In order to explain why I chose to name my blog “Navigating Hippo Hollow” I need to leave the past and jump to the present. Please bear with me as I explain.
We just had to take Tom for an MRI to access the progression of his disease. As I wrote earlier, a good twenty years ago Tom had “foggy days” and sought the help of a neurologist. At that time the MRI showed nothing. In 2012, the MRI showed some shrinkage of the brain, and in 2017, when we sought the help of the Dorothy Adler Geriatric Assessment Clinic he had a 3rd MRI as part of the extensive and thorough diagnosis process. Now the doctor at the Adler Clinic wanted Tom to get a 4th MRI to see how the disease was progressing.
I scheduled the 3D MRI appointment at Yale and checked out the pandemic protocols. I was a bit concerned because visitors were not permitted, but it did say that necessary caregivers could stay with the patient. On the morning of his appointment we drove to the site and sat in the parking lot preparing to go in. I gently told Tom that I might have to explain me being with him, that for today I was his caregiver instead of his wife. He agreed, because he knew he could not find where to go without me, and he was nervous. We went into the building and they checked our temperatures and asked the usual Covid screening questions. We were directed to proceed to the check in desk. I had his insurance card and license ready, when all of a sudden I felt a tap on my shoulder. A woman in a navy blue power suit was standing at my shoulder, and she said ” Is there any real reason you are here?” I was surprised, as I had been focussed on getting Tom checked in, and I asked her to repeat her question. She got a bit louder, and again asked if I had a real reason for being there. I looked at Tom, who seemed nervous and confused, and I said to him ” I’m going to have to explain.” Then I told the woman that there was a real reason, that Tom had confusion ( I try not to say dementia in front of him) and I needed to be sure he got to his MRI appointment, and then was able to find his way back to the car. I started to say more, but the woman realized the situation and quickly said ” you don’t have to say anymore, I’m so sorry! I’ll call upstairs and let them know.” With that, she hustled away. But I was left feeling stomach sick. And I can’t blame her, she was doing her job and Tom looks so healthy and strong that from the outside it is hard to know that he really cannot handle much without assistance. And this reminded me of all those times I have mentally questioned people in handicapped spots because they appeared able bodied.
Anyway, back to the title! So the 3D MRI was taken and I got Tom back to the car and home without further incident. A day or so later I was notified that we had a new MyChart message, it was the MRI report. Now our appointment with the Dr to go over the results isn’t until later this month; but, I have read the report and it showed more shrinkage of the brain, specifically the hippocampus, which was in the 1% volume range for people Tom’s age. This freaked me out because, as a former educator I am used to dealing with percentiles, and I don’t think I have ever seen such a low percentile rank. But it did explain why his disease has continued to progress, and it was clear evidence that his dementia ” was not just in my imagination” as some family members are prone to saying. This was tangible evidence that his brain was deteriorating.
A day or so later, Tom and I were having a glass of wine and chatting, and he asked me about the MRI. Now I had hoped he had forgotten about it, but this was one of those lucid moments. I told him that there was a part of his brain called the hippocampus, and that controls short term memory and navigation, and that the MRI showed it had gotten much smaller. My husband looked at me, and said with a straight face ” So I have a hippo in my brain?” And I said to him, “yes and it has lost a lot of weight”. He said “okay’, and took another sip of his wine. And that was the last he ever said about the MRI or the findings.
The MRI findings haunted me, and I kept replaying the “hippo” discussion in my head. And then I decided to write about our experiences, and needed a title. Hence Navigating Hippo Hollow:).