spinal stenosis and dementia

[Guest guest]

Hello all-

I joined the group earlier today and have spent some time reading the

archives. Your stories of pain and some of recovery have been quite

an education. Thank you for sharing them. I hope you'll bear with

me thru this long post - I hope I don't bore but was afraid to leave

anything potentially helpful out.

I joined this group to try to understand a problem we're having with

my dad who's 81, has lumbar spinal stenosis and is in early-mid

stages of dementia. This means he cannot very well articulate what

he is experiencing in terms of function loss or pain (he claims not

to have any). It's my hope someone with more advanced stages of ss

or others with parents with ss can share their layman's experience.

The bottom line at present: My dad's ability to walk with a walker

has been going south over the last year and I got the family doc to

send us a physical therapist to work with Dad. As far as she can

tell, he has sufficient strength in his legs to walk and cannot

determine what the problem is. (Dad gets tired *arms* when he walks

because apparently he's not putting weight on his feet, or at least

he's not by the time he's done going about 50 steps or so.) Perhaps

with his cognitive problems he cannot send the messages to his legs,

but maybe it's also possible he is sending the messages but they are

not getting to his legs. Does any of this ring true with what you

all know about spinal stenosis? Do the nerves in other body parts

sort of " die off " from spinal pressure? Do you " send messages " to

body parts and it doesn't do as you ask?

More medical history is below but I wanted to ask the question early

in this post.

Dad was diagnosed some years back (maybe 10?) with spinal stenosis (I

think L-4 L-5 area, but at least lumbar). At the time the

neurosurgeon basically said it wasn't bad enough to put himself thru

such a surgery. This was reinforced by Dad's knowing two people

who'd had some surgery for ss with no real improvement. He never

experienced back pain as part of his ss, but had involuntary " leg

jumping " while at rest, and sciatica down the legs and butt. Dad

would not go back to the doc after that, always stubbornly hearkening

back to the fact the doctor told him it wasn't bad enough, not

seeming to think an newer look was needed.

The reason his thinking was not good here may have been due to the

fact Dad was also probably begining some form of dementia, as yet

unrecognized. Now, it looks like Alzheimers but may actually be DLB

or dementia with Lewy bodies (which can affect the ability to walk

and may be a version of or cousin to Alzheimers, and is the second

leading cause of senile dementia, and is known to also affect

walking). Since late 1998 we've seen my Dad go from walking with

difficulty (running to one piece of furniture to the next like a

child) to using a cane, to using a walker. There were several falls

in there too. He had quad repair surgery done on his leg a year ago

October and never really walked after that except in PT or the daily

housewalking we do, or to transfer from bed to wheelchair or

commode. Our daily walk around the house a year ago used to be

4 " laps " (about 100 some steps) and has decreased to maybe 1 or 2

laps (25-50 steps). One person walks with him, another follows with

the wheelchair and when he becomes aware he's not going to be able to

go on, we pull up behind him and he sits down fast.

Does this " strength but not able to walk " (or this history) sound

like spinal stenosis in any version you have or know about?

Our family doctor is being- in my opinion- kind of passive about

diagnosing the issue, perhaps thinking my dad's so old or cognitively

impaired that it's best to " let it go " and just cope. My dad can't

advocate for more and in any case, he and Mom are of the generation

that anything the doc says must be right, and they will not change

doctors. Is there some test I should be asking our doc to do or send

Dad for?

Mom and I are trying to continue to care for Dad at home and his

being able to do a small amount of walking is critical to keeping him

here. What do his symptoms sound like and do you have any advice?

Your feedback greatly appreciated-

Sue