect and science-based medicine is treated with derision. In this place, since we are dealing with conditions that are complex in origin and difficult to reproduce and test in animal models, speculation is going to be a given. However, much of the speculation involves disregarding or even discarding the huge volume of information we already have from research.

There is absolutely no question that each condition being discussed is brain-based. There is absolutely no question that any effective treatment for these conditions is going to have to be a treatment of the brain. And there is absolutely no question that all the current approaches are aimed at relieving symptoms, whether through medication or other therapies, because research on the cause of symptoms yields results much more quickly than research looking at the most complex organ of the human body will yield information on causes. Science is churning away at brain research; new tools and knowledge are helping it to advance more quickly than it did in the past, and the findings from these are being used to develop even better tools and knowledge. Still, because there are practical and ethical limits on researching living human brains, results will not come as fast as they do for other diseases and conditions that involve other organs with simpler functions than the brain has.

Now that the introduction is out of the way. . .
Read the rest of this entry →

Dec22

My Brain Diary – Part 9

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My Brain Diary – Part 9

This is a tiny update, because I went for MRIs yesterday. I chose a few to share with you, similar images from each scan – September 2012, when I was diagnosed with the tumor, March 2013, when I was leaking cerebrospinal fluid and had pressure both inside and outside my skull, and yesterday, pictures for my 1-year (more or less) followup. I still have occasional problems with balance, but this is sporadic. My short-term memory, while it’s never been good, is still more of a problem than it used to be. The biggest issue I have still is word loss – names and nouns. If I see or hear a word or a name, I can immediately picture the person or object, but it doesn’t work in the opposite direction. If I see or think of a person or an object, I frequently have difficulty recalling the name of that person or object. I have no problem with recognition of that person or object, just with being able to recall what to call the person or object. I had read an article about a man who had a stroke in his left occipital lobe that led to the same issue, but I’ll be darned if I can find it again now. Maybe later. Anyway. . . (addendum. . .this might not be THE one, but it is one. . .)

Saggital (back to front – think of Saggitarius, the archer, and the direction he shoots his arrows) views without contrast:
Saggital-T1SE

Same thing, with contrast:
Saggital-T1contrast

Coronal (think of a corona or even a tiara-like crown – this is a vertical side to side view), towards the back where all the problems were:
Coronal-post

Axial (horizontal view. I can’t think of a simple mnemonic, so just remember that there’s only one horizontal axis, and that’s the Axial view) showing the cerebellar distortion. If you know what you’re looking for, other views show distortions as well, but if you don’t, then you won’t be able to tell them apart. So here’s where you can tell them apart:
Axial-cerebellum

So there you go. Things are looking better. I’ll hear what the neurosurgeon has to say in a few weeks.