I had an appointment with Melissa this afternoon to review my test scores. I’ve taken comprehensive neurological tests three or four times since I began working with her: the first time, right after my first stroke, on no medication, and then on Adderall this January, pre-HBOT, and this month. The results are somewhat encouraging; the numbers are not.
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ATTENTION TESTING
I don’t have a number for this, but I did much better in 2008 with one exception: the test where you have to tap when you hear a sequence of numbers that are 1 number apart (like 3, 2) with talk radio playing in the background. I don’t know what my original score would’ve been because I didn’t even get that far in September 2005; in 2008, I sucked. I’m sort of OK with that; I know that I have trouble paying attention when there’s music or other noise in the background. However, it kind of stank to hear my score, which was wretched.
VERBAL COMPREHENSION
I can’t remember what this test entailed. This is rather disconcerting, seeing as how Melissa just explained this to us this afternoon. Anyway, here are my scores:
September ‘05: 38 percentile
June ‘08: 53 percentile
You can see I have a ways to go on this.
VISUAL-AUDITORY LEARNING
This test was “extremely annoying”, to quote myself. You are shown a series of pictures and Melissa reads what they represent; things like “cowboy”, “horse”, “little”, “big”, “tree”, etc. Then you’re shown another page with sentences written in pictures and you have to translate. GRRR. I couldn’t remember the names of stuff from one moment to the next! And they keep building up to longer and longer sentences!
September ‘05: 23 %
January ‘08: 58 %
June ‘08: 45 %
You can see that I actually decreased from January to June of this year. I think this is just “normal” fluctuation; my tiredness levels have a LOT to do with my score.
PICTURE RECOGNITION
You’re shown several pictures on a page for 5 seconds and have to pick them out of a set of ~ 5 – 6 pictures on the next page. Sounds fun, eh?
September ‘05: 29 %
June ‘08: 75 %
Surprisingly, I did reasonably well on this this month.
MEMORY FOR WORDS
Melissa read a series of words — like, “hand, his, tab, wrist” — and I had to repeat them. Easier said than done, especially when her list gets up to six words long. (It doesn’t seem like much, but trust me … it is.)
September ‘05: 46 %
January ‘08: 66 %
June ‘08: 47 %
I decreased from 66% back down to 46% – 47% again. HBOT? It sucks! I want my 20% back!
RAPID PICTURE NAMING
Melissa has a book that has a bunch of pictures (like, 20 of them per page) and you have to name them as fast as you can. “Banana, boat, armchair, …” for four or five pages.
September ‘05: 24 %
January ‘08: 25 %
June ‘08: 29 %
Wow. This is one test that still stumps me. I remembered them all the last time I took it, but it took me 1 minute and 58 seconds. Apparantly, I get louder as I go through the pictures, too. Melissa attributes this to me trying harder and getting tireder. I didn’t do this at the beginning, though; I stayed at a nice, reasonable volume throughout. Now, however, I’m practically shouting by the end. It doesn’t surprise me; it’s pretty difficult to name all those things! This is definitely an aphasic result.
STORY RECALL
Melissa reads you a series of stories. You have to repeat them back to her as well as you can. The easy ones are just one sentence: “I went to the store and bought some chicken,” while the hard ones are multiple paragraphs. I remember one about a hurricane; the winds were 120 mph, the waves were crashing into shore, a car got swept away, etc. It’s nontrivial to remember the entire thing.
September ‘05: 29 %
June ‘08: 62 %
Apparently, I was doing so poorly on this the first time I took it that my score is based on the first half of the test only. That’s only the easy stories. This month, I got through them all, although I couldn’t recall the details of the long stories like “The Tale of the Hurricane.”
MATH FLUENCY
This is a times table test. 6×2 = ?, 3+2 = ?, etc. How many can you get in three minutes?
September ‘05: 79 %
January ‘08: 53 %
June ‘08: 63 %
These scores seem backwards to me, but there they are. Remember I’d had another stroke in between September ‘05 and January ‘08. Also, it’s largely a handwriting thing; you have to write your answers out instead of doing them on the computer.
“Eww,” I said when I saw these scores. “I’m supposed to be good at these.” Melissa replied that she took notes while I was doing this test, and she noted that I got visibly nervous when I found out it was timed. Which I did. However, that accounts for my scores, or so she says. I got them all right, she points out; I just didn’t finish. I say it still sucks, but that’s just me talking. However, my math calculation scores, which are based on an untimed exam, say that Melissa is right …
MATH CALCULATION
This exam covers everything from math facts -> algebra -> trig -> calculus. You get unlimited time to take it. This is my kind of test.
September ‘05: 93 %
June ‘05: 99.9 %
Ahh. This seems … normal. I did OK on it after my first stroke, and I rocked it this month. =P Also note that this was one of Ben’s big concerns after my second stroke; I couldn’t do ANY math facts, it seemed, in the hospital. “20 + 10?” “I dunno.” “Cube root of 1000?” “Umm … 100?” It was pretty embarrassing, and frightening because it’s what I’d based my schooling and career on.
WRITING FLUENCY
In this test, you’re given a picture and three words. You need to write a sentence describing the picture using the three words. So, a picture of a boy and his dog might translate to, “The boy and his dog go for a walk.”
January ‘08: 90 %
June ‘08: 99 %
I wasn’t given this test in September ‘05; it was too complicated for me. Also, I wasn’t used to my microscopic handwriting yet. (Melissa has a way of deciphering it that exceeds my expectations … no, exceeds everything … well, she’s very good at it.) Yay! It means that I CAN write a book. I CAN write thank-you notes that make sense to the thank-you-ees (assuming they’re type-written). I CAN write long, drawn-out blog entries about the results of my testing that nobody really wants to read but — oh, never mind.
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I told Ben yesterday that I was hoping to stop seeing Melissa. “I don’t think there’s anything else she can do for me,” I said. After seeing my scores, though, I definitely want to go back! I wish I’d taken these tests before the strokes to see where I SHOULD be, but I’d wager … oh … a lot of money that I was at least in the 80th percentile in almost all of the categories. I want to get better! Also, Ben mentioned my medication, which he thinks I’m trying out poorly, and Melissa said she’d be happy to help me manage it.
I should explain. I went to Dr. Stapleton last Wednesday (my birthday!) and she prescribed me several things: (1) a refill of Ritalin, (2) Concerta, which is a time-delayed release of Ritalin, and (3) ProVigil. I begged her for the latter; it’s a wakefulness drug that narcoleptics take so they don’t fall asleep in annoying places like church choir or on the road. It woke me up when I tried it after my first stroke, but it also made me very depressed. Suicidally depressed. I made the case that it might not have that side-effect now that I’m on antidepressants. I promised not to kill myself. (The depression wears off with the medication, so I know it’ll be over in a day. That helps a lot.) Also, I hoped that it would still wake me up, unlike the neurostimulants I was currently taking, which seem to have stopped after the second stroke. Dr. Stapleton finally gave in and gave me a sample package with two pills in it. Wow, is she generous or what? (Does she think I’m going to keep taking them if they make me depressed? What’s with the two-pill limit?)
The good news is that the ProVigil doesn’t make me want to kill myself anymore. Unfortunately, it doesn’t wake me up. Moreover, without the added cognitive benefits of the neurostimulants, I’m basically a jibbering mess. I cannot get a sentence out. So I ruled ProVigil out.
The Concerta I’ve tried twice so far. The hope is that if I can take it, the time-delayed-release will allow me to take one pill in the morning and not have to enslave myself to my iPhone alarm in the afternoon, which is when I take the Ritalin. So far, it hasn’t worked. The first day I tried it was Thursday, when I (incidentally) got up at 8:00am to go to a pottery class, which Ben signed me up for as a birthday gift. 8 in the morning is very early for me, and I was *exhausted* from about noon on. I took two Ritalin at 2pm; it didn’t help. I also took Concerta yesterday, but I took two pills in the morning. I was hoping it would give me enough energy to make it through Sunday School, which I was roped into scheduled to teach yesterday morning. I was awake for Sunday School, but fellowship was still a struggle for me (as is usual — see my “Attention Test” score above if you don’t believe me) and when I got home, I couldn’t concentrate on ANYTHING. Threading the elastic waistband through the skirt I’d just finished sewing? It got stuck on the seams and I gave up. Threading my sewing machine needle? The thread kept breaking and I called it quits. Since this medicine is supposed to keep up your concentration, I think this is a FAIL. So I’m going to be stuck with the Ritalin.
However, Ben makes the [correct] point that I need to systematically try these things out. Right now, I’m taking a 1/2 dose of Adderall in the morning and a round of Ritalin in the afternoon, which seems to work well. I can talk in the morning because of the Adderall, I’m sort of awake in the afternoon thanks to the Ritalin, and I can sleep at night. But Ben wants me to try it some more. Melissa said she can help me manage a plan to try all of these medications and combinations of medications, so I’m going to do that.
Anyway, I’m feeling a little sorry for and disappointed in myself because of my test scores. I’ll feel better tomorrow.
