If you've had a stroke, your first conversations about your symptoms and recovery will likely take place in the hospital. If you're noticing milder symptoms, you may decide you want to talk to your doctor about changes in your thought processes, or you may seek care at the urging of a family member who arranges your appointment and goes with you.
You may start by seeing your primary care doctor, but he or she is likely to refer you to a doctor who specializes in disorders of the brain and nervous system (neurologist).
Because appointments can be brief, and there's often a lot of ground to cover, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready and know what to expect from your doctor.
What you can do
- Be aware of any pre-appointment restrictions. When you make your appointment, ask if you need to fast for blood tests or if you need to do anything else to prepare for diagnostic tests.
- Write down all of your symptoms. Your doctor will want to know details about what's causing your concern about your memory or mental function. Make notes about some of the most important examples of forgetfulness, poor judgment or other lapses you want to mention. Try to remember when you first started to suspect that something might be wrong. If you think your difficulties are getting worse, be ready to explain why.
- Take along a family member or friend, if possible. Corroboration from a relative or trusted friend can play a key role in confirming that your difficulties are apparent to others. Having someone along can also help you soak up all the information provided during your appointment.
- Make a list of your other medical conditions. Your doctor will want to know if you're currently being treated for diabetes, high blood pressure, heart disease, past strokes or any other conditions.
- Make a list of all your medications, including over-the-counter drugs and vitamins or supplements.
Because time with your doctor is limited, writing down a list of questions will help you make the most of your appointment. If you're seeing your doctor regarding concerns about vascular dementia, some questions to ask include:
- Do I have problems with thinking, planning or memory?
- Do you think my symptoms are due to circulation problems in my brain?
- What tests do I need?
- Do I need to see a specialist? What will that cost? Will my insurance cover it?
- If my diagnosis is vascular dementia, will you or another doctor manage my ongoing care? Can you help me get a plan in place to work with all my doctors?
- Are treatments available?
- Is there a generic alternative to any medicine you may prescribe?
- Are there any clinical trials of experimental treatments I should consider?
- What should I expect to happen over the long term?
- Will my symptoms affect how I manage my other health conditions?
- Do I need to follow any restrictions?
- Do you have any brochures or other printed material I can take home with me? What websites and support resources do you recommend?
In addition to the questions you've prepared ahead of time, don't hesitate to ask your doctor to clarify anything you don't understand.
What to expect from your doctor
Your doctor is also likely to have questions for you. Being ready to respond may free up time to focus on any points you want to talk about in-depth. Your doctor may ask:
Apr. 30, 2011
- What kinds of thinking problems and mental lapses are you having? When did you first notice them?
- Are they steadily getting worse, or are they sometimes better and sometimes worse? Have they suddenly gotten worse?
- Has anyone close to you expressed concern about your thinking and reasoning?
- Have you started having problems with any long-standing activities or hobbies?
- Do you feel any sadder or more anxious than usual?
- Have you gotten lost lately on a driving route or in a situation that's usually familiar to you?
- Have you noticed any changes in the way you react to people or events?
- Do you have any change in your energy level?
- Are you currently being treated for high blood pressure, high cholesterol, diabetes, heart disease or stroke? Have you been treated for any of these in the past?
- What medications are you taking?
- Are you taking any vitamins or supplements?
- Do you drink alcohol? How much?
- Do you smoke?
- Have you noticed any trembling or trouble walking?
- Are you having any trouble remembering your medical appointments or when to take your medication?
- Have you had your hearing and vision tested recently?
- Did anyone else in your family ever have trouble with thinking or remembering things as they got older? Was anyone ever diagnosed with Alzheimer's disease or dementia?
- Dementia: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/dementias/detail_dementia.htm. Accessed March 6, 2011.
- Middleton LE, et al. Promising strategies for prevention of dementia. Archives of Neurology. 2009;66:1210.
- Rockwood K, et al. The inclusion of cognition in vascular risk factor clinical practice guidelines. Clinical Interventions in Aging. 2009;4:425.
- Vascular dementia. Alzheimer's Association. http://www.alz.org/professionals_and_researchers_13517.asp. Accessed March 4, 2011.
- Mixed dementia. Alzheimer's Association. http://www.alz.org/professionals_and_researchers_13516.asp. Accessed March 4, 2011.
- Wright CB. Etiology, clinical manifestations, and diagnosis of vascular dementia. http://www.uptodate.com/home/index.html. Accessed Feb. 15, 2011.
- Wright CB. Treatment and prevention of vascular dementia. http://www.uptodate.com/home/index.html. Accessed Feb. 15, 2011.
- Neurological diagnostic tests and procedures. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/misc/diagnostic_tests.htm. Accessed March 9, 2011.
- Carotid ultrasound. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/cu/cu_all.html. Accessed March 9, 2011.
- Aricept: Highlights of prescribing information. U.S. Food and Drug Administration. http://www.accessdata.fda.gov/drugsatfda_docs/label/2010/022568s004,020690s033,021720s006lbl.pdf. Accessed March 9, 2011.
- Medications for memory loss. Alzheimer's Association. http://www.alz.org/alzheimers_disease_standard_prescriptions.asp. Accessed March 9, 2011.
- Caring for a person with Alzheimer's disease. National Institute on Aging. http://www.nia.nih.gov/NR/rdonlyres/E0F45395-A473-4B26-8F7E-86F4314405CE/0/CaringGuide.pdf. Accessed March 9, 2011.