HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

What Causes Microvascular Ischemic Disease?

Posted on Tue, 17 Jan 2017

Question: I have been diagnosed with microvascular brain disease by a neurologist, following a referral after an eye exam that indicated left eye ptosis? My mother died after 7 years old Alzheimer's? Do I have a future? I am 68, 69 in January. I have chronic pain from fibromyalgia, chronic migraine, alleviated after 40 years by TMS therapy, and non diabetic neuropathy, Reye's syndrome, and clinical depression. I am treated for all of these by board certified doctors, overseen by my PCP, Dr. XXXXXXX XXXXXXX a gerontologist. I am fully prepared to end my life now, under my own circumstances. I have close family, 9 blood siblings, a practically perfect daughter, many devoted friends. I currently live alone, and have no wish to be or to become a burden to anyone. What do you think? I have a masters degree in English/ dramaturgy, and XXXXXXX generally considered witty and intellectual. I do not want to endanger others by driving if I shouldn't be driving, or by acting in any other rational manner. I see a psychiatrist every 3 months for Rx of cymbalta, which I take twice daily, 60 mg each dose. I also have a keenly insightful therapist. Additionally, I have had bariatric surgery, successful after 5 years out--BPD/DS done by Dr. XXXXXXX Boyce, and monitored at least annually by copious blood tests and nutritional counseling. I do not particularly wish to live under demented circumstances. I'm willing to be a guinea pig for whatever studies might be indicated and availablele in the East TN area. I'm also willingly and, so far able to travel, but not at my own expense. I have a PTSD diagnosis from the Basie of an abusive marriage, and I depend solely on XXXXXXX and teacher retirement pay. I do not wish to be remembered as either "Alice" or as my own mother.

Sincerely,
XXXXXXX XXXX
0000 XXXXXXX XXXX

0000- call or text
0000- home
YYYY@YYYY

Answered by Dr. Olsi Taka (2 hours later)

Brief Answer:
Read below

Detailed Answer:
I read your question carefully and I understand your concern.

However I think you are being too pessimistic. If what anguishes you this much is the microvascular disease then you should know that it doesn't equal dementia. Actually after the age of 60 microvascular changes are a very common finding. In a way they are part of aging. Simply having microvascular disease doesn't mean you have dementia, most patients function well in their daily lives.

It is only in a small portion of patients with very advanced widespread changes that dementia may develop. Even then it is not imaging which determines that, it is neuropsychological tests which assess cognitive functions, often there is discrepancy between imaging and cognitive state. So to assess your condition reports of imaging and neuropsychological testing are needed.

So you should talk to your doctor about those reports and the degree of changes. Should also share how you are feeling now as I suspect depression is playing its role and treatment prescribed by your psychiatrist may need to be re-evaluated.

I remain at your disposal for other questions.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar