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On Namenda for 12-15 years by psychiatrist. 3+ years ago first neurologist diagnosed Parkinson's. Then second severe brain atrophy. Then atrophy with a compressed spine and Alzheimer's. Now Parkinson's with a duel diagnosis of Alzheimer's. The doc is beyond reputable. The brain must really be an elusive organ to master. I find it so confusing as a caregiver to know what to look for, how to proceed. I like to be prepared (yes probably control issues). I guess it is a lesson in living in this 24 hours and look for tomorrow's needs tomorrow.

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My husband and I have had the same general practitioner for years. Today we had consecutive appointments, me first. We covered my issues and then I dumped on him with the problems my husband is having. A year ago our doctor referred my husband to a neurologist when he complained of memory loss. That turned to be a diagnosis of memory loss with several potential causes. The husband wouldn't follow up for the PET scan and the neuro-psych eval. Over the last year it's very clear that he has FTD, frontotemporal dementia. When I told that to the GP he scrunched his face and was like "what is that?". I had brought multiple pamphlets on FTD, open to the parts on the behavioral problems these patients have. I told him that either he was going to have to learn about this and treat him himself or get my husband back to a specialist pronto. And BTW my husband is totally ignoring his type 2 diabetes. He went from my exam room to my husband and prescribed new diabetes medicine. He also changed his antidepressant (previously prescribed by his now retired psychiatrist) from an SSNRI to a SSRI which is more appropriate for FTD patients, which is what I told him from my research. My husband didn't say anything about the dr visit except the new meds he walked out with. We go back in 2 weeks for a follow up to get results of routine blood tests. The doctor will get another dose of a kick in the rear to get going on pushing him back to a specialist. Oh and by the way this is for Dr. Helen...when I told our doctor that my husband needed to get back to a neurologist or a geriatric psychiatrist he said he didn't think that geriatric psychiatry was a subspecialty. I corrected him. Las Vegas may not have one but they are out there. So, in answer to the original question of this post, no doctors don't necessarily understand neurological diseases, even if you hand them the diagnosis.
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If only there was a single, simple test....an MRI type machine that could look into our LO's brains and punch out a diagnosis with a push of a button. My MIL was diagnosed almost six years ago with "atypical Parkinsonism". I'd never heard of it so I hopped on line and "googled" it, only to discover it was just an umbrella term for at least a half dozen different neurological disorders. It was only this past year that her neurologist finally reached what she felt was a more specific, reasonably definitive diagnosis, and it took a combined effort of her knowledge, skills, and experience and my observations as MIL's primary caregiver.
Despite what some of them might think, doctors are not omniscient, and they don't have crystal balls. (no pun intended) This is especially true when it comes to disorders of the human brain. IMO, the best way you can help your LO (AND his/her doctors) is keep a daily log or journal, write down your observations - even things that might not seem all that important - and before each appointment make a list that you can give the doctor, a "consolidation" so to speak of your observations since the last visit. As the caregiver YOU are the one that knows your LO best, and any doctor worth his/her salt will be grateful for your input.
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Some things we can hit the nail on the head, some things are mixtures of too many things... and the learning curve has been pretty steep lately. The "old GP" who hasn't been keeping up and isn't well acquainted enough with Dr. Google to look up about stuff he/she doesn't know is likely to be mired in the 1980's view of things.

You ever hear of Occam's Razor? Wellll, it doesn't work all the time.
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Until we can each get us one of those Star Trek scanners, 21st century medicine is just going to be a little primitive sometimes. Someday we will look back and be unable to believe we had to wait 4 months for a whole exome sequence that cost $4,000.00 and came back negative half the time or more. A lot of things diagnosed by clinical findings today will be pinned down to specific genes or specific autoantibodies in the future and that will help a great deal.
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Patients (and their families) tend to be very focused on diagnosis. I guess because we've come of age in an era where we expect that things can be 'fixed'. With dementia, 'fixing' is not possible. Coping is the goal. So, if you switch your conversations with the doctor (and your focus) from "get me an exact diagnosis" to "help us with behaviors X, Y and Z" you'll get more help. Of course, knowing which type of dementia you're dealing with can help with selecting drugs and setting expectations regarding prognosis, but what do you do right now to make the patient's life as meaningful as possible and the caregivers life as manageable as possible – that's the important stuff.
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That's why they call it a "practice". You would do well to get copies of all test results and read them yourself. When you go for imaging, always ask for a copy on CD. Read the bloodwork. Everything. With enough practice you will get pretty good at ti.
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Based on the "evidence" presented, they make their best, most educated guess.
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I, too, am not happy with my wife's GP; the MD knows of the problems, however, rarely has any suggestions as to how to deal with the situations.
And, improving the dementia seems to out of the question. Switching to a geriatric specialty physician is a consideration.
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We have an excellent neurologist. Not only does she keep on top of things, but she teaches. But she still is only treating symptoms while trying to narrow down the diagnosis. His shaking, dragging walk and mumbling seem to point toward Parkinsons, but the meds seem to be helping with that. His short-term memory is failing more and more so I'm not certain that the new med is working. I, too, would like to be able to put a name to his disease, but if our doctor can't do that yet, then I will just have to be patient.
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The day they can accurately diagnose neurological diseases of the brain is when they will be able to cure those diseases. The brain is a very complex organ that works differently for each and every person. Brain disease is not an exact science for medical professionals. They can only go by the basics and then observe the individual to recommend the best course of treatment.
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