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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Lonely on February 7, 2006, at 23:14:37
My hubby, who is diagnosed w/Bipolar 2 and/or mood disorder plus multiple sclerosis, just finished a neuropsych test session that lasted about 8 hours. This is his 3rd test (previously diagnosed w/stroke which was wrong)- he even remembers the questions although he said he's having more trouble answering and performing the tests.
1. He was tested by a person with a MA who is some sort of assistant but NOT a psychologist. Is this really ethical? From what I've read, it's important for the neuropsych to know the patient and the neuropsych only met w/my hubby for a few minutes. Doesn't the test giver need to be extremely well trained and experienced i.e. many things to think about and look for at many different levels on the part of the test giver?
2. My hubby claims the neuropsych told him his test would be over at a certain time but the tester planned to keep him there for at least another 1-1/2 to 2 hours beyond that. Hubby has memory and comprehension problems (they knew it from previous neuropsych tests)so I was no little bit peeved after driving across town. I informed him he was leaving then. He finished the test last week on Fri. Feb. 3rd. He could have finished at an earlier date but was tempermental. Could this have skewed the test and also the attitude of the clinic negatively towards me? (I think it did - partly because my hubby has been known to come up w/a lot of bologna.) MS patients, I've been told, are different than the general population or than AIDS or Alzheimers type patients.
3. From what I've read, errors are very common in neuropsych testing and the testing doesn't really apply to home type issues. Do they ever do home studies? W/MS I know the response can vary considerably. So far it has not helped at all and is always very stressful.
4. The test giver said that the neuropsych likes to see patients right away after the test so hubby scheduled an appt as soon as the clerk was there. The earliest available (allegedly) was Feb. 22nd and this was requested on Feb. 6th. He asked them to fax the report (we know it's just sitting there ready to go) and I called and asked them to fax the report. They said they would but then said she would have to ask the psychologist in the morning. They never faxed it. They offered him an appt. on Feb. 8th but then called back and cancelled it claiming the doctor had to go someplace. Is this a bit of "jerking around"? I know the results are bad and I don't even want to go to a feedback session based on experiences w/unethical psychologists in the past.
5. Is it legal to demand they send the report? Is there some way I can push it? I want to get this over and get some help - at least for myself, as I don't think there is any for him.
Thanks ~~~
Posted by James K on February 8, 2006, at 1:22:08
In reply to Neuropsych Testing, Validity, Feedback/Report, posted by Lonely on February 7, 2006, at 23:14:37
I don't have the answers to you all your questions, but to subject someone with MS to a test that long seems like they are looking for an exacerbation. You have an absolute right to the results of your tests. Please take it easy on yourselves and firmly but calmly get what is coming to you. Mainly I want to say this seems harsh and you have my sympathy. Someone else may have better concrete answers to some of this.
James K
Posted by Lonely on February 8, 2006, at 1:47:38
In reply to Re: Neuropsych Testing, Validity, Feedback/Report » Lonely, posted by James K on February 8, 2006, at 1:22:08
Thanks, James. I appreciate your comments.
It seems to me too that at least 8 hours of continuous testing (they allowed 45 mins for lunch) is asking for an exacerbation of MS. I know extreme heat, stress, and lack of sleep can and does trigger them. My hubby is still working and putting in 8+ hour days 5 days a week so possibly that indicated he could deal with it. He's also walking although w/some difficulty. Fell down twice on the way into the test building and hit his head on cement. He was alone.
From what I've learned in a support group, and this includes an MD w/MS, they do it intentionally because there are things they need to know about the way the patient responds as they get tired and how fast they get tired and how their response starts slipping. An MS'ers response is different than that of other brain disordered patients. The best I can say for this neuropsych is that he's very familiar w/MS. Slight lack of insight into the fact that this disease affects the whole family, though, and that the caregiver needs support and needs to be involved in the process.
This test was ordered back in Sept. of 2005 by a neurologist and it took until mid Jan. to finally get the test started partly due to insurance, ignorant primary care doc, and especially the ornery neuropsych who said he would just run the test and then submit to insurance for payment! That's the part that blew me away - we are in an HMO and NOTHING is paid unless it's approved FIRST!
At the first meeting he insisted upon talking to my hubby alone which I didn't want. My hubby doesn't report symptoms or meds correctly and gets confused about appointments and other important details. I walked out and left him there. The neuropsych still has not interviewed any family member or anyone close to my hubby. To me that seems like bad healthcare - at least it's lacking. So, there's some tension over all this.
I'd like to hear from others too who've had neuropsych experiences.
Thanks again to all of you out there who are reading this.
> I don't have the answers to you all your questions, but to subject someone with MS to a test that long seems like they are looking for an exacerbation. You have an absolute right to the results of your tests. Please take it easy on yourselves and firmly but calmly get what is coming to you. Mainly I want to say this seems harsh and you have my sympathy. Someone else may have better concrete answers to some of this.
>
> James K
Posted by fairywings on February 8, 2006, at 9:07:53
In reply to Neuropsych Testing, Validity, Feedback/Report, posted by Lonely on February 7, 2006, at 23:14:37
Hi Lonely, like James, I don't know the answers, but my sister has MS, and my dad had the neuropsych testing for Alzheimers. It's grueling, and 8 hours does seem like a LONG time. I wouldn't want to have to do it! What was the reason for having it done? Anyway, my sister hasn't done it. She is doing well mentally, just not physically, she's pretty frail. My dad had the testing, and it was done by the doctor along with a lot of talking. He told me, at the time (he's gone now) that he was miffed, so he didn't do as well as he could. Don't know if that's true or not. A lot of things could trigger him, and def. a lack of food or sleep triggers my sister.
Sounds like you feel like you're really getting the run around. Any other place to go for all of this?
fw
Posted by B2chica on February 8, 2006, at 9:15:48
In reply to Neuropsych Testing, Validity, Feedback/Report, posted by Lonely on February 7, 2006, at 23:14:37
my T told me once that there are MA level therapists that specifically do testing for the psychologist but that the psychologist evaluates them, the assistant? just administers them. he had a name for them but i ccan't remember what it was.
there may be issues about faxing them to you...not sure if they can for privacy issues...surprised they told you that.
don't have many other answers for you but it sounds like a horrible situation. i hope it gets resolved soon. i mean the psych could at least call you back and respond about your appt date.
best wishes
b2c.
Posted by Lonely on February 8, 2006, at 19:02:54
In reply to Re: Neuropsych Testing, Validity, Feedback/Report » Lonely, posted by B2chica on February 8, 2006, at 9:15:48
The neuropsych testing was ordered when we took my hubby to a new neurologist in a major medical center where they specialize in MS. Because of my hubby's problems with anger, depression, moodiness, etc. I followed the advice of a knowledgable person from the support group and asked if we could see the social worker affiliated w/the MS clinic. The neurologist hesitated, then side stepped my request by saying that the first thing to do was a neuropsych study to see what is psychiatric (mood disorder, mental illness) and what is caused by MS. That was back in September!
This is a very interesting situation ... I'm reading lots of conflicting information about psychiatric disorders and MS. Traditionally it was thought that MS just caused physical disability. But, from what I've read, bipolar disorder is twice as high in folks w/MS. Depression is about 70%. The loss of cognition is known to happen in many MS patients but traditionally wasn't talked about much. For that matter, if it wasn't for the MRI, we would never know he has MS - it was misdiagnosed as stroke. The false theory is that men don't get MS very much - especially older men.
The psychiatrist that he goes to, whom I like, indicates there is no way to tease out what is psychiatric and what is MS. The MS meds are certainly not helping. MS does affect the brain and presumably any disease that affects the brain can also affect behavior. So, I guess it's a little bit of an academic question re psychiatric versus MS.
I appreciate hearing from other people with these brain & psychiatric disorders.
This is the end of the thread.
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