So how am I doing?

How am I doing?  From the standpoint of memory and cognition, great.  But in some other areas...

My memory and cognition are my #1 interest, since there's nothing more important to how I'm able to navigate this world.  After my initial diagnosis of MCI in 2015, I joined the gym and began a course of steady improvement.  I probably hit bottom in early 2016, and my improvement probably peaked in April 2019.  Since then, they've been generally stable, although kind of an up and down.

Whenever I meet with one of my neurologists, they ask me how I'm doing.  I remark that people in memory care have good days and bad days.  I have good months and not-so-good months.  As a rule of thumb, I have one not-so-good month for three good months.  I can't call them "bad" months, but they're scary.  But whenever I seem to be going downhill again, I suddenly just sort of pull out of it.  Over the past couple of weeks I've felt unusually well following a scary period.

So what constitutes a not-so-good month?  In April 2019, the fist time I thought I might be losing ground, I stopped remembering to lock the car door when I parked.  (Bad idea in Seattle.)  I might be reminding myself while pulling into a parking space, but I'd find out later I had never locked the door.  And this could happen a few days in a row.

Probably my most sensitive measure is how well I can converse in Spanish.  I have been speaking with a couple of people in Latin America in Spanish four times per week for more than 10 years.  During some periods I have command of an extensive Spanish vocabulary, but during other times I can barely recall any words.  (Oddly, when I can't recall a word in Spanish, I'm also unable to recall the English equivalent.)

In Beating the Dementia Monster we discussed the logopenic syndrome which is associated with both aphasia and Alzheimer's disease.  (Bruce Willis and aphasia have been in the news lately.)  And the relationship between aphasia and Alzheimer's disease is not clear.  Aphasia involves a significant deterioration in language skills, and I've never been there.  Nevertheless, I've had periods that appear to me to be incipient aphasia or the logopenic syndrome.  This involves problems with word finding or understanding what's being said by another person.  But everyone over the age of 55 or so begins to have trouble with word finding, and it's not caused by disease.

During a not-so-good period I have trouble putting a sentence together in English.  This is not obvious to people I talk to, but I'll say less when I know I'm having trouble.  It's not just word finding, but also ordering the words into a coherent sentence.  During a difficult period, whether in English or Spanish, I feel victorious when I know I just said something meaningful and grammatically correct.

And then there are things like managing my meds and finding my car in a parking lot.  These go up and down, but lately it has all been well.  In fact, very well.  So I continue to get to the gym every day, eat right, maintain social connections, and do the rest of the strategy of the Dementia Toolkit.

What has not been going well is my balance.  It's gotten really bad, and I shuffle to get around.  I get a little bit of relief from the habituation exercises we discussed in Beating the Dementia Monster, but not nearly as much relief as I got just a year or two ago.  And bad balance affects almost everything I do.  Last year, I traveled twice to the East Coast, once with Amy and once alone.  Traveling alone now seems a bit dicey, as I worry about falling in the shower in a motel.  Fortunately, it has no influence on me when sitting, and I have no sense of it when driving a car.  At least for now.  So that's good.

My neurologists in Seattle are on it, and I had a set of three MRIs of my back about a month ago.  The idea is that this problem may be arising in my back and not my brain.  I have the radiologists report, but I have yet to get a readout from my neurologists.  That will happen on May 3.

The upshot of this is that, since April 2019, my memory and cognition have been relatively stable, albeit up and down.  But it's been mostly up, and I'm incredibly grateful for that.  Balance problems are significantly affecting my quality of life, but I'm waiting to see if the neurologists can do something about that.