When to Seek Diagnosis

Newcomer introductions, personal anecdotes, caregiver issues, lab results, and n=1 experimentation.
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vsanthony
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When to Seek Diagnosis

Post by vsanthony »

Hi, writing on behalf of my (3/4 and gs293 "tricarrier") 60-yo husband (with his permission) who is rarely in front of a computer. We don't THINK there is any MCI as of yet, or nothing worse than e.g. what I'm manifesting ("normal" 3/3) at age 67, hopefully it's just attention-related stuff we're losing. He also has managed hemochromatosis, diagnosed about 4 years ago. Lots of AD in his family - his mother and 2 out of her 3 siblings died from it.
We are wondering if it is too early to seek out a cognitive neurologist, or will he be laughed out of the exam room for not having symptoms? Would we even get a referral from our PC? We're aware that early detection can be important so we're just trying to be pro-active.
Meanwhile, he gets lots of exercise, eats pretty clean, and has work that he loves, so life is good. We hope to keep it that way as long as possible - And who knows, maybe it's not even in his future? Fingers crossed. So appreciate these forums, TIA for any tips. - Vicky
Vicky, wife of Phil who is ε3/ε4 and has hereditary hemochromatosis.
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Re: When to Seek Diagnosis

Post by NF52 »

vsanthony wrote: Thu Sep 01, 2022 1:21 pm Hi, writing on behalf of my (3/4 and gs293 "tricarrier") 60-yo husband (with his permission) who is rarely in front of a computer. We don't THINK there is any MCI as of yet, or nothing worse than e.g. what I'm manifesting ("normal" 3/3) at age 67, hopefully it's just attention-related stuff we're losing. He also has managed hemochromatosis, diagnosed about 4 years ago. Lots of AD in his family - his mother and 2 out of her 3 siblings died from it.
We are wondering if it is too early to seek out a cognitive neurologist, or will he be laughed out of the exam room for not having symptoms? Would we even get a referral from our PC? We're aware that early detection can be important so we're just trying to be pro-active.
Meanwhile, he gets lots of exercise, eats pretty clean, and has work that he loves, so life is good. We hope to keep it that way as long as possible - And who knows, maybe it's not even in his future? Fingers crossed. So appreciate these forums, TIA for any tips. - Vicky
Hi Vicky,

As a wife who also "with his permission" does stuff for my husband like moving the dentist appointment after a COVID diagnosis and thinking about doctors more than he would chose to, I applaud you asking a great question. And trust me, as someone who is 70 and has two copies of ApoE 4/4, no one will laugh you out of any room. If anything they will be thrilled that you both are being proactive and looking at the whole picture. You didn't mention whether your husband has had a physical in a while, but 60-year old guys can have very treatable things going on--like low thyroid, subtle hearing loss leading to not catching things and seeming inattentive, enlarged prostate causing disrupted sleep. and fatigue or reduced mental energy during the day.

It might depend on where his attention is flagging; it is for things he knows you handle, especially planning or upcoming events? Or is it knowing where he is when he's driving, or forgetting information on topics he likes and heard recently.

Overall, it sounds like he's feeling things are different and you're seeing that also. Since life is good, why not see what's causing this sense of something different?

That doesn't mean he has a Mild Cognitive Impairment; it probably does mean it's time to start with his doctor and run a pretty thorough round of tests to see how his overall health is. If nothing shows up there, you can absolutely contact a regional memory center, if you live near an academic teaching hospital, or ask your doctor for a referral to a neurologist or neuropsychologist just to get their view. As someone who has gone through lots of tests for a clinical trial for people with ApoE4, I know that neuropsychologists are some of the kindest people on the planet! And often can reassure us that we're doing just fine.
4/4 and still an optimist!
vsanthony
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Re: When to Seek Diagnosis

Post by vsanthony »

Thank you, NF52. The memory issues are barely perceptible at this point and he'd be quick to point out that I forget things too, which is true - But I know as far as my own memory issues go, it's more of an attention and problem (i.e. not paying it), and so I try to look at him and listen when he's talking. Honestly, at times with HIS memory, I feel like there's a blank where there should be at least some memory that we discussed a subject. I also worry that, because I know his apoe status and family history, I'm anticipating trouble and maybe over-reacting to his memory lapses. It's also difficult when you are with someone from day to day - So he may have more memory problems than he did e.g. 6 months ago, but it's so subtle and gradual that I'm just not sure. Oh, there are no easy answers.
He does get regular physicals and while there's nothing terrible, there are various flagged values that I'm keeping an eye on (diabetes in the family, heart issues - He pulled the short straw genetically speaking). Luckily he is fit and thin and has an active job. I also keep tabs on Bredesen, Isaacson and many others; and an eye on new research.
I appreciate your optimism - I'm going to put the question to our PC and see if she'd be willing to refer us to e.g. a cognitive neurologist. We're in the greater Boston area so there's no shortage of good doctoring here, thankfully.
Thanks again.
Vicky, wife of Phil who is ε3/ε4 and has hereditary hemochromatosis.
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Re: When to Seek Diagnosis

Post by TCHC »

Hi Vicky & Phil
I would really hope that no-one ever would laugh you out of any room for trying to look after yourself. You're already doing great work in terms of lifestyle.
Have you tried this test: https://www.apollohealthco.com/cognitiv ... trial-2022
It gives you results compared to people your age and gender, so you'd at least be able to see if what you're experiencing is "average".
I take it every 6 months or so and although I'd have said I was living very healthily before, I have upped my lifestyle game and improved my scores.
Good luck!
Lindsey
TCHC - Lindsey Byrne - The Cognitive Health Coach - UK
Functional Medicine Certified Health Coach (FMCHC)
Certified Re:CODE 2.0 Health Coach
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