Please Refrain from Standing on the Furniture

These guys don't see the sign.    

In our hyper-alert state, Valerie and I are keenly aware of the the sign in the waiting room of our neurological evaluation at the National Institute of Health in Bethesda, Maryland on a record-breaking 93 degree day on April 6, 2010.

   

Darn, we fly 1500 miles each way, and we have to refrain from standing on the furniture.  We don't really want to stand, just dance on the furniture, but we refrain. We're being evaluated  at the National Institute of Health, (NIH) not the National Institute of MENTAL Health.

Valerie and I wait in the lobby and stress about the presidents as we prepare for the inevitable question: "Can you list the presidents in reverse chronological order?" We've been practicing for a couple of weeks and frequently forget the Republican presidents. Can anyone with or without Parkinson's really name all the presidents backwards or forwards?

Obama, Little Bush, Clinton, Big Bush, Reagan, Carter, Ford, Nixon, Johnson, Kennedy, Eisenhower, Truman. That's all that I can remember -- up to "Give 'Em Hell Harry" (Truman) from my birthplace in Missouri. Valerie remembers a few more: Roosevelt, Hoover, Coolidge. We both worry that we will appear stupid, despite various advanced degrees earned many lifetimes ago. So we commit to memory as many presidents backwards as possible.

Someone tells me to follow her as she calls me by my legal name, Kathleen, despite protests of "I prefer to be called Kate." Valerie and I wish each other luck. I think that we need more than luck as we are evaluated by most of the members of the Movement Disorder team at NIH.

An evaluator tests my time, place and orientation by asking "Where are you?" I respond with "I am at National Institute of Health in Montgomery County (I cheated by asking the hotel clerk the name of the county) in Bethesda, Maryland on the 5th floor of the Clinical Center, Building 10 (Magnuson) in the Outpatient Department on Tuesday, April 6, 2010 at 8 AM on a warm spring, that feels like summer, day." When I read upside down, I see that the evaluator writes"alert." This is good. I would have written, "alert with OCD tendencies."

I am familiar with many of the neurological tests: chicken dance hands, wave to the queen, walk down the hallway, turn around and walk back.  I remember to swing my arms as I stroll the neurological hallway. I know the drill. While being videotaped, one of the evaluators tries to push me over to determine my balance and comments "You  are strong." I respond with "I've always had excellent balance."

I am also videotaped reading a paragraph from Rainbow passage that is frequently used by speech therapists when they evaluate one's speech and voice.

I am asked to remember five words and recite them later as well as perform a clock drawing task.

I am asked to count backwards by 7 starting from 100 as quickly as possible: 100-93-86-79-72-65-58, etc. No problem -- I can do this.

In order to test my attention and concentration, the examiner reads a string of digits at a rate of one per second, and asks me to repeat it backwards. For example, if she says 8, 4, 2, 3, 9, 7, 5, 4, 1, 0, I must repeat it back as 0, 1, 4, 5, 7, 9, 3, 2, 4, 8. I silently wonder what it has to do with Parkinson's.

One of the evaluators comments that I look stressed. I respond, "I am worried about the presidents." He quips, "Not to worry -- I am going to ask you to list the names of the prime ministers of Britain in reverse chronological order." I wish I could say that I respond with "Brown, Blair, Major, Thatcher" etc.,  but unfortunately this is not the case.

The test that I found particularly difficult is the scratch and smell test. I could not identify ANY of the smells in the test. I can't determine the difference between the smells of peanuts, burning leaves, and gasoline. I guess at all 40 questions of the multiple choice test. I know that my sense of smell is poor, but am shocked to discover that it is non-existent.

Valerie and I manage to complete the evaluation and refrain from standing or dancing on the furniture and avoid being referred to the National Institute of MENTAL Health. Overall, it is a positive experience, and we look forward to receiving a report that we are in perfect health except for Parkinson's Disease.

 

 

 

 

 

Comments

[Diane Cook]

Kate -- I LOVE this column! It is so perceptive in terms of what your emotional state was. And so full of humor! Every one of us who has tried to review the Presidents backwards on our way to our neurologist's appointment or sat in the waiting room silently counting backwards by 7 (only to flub up during the appointment) can totally relate to your experience. Do you think we really have to start worrying about the Prime Ministers of Britain?? Maybe that's just a Washington, DC question and those of us in Colorado have a free pass. Your parenthetical questions were priceless. Bravo! It is a column I will reread, knowing it will bring a smile to my face each time I do.

[Dorothy Hasinoff]

I am going to send this to my nephew, who is a neurologist.