2019-09-16
Catchy title, huh?
Today, dad had his appointment with a neurologist. Dad specifically wanted the appointment to address his facial muscle spasms that results in his left eye closing...his good eye. If I'm honest, I wasn't 100% on what the reason for the appointment was from the VA's perspective. That was clear when I opened the paperwork that 'The Lodge of Howard Lake' RN sent along. Moments before we went into the building I thought to myself....."why are we here?". When I opened the paperwork, the reason for the appointment was simply 'tremors'. Mom and I sat in on the examination and I learned a bit, hopefully worth a share.
Dad's been having tremors for a few years, let's say 3. This was diagnosed as 'essential tremors' which caused his hands to shake to the extent that he couldn't hold a cup of coffee. Around the same time his left side of his face began twitching. When they prescribed a medication for the tremors, the facial spasms went away as well. So, the medication seemed to address both symptoms. Last May his facial spasms came back and the VA increased the medication in hopes to address it. The important thing here is that the last med update was for his face, rather than any other tremors.
The neurologist felt that the facial tremors are not typically a result of 'essential tremors' and feels instead that it's likely 'hemifacial spasms' and recommended botox injections that likely will quiet the nerves. Will be scheduling these injections sometime this week. Often needs to be repeated every 3 months. The VA originally suggested that this may be an option as well, so the diagnosis and procedure aligns with previous recommendation. We may want to consider requesting the med increase for the tremors to be backed to original dosage since the increase was perhaps unnecessary, meant to address the facial tick but ineffective.
Next Monday, dad's going in for a follow-up MRI. Likely unrelated to the facial tick, but a couple reasons; 1) dad may have had a minor stroke in the past and 2) he says he has a small tumor that hasn't changed for years. For those reasons, the VA neurologist had recommended a yearly MRI to keep an eye on both. That, I believe, was the reason for the VA neurologist letter that dad received. So, going forward, we'll make sure he gets a yearly MRI, the real reason for the one scheduled monday evening.
Couple other things, not pressing, but worth knowing if you didn't know this already. Uncle Grant was born with a single kidney, and his death _may_ have been due to that in some form or another. I think dad said he had cancer originating in his kidney. Dad _may_ have a kidney 'thingy'; can't be more specific to that, the brief medical history provided to the neurologist indicated something about his kidneys that dad wasn't aware of, so either relevant of a mistake. I need to review some of their medical records that Dawn provided. If any of you know more about this feel free to share.
We also have a history of cancer in the family; Uncle Grant, Aunt Arlene and Grandpa Lipelt all were found to have cancer and quickly passed thereafter. I didn't know that, or had forgotten, but according to dad, grandpa was severely constipated, thinking it was a blockage in the colon they cracked him and found he was riddled with cancer. He died shortly thereafter, never leaving the hospital. I didn't know. Things you learn during a comprehensive medical history discussion.
Three months from now there is a scheduled neurology follow-up, to review the MRI and reaction to the botox.
Hopefully, the botox will address his facial tick, otherwise the neurologist indicated there still is a possibility of increasing the medication. Dad indicates that his tick is better shortly after his 2 daily doses, worsening as the day goes on. /shrug
In the future we will need to get them scheduled for other annual appointments: dental, eye, foot, and perhaps a hearing exam. Dad seemed somewhat open to hearing aids in a short conversation some weeks ago.
Anyway, that's how the day went; the appointment went good, they were both in good spirits and it became apparent to me how little I know about our family medical history, mom and dad's medical history and how hard it is to keep my attention when the medical jargon comes out :) I keep thinking of sandwiches.
Cheers.
Today, dad had his appointment with a neurologist. Dad specifically wanted the appointment to address his facial muscle spasms that results in his left eye closing...his good eye. If I'm honest, I wasn't 100% on what the reason for the appointment was from the VA's perspective. That was clear when I opened the paperwork that 'The Lodge of Howard Lake' RN sent along. Moments before we went into the building I thought to myself....."why are we here?". When I opened the paperwork, the reason for the appointment was simply 'tremors'. Mom and I sat in on the examination and I learned a bit, hopefully worth a share.
Dad's been having tremors for a few years, let's say 3. This was diagnosed as 'essential tremors' which caused his hands to shake to the extent that he couldn't hold a cup of coffee. Around the same time his left side of his face began twitching. When they prescribed a medication for the tremors, the facial spasms went away as well. So, the medication seemed to address both symptoms. Last May his facial spasms came back and the VA increased the medication in hopes to address it. The important thing here is that the last med update was for his face, rather than any other tremors.
The neurologist felt that the facial tremors are not typically a result of 'essential tremors' and feels instead that it's likely 'hemifacial spasms' and recommended botox injections that likely will quiet the nerves. Will be scheduling these injections sometime this week. Often needs to be repeated every 3 months. The VA originally suggested that this may be an option as well, so the diagnosis and procedure aligns with previous recommendation. We may want to consider requesting the med increase for the tremors to be backed to original dosage since the increase was perhaps unnecessary, meant to address the facial tick but ineffective.
Next Monday, dad's going in for a follow-up MRI. Likely unrelated to the facial tick, but a couple reasons; 1) dad may have had a minor stroke in the past and 2) he says he has a small tumor that hasn't changed for years. For those reasons, the VA neurologist had recommended a yearly MRI to keep an eye on both. That, I believe, was the reason for the VA neurologist letter that dad received. So, going forward, we'll make sure he gets a yearly MRI, the real reason for the one scheduled monday evening.
Couple other things, not pressing, but worth knowing if you didn't know this already. Uncle Grant was born with a single kidney, and his death _may_ have been due to that in some form or another. I think dad said he had cancer originating in his kidney. Dad _may_ have a kidney 'thingy'; can't be more specific to that, the brief medical history provided to the neurologist indicated something about his kidneys that dad wasn't aware of, so either relevant of a mistake. I need to review some of their medical records that Dawn provided. If any of you know more about this feel free to share.
We also have a history of cancer in the family; Uncle Grant, Aunt Arlene and Grandpa Lipelt all were found to have cancer and quickly passed thereafter. I didn't know that, or had forgotten, but according to dad, grandpa was severely constipated, thinking it was a blockage in the colon they cracked him and found he was riddled with cancer. He died shortly thereafter, never leaving the hospital. I didn't know. Things you learn during a comprehensive medical history discussion.
Three months from now there is a scheduled neurology follow-up, to review the MRI and reaction to the botox.
Hopefully, the botox will address his facial tick, otherwise the neurologist indicated there still is a possibility of increasing the medication. Dad indicates that his tick is better shortly after his 2 daily doses, worsening as the day goes on. /shrug
In the future we will need to get them scheduled for other annual appointments: dental, eye, foot, and perhaps a hearing exam. Dad seemed somewhat open to hearing aids in a short conversation some weeks ago.
Anyway, that's how the day went; the appointment went good, they were both in good spirits and it became apparent to me how little I know about our family medical history, mom and dad's medical history and how hard it is to keep my attention when the medical jargon comes out :) I keep thinking of sandwiches.
Cheers.
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