Angie & Jim

A Trip to the Doctorby Jim

We took Mom to see Dr. James Lah (pronounced “law”) today; he’s THE doctor in the greater Atlanta area for Creutzfeldt-Jakob Disease (CJD).  He was very kind, professional, and friendly.  He met Mom and then went over a history of the last six months with Dad.  Then he asked us to stay quiet while he talked to Mom.  He asked her questions, tested her reflexes, etc.  It was very interesting to watch, if a little disheartening at times.  She could say Dad’s name and Jim’s, but not Angie’s, or at least had run out of steam to say it.  She could repeat back a short phrase word for word, but gave the wrong answer for how many children she has.  He examined her muscle tone and eye tracking.  She was obliging and agreeable, but pretty mellow.  He then asked her if she would smile for him and she immediately had a huge grin on her face — that was darling.  He even got her to laugh a few times, which was very nice.

Finally, he asked Mom if she would mind if he stepped out with us for a while.  We left her listening to some quiet music with her lap quilt and Maggie (the sheep Pam gave her), and Dr. Lah led us into another exam room.  He confirmed what we have been anticipating: he is confident that this is sporadic CJD, and believes Mom is in her last weeks.  All her symptoms are classic for CJD.  In most cases the balance is affected first, and slowly becomes worse.  Other symptoms follow and accelerate as the disease progresses, including difficulties with muscle control, memory, and concentration.   He also said that her MRI was “practically a textbook image” of CJD characteristic features.  Looking back to her MRI in November, he said that he could see the very beginning indications, but that it would have been practically impossible to notice if you weren’t looking for it.  He added, though, that he believes it is better we didn’t know yet, so she didn’t find out early enough for it to weigh on her.  In his experience, earlier awareness of the severity this condition is not helpful to the patient because of the way their cognitive processes diminish over the course of the disease.

Dad asked about the possibility of identifying a cause — specifically, if this could have been brought on by stress.  Dr. Lah said that there is a possibility that her busy summer and/or traumatic autumn are completely unrelated to her condition, but he emphatically dismissed the suggestion that stress was the actual “cause.”  He believes the truth most likely lies somewhere in between: that stress may have “provoked or triggered something that has been brewing for a while.”  It’s also possible that stress accelerated the progression of her symptoms, but the disease works so quickly anyway that there’s no way to be sure.

He ordered some blood work (“just for the sake of clinical completeness”) to eliminate any of the possible autoimmune or viral diseases that sometimes mimic CJD, and received Dad’s consent to draw more for research.  Unfortunately, because of Mom’s involuntary movements and low hydration, it took three pokes to get all they needed.  She was a trooper, though, and endured it patiently.

It was a relief to finally head home, and we were delighted to find on our arrival that Kay and Louise had been grocery shopping, bought Mom some flowers, and had dusted and vacuumed the house while we were gone.  Mom was exhausted and said she wanted a nap, but was too restless to actually sleep.  We only got a little dinner and some Ensure into her before we could tell she was pretty much done for the day.  Even the usual after-dinner routine of “Smiles for Life” and Studio C didn’t perk her up much, so she headed to bed early.

Carol arrived this evening, and we’re so glad to have her here.  She has a sweet, calming influence and a lot of insight from her experience as a nurse.  It will be fun to have both her and Kay with us for a while.  We’re sorry to see Louise go tomorrow — her bright personality has a wonderful affect on Mom.

Your posts and videos to this community are very welcome; we keep Mom updated on all that people send.  She also enjoys very short phone calls, so if you have a few minutes you can call Dad and see if it’s a good time.  Your continued prayers are appreciated as well.