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Neuro Psych Test results

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Unread 12-03-2010, 11:41 AM   #1
roadrunner63
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Default Neuro Psych Test results

My neuropsychological test results came in today's mail. I have no clue about most of what is in the eight page result.

"It is possible that substantial improvement in functioning will be noted over the next six months. The possibility of residual deficit is very real. The patient's prognosis is, at this point, unclear." = Who has a clue?

Recommendations:
  • Be fully informed of the results of this evaluation.
  • All current treatment should continue.
  • Psychotherapy is recommended.
  • Retest in 12 months is recommended.
  • Speech/Language therapy emphasizing teaching of memory strategies.
  • An exacting structure to include a predictable schedule is recommended. Working for short periods of time, punctuated by frequent breaks, is also recommended. Regular exercise and a well- balanced diet are also recommended.
  • Recommended compensatory techniques for memory impairment include the use of electronic devices, and a daily planner, as well as use of a dry erase board to post daily tasks/schedules.

The only things I am not already doing is psychotherapy (I think they are suggesting this to deal with anger and acceptance of the changes) and speech/language therapy.
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Unread 12-03-2010, 02:40 PM   #2
Mark in Idaho
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I agree with you about the reason for psychotherapy.

These recommendations seem quite broad and boilerplate. What I think is more valuable about a NP assessment is the validation and defining of your symptoms.

Processing speed (WAIS-II), verbal memory, and visual memory are the most indicative in my experience. Comparing them to WAIS-II intelligence scales can also be illuminating. Higher intelligence score with low processing and memory scores is a true indicator of organic brain injury. Validity scales also help one understand their consistency of performance.

When a PCS subject has a high intelligence vs low memory and processing, it provides hope for overcoming many symptoms with compensatory systems, i.e. workarounds and other tricks.

The recommendation to use electronic devices etc. can be a problem if one struggles to remember to use them. I struggle to use anything that is out of sight. The white dry-erase board on the refrigerator works good. The dictation recorder was a waste of money. I forget to use it. A daytimer can be very helpful, especially if you already had any level of habitual use of one.

The biggest challenge I have had is learning to use these systems. I had a very good memory so I never developed any habits of using time management systems.

I do use post-it notes in some cases. My most important skill was learning to stop what I am doing to set up a reminder immediately. If I put off filling out the reminder, I will consistently forget to use it. I know that if I think about a task for tomorrow and don't write it down or set up a cue, I will most likely forget it completely by tomorrow. I have even gotten out of bed to set the cue. Sometimes, I even set the cue so that I will have to step over it so then I will notice it.

If you feel safe sharing any of the scales/scores, I have studied many of the different tests to understand my own NP reports (3)

At least you have information to move forward with.

My best to you.
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Mark in Idaho

59 years old, retired due to disability, married 34 years, father of three, grandfather of four, Suffered a serious concussion at 10 years old (1965) stopped most driving after concussion at 46 years old (2001), Post Concussion Syndrome/Multiple Concussion/Impact Syndrome with PTSD, immediate/short term visual and auditory memory problems, slowed processing speed, visual/auditory processing difficulties, insomnia, absence seizures, OCD, 14 concussions since first concussion at 8 years old, Taking paroxetine for 14 years and gabapentin for 12 years. Added L-Tryptophan and stopped paroxetine after 3 months of tapering. I currently take 500 mgs of L-Tryptophan AM, 500 mgs noon, and 500 mgs PM.


As of Nov 15th, Due to high stress issues resulting in PTSD, docs put me on 3 meds. Clonazepam but only for 30 days ) .125 mgs twice daily (Doc presc. .25 mgs 2x daily but half a tablet is good) , citalopram (Celexa), an SSRI , and olanzapine (Zyprexa), an atypical anti-psychotic that usually causes weight gain before bed. I lost over 30 pounds since mid July. It just stopped the weight loss. Took me off the gabapentin. I am feeling better than I have in years.

This great feeling only lasted a month. Back to the same old PCS doldrums.

May 2014, I am off the olanzapine due to a 6 fold price increase. Back on 600 mgs of gabapentin before bed.

I am also taking L-Theanine to help with GABA regulation


"Be Still and Know That I am God" Psalm 46:10
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Unread 12-03-2010, 03:14 PM   #3
Discododi
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Hi Roadrunner 63,
I see you are in Central KY. There is a wonderful Psychologist in our area that I highly recommend for therapy. She has experience working with Brain Injury survivors and I think she is top notch. Dr. Jane Brake.

Also, think about speech therapy at Cardinal Hill Rehab Hospital. I speak from experience. Both helped me during my recovery, and I am forever thankful.

Best Wishes, Dodi
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Unread 12-05-2010, 08:55 AM   #4
roadrunner63
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Thanks for the recommendations. I'm about an hour from Lexington.

Quote:
Originally Posted by Discododi View Post
Hi Roadrunner 63,
I see you are in Central KY. There is a wonderful Psychologist in our area that I highly recommend for therapy. She has experience working with Brain Injury survivors and I think she is top notch. Dr. Jane Brake.

Also, think about speech therapy at Cardinal Hill Rehab Hospital. I speak from experience. Both helped me during my recovery, and I am forever thankful.

Best Wishes, Dodi
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Unread 12-05-2010, 09:13 AM   #5
roadrunner63
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Quote:
Originally Posted by Mark in Idaho View Post
If you feel safe sharing any of the scales/scores, I have studied many of the different tests to understand my own NP reports (3)
All my test scores were average or above except the following:

Test: TEA
Subtest: Map Search
Neuropsychological Function: Auditory Mental Flexibility
LA (Low Average)

Test: RSTMT
Subtest: Letter Span
Neuropsychological Function: Immediate Auditory Attention
LA (Low Average) Score: 40

Test: SRT
Subtest: Sum Long-Term Storage
Neuropsychological Function: Verbal Learning
Mdl (Moderately Impaired) Score: 23

Test: SRT
Subtest: Delayed Total
Neuropsychological Function: Long-Term Verbal Memory
Ml (Mildly Impaired) Score 31

Test: WMS-IV
Subtest: Logical Memory I
Neuropsychological Function: Short-Term Verbal Memory
Ml (Mildly Impaired) Score: 31

Test: WMS-IV
Subtest: Logical Memory II
Neuropsychological Function: Short-Term Visual Memory
Mdl (Moderately Impaired) Score: 26

Test: WMS-IV
Subtest: Visual Reproduction I
Neuropsychological Function: Long-Term Verbal Memory
LA (Low Average) Score:38

Test: WMS-IV
Subtest: Visual Reproduction II
Long-Term Visual Memory
LA (Low Average) Score: 36

Test: RFFT
Neuropsychological Function: Divergent Reasoning: Nonverbal
Ml (Mild Impairment) Score: 34

My WAIS-IV only had the following Subtests:
Information (General Store of Verbal Material) Average (44)
Picture Completion (Nonverbal Knowledge) Average (50)
Digit Span (Immediate Auditory Attention/Working Memory) Average (53)
I didn't see anything about processing speed.
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Unread 12-05-2010, 09:20 AM   #6
roadrunner63
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Default Work-Arounds

Since I own my own business I had to put some work-arounds in place right away. I have a large marker board I use specifically for business tasks.

Post-it notes have become my best friend. If I have to go 5 places I have a post-it note for each and when I am done with each one I toss it. In the car my post-it notes are by the speedometer (the only place I look on a regular basis).

I have all appointments in Google Calendar AND an appointment book which I try to carry almost everywhere with me.

The downfall is not entering info IMMEDIATELY and thus forgetting until it's too late.

Oh, and I have the alarm on my cell phone but it doesn't work well as I tend to hit the off button and never think twice about what it was set for!
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Unread 12-05-2010, 10:45 AM   #7
Mark in Idaho
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I can understand your frustration/struggle. Your memory scores are weak but somewhat acceptable. The lack of WAIS intelligence scores leaves the others without a context. The score means where you stand in the population. 26 means you are at the 25% of the population. 74 % of the population have better function than you.

It is too bad they do not study and report on the meaning of the differential between the lowest scores and the highest score.

Has you tried any self rehabilitation? There are some free online 'brain training' programs that can help you exercise your brain. Posit Science and Lumosity have some freebies. You can google them. Try to do maybe 15 minutes a day.

Sometimes, memory and processing weaknesses can be improved by learning new ways to focus. Past abilities to do tasks without effort may not work but the same task with a purposed focus may improve. The need may be as simple as learning to block out other stimulations (ear plugs, dark glasses, quieter environment, etc.)

What were your highest scores? They can be affirming that you still have a good mind that is capable of working around your weaknesses.

Well, I am freezing. My office is cold so I must get some warmer clothes on. I can hear the snow and frozen slush crunch as cars drive by my house. Brrr.

My best to you.
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Mark in Idaho

59 years old, retired due to disability, married 34 years, father of three, grandfather of four, Suffered a serious concussion at 10 years old (1965) stopped most driving after concussion at 46 years old (2001), Post Concussion Syndrome/Multiple Concussion/Impact Syndrome with PTSD, immediate/short term visual and auditory memory problems, slowed processing speed, visual/auditory processing difficulties, insomnia, absence seizures, OCD, 14 concussions since first concussion at 8 years old, Taking paroxetine for 14 years and gabapentin for 12 years. Added L-Tryptophan and stopped paroxetine after 3 months of tapering. I currently take 500 mgs of L-Tryptophan AM, 500 mgs noon, and 500 mgs PM.


As of Nov 15th, Due to high stress issues resulting in PTSD, docs put me on 3 meds. Clonazepam but only for 30 days ) .125 mgs twice daily (Doc presc. .25 mgs 2x daily but half a tablet is good) , citalopram (Celexa), an SSRI , and olanzapine (Zyprexa), an atypical anti-psychotic that usually causes weight gain before bed. I lost over 30 pounds since mid July. It just stopped the weight loss. Took me off the gabapentin. I am feeling better than I have in years.

This great feeling only lasted a month. Back to the same old PCS doldrums.

May 2014, I am off the olanzapine due to a 6 fold price increase. Back on 600 mgs of gabapentin before bed.

I am also taking L-Theanine to help with GABA regulation


"Be Still and Know That I am God" Psalm 46:10
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Unread 12-08-2010, 03:32 PM   #8
July63
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I just looked at part of my neuropsych testing and some the bad ones scored these.

HVLT-R / 12 words
learning trials 6,8,8, (-1.5) deficient
delayed recall 4 (-3.0) impaired moderate-severe
retention % 50 (-2.8) impaired moderate
recognition discrimination delayed 10 (-0.9) WNL-deficient
true positives 11
false positives 1

ROCFT
delayed recall /36 12 (-1.9) deficient
recognition /24 19 (-1.0) deficient

WMS-R Subtests
LM I /50 17 (-0.8) WNL
LM II /50 8 (1.3) deficient
LM retention% 47 impaired
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Unread 12-08-2010, 09:22 PM   #9
Discododi
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Roadrunner,
I used post-it notes in my car as well when I first started driving after a brain tumor was removed. My memory was a little bit shaky and if I needed to get somewhere, I put a little reminder in the car to help make sure I got to all my planned stops.

Nice to know there are others with the same idea!
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Unread 12-11-2010, 06:08 AM   #10
vini
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hi roadrunner63

like mark says aceptence of a brain injury is a long process take help were you can.

this forum has help me getting involved typing reading all helps and it is something you can do as and when you feel up to it

best wishes
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