Stuck between Alzheimer's and Autism in Austin

Fear and Loathing of Red Flags or the scent of an old Red Herring?

My current cognitive dysfunction and agitated state has shifted from distress over Alzheimer-like short term memory deficit to one more commonly associated with Autism:

I’m hyper-sensitive to a point of distress and distraction by common background stimuli [sounds such as a refrigerator motor or ceiling fan in hallway are as disruptive and irrepressible as the pounding of a headache or ringing in one’s ears]
This hypersensitivity [from my dubious perspective] appears to contribute to or precipitate additional cerebral static. The cumulative effect of these sensations only inflames my anxiety over the genesis of the symptoms and prognosis for attaining and a more predictable set of expectations for any given day, the next week, or the rest of my life. I’m confused as how to interpret and if to share all this data with my medical team. Imagine how conflicted I feel about reporting to my neurologist that I’m having troubling walking and sleeping because of the inflamed big toe on my right (good) foot. My doctors carry a heavy case load of patients in what I assume are in a more acute phase of treatment for more life-threatening or debilitating disease. I’m guessing that the resurgence of the left leg spasticity has thrown a new gait dysfunction that is irritating toe on other foot Question: Will a neurologist see this as a red flag or a red herring? Does my asking beg the question? Or Is this all just fear and loathing?

I though I was past this stage already

In a posting quite some time ago (August of 2006) I referenced a comedy routine by Stephen Wright to describe my then state of mind: a persistent sensation of just catching oneself from falling while leaning back on two legs of a chair. His surreal, delusional monologue described[comically] "feeling like that all the time." Four months later, (December of 2006) I was celebrating “my enigmatic lucidity” acquired after relief from the cognitive impairments inflicted by medication of my spasticity with a drug called Baclofen. Soon thereafter, I reported the significant improvement I attributed to the resumption of the rigors of cognitive therapy – with an escalation to the equivalent of “doctoral- level” cognitive therapy [February of 2007 - April 2007]

These most recent hour-long therapy sessions involved annoyingly complex and repetitive arithmetic tabulations in highly distracting settings. My performance in each session was carefully monitored, analyzed and re-calibrated by my ever-vigilant and [if not for her passion for her patients and craft] the frighteningly-skilled Speech Therapist a.k.a Brain-Repair-engineer Shilpa . For example, setting of one session was conducted in the same room in which a brain education session for a group of other rehab patients was being held. Try self-monitoring your own brain function while a lecture of how the brain works is running in the background – while performing sequential, cumulative calculations in which functions are encoded symbols[e.g # represents “subtract 4” from running total]

As if on cue, (perhaps the body rebelled from all the attention that damn brain was getting?) the symptoms of my personal case of spasticity: persistent contraction of left leg - followed by sciatic nerve inflammation escalated and drove me to a level of distraction and discomfort to pursue treatment via Botox injection referred to as chemo-denervation in the rehabilitation journals [not as bad as it sounds] but the procedure does involve the introduction of a neuro-toxin by a needle large enough to penetrate the belly of my offending hamstring. The hope and desired affect is temporary “paralysis” of the injected muscle [the presence of the toxin inhibits the muscle’s reception of and transmission of the signal initiated in the brain.

So, any potential for relief from pain is gained through temporary reduction of the muscle tension that precipitates secondary effects of cramping and sciatic involvement. In my case, a relatively low –level dose was injected to the outer side of my left thigh. This represented a conservative approach - a modest initial dose to assess my body’s tolerance for this mode of treatment and a location least likely to destabilize normal daily activities. Within 10 days I was able to detect a few modest signs that toxin was actively reducing reception of signal: my outer left hamstring was "softer to the touch" [i.e. not fully flexed] and noticeably non-responsive in a few of the exercises prescribed in physical therapy[sessions were scheduled for two-three per week. Unfortunately, the persistence and intensity of the sciatic pain resurfaced the ambiguity of possible disc involvement as a contributing factor – so sessions with physical therapy involved significantly more time on diagnostics than the aggressive stretching and neuro-motor retraining I had hoped to pursue.

After 3 weeks, the assessment was that disc involvement was highly unlikely and that adhesion somewhere along the sciatic nerve had developed. The recommended treatment would require an invasive [20 minutes of stretching every 2-3 hours ] and painful set of stretches to elongate the nerve itself and to relieve adhesions along the nerve the runs from lower back to foot]

Recall that the theoretical source of my case of spasticity is that a lesion detected in area of brain called basil ganglia – the command and control center for outbound motor signal as well moderation of outbound signal based on interpretation of inbound sensory input from extremities. This complex interplay between inbound and outbound messages is how and why you can manage to grab a Styrofoam cup of coffee without puncturing the cup by squeezing too hard. With that background, imagine possible reactions of a dysfunctional basil ganglia to stimulus of pain generated by stretching an inflamed and irritated sciatic nerve.

Now ask yourself, could the simultaneous increase in spasticity in the left leg with significant decline in cognitive function be a red flag or a red herring? I both fear the answer and am loath to ask the question.