The Initial Diagnosis


Dr. Smith, upon our request, scheduled an MRI, then referred us to a neurologist I’ll call Dr. Gazhail.  Patty volunteered to take him to a series of appointments to seek a diagnosis for his dementia.  Dr. Gazhail was very personable, taking the time to respectfully talk with our dad.   Patty was able to ask questions and could call with follow-up issues.

The Mini-Mental Exam

Part of the exam is a question-answer period (mini-mental), to be repeated to check for progression.  In spite of a caring medical team, the process is humiliating, especially to a man like my father, a self-made business man.

  • Draw a clock.
  • Who is the President?
  • What month is this?
  • Where do you live?

All basic questions or tasks most of us could easily answer.  But when dementia is knocking at the door, simple questions become frustrating and confusing.  It made Dad very angry.

My father, however, was determined to beat the system. Once when we were at the VA they were giving him the “mini-mental” exam.   He came out laughing, “I showed that guy!”  I asked how?  He reported “That guy [the doctor] asked me “Who is the President?”   There was a picture of George Bush right behind him — and I got it right!”

As I said, you must appreciate the humorous moments as they come.

That “Crazy” Disease

We waited anxiously for the diagnosis.  Finally, a letter arrived. It seemed like relatively good news – he was diagnosed with a dementia “not in the pattern of Alzheimer’s disease”.  They said he had vascular dementia.  According to WebMD, “Alzheimer’s disease, which happens when the brain’s nerve cells breakdown, vascular dementia happens when part of the brain doesn’t get enough blood carrying the oxygen and nutrients it needs.”   Vascular Dementia

Linda described vascular dementia like this, “Picture a mouse gnawing at the outside layer of an extension cord.  It keeps gnawing and gnawing until it hits the electrical part, then snap – the mouse hits the electrical wires and blows them apart.  This is like the white matter in the brain.”

Dad was VERY relieved.    Thank goodness “I don’t have that crazy disease.”  (Part of dementia is word-finding; he couldn’t recall “Alzheimer’s”, so he picked his own definition.  No offense intended to any of my readers.)

Executive Functioning

They said his “executive functioning” in the brain was impaired.  According to WebMD,  “Executive function is a set of mental skills that helps you get things done.  These skills are controlled by an area of the brain called the frontal lobe.  Executive function helps you:

  • Manage time
  • Pay attention
  • Switch focus
  • Plan and organize
  • Remember details…”

Executive Function

Yet we felt we could deal with this diagnosis.  If I were a ballerina, I would have danced a ballet.   I of course didn’t know what diagnosis would come much later.


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