‘That could be a good or bad sign.’ I thought.
This appointment would be with the clinical psychiatrist and no, I haven’t any idea what the difference is between the two, perhaps this meeting will clarify their respective functions.
So here I am again, sitting in glorious isolation, in the waiting room of the Memory Clinic. It’s 9.30am and I'm the only customer so far, so when a man walks in carrying clipboard and papers, it’s a fair assumption that he is THE man I have come to see.
I'm disappointed, I was hoping for a female psychiatrist, I don’t fair well with most men, especially those in positions of authority.
History has taught me that men are abusive and although logic tells me that this is not the case with all men, experience and emotion invariably persuade me otherwise and I become defensive and sometimes verbally aggressive, depending on the situation. I have a feeling this could be one of those situations.
I'm right – this is the man. He introduces himself and in five seconds or less I have forgotten the name. He invites me to follow him along a corridor to his consulting room.
He begins by asking me why I have concerns about my memory. I had a list with me on the last visit and didn't use it. Today I have no list. I did have it last night and I put it somewhere safe, so safe that I couldn't find it this morning, so I'm flying solo. He’s focusing on memory only. Alzheimer’s disease isn't all about memory, it’s about skewed perceptions and faulty spatial awareness, loss of language and so much more. I give him the information about memory, the bits I can remember.
He looks at his notes.
‘Are you still taking antidepressants?’
‘Not at the moment,’ I reply. ‘I've stopped them for a while because they reduce my white cell count and the outbreak of folliculitis on my face wouldn't heal. My face isn't brilliant now, but it was scaring babies and horses three months ago.’
I can see my feeble attempt to lighten the mood has failed. I notice that he has a very dark mole on the bridge of his nose, I want to ask if he’s had it checked out but realise it would be inappropriate.
‘How long ago did you stop taking them?’ he asks, raising his eyes from his notes.
‘I've done it gradually over a month but I haven’t taken any for about three weeks.’
‘Are you okay? How do you feel at the moment?’
I was fine until he asked me, now I can feel the tears welling up unbidden. Not a good thing. Showing weakness in the presence of a male of the species doesn't bode well.
I know this is only going to confirm, in his mind, that I'm depressed and not coping.
I've lived with depression a long time. Not coping means I turn into a Rottweiler on acid. Weeping is something I welcome.
When I’m depressed I’m aggressive but extremely articulate. On antidepressants I’m devoid of any emotion good or bad. At this stage of being off drugs but not depressed means, for a while, I’m “normal”. I can react rather than act the part I’m expected to play or be so out of control that all, but very good friends, avoid me.
These tears are because I know how this is going to pan out and from here on in there will be nothing I can say that will persuade this man that my “memory” problems are not a result of depression. He has already made his mind up about which route he’s going to take.
We continue with the charade for a further fifteen minutes or so (the NHS clock is ticking). How well did I sleep? He already knows – it’s on his clipboard.
My sleep pattern is lousy and has been that way on and off from childhood. I stopped stressing about it years ago. I survive on four or five hours sleep a night. This is not new or, I feel, anything that is directly causing my cognitive impairment, though it’s a recognised possible precursor to developing Alzheimer’s, as is depression.
I explain all this but I know I’m wasting my breath.
'I want you to start taking antidepressants again. I’ll prescribe one that has a more sedative affect and also start you on a course of Melatonin to improve your sleep pattern.'
‘I’ve been prescribed Melatonin before,’ I protest pointlessly. ‘I stopped taken them after a week when I read the extensive list of side effects.’
‘I’m not forcing you to have a drug that you’re not happy with but we have to try this approach. Your MRI scan showed no abnormality, it was within the normal parameters for a person of your age.’
He is already standing up, signalling that my time is up.
I deliver my parting shot.
‘I know as well as you do that an MRI scan is a lousy diagnostic tool for detecting early signs of Alzheimer’s.’
He is not going to treat me like an idiot. I'm being fobbed off. He knows it and I know it.
‘Well, if there’s no improvement with the change in medication, there are other tests we can do,’ he concedes.
I left. I think there is another appointment to come. I don’t recall the why, what or where. I'm sure all will be revealed in the fullness of time
The one thing this visit did prove - I wasn't depressed, because when I left, his throat hadn't been ripped out.