Physician, "Heal Thyself": Pt. lVb Dr A

Miss Cathy has seen Dr A at least a dozen times in the last 2 1/2 years.

During her appointments he’d perform a few rudimentary tests to check her short-term memory and cognitive skills after which he’d determine that she was more or less the same…which was good news.

And so it was year after year, it was all pretty routine more or less until the last two visits.

Given that set of facts my complaints against Dr A seemed pretty much ‘surface’ stuff (like his patronizing ways (he always called Miss Cathy ‘Mom’ which I am convinced he doesn’t do out of affection or as a pet name but because he can’t be bothered to learn what her name really is).

I didn’t campaign for his removal from the ‘team’ since it was his manners and not his medicine that were in question.

We went to see him the day after our appointment with Dr S, the ophthalmologist (and we all know how well that didn’t go) hoping he’d have an explanation for her increased confusion (at least) and maybe some insight into her loss of sight.

Upon hearing about the changes in Miss Cathy’s condition Dr A seemed to rise to the occasion and focused his exam on the new information that we were bringing him but ultimately (surprisingly…not surprisingly?) he let us down when he didn’t have much in the way of answers or an explanation as to what was happening to mom.

Miss Cathy was very concerned (understandably) about going blind and made a moving plea for his help.

Truth be told he didn’t seem ‘moved’ one way or the other.

I mean, I know he sees distraught patients everyday but his sensitivity to her rapid decline was minimal at best (holding her hand and calling her ‘mom’ was something I was already doing on my own time at home-and I don’t have a medical degree).

Besides, what we (me) wanted were solutions not sympathy.

As for diagnosing her loss of vision…he simply ‘passed’ on that one, deferring to the ophthalmologist (whom we had just seen and I made a point of reminding him of that fact) and referring us back to where we’d just come from.

In the end he did order an MRI for the next day thinking it would give him more information as to what might be happening to her brain and said that he would call that night to discuss what he concluded after reviewing the film.

So, the next day Miss Cathy took a couple of Valium (even in a partially open MRI she gets claustrophobic and panicky) and took the test.

That evening we waited for a call that never came.

Physician, "Heal Thyself": Pt. lVa Dr A, Neurologist

Dr A was the neurologist on call at Doctor’s Hospital where Miss Cathy was recovering after an accident in 2010. He was brought in the evaluate her after I noticed that she didn’t seem quite right even though the hospital was about to discharge her because she’d (luckily) not sustained any broken bones after her fall and her vital signs were all normal.

And sure enough, after a series of tests Dr A concluded that she had Dementia, Stage one Alzheimer’s.

I left my life to join hers soon after and became her primary caregiver.  

It made sense to add Dr A to her ‘team’ of doctors since she was comfortable with him and he was the doctor that diagnosed her condition.

When I first met the doctor I took note of his professionalism, directness and knowledge of the disease (which at the time I only had a “Lifetime Movie of the Week” awareness of).

Once she was back home we saw Dr A at his private practice near her condo.

I was a fast learner and not just about the disease. One of the things I learned was that a doctor’s beside manner in the hospital is one thing and how he runs his practice to be quite another.

In time I became dissatisfied with Dr A and had to remember that I was the caregiver and not the patient. Miss Cathy by all accounts (and after direct questioning) was pleased with his care.

I had to remind myself of what one of best friends said to me early on, “Regardless of your personal opinions or feelings toward any of the ‘team’ all I have to do is collaborate with the doctors and get them to collaborate with one another”.

My friend stressed the word ’collaborate’ so many times that it’s all I can remember.

In my mind’s eye I couldn’t help but see the duck from the old Groucho Marx TV show drop down from the ceiling on a string with the word ‘collaborate’ written in block letters on a piece of paper hanging from it’s beak.

But, this was not some late night talk show with a panel of ‘B’ list actors from the Golden Age of Television and I was not a quick witted, Jewish comedian with a sight gag. I was dealing with a humorless doctor and a parent/patient that was content.

So, as the months turned into years and as the appointments with Dr A started to accumulate I started to question his methods and wonder if another neurologist could serve my mom better…or was this just about me and my ability to collaborate?

No matter, Miss Cathy was happy with Dr A, and in her eyes he could do no wrong…that was until a loss of vision caused her to see him in a different way.

Therapy Pt. lV: Alz R Us

Since Dr G’s referral for a therapist for Miss Cathy didn’t work out my next call was to Maureen Charlton, the Helpline Program Coordinator of the Fairfax, Virginia Alzheimer’s Association^® National Capital Area Chapter.

The Alzheimer’s Association is a wonderful organization and I highly recommend them to anyone who has been touched by the disease. They have a wealth of resources and information.

The first thing I was grateful for was that they helped me to realize that I was not alone.

Their mission statement reads; “The Alzheimer's Association is the world's leading voluntary health organization in Alzheimer's care, support and research”.

But (like everything in life) I have found it best not to depend on them completely and to think of them as just ‘one’ of your resources and not the ‘only’ one.

After talking to Maureen and explaining what I needed she emailed a list of doctors and therapists.

Unfortunately, as I learned a couple of years ago when I requested a list of ‘Elder Lawyers’ (no, not ‘old lawyers’, rather ‘lawyers’ that specialized in legal issues for the ‘old) I’ve learned that Alz.org’s information and referrals are not always up to date or current.

I found more than ½ dozen of the physicians on the list that she gave me for referrals was outdated.

Was I mad (no), did I get frustrated (yes) but considering the help that they’d already given me and the fact they were mostly a volunteer organization where everybody was doing their best I couldn’t ‘not’ cut them some slack.

Besides, they were kind enough to feature my journey with Miss Cathy as part of there “World Alzheimer's Day Story Project” in 2011.

So, I took it upon my self to compile my own list of names that needed to be deleted from their list and emailed it to Maureen.

But, that still left me with more than enough professionals to contact so I got work.

As I worked my way down the list of doctors and therapist that were available to me I had to consider the very real possibility that this could all be a huge waste of time. I mean lets face it, I was looking for a therapist to help someone with problems that she might not remember having let alone remembering the solutions once she got up off the couch.

But, if Miss Cathy thought therapy might help then it seemed to me to be worth the effort to find her a good doctor, no matter the outcome.

Later that day I received an email from Maureen. She couldn’t have been more apologetic and wrote ”We do make every effort to keep our lists as accurate as possible, but as you can imagine, we cover a large territory and things change”.

She said that she was very appreciative of the info, but for me not to feel obligated, she knew that I had a lot on my plate already. 

I wrote back that I knew they were doing their best and I was happy that I could help.

I just wanted to make sure that they updated their system so that another caregiver (or heaven forbid) a person with Alzheimer didn’t spend the day as I had trying to contact doctors that were either no longer in practice, had moved or in one other case needed to be removed for an entirely different reason.

http://www.alz.org/index.asp

Therapy Pt.lll: The Three "P's" plus One

Even though I was perturbed, I’d not yet written off Dr G’s referral (but I was turned off by what I’d learned so far).

Before I dove into the mountain of paperwork required to see the doctor I decided to call back to ask what type of therapy the doctor practiced. When the person answering the phone couldn’t answer what I thought was a perfectly reasonable and simple question I tried to help her by asking, “Does he follow Freud, Yeung? Is he a Behaviorialist?”

You can’t really hear silence but it’s not like she was saying anything so that’s all there was on the other end of the line. When she did speak it was to mispronounce the names of the two long dead fathers of what we now call ‘talk’ therapy.

I went from being frustrated to disturbed that she couldn’t answer me.

But, realizing that she probably wasn’t get paid enough to know more than how to say “Doctor’s office” and “Please hold” I cut her some slack and asked if there was anyone else in the office who could help me.

So, using one of the skills she had at her command she put me on hold for a moment, after which another female voice came on the line and introduced herself as the office manager, understood that I had a question and asked if I could “please repeat the names I’d said earlier.”

“Sure”, I said and parroted my query.

“Fried?” “You who?” was her response and that pretty much told me all I needed to know (if not about the doctor, then about who he surrounds himself with and who he chooses as his representative to the unsuspecting and often unbalanced public).

“Umm,” she stammered, “I’m not familiar with those names she said, “but I think it’s the last person you said.’

“You’re the first person who’s ever asked that question. I’d ask the doctor but he’s in with a patient at the moment.”

“Think!...you think?!” I thought to myself. (Horrified) that she identified a type of thereapy that a doctor practices (behaviorism) for an actual person, I wanted to ask if she was pulling my leg but what I said was, “I think that’s all the information that I need, thank you.”

Setting aside the fact that she was the ‘office manager’ and the one person in the practice who should know the doctor’s credentials and methods I wondered, “Hadn’t she ever seen a Woody Allen movie or any Rom-coms based in New York City?”

They’re filled with therapist humor. Someone is always; either going to a shrink, making fun of shrinks…or is a Shrink.

I clicked off the line knowing that I wouldn't be clicking on their website, wasting anymore of my time or printer paper anytime soon.

Update: I was later corrected by a clinical psychologist (who just happens to be a dear friend) who told me that the doctor I was referred to (and was asking about) was a “Psychologist and not a “Psychoanalyst” (a disciple of Feud) so I was asking the wrong question.

Okay…my bad, so the “Freud, Yeung, Behaviorist” query didn’t apply….but still?”

Not to absolve myself of my personal responsibility but shouldn’t they have known that I was barking up the wrong type of analyst’s tree?

Fortunately the following link can explain the Three ‘P’s” (The Psychiatrist, Psychologist, and Psychoanalyst) so that you don’t sound like me…the fourth “P”(a ‘Putz’) when you’re shopping for a therapist:

http://www.estronaut.com/a/psychiatrist_differences.htm