September 18, 2007

Picks Disease - Aphasia and Leaning (to the left)

This past August marked the 6 year anniversary of our move to Colorado to help my mom cope with my dad who has Picks disease.  When we first moved, we assumed that we would be here two years, three at most.  We were told upon diagnosis that my father would most likely only live another 6 years from that point. (He was diagnosed in the spring of 2000. The disaster of Y2K came for us in the form of a disease rather than a coding glitch.)  But the 6th anniversary of his diagnosis has not only come and gone, but physically, my dad's health has remained quite strong.  He continues to be active, walking as much as 5 hours a day.

For several years, friends would ask how my dad was doing.  I'd shrug my shoulders and say, "He's about the same."  It was a disappointing answer to be sure -- disappointing on my end because, though things never got better, they never got worse either, meaning the end was still a long ways off; disappointing on my friends' end because I could tell by the tone of their voice that the lack of "events," tragic moments that I could cling to tearfully as signs of my dad's descent towards death, meant they were beginning to doubt if there really was anything wrong at all.  In fact, when my friends saw my dad, he looked not only fine, but quite healthy.  It wasn't until they talked to him that they might think him odd.  But it was only if they'd known him before the disease that they'd have a true sense of the change that had befallen him.  (For a taste of what it as like to spend a minute with him during that time, see my post, One Minute with Picks Disease.)

But this past year there has been a noticeable difference in my dad.  He does less (no more picking up coins in parking lots, moving pictures around on the walls, or doing dot-to-dots) and paces more (activity without productivity -- not that his previous actions were all that productive).  He nervously rubs his thumbnail across his pointer finger to the point where he's worn a groove in his finger.  He's confusing our names more often.  (He knows I'm Meg, but he doesn't seem to know what our relationship is.  And my mom has become his mom, even when his mother is in the room with them.) 

He's also, oddly enough, started to lean.  He doesn't always lean.  In fact, it only seems to happen a few times a week, most often when he's walking around my block.  But he'll round the bend and there it is, he's leaning to the left.  He doesn't seem to notice.  And after awhile he straightens back out.

And he's becoming increasingly silent, entering into the aphasia stage of the disease.  Some people with Picks hit this stage straight out, losing their ability to speak before they even begin to lose memory or ability to reason. But for my dad it's been gradual, sneaking upon us so stealthily, that when it finally dawned on us that he was losing language, he had already been reduced to about 500 words.  I don't know that he even understands most of what we say.  When asked a question, he will most often either ignore it, or nod his head and say "yes" before walking away.

Oddly enough, despite the fact that he's lost reason, memory and language, he has retained mechanical ability.  When I picked him up from day care yesterday, he was in the yard behind the building and the fence had a clip that kept the gate from opening.  There was another gate that wasn't locked, so I directed my dad toward it, but while I was busily gesturing and explaining, he walked right over to the closest gate and figured out how to undo the clip that was locking the latch.  He walked out without a word and headed straight to my car.  Before slipping into the passenger's side seat he muttered vaguely, "Let's go shopping, Meg," one of his few remaining phrases.