David's recent and continuing problems

I know that this is a terrible time to post an entry like this. Succot is supposed to be זמן שמחתנו zman simkhatenu, the time of our joy, and we are told והיית אח שמח v'hayita akh sameakh, "and you will be especially happy". But life doesn't always follow the neatly laid out seasons, and so here we are.

I don't want to bore you, and, more importantly, I really don't want to dwell on negative things. So I'll try to be brief (not my forte, as you all know!) and to give you only the highlights.

Already by last winter, we had realized that David was having some kind of cognitive difficulties. We feared that it might be early Alzheimer's, since his father had had it, starting at about his age. So, we arranged an appointment (at our own expense, since it wasn't covered) at the Cognitive Clinic at Rambam Medical Center in Haifa last February. The appointment took several hours, during which time an expert neurologist specializing in this area interviewed us together and did extensive cognitive tests on David alone. The conclusion was that he did, indeed, have some abnormal cognitive problems but that it is NOT Alzheimer's. She also said that he should have an MRI, but, of course, that has to be ordered by a Maccabi (our HMO) neurologist and approved by Maccabi, since it's very expensive. So it was not initially approved.

Meanwhile, David began having epileptic seizures, although they happened when no one was present in the room to view precisely what happened. Nevertheless, he had several falls, and he also began having "drop outs", short times when it is like the electrical system dropping out for just a fraction of a second. These, too, however can cause falls if he is standing. Besides this, his balance began deteriorating and he became quite unstable walking. He began using an old cane of my Mom's and eventually we got a better one for him, although it's currently only on loan.

In the week before Yom Kippur (which was on 18 September this year), we realized that we would need a wheelchair for that day. Virtually no one in Israel drives on Yom Kippur, so we had arranged to spend the night with friends who live in Nahariya. However, there was clearly NO WAY that David would be able to walk between their apartment and the synagogue. So, we went to a medical equipment store in Kiryat Shmona and purchased a wheelchair, figuring that he would need it for other occasions as well.

Last Monday night (or, really, very early Tuesday morning), David got up in the night to go to the bathroom, which is quite normal for him, even though he had fallen several times in the past when doing this. This time, he fell as he was turning around to sit on the toilet and hurt his ankle. We thought that it was broken, but when we had it x-rayed we found that, thankfully, it was not, only sprained. Nevertheless, he has not been able to walk on it and thus has become wheelchair-bound, making us very thankful for that purchase! The ankle has definitely begun healing, but he still can only take a step or two on his left foot. We set up a roll-away bed for him in the living room so that he doesn't have to get up the 17 steps to our upstairs bedroom (or even the 5 steps to the closest bedroom). This has worked well for him. We also hit upon the idea of using old empty coffee cans for him to pee in instead of having to risk getting to the bathroom during the night (which we should have thought of long ago!).

So, you are probably asking by now, "What is causing these problems?" Unfortunately, we don't have any answers yet. The local Maccabi neurologist, who is very good, sent him to the Epilepsy Clinic at Rambam, where he was seen by an expert there. She also said that he should have both an MRI (magnetic resonance imaging) and an EEG (electro-encephalogram). This time, when the local neurologist ordered these, Maccabi approved both of them. We still have to schedule the EEG (which should be fairly easy), and the MRI is already scheduled for 4 October (after the holidays, of course!). Thus, we are simply waiting and wondering what they will find, which isn't particularly easy.

The balance problem and the cognitive difficulties have both continued to slowly deteriorate. The latter tends to be somewhat sporadic, so often David's thinking is perfectly normal. But then, suddenly, he will forget what he is saying in mid-sentence, or he will become very confused about something that happened very recently or about what day it is. It's all quite worrying for both of us, especially since it's also very mysterious. We try to remain hopeful, but I must admit that it hasn't been so easy.

We have tried to continue doing interesting things and to live as normally as we can. Today, we took a drive to Gamla National Park, where we have been many times before, and I took David in the wheelchair on the nice paved path. I'll post more about that, including a picture, in the next post.