Sunday, December 28, 2014

Neuropsychologist, vagus nerve, and sanity

My Neuropsychologist appointment was December 1st. His name is Dr. Thomas Sullivan.

I really like him.  I always felt I need "brain" help, not "emotion", or mental I never thought of calling one.. but I reached a point where I believe they are both connected.  One affect the other. Makes sense.   I was very glad that this Doctor in particular agree to "take me on". When I called, I was told he very randomly takes new patients and it can take a while.  I left him a message in October, got a called that he agreed to see me and do the Neuropsychology testings in November, and was scheduled to see him December 1st.

I expected to have some testing done that day, but all we did was basically go into my medical history, surgery, recovery, and access what he felt was the cause of this, or that.  I was very impressed, and glad, that he truly know Neurology. I know that sounds bad.... You just know my experience with some neurologists... I am not sure why I doubted that he would... haha He took out one of his books and showed me a graphic of the location in my brain where the CM was, and after he asked me where my incision was, he showed me what nerves was most likely touched, or traumatized haha by the hemorrhages before surgery, and the surgery itself etc.    He started asking me questions , some of which I never even thought were  related. These were, and not limited to:

Do you cough sometimes, for no reasons at all? yes
Do you notice a rapid change in your heartbeat or breathing? yes, but i knew it was related.
Do you feel like you are going to faint, or do you faint? Yes, I cant do anything that has my heart rate elevated without feeling like I am going to faint. 
Do you sweat at night? yes
Do you find it hard to either lose weight, or gain some? yes
Do you have incontinence? i pee a lot hahaha and dont make me laugh or sneeze when my bladder is full!  teehee But that's because of motherhood and age. haha

There were more questions, but these I remember most because I didnt tell him about those symptoms. I was a bit confused as of why he was asking me about my "physical" state, since I was there for my "head".   After I answered, he said "Have you been told that your "Vagus Nerve" has been damaged?  I told him no. He explained to me what the Vagus is, where it is, and what it does.

"There are 12 pairs of cranial nerves which perform the sensory and motor functions in the body. Vagus Nerve is one such  cranial nerve that  also happens to be the longest nerves in the body that innervates the throat, thorax, abdominal muscles and other organs and has several functions, which is why it  is one of the most important parts of our nervous system.  The vagus nerve connects our brainstem to the body, due to which the brain receives, controls and monitor several body functions automatically. The vagus nerve forms a sort of electrical circuit while linking our heart, lungs, and gut to the brain-base. This type of ancient circuit connection is common in birds, mammals, reptiles and also amphibians. This vagus nerve connection resembles the USB or Firewire computer connection in many ways. It encompasses the major nervous system and contributes to motor control of physiological functions including gut mobility and heart rate. 

What are the Functions of  the Vagus nerve?

Some of the main functions of the Vagus Nerve include,
  1. Breathing
  2. Swallowing
  3. Speech
  4. Sweating
  5. Helping in keeping the larynx open during breathing (it makes  you cough when its working harder than usual. 
  6. Monitoring and regulating the heartbeat
  7. Informing the brain of the food that is ingested and food that has been digested
  8. The Vagus Nerve performs the major function of emptying the gastric region of food.

He explained that the Vagus nerve was the one with most likely the most damages, but the other nerves around it must of had some "trauma" too. The nerve next to the Vagus one controls taste and swallowing.   This brought me back to before the surgery, when Neuro's in the ER said it made no sense when i told them I had a hard time swallowing and breathing.  I cant blame them for not knowing that sometimes, the problems are from a nerve in the brain. hahaha I forgive them for treating me like shit and tell me it was anxiety, I really do :) 

After he told me about nerves, I finally had a chance to ask him what does this have anything to do with the way I feel that something is wrong in my "head", my mental state.  Why, sometimes, I am hit with this wave of confusion, this agonizing feeling of not being myself, or not knowing what to do with myself.  He said "because it is a lot more physically related than mentally related, your mental state is fine in itself, the brainstem does not control it. But the brainstem controls things that can physically affect your entire brain and body. Just like dementia is a symptoms of Alzheimer and not the cause of it.  Dementia is a word that I never wanted in my vocabulary.  I asked him if that meant that I had, or would have, dementia. He didnt really give me a straight answer, but he repeated that Dementia is a symptoms, not an illness, and not all illnesses are incurable.

I realized that I was very ignorant of dementia and  its causes, and how it "works". Just like cancer, or a stroke, or anything else... we can all get affected by it at some point in our lives. Hopefully temporarily!  Did you know that Robin Williams was diagnosed with Creutzfeldt-Jakob disease, and had said to his loved ones he didnt feel like himself?  When I heard that he committed suicide, my first words were "Why did he do that? Why was he so selfish and stupid? This breaks my heart now, that I have said that of him, and others...  This has taught me that suicide is not always 100% a choice...but that is another post. 

Here is more information about Dementia. 

What Causes Dementia?

The most common causes of dementia include:
  • Degenerative neurological diseases, including Alzheimer's disease,Parkinson's disease, Huntington's disease (a rare inherited disorder), and some types of multiple sclerosis
  • Vascular disorders, such as multi-infarct dementia, which is caused by multiple strokes in the brain
  • Traumatic brain injury 
  • Infections of the central nervous system such as meningitis, HIV, and Creutzfeldt-Jakob disease (Robin Williams), a quickly progressing and fatal disease that is characterized by dementia and muscle twitching and spasm
  • Chronic alcohol or drug use
  • Depression
  • Certain types of hydrocephalus, an excess accumulation of fluid in the brain that can result from developmental abnormalities, infections, injury, or brain tumors.

There are different type of dementia, one of them is called "Vascular Dementia"
"In vascular dementia, changes in thinking skills sometimes occur suddenly following strokes that block major brain blood vessels. Thinking problems also may begin as mild changes that worsen gradually as a result of multiple minor strokes or other conditions that affect smaller blood vessels, leading to cumulative damage. A growing number of experts prefer the term "vascular cognitive impairment (VCI)" to "vascular dementia" because they feel it better expresses the concept that vascular thinking changes can range from mild to severe."

Are you shocked yet?  I bet, like me before, you had no clue that dementia can be a symptoms of all these things. Some are permanent, some are temporary, some comes and goes.  Folks, I am not telling you that I have some type of dementia. I am telling you that I have experiences bits of it, and I simply know why.  Educating myself is the best thing I can do to understand it, get help when overwhelmed, and most of all, help others.  I will never look at a "crazy" person the same ever again.

... and if I ever witness, or am the "victim" someone being called "crazy" because they have issues, you will see a side of me you have not seen before.  

The doctor proceeded to tell me that stress and fatigue would be a trigger in my case.  I totally, 200% agree.  I have never been someone to stress easy, but I found that its not the feeling of being stress that affects me, its just stressful situations for me. It does not have to be dramatic, or full of emotions.  I can feel stress and start feeling confused and can't "think" if I am in a loud crowd for example. I don't "feel" stressed, but my body sure is.  Its really not the feeling and emotion of feeling stressed.   He suggested that I see my doctor and get on anti anxiety meds, just to keep the stress level down.  So I did that.  I have been on the "highest" dose my doctor can prescribe in the medicine I am taking, 200 mg of Wellbutrin, 2x a day.   He told me that I need it "physically" more than "emotionally" but the need is the same.   Thinking of it, mental illnesses are "physical", if the brain causes them, everything going wrong in our entire body IS physical. So I guess mental illnesses "are" physical... out of your control. Its not something you can control.  Its never someone's fault... to be paralyzed or have Alzheimer, in the end, its the body that let us down.

We didnt talk much about my trouble understanding, processing information, and what seems impossible for me to follow instructions unless its one step at a time, slowly... and my awful memory and "blanks" that I call brain farts.   He gave me 2 other appointments for this. They will be 3 hours each, 3 weeks apart, and I will have the results March 3. Results of my Cognitive state I guess. hahaha I hope I get at least a C... :) 

All this said, it was a very interesting appointment and I learned a lot. Being a psychologist, I think he knows that to tell Traumatic Brain Injuries (sounds better than brain damaged haha) patients that they are not going crazy mentally, its really the brain itself,  that is damaged.  

Keep sane, my friends

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