The first I've heard about NPH...
...at least the first I'd registered, was a startling commercial, did you catch it, which I saw for the first time a few nights ago: An older man, in 30 seconds, takes us from being senile and infirm to being vital, vigorous and aware. Nothing, of course, is explained about NPH, the acronym is just mentioned.
    Last night I searched it. Several references came up but I chose only one; I wanted fast information: All About NPH. From what I read, the NPH profile sounds very like my mother; but, my mother easily fits more than one dementia profile. Oddly, the one she doesn't fit is the Alzheimer's profile. I also noticed, in scanning the other references in my search, that the word "diabetes", even the phrase "elderly diabetes" came up a lot in the literature, although I didn't go into any another links last night.
    I excitedly read about the shunt procedure. Then I read the section about diagnostics. The two most critical tests, cranial CT and MRI, were performed on my mother in September of last year when she was hospitalized after her blood pressure crash. I noticed that the material I was reading was copyrighted 2001-2003. The results of both of these tests clearly showed my mother had suffered a small stroke to the back left lower section of her brain some time in the distant past and showed "nothing else", including that her crash had been another stroke. You'd think that if NPH were evident it would have been mentioned. I will ask her doctor about this next week during our appointment.
    From the little I've read, though, it looks as though my mother may not be an NPH sufferer because her dementia appears to be related to a variety of other factors and loosens its grip as these factors are addressed.
    The procedure sounds more than fairly risky with a variety of high risk complications after the shunt is installed, most of which appear long after the procedure. Behavior may revert as the shunt needs to be adjusted. As I read through the material I got the image of an extremely risky and pricey operation that probably is never done on an other than voluntary basis, which is, thus, likely, not covered, or not well covered, by insurance.
    I wondered why I'd never seen the commercial before or heard about the condition in all my readings about dementia; I've probably run across it, but it hasn't been highlighted. It's been noted and addressed for awhile, it seems. Maybe, I mused, since this material was first published, some of the riskiness of the operation has been addressed, some of the trickiness to controlling dementia through shunt adjustment has been alleviated, so the medical establishment is now promoting the procedure.
    I'm thinking, from what I've read, that my mother is not a candidate, which saddens me. I cannot get the panoramic image of Frail Man to Robust Man out of my head. I would love this for my mother. I'm sure the advertising agency had this in mind when they crafted the ad. It addresses everyone's hope against hope, those of the charge as well as the caretaker.
    A funny Thank You Thing: There's been minor tension here the last few days. I think my mother's been feeling especially dependent and not liking it so she's been gently but firmly putting up boundaries. I've, of course, been stepping back, as much as I can without endangering her. It's part of the dynamic of our relationship, the part where she creates distance between us, which, curiously, is the most hopeful part of our dance.
    One of her methods of expressing distance is upping her use of the phrase, "Thank you". When she is irritated and marking off her psychic and/or physical territory, when I do or say something that she considers an invasion, usually a direction I need her to follow that we both know she doesn't want to follow, she'll say "Thank you". Most people would, under these circumstances, say it icily, but not my mother. She says it as though she's enlarged the letters a bit, but when she says it, it's not a pose. I realized, yesterday, her saying it is actually like a mantra that helps create within her the grace to be grateful for being able to define herself in opposition to others, and that there is someone in her life with whom she can do this, safely, on a daily basis.
    Whenever she slips into this "Thank you" mode, I am always, well, not exactly chastened, but I become instantly thoughtful about my own perceptions of periods of trial with her. During these times I redefine what the word "trial" means, and find my scale of grateful acceptance rising to task of being my mother's final companion.
    Thank you. That's all I have to say. Just, thank you.
- posted by gail rae @ 11:20   email...this post