My 93 year old mother in law has Parkinson’s and has had numerous medical issues recently, such as bladder stones, bladder infection, and blood pressure instability, and has been to the ER three times in the past 2 weeks. But without a doubt the most disturbing are these episodes she has that, for lack of a better name, we’ve been calling vertigo because it always includes dizziness and lightheadedness. She sometimes says the room is spinning and sometimes not. These episodes can be precipitated by a poor nights sleep, pain of any kind but especially headache, or any stressful event. It often happens in the afternoon. The other day, she got upset because she couldn’t find a receipt for something she had ordered. It was the day before Easter so I said I would call about it on Monday, but she continued to fret and look for that receipt. She started to get dizzy and lightheaded, it affects her balance, her head control and eye focus are decreased, and she becomes preoccupied with old, sad stories or worrying about dying. This time, she kept asking if I thought she was going to die soon. (This is very stressful for me!). She gets so upset she started throwing up, and couldn’t go to sleep in spite of medication for anxiety and nausea which I gave to her. Writhing in bed and throwing up, she kept asking if I could call the doctor or paramedics. So we ended up taking her to the ER ( it was 9 pm and drs office and urgent care were closed. ). They treated her with IV fluids for dehydration. She was already on antibiotics for a UTI. I talked to the ER doc about her recurring anxiety attacks and concern about dying and his suggestion was to ask her doctor to do a “dementia screen” because, according to him, anxiety and preoccupation with death can be associated with dementia. She had never been diagnosed with dementia and in between her “episodes” is lucid and alert. I can see where someone would consider dementia if they see her during one of these episodes. They’re terribly distressing for her and anyone present. She has a PCP and a neurologist with whom I have discussed these episodes. She also has an outpatient urology procedure this coming Friday that she has been Very anxious about, and she has an appt (follow up from ER visit) with her PCP on Wednesday. My question is: although I know I should follow up on the request for dementia screening, I believe in my heart that if we do that this Wednesday, it could put her anxiety thru the roof just before her dreaded urology procedure on Friday. I think I should wait until after the procedure, and talk to the doctor about it soon after. What do you think?
You send or take a list of your concerns to the doc on Wednesday ( if you can email or fax them in advance, that would be great). You tell the doc in this brief letter what your ongoing concerns are, but that mentioning cognitive testing is best left for another time, after the procedure.
What you want to talk about is her daily anxiety, dread and rumination. These are all symptoms and they deserve treatment, either by her PvP or by a geriatric psychiatrist.
I had a uti last month. I am over 65. My symptoms included loss of balance, loss of coordination, and frequent falling down. Loss of sense of smell, food tasting "funny", loss of appetite. Hearing things. Confusion, brain fog. ALL of these symptoms cleared up when the uti was cleared up. Who would have thought so many things seemly unrelated to urination could be caused by an infection in the urinary tract? (BTW, since I had fallen several times, my doctor included a brain scan as part of the diagnosis, to be sure I hadn't injured my brain.)
Understand that I am not trying to tell you that MIL's symptoms are from her UTI. Just pointing out that lots of things can cause unexpected symptoms. She should be "screened" to help understand her mental status. But don't cross any bridges until you come to them. One thing at a time.
Just saying.
Hope you get it diagnosed soon.
May God bless you.