Clinical neuropsychology

[Nancy]

Tomorrow morning at 8:30 I'll be deep in the city in the neuropsychologist's office taking this miserable test for the THIRD time. Four and a half hours of timed tests. Oh, how I hate it.

The first test was one of the very first THINGS the docs did to me after discovering my tumor. The second time was exactly 6 months after surgery. This, the third time, is exactly 6 months after the second surgery. They say they have to see how things are going ~gulp~ in my left temporal lobe.

Again I'm instructed to eat a hearty breakfast and bring a snack. Yeah, sure, you betcha.

Here's a site that gives a very loose/general explanation of the test http://www.brainsource.com/npassmnt.htm

[speber]

hope some good comes of it for you!

[RobinN]

Thanks for that Nancy. It has been suggested for Rebecca to take a test like this.
I gather there are tests that insurance will pay for, but then there are more extensive tests that give a thorough picture that are not covered.

So far I have declined the testing.

[brain]

Oh No Nancy! I DO know 'cheat codes'

after having taken so many of them ...

(((((((( HUGS Nancy ))))))))))

Keep us posted how the Neuropsych came
out! If you managed to out-psych the
Neuropsychologist!



Will be keeping you in my thoughts!

[RanMan]

Nancy,
My employer of 30 years sent me for a neurologist/psyc. examination b/c he didn't believe that I had epilepsy and thought that I was just using that as an excuse to get out of doing certain tasks.
Now it has been documented as well as what I can and can't do.
My test revealed that due to the long term use of meds (28 years) I did not have the ability to learn new tasks, and since my employer was downsizing and I was close to the early retirement age, the neurologist/psyc. Doctor suggested to my employer that I go on "Medical Retirement" (I was 47 years old at the time ~ 3 years ago)

I find the neurologist/psyc examination very demeaning and I felt like I was in grade one.

Randy

[brain]

So far I have declined the testing.

Robin - you shouldn't decline the tests. They
are actually are of benefit. I've taken them
in my entire life since a child. And I do have my
old, old ones - and some of my Doctors wished
my mom hadn't thrown out the really old ones,
and especially the divorce; where a lot of them
vanished alongside with my medical records, for
they were of extreme importance.

---------------------------------------

Now the Neuropsych Tests are primarily used for
those who are going to become surgical candidates
and for children, to benefit better in school and
education and for monitoring and established
history.

[Nancy]

As I said - I've had that testing twice before, once under Blue Cross/Blue Shield and once under GHP. Both times it cost $1400 and they paid for it 100% (wow!).
This time we're using Tri-Care (simple partial?) and a suppliment retired military insurance and we will have to pay a small fortune ourselves.
(Which reminds me -- my fantastically expensive surgeries were 100% paid for by insurance ... can you believe that? Many, many MRIs and PETs, VEEGs and things like that -- all paid for 100%. Now husband is retired from civillian job and we're back depending on the military insurance)

Randy - I've had two different people giving me the tests and I've never felt that way. COMPLAIN. For what they charge they have to treat you better.

I spend about 10 or 15 minutes before the testing with the neuropsych herself and she asks the expected personal questions ... then the testing starts.

Robin - I do think it's important that your daughter has this testing NOW. It could tell you exactly where/what problems there and in a couple of years it could show if there have been any changes.

Brain -- QUICK - send me the cheat sheets!!!

[brain]

I spend about 10 or 15 minutes before the testing with the neuropsych herself and she asks the expected personal questions ... then the testing starts.

Robin - I do think it's important that your daughter has this testing NOW. It could tell you exactly where/what problems there and in a couple of years it could show if there have been any changes.

Brain -- QUICK - send me the cheat sheets!!!

1) I agree with Nancy on that in reference to
Robin.

2) Nancy - don't'cha just love those deep down
personal questions they ask... GEESH! And you
get only 10-15 minutes of it? NO FAIR!
::: sulks :::
They usually take about 30 or more minutes
asking me, to a point I ask them are you planning
on writing a book?


3) Nancy - See your PM - and try to contain yourself,
better wear your Depends from laughing
so hard!

[Nancy]

Oooooooooooo it's over and they assured me this was the last time unless I get hit for surgery again. Please God, NO.
And this neuropsych test was 20 times easier because they did not check my intelligence --- that had already been established (lol lol lol) and they just need to see how the old brain was working now.
Now it's time for a long winter nap.
TTYL

[Zoe]

I was not a good neuruopsych patient on the epileptologist ward. One of the people doing the test was well known for having developed some of them. I called him a quack, because he was, to me, a total fraud.
When the tests came back, he had determined that I was so severely brain damaged as to be "not trainable" At the time I was on the president's list at the local community college. I had too many seizures to attend classes so had made arrangements through disabled student services to do my work at home and only go to campus to return and receive class assignments. I ended up getting a BA in Liberal Arts with a major in Writing and I'm a published writer.
Don't let the tests intimidate or define you. They are very limited in the information they can provide on how you are functioning the day you take the test. They don't give a good picture of how you function in general in your own environment or of your overall abilities.

Because I "quacked" whenever the fraud went by, they somehow "forgot" to do the follow up neuropsych testing that was part of my second brain surgery package deal. That was just "ducky" with me!

[Nancy]

Ah, Zoe - this outfit - A university hospital tested me very long and carefully before my first surgery and again exactly 6 months after that. This third test was exactly 6 months after my second surgery.
As I was leaving there was general teasing and promises called that they would never, ever see me again UNLESS I had surgery again and they were hoping I wouldn't.

The neuropsych will telephone me Monday to talk about the results of the test just as she has done following the past two tests. All the results will be explained ..... as well as I can understand them.

[brain]

Well Nancy - whatcha think
of my cheat sheet?



Zoe: Neuropsych tests can drive ya whacky!
I actually have a valid proof where they had
performed tests and revealed me my entire
comprehension level as grade 5.4 and yet,
I took a regular standard University entrance
examination and exceeded? They even wrote
me a letter of additional scholarship because
of excellency and commended me on such?
Speak of such controversial comprehension
betwixt the two insomuch my parents were
beyond the state of confusion and bewilderment.

So they never did understand the purpose or
meaning of neuropsychological tests at all.

[Nancy]

Hi brain ... The only part of the test I'd ever seen was what you showed me first ... the colored words. I had that on the first two testings but it was presented by flash card -- one card with one colored word on each card.

Did you change the presentation of the entire test? LOL

And I did not get it or anything like it this time. .... Just the tests wanting to see if I have any memory and things like that.
Including the funny/strange tapping the little key like a Morse code counter as fast as I could with my right index finger for 60 seconds. Then using my left index finger .... then again with my right .... then repeat with left.......... right again........ over and over. The tech said this part of the test (that I had also done the two previous tests) did record the function in a certain part of my brain (???).

It's beyond me ....
Thank Goodness.

[brain]

Hi brain ... The only part of the test I'd ever seen was what you showed me first ... the colored words. I had that on the first two testings but it was presented by flash card -- one card with one colored word on each card.

Did you change the presentation of the entire test? LOL

And I did not get it or anything like it this time. .... Just the tests wanting to see if I have any memory and things like that.
Including the funny/strange tapping the little key like a Morse code counter as fast as I could with my right index finger for 60 seconds. Then using my left index finger .... then again with my right .... then repeat with left.......... right again........ over and over. The tech said this part of the test (that I had also done the two previous tests) did record the function in a certain part of my brain (???).

It's beyond me ....
Thank Goodness.

[blush]
Ummm - maybe I did have something to do
with the color presentation of say the color
and not the word.
[/blush]



I told you I got caught "cheating" and that
test was brand new at that time; like I told
ya on PM - LOL!

The finger tapping is a major problem for me
with Carpal Tunnel's Syndrome.

Same way with the script writing with mnmnmn
and since I can write left and right, they have
a hard time discerning which hand wrote which.
And for that reason I write on the top LEFT HAND
and on the other paper RIGHT HAND. Otherwise,
they wouldn't know.

I've had them go further with me insomuch as
writing my name, sentences, even paragraphs.

But they can tell I'm a "southie" (southpaw)
by the way I hold my papers when I write
with my left and the way I hold it when I write
with my right.

[Zoe]

As I was leaving there was general teasing and promises called that they would never, ever see me again UNLESS I had surgery again and they were hoping I wouldn't.

The neuropsych will telephone me Monday to talk about the results of the test just as she has done following the past two tests. All the results will be explained ..... as well as I can understand them.

Hi Nancy,
I hope you will take the results, positive and negative with a [very large] grain of salt. They don't tell you how you are, only how you "performed" at the time of the testing. And then, compared to what? Overall, just trust in your perceptions, and pacing yourself and setting goals you know you can manage.
I had some severe vision problems after my first brain surgery. I also lost about 40% of my hearing and much of the ability to easily understand speech. I could do really well on some aspects of the testing, especially verbal skills, and some of the problem solving. BUT, this was only when in a very controlled situation with no distraction. When in public, like at a store or in the bank, I couldn't filter out the normal sounds and would be so confused I could not write out a check or understand simple instructions.
My ability to identify the problems and develop ways to recover were hindered by a psychiatrist who interpreted my very real and valid reservations about doing some kinds of work as a loss of confidence--in other words denying the reality of the impairments to my vision, hearing, and auditory processing---because I was a straight A student as long as I did all my work at home alone, with no distractions. I could not even function in a math lab for remedial learning because my speech comprehension was so poor. Pushing me to do things which I no longer could do only served to further erode my self-esteem and hinder my recovery by preventing me from adequately dealing with my reality.
Pay attention to yourself, and your own unique needs. You will sense and come to understand them better than any one person, or test.

[Zoe]

Zoe: Neuropsych tests can drive ya whacky!
I actually have a valid proof where they had
performed tests and revealed me my entire
comprehension level as grade 5.4 and yet,
I took a regular standard University entrance
examination and exceeded?

So they never did understand the purpose or
meaning of neuropsychological tests at all.

The testing allows you to be labled, to be defined by others, rather than by yourself. It isn't at all surprising that you might perfom poorly on the neuropsych test and excel elsewhere. You demonstrated well the limited usefulness and validity of the tests.

[RobinN]

That is exactly what I have felt Zoe.
They tend to pigeon hole you into a box, and your box isn't decorated with all the unique qualities and grace that are special to you.

[Nancy]

After my first neuropsych test (that was my first major test after discovery of the tumor), before the first surgery, my neurosurgeon said it didn't show anything wrong, it was fine. If they didn't have that MRI they would assume I was OK (except for epilepsy. My test showed no problems for someone my age, education, location yadda yadda.

They have no idea why or how I "knew" something was wrong and had insisted/begged to my local neurologist for man months for additional help. I had been screaming, crying, pleading, sending email to my local neurologist that I could not paint, was dyslexic, having other problems.
He said and wrote back that I was simply trying to gain attention.

However I STILL know things are wrong that they don't see or cannot verify.
Oh well...........

[Nancy]

aaaaaaggggh - I forgot to mention (did I ever tell you that I have a distinct memory problem?) that each physician involved with my brain has photos of my wood carvings tucked in their folder? The neurologist told me that they are spread over the table at the meetings. Those are the most important things in my life. Yes, THOSE things are the most important.
Neat, huh?

[Zoe]

They have no idea why or how I "knew" something was wrong and had insisted/begged to my local neurologist for man months for additional help. I had been screaming, crying, pleading, sending email to my local neurologist that I could not paint, was dyslexic, having other problems.
He said and wrote back that I was simply trying to gain attention.

However I STILL know things are wrong that they don't see or cannot verify.
Oh well...........

Hi Nancy,
When I went blind in the left field of vision of both eyes, it was diagnosed as "hysterical blindness".

The pressure I felt on my brain from the massive deformed blood vessels and fistula [abscess\cyst-like formation] was also discounted, trivialized, or interpreted as some sort of psychiatric symptom, right up until the day I collapsed and went into status while having a stroke [ I was a "hysterical personality type"].

There is a lot they don't see or recognize about brain inury, including the capacity for the brain to heal, to relearn what is lost or damaged. At some point I figured out that there was impairment of my memory in that I could only mentally "see" and juggle two or three words or bits of information at one time; too much information too fast and I completely blank even lose my speech and ability to tell someone what's wrong. No one tested for this type of memory loss, so I just manage it as best possible. Games like scrabble also were useful in retraining that kind of memory, having to work with the letters to form words. Crosswords and other games helped as well. I got some shape puzzles, tannegrams and others to kick start my brain's ability to picture things better.

By studying and thinking about what you find is a problem, you may also see hints of how to overcome it and relearn. I got a tape recorder and used it to teach myself to speak more normally again, reading one or two sentences at a time, then playing back and practicing until I could read and pronounce the sentences correctly at a normal rate of speed.

As you become aware of what is a problem for you, you can also develop strategies for relearning or overcoming them. The myth of neurons being irreplaceable is finally being overturned more than twenty-five years after it was shown that neurons do regenerate, we are growing new nerve cells all our lives.

Throughout the time I was overcoming paralysis and the damage following the brain surgeries, I had periodic dreams that were guides to my recovery. In one dream my task was to rewire a stack of circuit boards that had been damaged in a fire. All night I worked so hard to rewire those boards. The next morning was the day I got the thumb on my left hand to move for the first time since the stroke.

To this day, I cannot write legibly by hand and haven't had the courage to try and draw again. If I ever get settled and feel safe again, I'd really like to try some drawing, maybe painting again too. Can you post some pictures of your wood carvings? Are you able to do them now?

It can be soooo frustrating to be so acutely aware of something wrong and not have anyone else be able to grasp it as real. Just keep trusting in your own knowledge and ability and keep open for those times when you do meet others who can understand.