Friday, November 23, 2012

Maybe the Beginnings of a Breakthrough???

Since I am having some problems with memory, my physical therapist recommended that I see a neuropsychologist and do the program, Cogmed.
So, off I go to see a new neuropsychologist.  And had a very interesting conversation.

She is not completely sold on the whole "Nonverbal Learning Disorder" diagnosis.   First, she never bought into that diagnosis in the first place.  According to her,  NLD is so passee. (I never thought about diagnoses having a fashion sense!  But apparently they do!!)

She just doesn't think my profile makes sense and has some questions about my neuropsych evaluation.  She is wondering if there are any physical causes and wants me to get a full neurological workup as well as a physical by an Integrative Health Specialist.  Also, she needs to rule out cognitive decline about some specific things,   and she does not want to do Cogmed if I am having seizures.  She would also like to rule out autoimmune disorders.

So the plan is to get a neurology consult and get an EEG and a new MRI.   I am to look for neurologist who specializes in CNS disorders like MS and ask to be evaluated for "documented impairments in a neuropsychological evaluation in the context of a high or very high IQ(sorry to brag)..  Look for deficits in adaptative functioning".

 Finally, retake some neuropsych tests to see what the effect of therapy has been and get a new baseline before I do Cogmed.

She is concerned about being in the 1 percentile for inhibition and also articulation and word finding problems not fitting the profile.

We also talked about what I have done in therapy so far.  Her concern is that I have been treating a lot of the symptoms and not looking at a main cause.  I explained to her that originally I started looking at things overall but there was no guidance given to me by other neuropsychologists other than go see a Job Coach or go get Social Skills training.  When you google "NLD" you don't get much else in terms of an actionable strategy.  Also, all my other therapists don't seem to think that social skills is my key problem.  (Although my psychologist has noted that "No one can EVER have Too Much Social Skills Training"!)  And also, other neuropsychologists tend to diagnose and go away.  I would have very much liked a neuropsychologist to have been riding herd on whatever is going wrong with me... but, until now,  no one seemed to want to step up to the plate.

Her feeling is that I have not been served well by the profession.  She also thinks I need to be seen by someone who specializes in adults.  All my other non-neuropsych therapists have been looking at this through the lens of childhood development.  She, herself, specializes in children but has a partner who works with adults.   Also, she said that she (or her partner) would like to be available to help guide me through the process of looking at the brain as a whole.

Well, it's nice to have someone to help sort things out in a more global sense.  Periodically, through my different therapies, I have wondered about how my vision problems relate (or not) to my hearing problems to my motor apraxia to global brain function.  It's nice to have someone who has a lot more background on the brain help sort things out with me.

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