Fronto Temporal Lobe Degeneration - A different kind of dementia, most often called FTD. With this blog, I am hoping to offer information and insight into dealing with FTD, whether you have the disease, are a caregiver for someone who does or if you know or love someone who has the disease and want to learn more about it. I hope this blog helps you to understand.
Sunday, May 30, 2021
Please Be Patient
Sunday, May 23, 2021
Different Yet the Same
While I do try to not speak for everyone with FTD, sometimes it is difficult not to. Yes, no two cases of FTD display the same exact symptoms and the disease progresses differently in each person with the disease. One person can need to use a walker or be in a wheelchair to be able to move from one place to the next. The next person can take long walks or even jog with no assistance. One FTD'er discovers hidden or new artistic talents but the next loses artistic abilities they had before they were destroyed the disease. Some can still hear well, the brains of others do not allow them to hear, or they hear the sounds but the brain can no longer interpret the sounds into words. Absolutely everything a human being can do is controlled by the brain.
A good example is the hearing. A person with FTD can score perfectly in a hearing test conducted with just the beeps because our ears can hear fine. I explain it as "My ears can hear, but my brain can't." I become irate when someone says to me, "You just have to do it more often" or "You only have walking issues because you need to get out of your chair and walk more often." There are an endless examples.
I already know the limitations my disease has put on me, I don't need people telling me I just need to pay attention. I do not need people accusing me of being stupid or lazy. I often feel that way on my own even though I know I am not, so please don't remind me.
Last week I visited the office a physician I had not seen before. The physician's assistant came in first to get my history and explain things to me. With everything being automated, he was typing into a laptop the entire time so he was not looking at me. Since he was in front of me, but several feet out of his visual field. He was rattling off the same information and questions that he does dozens of time in just one day, so it was rapid-fire.
On that same trusty laptop, I suspect it clearly said "frontotemporal degeneration" or, at least, "dementia." I finally, politely I hope, said "Excuse me but I just cannot hear you." I explained that I had FTD and if I could not see him, I stood no chance of understanding." He was gracious and apologized. He apologized and took a step closer to me and started talking much more loudly. I kept the irritation in and laughed that he thought he had to speak louder. A HUGE but here... when he started dumbing down his vocabulary and defining one or two words in every sentence, I lost it.
I was good, honestly I was. I didn't scream at him, jump up and down, slap him or walk out. I certainly wanted to but instead said (okay, I said it very loudly.) I am NOT STUPID! I only need for you to speak clearly and at a normal pace instead of rattling off all the things that I am sure you get sick of saying." He left the room quite quickly after that and, most likely warned the doctor before he came in.
Fortunately, the doctor was somewhat familiar with FTD. He is a gastroenterologist and has dilated enough esophagus's to know at least that issue the disease can bring. I actually loved him! I did not complain about the PA but, if I experience it there again, I will. Didn't seem wise to complain before he sticks scopes up and down inside my body!
I wish it was only PA's and Physicians or other medical providers who act this way with someone who has FTD. Unfortunately, it is rampant.
I cannot count high enough or remember well enough to tell you how often I am told things such as "You can do that yourself, you know how!" which develops into a shouting match and I break down crying and apologizing profusely. When I started to be able to cry again, after several years of FTD preventing it, I thought it was a good thing. Nope, no way! Crying is no longer cathartic. Throwing things at someone is not very helpful either. Fortunately, my aim is off because of my double vision so I haven't hurt anyone... yet.
I guess I should clarify. I don't recommend yelling at healthcare professionals, caregivers or family members. It doesn't help these relationships at all and can leave you more upset than you were by whatever it was that happened. Yep, I don't recommend that but cannot tell you how to control outbursts that come out of total frustration. I haven't figured that one out yet.
To clarify this to family, friends and caregivers, I am fairly certain that it is not just me, this one person with FTD, who cannot control the outbursts. I know I cannot stop them, it is the disease that robs us of that control. I will not say "It's not me, it's the disease." I hate that expression! I am a person, a human being, and do not deserve to be defined by my disease. If you know someone who is missing a leg and cannot climb stairs in that manner? "Oh, don't mind him, it's just his condition." Would you tell that person, "You know you can do that, just do it"???
Well, that explains us. No, you cannot see a missing body part on us. However, you should be able to relate to the fact that there are parts of our brain missing.
Now, why do I scream these things at a family member or friend but don't at those like the PA that started me into this rant? That is easy. Just as a child whose teacher tells you how kind, helpful and sweet your child is and makes you turn your head to see who is behind you because you are positive the teacher cannot be describing your child. Yours is the one who comes home grumpy, grunts a few words or explodes at you and when you ask a question and refuses to do a simple chore. How can this be? Simple, because if s/he acts out at home, s/he probably knows there may be repercussions but that you will still love them. So that is where they are comfortable to let out their frustrations just as we are.
But, I also don't like being referred to or treated like a child. I may, at times, behave like a child but I am not one. Yeah, caregivers can't win some days either!
Sunday, May 16, 2021
Better Informed but More Frustrated
If you have any doubt if I have FTD, let me tell you... I just spent 2 hours trying to get logged in. I have no clue what I was doing wrong. I know I kept having to log into Google and enter password. I was looking at my list of passwords, but it wouldn't work and I ended up having to change passwords about 5 times and resetting my privacy settings. Whatever, I don't remember it all, but I am here. Yes, that sounds excessive and it was. I know it was user error, I just don't know what error triggered it. More about my loss of technology ability later.
Many of you know, but the Association for Frontotemporal Degeneration (www.theAFTD.org) has annual education conferences for all interested in FTD, from those with the disease to medical professional and more. I, and if I may speak for all of us with FTD, look forward to the next one as soon as we return home. It is a wonderful opportunity for those of us with FTD to meet, learn, share information, and have fun. To meet and hug and then spend an entire day with others with FTD is priceless. We can let our hair down and not worry if we aren't using the right words or stumble across the room. We can be ourselves. Then came COVID!
Last year's conference was cancelled due to travel restrictions, size of gatherings and risks of infection. We were REALLY looking forward to this year's but it met the same fate.
The AFTD responded by planning two days of an online virtual conference. We were given just as much information as we did when it was in person, thanks to many wonderful experts on FTD. It was obvious that everyone with the AFTD must have put in a huge effort and utilized a lot of technical abilities.
There was enough information shared that I had to feel a bit hopeful. Let's be realistic. I know there will not be a cure for me. We all know that even when a cure or treatment is found, it will need to go through years of testing and trials to get government approvals. I heard enough, though, to be hopeful for the next generation. And, that was just the first day!
I am blaming the progression of my FTD for this next part. The second day, Friday, was again loaded with presentations by many experts. The information seemed more geared to everyone, except those with FTD. I will admit that I was exhausted after the first day which took its toll on my brain functions. Fortunately, there was a link on the screen for technical help. I needed help.
My screen was frozen and I had no clue what to do. I clicked on the link and was answered immediately. They asked what operating system I was on. I had no clue. They said if I could switch to Google, the broadcast would be better. I thought I was on Google but they could tell I was on Microsoft Edge. Kind of scary they could know that and I couldn't. So they suggested I go ahead and download Google. I think my response was an intelligent, "Huh?" Fortunately, there was an alternative to just click on the reload icon. That I could do and it worked. I had to ask for help a couple more times from them and twice from my daughter who just kept saying "Stop crying!" She wasn't being mean or thoughtless, it was that she could not understand what I was saying.
Lovely, I was left feel stupid and useless. This did not help my mental state at all! To add to my mushy brain function, the information being presented did not seem geared for those with the disease. A couple presentations were about the care team you should have. I wonder if this was mainly geared to caregivers and family members because it sure didn't help me.
Yes, it makes total sense that you should have a social worker to coordinate things and find things and ways to ease the way. We also were to have a neurologist, a family doctor, any other needed physicians, a caregiver who comes to the home and helps with things like housework, bathing, etc. Someone was to coordinate medical appointments and respite for the family member who whoever provides the constant care. I think I am forgetting a couple, but it doesn't matter.
My thoughts were, "How do I find these people?" "If I do, how the heck am I supposed to pay for them?" "How am I going to keep track of all these people?" "What are the odds I find that many people who have knowledge of FTD?" I don't know, maybe the social worker does that. I also worry about being stolen from. The part time helper I finally got when my husband died and I was still in PA, was robbing me blind. Sob story after sob story, I would help her out with money I couldn't afford. Eventually, she would come over, take out the trash then sit down and watch soap operas, then wait for me to fix dinner. I knew she had helped herself to several things in my home, but it wasn't until I was moving that I realized how much was missing. She even maneuvered me into signing my car over to her. So how do I find a "team" I can trust?
At one time, when still living, alone, in PA, I was offered assistance through the county's Senior Services program. A social worker visited and explained all that she could do for me. The main thing was she would coordinate my care and find help for me so I could stay in my home. BUT, I would have to pay, if I remember correctly, $270 a month for her services. Then I would have to pay the going rate for all the help she found for me which ranged from around $10-25 per hour. Some even higher. I had to try to educate her about FTD on top of it. She had no clue. The worst part was that I never heard from her again, even after paying the first month of her services of $270. This was not a fly by night company, it was the county's answer to the state mandate of a Senior Services organization. They did provide van service for seniors at a very low price, but I had already set that up for myself.
I understand that if you are eligible for Medicaid in your state, most of these things are provided at no or little cost. I am on Medicare but I receive around $150 a month too much Social Security to receive Medicaid. That whopping amount wouldn't even have paid for the social worker.
I am okay with that. I manage fine now that I am living in my daughter's home.
However, being told I need to have this "team" broke me. I felt even more stupid, useless and worthless. Why cannot I not find these people? I don't even have a doctor who understands FTD, except for my new gastro enterologist and, fortunately, my retina specialist. . If I could travel to one of the research medical facilities, I could maybe find what I needed. But what good would having these professionals 150 or so miles away with no way of getting there. My daughter's employer is already complaining about the time she has to take off for my local appointments.
To manage this myself would require more searching for and arranging transport, to say the least, than I am capable of. Right now, I am not even sure I could research these things on the internet. I couldn't even switch between sessions for the conference. To be perfectly forthright... today, when logging in to start this blog, it asked for my email address. I panicked for about ten minutes. What is an email address? I tried putting in just about anything. I finally thought I had the answer and got up to get my list of passwords. I tried putting that in which of course didn't help either. I finally figured it out. Part of this is because I am still tired from the two days of conference. If anyone has the answers, I would be glad to hear from you!
I have utilized technology my entire life. My first paid job was operating computer equipment. I loved it and it was definitely my niche! I went on to operate huge computer systems, back in the days when they filled an entire room yet didn't have the power this laptop has. I programmed computers. In later life, I was an expert in an accounting system and was on the company's support list for others to call for help.
Now, I cannot remember what an email address is?
I still want to profusely thank the AFTD for their monumental efforts to put together this virtual conference. The information presented was priceless and very much appreciated. Next year, it hopefully will be an in-person conference so that those of us with FTD can receive the social value as well.
Saturday, May 8, 2021
FTD Mistakes and One Phenomenal Book
Sunday, March 14, 2021
My Mind Rambles...
It takes a lot of energy and focus for someone with FTD, myself included, to explain things to people. I often struggle to explain what FTD is, what it does to me and how difficult it is for my family to deal with it. Someone recently asked, "How on Earth does your daughter work full time and still be able to care for you?" If you have been following my blog for any length of time, I am sure you understand that my reaction was one of anger and frustration.
We had been chatting on Facebook for nearly an hour by time she asked that. Reading back, I do believe all of my answers were somewhat intelligently written and most of the words were even spelled correctly except for when I was typing too fast and the wire from brain to fingers got confused.
I cook for both of us. I clean the house (no more than I have to) and do my own laundry. At least until late stages, many with FTD do not sit around, unable to contribute to our care. Absolutely, my daughter's life has changed since she convinced me to move in with her after my husband died. Absolutely it has, some for the better, some for the worse. Caring for the caregiver is essential, but what the person asking about her welfare obviously didn't realize is that this last sentence is true for me as well. My life has also changed, some for the better, some for the worse.
Fortunately, I held my tongue long enough to find some humor in the situation. I was able to answer by saying, "She does it quite well." Our chat ended shortly after that. I am not sure if I ended it because I didn't answer how she was expecting or if I became a bit testy after that. I suspect the latter.
Frontotemporal Degeneration definitely alters lifestyles of those with FTD, their family and caregivers. I know I am not easy to live with. (Truthfully, though, I never have been.) With FTD, though, I rarely want to go out anywhere nor to visit with anyone. I forget things. I often struggle to make civil conversation. If I am asked simple questions, maybe like, "I am making a list, is there anything you want from the grocery?" My answer is usually a dumbfounded look. I have to sit and think, go through the past few days to remember what kind of things I may have used up.
It shouldn't be difficult. My needs are simple and boil down to coffee, tea, agave nectar, half and half, frozen waffles, oatmeal and granola bars. Oh, and ice cream. She always keeps us provided with fresh fruits and veggies and healthy snacks. I have meal kits delivered because they make it easier for me to still be able to cook and they are healthy meals... low fat, low carbs and fresh, healthy ingredients. Plus they are premeasured and simple recipes laid out step by step. Everything is included, so I don't need to worry about the groceries I will need for dinners. Yet it will take me 20-30 minutes to figure out if I need anything for the grocery list.
I try to do housework, one task a day. One day last week, I knew there was something I intended to do that day but couldn't come up with it at all. I mentally walked through the house but, nope, couldn't remember. Later in the day, I was talking to my sister on the phone and she said something about her floor. Aha! That was it, I had intended to mop the kitchen floor! We cut the call off immediately so I would not forget again.
From talking with others with FTD, I know that is how an FTD mind works... in bits and pieces, in forgetting and remembering, in needing to do things right then before the thought drifts off into black holes.
It isn't easy. As the disease progresses, the black holes multiply and grow. Unless I must venture out of the house, I am always dressed in comfy clothes. Usually flannel pants and a hoodie or tee shirt. Sometimes I struggle to remember to put clean ones on. I swear I have the most organized clothes closet only so that I can easily find something to wear and, hopefully, that the colors match. I learned over these FTD years to limit my choices so there are not a huge number of clothing pieces to choose from... except for plenty of hoodies and flannel pants. This should just take me back to my childhood when my father believes no one should need more than 4 or 5 outfits to choose from. It did matter then due to peer pressure. Now, not so much. My peers have FTD so they don't care any more than I do.
I do remember to do my laundry but it is more difficult to remember to wash my bedding. I eventually get there and this crap doesn't matter. It used to matter to me, but no longer. If I am dressed in mismatched clothes, as long as they aren't clashing horribly, it doesn't matter to me and not a lot to my daughter. If it bothers anyone else, so be it! Now, part of this attitude may be helped that I don't know more than a small handful of people down here in NC. It is easier to not worry about what people think when they are all strangers.
For those with FTD, their family and their caregivers, it helps if you learn to fly by the seat of your pants. It helps tremendously to be as flexible as possible. It is more than enough stress to worry about the important stuff like taking meds, remembering to go to the bathroom before it's too late and brushing the teeth.
If a day or two go by without me having a balanced meal, it doesn't matter. Much longer than that, it may start to be concerning. If I don't eat protein for a couple days or fresh fruit and vegetables or anything else we "should" eat, it doesn't really matter. If I want to sleep for 12 or more hours in a day, it matters but only because I need that much sleep that day and if I don't get it, I am in for a bad FTD day.
To me, the bottom line is that FTD is killing me anyway. So why stress about if I eat properly, sleep too much or spend an entire day petting the cat or dog? Keeping a routine can be necessary for the family and/or caregivers but no so much for the FTD'er.
Today's blog is also an excellent example of the wandering mind of someone with FTD. At times, an FTD'er is like someone with AD/HD. You must watch out for those squirrels and I seem to have plenty of them jumping into view today.
I hope that, despite my wandering mind, I have said at least a couple things to help you cope a bit better.
Sunday, March 7, 2021
Ramblings of the Exhausted
I don't want to have FTD anymore. Not that I ever did, but it just keeps getting more difficult. I often say that there is no way that anyone who does not have FTD can understand it. There is no way to explain how having the disease feels.
Family members, caregivers and professionals often insist that they do understand. Nope, sorry, unless you have it yourself, you don't! This past week I have experienced a lot of the vast spectrum of feelings involved with having the disease.
Just two days ago, I participated in a forum organized by the Association of Frontotemporal Degeneration on FTD. It was a virtual presentation to the Food and Drug Administration. The purpose was to educate them on FTD, its effects, the difficulty of getting diagnosed and, most of all, the lack of available treatments and resources for those with FTD, their families and caregivers.
I was happy to participate and provided a prerecorded testimony on my and my family's history of the disease, trying to explain to them how it devastates families and how it can continue for generations.
I did not expect to be affected very much by watching the entire presentation but hearing so many stories of frustration, destruction of lives and fear of the future left me exhausted... mentally and physically.
It seems that it is difficult to anyone, outside of the disease, to understand. Once the event was over, they could jump back into their lives where they left off that morning. It isn't that easy for anyone involved in the world of FTD. It can be difficult for them to comprehend how it can leave us mentally and physically exhausted. "Come on, it's been two whole days, why are you still exhausted from that?"
In my case, after a while, I will realize my daughter is talking to me and that I had missed most of it. Of course, my reaction and next word is "Huh?" Sometimes she will repeat it, other times she will mumble under her breath and, usually, somewhere in between. No, I cannot understand what she is mumbling, except for a word here or there. It doesn't matter what the words are. As soon as I said the dreaded "Huh?" I knew she would be upset. She is not being mean and she isn't angry. She is simply as frustrated as I am.
I have written about this inability to comprehend spoken words. If an FTD brain is not aware that words are coming, it often takes long enough to know and, by then, you have missed something.
The frustration for everyone other than the FTD'er is akin to living with someone with a hearing problem. It is not the same, though, because those problems can usually be helped.
I do realize I mentioned this is a recent blog. Sorry I got lost on a tangent again and I hope you are still reading... The other thing that has me emotionally exhausted is hearing of three different situations involving an FTD'er and the current circumstances being thrust upon them. I will not even begin to explain the individual issues, it is not my place. You will just have to trust me that, while each is totally different, they all left me concerned, sad and angry.
In two of the cases, it would be easy to blame it totally on the caregiver. In the past, I probably would have. This reaction usually comes from the knowledge that the caregiver can change the circumstances while the FTD'er cannot. But, is that really true? In so many undesirable situations, it may seem to be impossible. When a caregiver or family member is already bogged down with worry, lack of sleep or just plain exhaustion from all the seemingly unending caregiving acts, it can be nearly impossible to come up with solutions that would have come easily before dealing with FTD. Yes, in an ideal situation, the caregiver would have endless energy and patience.
Sometimes I wish that my total apathy and lack of empathy would come back. The years I spent without those were easier. On the other hand, I don't really want to lose them again. I did not feel like myself knowing that I should care but didn't.
Now, I am wondering if in circumstances that are intense and seemingly impossible to do, if that forces apathy and lack of empathy onto the caregiver. I am not believing that this is true for all caregivers. There are way too many truly bad caregivers out there. You know the ones... the ones who say horrible and hateful things about their FTD'er, the ones who leave their FTD'er home alone for hours even though they know it is not safe, the ones who ignore signs and symptoms... I do not need to go on.
I don't know about you, but I can understand how caregivers could reach a breaking point and just not care as much as they used to or even as much as it seems they should. Now, it would be easy to say that they should ask for help. Again, yes, in an ideal world, it would. Unfortunately, most of us know how impossible that can be. If you can't even get family or friends to stop by and visit with the FTD'er for an hour or two so you can get some things done or at least to sit down and catch your breath, what is the likelihood of anyone being willing to come and really help?
Those of us with FTD should better recognize how difficult it is for the caregivers. I fear, though, it is often impossible for many caregivers to understand how difficult it is for the FTD'er. We often cannot discern the mood and comfort level of the caregiver. We don't understand subtleties like that. We don't understand sarcasm or have the ability to recognize joking.
I know how, when someone is dismissive or reluctant to do something I need, I don't have the ability to realize that they might be tired from a day's work or because the store was crowded. If after coming home from the grocery store they say, "It took forever because I couldn't find the things you wanted," What I hear is something like, "It's your fault it took me so long because you wanted all those things!" Yes, when the paranoia that FTD brings is the filter through which you hear everything, it can cause huge misunderstandings and hurt feelings... on both sides.
I do apologize for rambling. I tend to do that vocally when I am exhausted and, obviously, it is the same when I am writing! Oh, wait, I forgot to say that caregivers don't always pick up on the subtleties of what the FTD'er says or does. Okay, that is for another day...
Saturday, February 27, 2021
Unanswerable Questions
Saturday, February 20, 2021
FICKLE!
- changing frequentlysynonyms:
Saturday, February 13, 2021
Communication
When I resumed blogging last month, I vowed to myself that I would be more considerate of the feelings of caregivers. I am trying to always keep my caregiver experiences in mind. At times, though, it seems like I am picking on caregivers because they are the ones who are capable of change while the FTD'ers often are incapable of changing.
Communication is extremely important in any situation. With FTD, it becomes even more so. Talking to each other becomes a challenge for the one with FTD as well as the caregivers.
One of the biggest obstacles is that it is very difficult for someone who does not have FTD, even for the best and most experienced caregivers, to understand that while it quite often comes across as though we are ignoring you. Most often, it is quite the opposite. We do try to hear and understand what is being said to us but, as we all know, an FTD brain doesn't work in the same way as a healthy one.
The first issue is that our brains, as well as our bodies, often are slower to react to anything.
When someone talks to me, it takes at least a couple seconds to realize someone is talking, then a couple to realize they are talking to me. By then, the speaker is several words into what they want to say and those are the words that usually clue you into what the subject is.
So, by now, I am lost. I truly am attempting to hear and understand all the words but this is often difficult to do when you have already missed so much of it. I will give you an example: The other day my daughter said what I interpreted as "... ... blah, blah blah... the powder room still is really pink." Later, I remembered what she had said and went to look in the powder room because I did not remember putting any pink in there because it wouldn't go with my color scheme. I didn't see any pink. When I came out, I said "The paint in the powder room still makes it stink." She got upset and snapped "I just said that a few minutes ago!"
I quickly left the room, then returned and told her what my brain had heard. She looked at me dumbfounded but at least we had a good laugh.
I had not ignored her at all, it was a perfect example of how to not communicate when FTD is involved.
The best way I have found, back when I was a caregiver and now with FTD, is to make sure the FTD'er is aware you are about to talk to them. The trick is to make sure they know you are about to say something. If you are nearby, a gentle touch and looking them in the eye is great. I find that if someone goes to the trouble of doing this, I know to pay attention. If this is not possible, it helps if you say a few words before you say anything on the subject. "I want/need to tell/ask you something," just a few words for their brain to kick into gear to give them the best chance of hearing you. Ideally, you could do both.
Another thing that helps is for the speaker to take a couple good breaths before speaking to ensure the tone of your voice can not be interpreted as hostile. Just the other day, someone told me how his caregiver had verbally attacked him. When he told me what was said and what had led up to it, it was easy to see how this could have been intended as a helpful conversation yet interpreted as a hostile one. I probably wouldn't be speaking in a pleasant tone either but if she had paused and breathed a couple times, she may have been able to control the tone of her voice. It may have kept things calm and not led to the hostile afternoon he described.
Volume and tone of voice make a huge difference and it would be ideal if both caregiver and FTD'er could control their own. Unfortunately, in real life, it often doesn't work that way. Often, I believe the caregivers, as well as family and friends, try to speak more loudly to me. They think that I am not hearing them and that if they speak louder, and often slower, my ears will hear them. If only it would be that easy. Hearing aids are often of no help either because the issue is with the brain, not the ears.
Communication is not limited to speaking. Gentle touches, even gentle hugs, communicate volumes. To me, they say, "Hey, I still care about you." Sometimes though, even if the hug is gentle, it can feel too confining. With me, hugs are not the way to apologize to me because I am probably still hurt and/or upset. But gentle hugs or touches are often the best way to say hello or I still love you or I'm sorry you were upset.
One more thing, listening is as big of a part of communication as speaking. There is nothing more upsetting to me than when someone finishes my sentence, thinking they know what I am going to say but that they can say it more quickly. That is often true and more often than not, the finish it correctly. It can also be interpreted as "you are so stupid you can't even get the right words out." You don't need to tell us that, we already often feel that way ourselves. Please believe me, it is horrible to feel that way. In fact, my daughter made it a rule that I can never say, "I hate myself" or "I am so stupid!" Instead, I say "I hate this disease!" It has helped because it reminds me that I am not stupid nor worthless. Simple things often do help.
Do I think it is possible in all circumstances to follow all these suggestions, especially when in a hurry or there is a concern? Absolutely not. Believe it or not, I yell sometimes and can not always follow my own suggestions. However, if you do these things most of the time, it won't be as frightening or depressing to the FTD'er when there is yelling and frustration.
Saturday, January 30, 2021
Why Do Doctors Not Understand?
I know fully well how difficult it is to understand FTD, especially for those who have never heard of it before. I know I didn't understand it when I was first experiencing it.
What I don't understand is why many doctors do not understand it or assume that since they know about Alzheimer's they know about all dementias. Before I go to a new doctor, I ask if the doctor knows about FTD. My current family doctor assured me that she knew of it but admitted she didn't know a lot but was willing to learn. The first visit to her office was okay. Despite Covid, she allowed my daughter to go in with me which helped and she willingly sat and listened and took a lot of notes.
At the end, since it was the first time we had met, she asked if she could schedule me for a revisit in three months. She also handed me new prescriptions for all my medications for issues other than FTD because I had recently moved from another state. She gave me a 3-month supply with a refill for another 3.
I returned for the 3-month revisit and we went over all my lab results and discussed a few things, again not related to FTD. We did not make a follow up appointment but were to do so in six months. Which, to me, meant six months after that visit and we made the appointment online after we got home.
Last week, I received a call from our pharmacy that she had refused to refill my prescriptions without seeing me first. This is why I ask why they do not understand. According to the way I looked at it, it had only been 3 months. I suspect it is not even her rule to be seen before refills. It is more likely that the health system she is part of is responsible for such rules
For those without FTD, or even any dementia at all, it is no big deal except, maybe, missing a couple hours of work. Maybe we would also spiff ourselves up a bit to look our most presentable. Not that simple anymore...
Now it means worrying about the appointment: how I would get there, if my daughter could miss half a day's work, and if I was going to have to explain everything all over again for a third time. When the date of the appointment arrives, I have probably forgotten about it. My daughter would remind me I am going that day and panic would set in.
For someone with FTD, it is all extremely stressful. I am going to need to shower which is stressful and exhausting in itself, pick out something other than flannel pants and a sweatshirt to wear and worry about the trip to her office which is in the city. Riding in traffic stresses me so much that by time we arrive, I am already a nervous wreck.
The practice of this office is that they make the appointment but tell you that you must be there 15 minutes before the appointment time. All that happens when you get there is they ask if all my information is the same and, if I have a copay, I am to pay it then. I don't have one so that isn't even necessary. They stick a thermometer in front of my forehead and find I have no fever. Then I am told to have a seat. I am happy to take a seat as, by then, I am exhausted and it took one or two minutes, not 15.
Well after the appointment time (I understand how doctor's schedules work and if mine is always right on schedule I wonder if they truly take the necessary time for each patient or just end it when time is up.), I am taken back to an exam room and a medical assistant comes in and goes over my history, verifies all my meds and asks if I am having any new problems. By then, I am so exhausted and stressed that I don't even know if I gave the right answers.
After another wait, the doctor finally enters and asks most of the same questions I was just asked. I am relieved that I am finally seeing the doctor but already so worn out that I cannot remember the answers. All I want to do is get out of there and get home.
It is both physical and mental exhaustion. I am beyond cranky and am probably irritating her. After all, she truly is there to try to help. I have to look to my daughter for every answer because I am either unsure of or don't remember anything. I am close to biting a hole in my tongue if she asks the same question again, even if it is because my answer was not very clear. I even get irritated if my daughter does not know the correct answer because then I have to come up with the proper words to correct her answer.
At this point, I just want to be at home, back in comfy clothes and probably curled up in a fetal position in bed. So she gets very brief answers at best which is not the ideal situation for a doctor to understand and help a patient. Usually, blood is drawn for some lab tests. These results will arrive later, via email, and I don't get to discuss them until the next visit. At least those are now going to my daughter so I do not accidentally delete the email... again.
It does not matter what time the appointment is, by time we do the return trip, I have nothing left. I am sure you understand that I am immediately back in my comfy clothes and into bed.
For those of you with FTD, I am sure you have experienced and understand this or a close variation. To those of you who are caregivers for someone with FTD, you are probably reliving the nightmare as well. You have the added pressure of trying to keep us calm enough to not create a scene. The others, especially those in the waiting room who have no clue that I have dementia, must think I am a royal you-know-what and are thanking their lucky stars they don't have to live with me. I don't blame them. I don't like myself much at this point either.
Is there a solution? Not that I know of. The situation can be improved a bit if everyone in the doctor's office understands FTD. The odds of that? Probably zero.
Would it help if this was a visit to a neurologist instead of my family doctor? I doubt it very much because most of them do not understand FTD either, much less their staff.
The only thing I can think of is to give a copy of this blog to my doctor. I don't know if she would read it. I DO know that I would most likely be searching for a new doctor. At this week's appointment, I am going to take my lap pad sized weighted blanket. Hopefully, it will help! Other than that, I am out of ideas.
Friday, January 22, 2021
ANTICIPATORY GRIEF
I have decided to begin blogging again after a six month hiatus. I apologize for being gone for so long, but it was time I needed to regroup after my husband's death. I am now happily ensconced in a new home that I share with my daughter who is now my caregiver. I am greatly enjoying the much milder North Carolina winters compared to those in Pennsylvania.
Today, I saw the term "anticipatory grief" and in that particular usage, it confused me. I, of course, know the term and have read about it often. I looked up the definition and to summarize, it is when you or your loved one has a terminal disease and you are planning ahead for the death that you know is coming. It can happen to the one with the disease and/or their loved one.
This definition actually surprised and explained my confusion because I had always heard this term in relation to the caregivers. It is totally understandable in the role of a caregiver because they tend to be constantly exhausted, weary and missing the person their loved one used to be all while knowing (and anticipating) the death that is coming.
Because I had always heard of anticipatory grief in relation to the caregivers, I often wanted to scream out "What about us? We are in constant grief." I know I have been, even before my official diagnosis. My FTD is hereditary so I recognized I had it long before a doctor diagnosed it.
Knowing you are going to die is one thing. To paraphrase what was actually said recently to someone with FTD... we are all going to die sometime. And, yes, I am still appalled someone said that to her. The context was basically, stop complaining.
Of course we, myself included, know life is not eternal and normally one doesn't focus on the fact we will die one day. Unless, of course, you know that you have a terminal disease that is constantly stealing abilities, both physical and mental. We know this will continue until we do die. We also know that our death will most likely be horrid. That definitely falls under anticipatory grief.
Anticipatory grief hits me every time a new symptom appears or one worsens enough that I notice it happening. It hits me every time I see a look of irritation on the face of a caregiver. It hits me every I am struggling to do a task that used to be second nature.
An example of this occurred yesterday when I could not remember how to print a document I had just typed on this danged computer. I became so frustrated that I yelled, "I feel so stupid and useless!" My daughter, who is working from home, thought I was yelling because she couldn't help me right then and promised she would as soon as she could take a break. I yelled again, "I know you will, that doesn't matter. I just feel so stupid and useless!"
It wasn't only that I couldn't do it. Yes, that was a part of it but it was combined with the knowledge of what is to come. I know the ability to do what used to be simple things will continue to grow. Had she not been here, the printer would be toast. I would have thrown it to the floor or beat on it until it was totally broken and probably the computer as well.
When the solution was as simple as restarting my computer, you guessed it, I REALLY felt stupid and useless. I curled up on my bed and grieved. There is no other word for it. I grieved that my symptoms will continue to worsen until I am 100% dependent. I should be caring for her, not the other way around.
She would have told me to stop if she knew what I was feeling. She does know what to expect because she watched me caring for my mom and aunt until their passing. What I know, however, is that she will still be working full time long after I die. I was working part time or not working at all when I did it.
This was a great example of anticipatory grief from both sides. She grieves because she knows I will continue to worsen and need more of her care. She is also fully aware that she will no longer have me to depend on. I grieve because I know how horrible my future will most likely be and because I know what I will put her through.
This whole incident happened just a couple days after an incident when I was unable to breathe. I had swallowed a large pill but didn't realize it was still stuck in my throat. Most people would have realized that and taken another drink but, no, I took two more smaller pills that just added to the blockage and I could not breathe at all. We were both thankful that she was here, working from home, knowing I very well could have died. Seeing the fear on her face is something I never want to experience again. Yes, more grieving.
I apologize that my return to blogging was not an uplifting one. When I blog, I sit at the computer and somehow whatever is on my mind comes out. Hopefully, the next time, happy things come out!
Saturday, August 15, 2020
Give Me a Break
I disproved one of my own theories about FTD. I was diagnosed in 2011 and realized, even then, that I could no longer cry. I would feel an intense need to cry and often felt, that if I could just cry, I would feel better. Many, many other FTD'ers have said the same thing. I have probably even said this in a blog or two over the years I have been writing. How did I disprove it? Strait forward, I cried for two days straight early this week and have continued to break down occasionally in the days since.
Earlier this week, I was contacted by the admin of one of the support groups that includes caregivers and those with FTD. This group is the only support group I actively participate in other than the private FTD Patient Support Group and the AFTD's support group.
The admin, after apologizing, asked/insisted that I removed all of the posts containing links to my blog. She informed me that she had been receiving complaints about the posts and just didn't have the energy to support me any longer. She would not just delete them, I had to go in and delete each one. The ironic thing is that I haven't even been blogging very often since my husband succumbed to his Alzheimer's Disease back in November. So, I went in and after a year or so's worth, I just couldn't do it anymore. It felt like I was cutting off a part of me. About 3 or 4 deletes in, that is when I started crying. Mind, I did not post my blog entries, merely a link to them. If someone objected, they could have skipped right past the links.
When I wrote to the admin and told her I had deleted that far back and if she needed further than that, if she could just delete them all. She then tried to tell me how much she had been supporting me by defending my posts about the fundraising I have done for the AFTD. That was the final straw. I asked her to please remove me from the group. No, I would have to do that myself but I could not figure out how to do that as my FTD was in high gear.
She wrote me detailed instruction and it still took me half an hour to figure it out. The ironic part of needing to do it myself? A dear friend actually posted in the group, clearly upset that I was pushed out. Her post and her access to the support group were terminated in less than five minutes.
Back to the fundraising posts. The bylaws of the group read that fundraisers could be posted if all the proceeds were to benefit the AFTD. The only fundraising I have done benefited the AFTD. The last fundraiser I did, before the current one, was for caps and shirts bringing awareness to FTD. Plus, the ones done last year were at the request of quite a few caregivers, not those with FTD, and I modified the wording for caregivers.
A fundraiser had just ended, so I was fairly certain the complaints were about that one. I had come up with an idea to have face masks that raised awareness of FTD. Since the masks had already been paid for by my daughter and I, 100% of proceeds went directly to the AFTD. I did not touch the money. All the ordering and donations were handled by Classy, the AFTD's preferred fund raising platform. All that I did was design the masks, pay for them and mail the orders out once they arrived. I followed the group's rules so I was floored by her telling me there had been objections. When I had extras at the end, I took the orders but the donations were again made directly to the AFTD. I had told no one except a member of the AFTD staff that my daughter and I covered the costs of the masks themselves. I would never have mentioned it here except for hearing of their objections to my posts about the fundraising. It should have stayed between me and the AFTD, but I felt I needed to defend myself. Seems quite pathetic to me that I needed to.
Back to the complaints about the masks. I was accused of running a scam. I was informed, not so politely, that someone's dad had ordered 5 masks, but only received 2. I told her that since 5 masks would not fit in one envelope, they were split between 2. I have not heard back from her so I am pretty sure he received the the second envelope by now. I know I did mail them. There were more...
I support the AFTD because of how much they support me and those with FTD and how they strongly work for research on FTD and possible treatments. It seems the least I can do. I do not do it for self-gratification.
The past 12 months have been difficult beyond belief for me. I was my husband's full-time caregiver while dealing with my own FTD. I scheduled a Celebration of Life to be held in his hometown in IL. We couldn't have it do to Covid 19.
For his last few months, I had a woman who stayed at my house 2 or 3 nights a week so I could get some sleep. After he died I had her still come to work for me 3 afternoons a week. It wasn't until I was preparing to move to NC and share a home with my daughter that I realized she wasn't even doing any work except taking the trash from the kitchen to the garage. When I would mention we needed to clean the house, she would insist my house was not dirty. When I would ask her to do a specific chore, her injured hand prevented her from doing it. She did, though, take paint left over from getting my house ready to sell, to her house and painted all the trim with that very same hand. She informed me, after she had done this, that she had taken the paint. I didn't need it, but was planning on leaving it for the buyer so they had matching paint if they wanted to paint another room. As the moving date grew closer, I discovered that she was taking other things from my home. She also conned me out of my car.
Family members had been warning me, but I chose to trust her. Until... her son and his family had stopped by one day to pick up the rug from my husband's bedroom. (She didn't ask if she could have it, she went into the room when the installers were there with the new carpet and told them she was taking it. She even tried taking the large sections left over and handed me a 1" x 12" scrap "in case I needed to patch anything.") While they were in the driveway, I don't think she realized I was close enough to hear, she told her son to go in the garage and see if there were any tools he wanted because I would give them to him. He actually started telling me what he wanted before I informed him I was taking all of them to NC. I wasn't, but I sure wasn't giving them to him.
Of course there were other things... they just kept piling on... but I was semi-holding myself together. After all, I had my FTD friends to support me. Many of them did, The hurt I felt by being rejected by one of my 3 support groups? It devastated me. I did literally cry for two days. I cannot handle any more of this and still hold myself together. I need what little energy I have for when we can finally move into our new house.
I am going to take a break from everything... from blogging, from support groups, from everything FTD related. Fortunately I already have a very small, private support group and I will rely on them for support, as they always have done.
IF, you need answers to specific questions about FTD, I am still here for you. You can private message me any time. If we are not Facebook friends, feel free to send me a friend request. Perhaps, in a few months, after settling into our new house, I will jump back in. At least that is my current plan. Please take care of yourselves!!!
Sunday, June 28, 2020
Please Forgive the Rant
I wish all my "friends" and loving "family" members could see me today, better yet, jump into my brain and realize how it feels to have FTD. I may as well include caregivers in there too. It truly is impossible for anyone who does not have FTD to realize just how much and how devastatingly this disease affects those of us with it. I know many try and actually think they do, but you can't, just as no one can fully understand the strain of being a caregiver. I have been both. I would voluntarily be a caregiver again. I would never volunteer to have this disease again, even if there was a way to go back and not have FTD.
I feel like I am falling apart. My daughter and I are still living in her one-bedroom apartment and will be for another two months. She is also working from home most days and of course, thank you FTD, I forget to be quiet and not interrupt her with questions about what she is doing. No impulse control here.
I feel like the world is falling apart around me. All the hatred being spewed. I do not remember any election becoming as full of hatred as this one has. I can't help but look back at the first presidential election I can remember... Kennedy vs Nixon. Now there was a hullabaloo about the horror of possibly electing a Catholic, but that was even handled with complete decorum compared to this one. The taunts I remember are "Nixon, Nixon, he's my man. Kennedy belongs in a garbage can." I heard it just as frequently the other way around. As I aged, I still knew of politicians reaching across the aisle to work for the common good. That is a far as I dare delve into politics. I only raise the dangerous subject to explain how all the dissension affects me and piles on the stress to my FTD burden.
I mention it partly to explain how, this week, when I went to get my new driver's license and was given the opportunity to register to vote in my new state. I was terrified when it was time to declare my political party. As it was, I whispered it to the agent so no one would overhear me. To me, it is pathetic that I had to feel that way. It actually helped when she laughed at me.
I have just one family member living near me (excepting my daughter and sister) who has stood by me through my battle with FTD. She would pick up on when I was feeling down and she would come by the house to help or just visit with her fiance's child who, by the way, looked adorable in his face mask! Yes, it was technically a violation of the stay at home orders, but it was a medical emergency in my mind. Now that I am several states away, she is going through an extremely difficult time and I am not there to stand by her side. So now we add self-imposed guilt into my frame of mind.
Yes, I try to provide support via phone and social media, but it isn't the same. To top it off, she is 3+ months pregnant and a high risk for carrying to term. Thinking about it, it is probably better that I am not there because I would probably be arrested for attacking the other family members who are unreasonably causing the hardships on someone they should be loving and caring for, especially right now.
With all this that I am stressing over, whether justified or not, trying to make choices for the new house we are having built is way too overwhelming. My daughter has her ideas of what colors to paint and I have mine. She has her ideas of what furniture to use and where to put it. It would be ideal to buy new things for a new house, but with more than two households full of everything, it just does not make sense. I don't even want to think about trying to decide how to arrange furniture and such. Already, during a walk through of the house, the project manager mentioned an open area and I said "Oh, good, a place to put pretties." My daughter scoffed and said "Not your pretties!"
I did have a break through today while trying to agree on wall colors. Nine years after being diagnosed with FTD, I discovered it IS possible to cry. It is also possible to curl up into a fetal position while you do, but FTD has never prevented me from doing that. I finally came to the conclusion that my daughter must allow me to select the colors for the rooms in my part of the house and I will allow her to choose the ones for her rooms. The common rooms will be a warm shade of neutral, a vanilla choice really, as that is the name of the paint. That's as close as I can get to being humorous today and that is only pathetically humorous.
I also must add that I am greatly worried about an FTD friend who is worsening rapidly. It is probably more frustrating for me when I am worried about any of my FTD friends than when I am worried for myself. For myself, I seem to be able to go along with "It is what it is" mentality, but not so when it comes to others.
It doesn't help that I just came off a multi-day FTD headache either. At least today I can actually exist without drugs. Oh, and while trying to work through the headache, I burned myself, as I tend to do. forgetting things are hot. Things like that, things that FTD'ers do nearly constantly, make me angry at myself and angry at the world.
So, why did I wrote this blog entry knowing that it was going to be a rant against everyone and everything? The answer is simple. This is a look into the mind of someone with FTD... constant frustration, much anger, much hopelessness, some paranoia and pain gets thrown in as well. To top it off, I couldn't remember how to go back and correct my typos and ended up deleting entire paragraphs that I had to try to remember so I could rewrite them.
Ah, yes, FTD how I love thee... no I don't.
Sunday, June 21, 2020
The Eyes Have It
This blog is written using my experiences of living with my own bvFTD and of being a caregiver for three family members who had FTD and my husband who died of Alzheimer’s Disease. I have no medical degree. I research subjects and attempt to be totally accurate. However, I do have bvFTD and can make unintentional errors. I do not suggest you make health decisions based on this blog without first discussing it with your, or your loved one’s, doctor.
We know that frontal and temporal lobes shrink during the process of FTD. We know that the retina is connected to the brain via the optic nerve. The retina is considered part of our central nervous system. I had major retinal issues in my eyes for over a decade before I was diagnosed with FTD which allowed this study to make sense to me.
I was diagnosed with macular degeneration in (I am estimating here) 2002. Macular Degeneration is caused by the thinning of the retina. The retina is in the back
Some of the symptoms of macular degeneration are visual distortions. One example of this is straight lines seeming bent. It also often causes reduced central vision in one or both eyes, the need for brighter lights and increased difficulty to adjust to lower lighting such as in restaurants. Words may become blurry, especially on the printed page. Now for a couple that I did not know, but have been experiencing for years, worsening as my FTD progresses. It can cause decreased intensity or brightness of colors, loss of depth perception and objects may vary in size between the two eyes.
One that surprised me as I researched this today is difficulty in recognizing faces! I experience, and have heard of others with FTD experiencing, increasing difficulty in recognizing faces. For instance, all men with dark hair look like the same person, all women with long blond hair look alike. This is accentuated even further on television. The second that surprised me is difficulty in recognizing objects we are searching for. For me, the most embarrassing is when I am needing the remote control and become out of control from frustration only to have someone point to it and I had been looking right at it.
I am not alone in experiencing these gaps between vision and recognizing objects. Many of my friends with FTD talk about experiencing the same thing.
I am not suggesting that everyone with FTD has Macular Degeneration nor that Macular Degeneration causes FTD in any way. I am merely saying that when I read the research on study whether FTD can be diagnosed earlier via examination of the Retina. Also that the symptoms are quite similar. An extreme example is a headache. Is it sinus, is it stress, is it a migraine or a brain tumor.
Symptoms occur in many similar illnesses.
I hear from many with FTD and/or their caregivers complaining of double vision and, even more so, loss of depth perception. The symptoms I mentioned, such as double vision, loss of depth perception and changes in size of image or intensity of color can all be caused by the two eyes not working together.
Each eye sees its own separate image. The two images are put back together, in the brain, into a single image once more. I have no problem accepting that the vision issues are in the brain not being able to do its part, not the eyes.
Because of this, most of FTD vision issues cannot be corrected by visiting the "eye doctor." I can definitely say, in my case, that the differences between the two images constantly vary as they fluctuate constantly. No eyeglasses, even with prism lenses (which work when it is an eye muscle issue causing double vision) do not help for any length of time, if at all.
I must caution that if you are exhibiting any of these symptoms, you should be evaluated by a qualified ophthalmologist or retinal specialist. As I said above, I do have wet macular degeneration and regularly must get injections of medication into my left eye because my macula is actually degenerating. This does not cure the symptoms I have discussed, but it does keep it from totally stealing all the vision of that eye.
I wrote about eye issues quite a while ago in a blog. However, since the past couple weeks, multiple questions have been posted in the support groups that I decided it was times to write about the vision issues once more. Plus, I understand the issues even more than I did before.
For the caregivers, eye issues may explain things like how the FTD'er used to watch movies, television and/or read and no longer have interest in those. It can also explain many other issues, such as tripping, falling and dizziness. Personally, I must watch my feet when walking because I cannot see any difference in the surface I am walking on. For me, I believe I have mentioned in previous posts on the subject, Strangely, ramps and very small changes in depth are the worst. The absolute worst are corners that are adapted to meet disability standards. There are different slopes, beginning at the sidewalk and the street. To make it worse, the sides also slope so that if you are not smack dab in the middle, there are multiple elevations to deal with. THEN, they mess with the brain by being curved and often painted yellow, both of which make it even more difficult to sense the changes in the pavement.
For those with FTD, if you are not comfortable walking outside, take a look at the sidewalks, cracks and the sloping corners to see if that is one of the reasons it makes walking so difficult. Stepping off curbs is a hazard as well, at least for me, because with no depth perception, I cannot tell how high the step is. I find myself holding onto to something or someone and stepping up or down slowly and carefully in order to not fall. Even then, when my foot hits solid ground, it is a shock everytime.
It is safe to say that everything all do is eye-related. The only exception to that is when I am sleeping. I am able to walk just fine in my dreams. Again for the caregivers, try walking around your house or backyard with your eyes closed. That will give you an idea of what we constantly deal with plus help you find things that should be changed or moved. For me, the absolute worst is when something appears right in front of my face. Moving things closer does not help me at all. If I turn a corner in my hallway and there is an object right there, it startles me even if it has been there for ten years.
One more suggestion, this time for those of us with FTD, I find that watching television with only one eye makes it doable again once you get used to it. I usually drape a cloth over my head to cover the weaker eye. I am also getting good at keeping one eye closed. Please use caution though, when you open or uncover the eye, the shock of the difference in light for the covered eye can make you dizzy for half a minute or so. For me, it is worth learning to remain still for a minute before standing and walking.
Again, to the caregivers, these eye issues can explain a lot of the things that upset you about your FTD'er. Why they do not recognize your face yet still seem to know who you are after a while, why they are constantly losing things (they aren't lost, they just cannot see them... there is a difference). The eye issues can take away the enjoyment of many things they used to love. If you ask, do you see two of everything, they may not realize they do. If you ask them if their eyes make it difficult to walk, you just might get a blank stare. That doesn't mean the issue isn't there. It might be that they simply don't recognize the symptoms exist.
Another suggestion is to decide what are the most important things to them. You can put a large and bright colored sticker on them as an experiment to see if it helps. We all know, though, just because something works for me does not mean it will work for your FTD'er. Experiment with different things to make important things more visible in case you can make their life just a tad easier.
If any of you have any other suggestions, especially to help an FTD'er more able to find things, please let me know because I really could use some!