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Cognitive Impairment NOC

As we get older, we all start to forget stuff. Usually, it's gracefully, but some are not that lucky and get head injuries, early-onset #Alzheimers, post-concussive syndrome, #TBI, and now I'm hearing long-term #covidbrain. All of these can be life-altering diagnoses.

I had a grand mal seizure, yep full #tonicclonic where I flew from one room to another, hit my tile floor, and turned blue a little over a year after my mom passed away. I can't say it was shocking because I was still a walking shit-show, mentally and physically even a year later.

The worst part of the #seizure was not the #seizure because you have no recollection of what happened when you come out of it. In fact, like many head injuries, it is often to wake up agitated, and I certainly was.

I was having a birthday party for my husband; the house was immaculate, food out, adult beverages ready, and suddenly bam. A half-hour before the party started, I was put into an ambulance, very pissed off and in disbelief at what I was told happened.

It was over a year after my mom passed away. Unfortunately, because my mental and physical state was still horrible, everyone in my family, work colleagues, and close friend circle was confident that the seizure's cause was medicine-related. (benzodiazepines). Rolling the tape back a little further a week before this happened, I was in the hospital with severe colitis and on high amounts of steroids. At the time of the seizure, I was still on a big prednisone dosage, and if I slept two hours in a night, that was a lot. I still held a full-time job, commuted over 100 miles a day to work, and had a two-year-old. Together with acute textbook #depression, #ptsd, #anxiety, #grief, #anger, #sleepdepreivation, and a terrible gastrointestinal disease, something bad was bound to happen. I didn't eat. I lived on Boost and layered my clothes at work because I was so thin, I was wearing sizes 0 to 2, and even then, I had to bring my work pants to a tailor to get them to fit. My close friends at work noticed. They called me out. I'm not mad at them because they cared and saw my self-destruction.

During the summer of 2011, I decided to get off the benzodiazepines. My occupational experience and degree taught me that I was playing with fire as these medications are addicting. The truth is, I could not have a conversation without crying. That is what got me through work, but I was only putting a bain aid on a very deep wound. I also had terrible #ptsd that made me see my mom passing on my parent's couch over and over all day long. These images would not stop. They stole my sleep, concentration and eventually, I broke.

I was well versed in all psychiatric medicines as I learned about them in graduate school and dispensed them to patients. I knew the way they worked, why they worked and what they were for. I was always against them because not one patient ever left without a script when I worked in the psychiatric emergency room. I thought they were prescribed far too quickly, particularly to kids. I also saw Dr. Peter Briggin speak on #toxicpsychiatry, and it opened my eyes to a lot of abuse. If you are interested, here is the link to his book

As I was 41 years old and had no epilepsy in my family, the doctors and emergency room staff were uncertain why this happened to me. Thankfully, my toxicology test was clean, yet I still had some doubters. In order to respond to those that thought I was lying, I became resentful, but on the other hand, I understood. I looked like shit, had a shit attitude, and was wearing size 0 pants. I had Anthony come to my appointments and gave him full HIPPA access, so I had a witness to see my labs and attend doctor appointments. Long-term, I get it. If it acts like a duck, looks like a duck, it's a duck, but I was more like a starved seagull! Shitting on a lot in my path. The cliff notes are after 3 doctors I got an MRI with contrast, and they found that my hippocampus was not equal. One side was significantly larger than the other that left me at high risk for seizures. Who knew?

In New York State, if you have a grand mal seizure, you automatically lose your driving privileges for a year. The doctor does not tell the Department of Motor Vehicle, but if you are caught or worse, you cause an accident, you will be in a lot of trouble both with the law and face almost certain litigation. You never know how bad you need a license to drive until you lose it. After my time out, I went back to work, and I noticed a bit of a culture shift. When you are out a year, a lot happens. People move around, take on new positions, added responsibilities, and you have missed a year full of the corporate tea. You are definitely the odd man out for a while.

After being out a year, struggling to keep my head in the game, I forgot a lot on the prescribed seizure medication. It is called Kepra and it was a very bad drug for me to be on for many reasons. Besides memory loss which they did not think was related to the medication, it turned me into a raging bitch. Let's keep it real, I'm not a bitchy person but I also don't take any shit so being on a medication that has rage and aggression as side effects was not a good fit.

My brain was broken. I transposed numbers from spreadsheets to insurance models and any other excel reporting that I had to do. I had piles of half-done projects on my desk because I spent a lot of my "day job" doing not day job things and found myself starting conversations like this "If I have told you or asked you this already, please let me know." I brought outlines to client meetings because there were times that I would be around my team in a conference room on the speakerphone and repeat myself to ask a question that was already answered. I would lose everything and my short term memory was shot. I would get into arguments with people that would say "but I already told you this" and I did not remember.

I saw it, my family saw it, and those that know my work ethic and were aware of my annual occupation performance reviews knew. I had very patient bosses. I talk about them in my book #notinvainapromisekept. They were more than just work colleagues they were family and some pulled me aside to discuss what was going on with only good intention although I didn't know it or take it that way at the time. The ego is a powerful thing. I had a friend in another branch office get early-onset Alzheimers and it was a tragic and terrible nightmare that stole his life at a young age. None of my close doctors knew what to do, so I was recommended to see a doctor who works in a famous rehabilitation center in New York and also treated the New York Giants for concussions, post-concussive syndrome, stroke, and TBI. I'm blessed with Cadillac health insurance but this doctor and the entire hospital only took Medicare or Medicaid. I found it strange because I know what these specialists charge and when they bill the government, the insurance write-off and fee scale accepted is probably 60 to 70 percent less than private insurance. The only thing I can think of is ease from an administrative side in billing because if they took private insurance, they would most definitely make a lot more money. At this point, I'm almost two years post my first seizure. I was desperate,

I paid out of pocket. It was probably one of the best $700.00 I ever spent. This doctor took three hours with me. He gave me a neurological exam as well as paper questionnaires. Anthony accompanied me to help fill in some blanks that I missed and there were many. The good news was I did not have early Alzheimers; the bad news is the doctor said, and I quote, " you have a real problem here with your cognition." He diagnosed me with Cognitive Impairment, NOC (not otherwise classified). That is a big bucket, for we really do not know why your memory and everyday executive functioning is messed up, but organically (MRI) and physically, you have failed our memory testing protocols. Due to the enormity of the unknown, there was also no fix except trying to work on my short-term memory using a speech pathologist for about a year. I never knew this type of treatment was in their wheelhouse. I felt like I was playing the same memory game my son was playing in pre-school, but it had its value and taught me some tips to better organize my thoughts, and the biggest was to write stuff down.

As much as I did not want to see or admit it, my cognitive functioning was getting worse and worse so I had to make some tough decisions. At the end of a 20-year job with an amazing employer, I resigned without any hassle on my terms. I knew in my heart of hearts that a sub-par employee would not last forever. I always got above-average performance dialogues or excellent and there was no way I would allow myself to be terminated from a job that I loved both the people and the corporation.

I was thankful for my work family, for all that I learned, being empowered in a primarily male management team, and the opportunities they gave me to lead and push me to take chances to make executive decisions without the need to go through ten people get an answer. You don't see this a lot in corporate America. Trust me. I have dined with many presidents and C Suite clients. Getting a seat at the table was not easy, but I did it.

I left a very lucrative career that flew me to California from New York for lunch first class and all over the country to become a stay-at-home mom. To be honest, after Luke was born, the late business dinners, early morning limo pick-ups, client dinners, thrill of going to new places became not as attractive as they were before. I had no interest in leaving Luke. In the end, I was able to switch my travel request to others, but I knew that would be short-lived. Eight years later, in the COVID reality, I bet nobody is flying for business, and everyone is zooming in and working from home. If they are flying, it is very minimal. Raising my son and being home with him is the best thing that could have ever happened.

It took me a while to stop resenting those that were mad that my toxicology report was clean all of those years ago because some people can never be proven wrong, but in the end, I know their intentions were to love and caring.

You never know what people are dealing with, so lead with kindness and support.



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