Saturday 27 May 2017

My HAND on my head - Memory Screening Tests

Now I Remember
‘It loves the brain.’ He said. In fact, there are many things that go after brain for all sorts of reasons my lack of medical expertise cannot explain.
Quite particularly, sexually transmitted diseases, everything appears to happen down there and once contracted they want to travel to the very top and take control. Nature seems to have beings in the ascendancy.
I had an appointment at the hospital on Thursday, if I can remember clearly, I thought it was in relation to the abdominal scan I had just two Saturdays ago since the letters literally arrived at the same time.
I took an Uber cab for the 9:50 AM appointment which was on a surge pricing and we made it on time without any of the stress of the appointment before the last. Ushered in by the staff, rather than stand on weighing scales I sat on one and it appears with clothes on, I am dropping kilogrammes.
Correct in my assessment
My blood pressure also read within the limits of acceptable for the first time in 4 visits which was really good news for me. I was called in to see the consultant where I was told it was my appointment for the HAND clinic or the Memory Screening Clinic.
Now, for a person above 50, I needed to be sure that certain elements of my activities in forgetfulness, responsiveness and anxiety which I somewhat have found compensatory mechanisms for were either age degenerative or as a result of my long-term condition.
The session which lasted almost 90 minutes started with filling in a Hospital Anxiety and Depression Scale form that pointed towards elements of anxiety that needed a bit more analysis. However, since this was our first clinical assessment, much was dependent on what I subjectively thought were issues bothering me.
Suffice it to say, I completed that form and even annotated a grammatical correction to give a sentence a finality in context rather than the open-ended inquiry. Then I was passed the 'Questionnaire for HAND clinic' that required long form writing and I probably gave a detailed treatise to about 20 or so questions.
Convention is indistinct
After that, a number of cognitive tests were performed on transcription, memory, recall, acuity, reflexes, alertness and so on.
One such activity required drawing a clock with time 10 minutes past eleven, I went for a square face with 4 cardinal point numbers and then the minute and hour hands. A majority, I was told, draw a round clock face with all the numbers in before putting in the hands. Minimalist and functional works for me and that was some reflection on the kind of personality that I am.
I was good with the numbers tests, but I was never able to recall the words in the right order, even though every time I got all the words right and then after ten minutes of other activities. The reflexes seem to be fine and it would appear I have good cognitive skills that fall well within the standard deviation of normal.
Remember to smile
It would take a couple of tests over years to determine if there is any degeneration and whether through the results of the blood tests there are other noticeable indicators that can be controlled with reference to my thyroid, my liver, blood counts or folate functions. I might be in for a computed tomography scan of my brain – awesome, but will not be keen on a lumbar puncture for the drawing of cerebral spinal fluids.
By process of assessment, analysis and elimination, it is good to have this kind of activity in professional hands than leave it to my personal perception and watch some deterioration as a matter of course. It would appear there is not much to be concerned about, but I can in future request clinical psychiatric assistance if needed.
The ‘It’ at the beginning of the blog is HIV and the HAND is HIV-Associated Neurocognitive Disorder which in my 15th year since diagnosis, though on my 8th year of treatment seems to be well managed with an improving CD4 count and an undetectable viral load. All other indicators from my blood tests of two months ago seem fine too. I guess I remembered most of what happened and kept some back for privacy.
Everyone with HIV should consider attending a HAND clinic and at least every 12 to 24 months thereafter.

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