Normal Pressure Hydrocephalus
Yesterday I heard an interview of internist Dr. Marc Siegle who speculated that President Biden’s frequent falls and occasional confusion could be explained by this disease, normally referred to as NPH. I am not surprised, for I, too, suffer from it.
I cannot walk any distance unaided. I often sleep most of the day. I have expressive aphasia, a result not only of the NPH but of multiple Cerebro Vascular Accidents, or strokes. I’ve also had at least a dozen mini-strokes, or TIAs (Transient Ischemic Attacks), which exacerbate the aphasia. According to the Johns Hopkins Medical Center, the common symptoms of NPH are
· Trouble walking (feels like the feet are stuck to the ground)
· Poor balance
· Falling
· Changes in the way you walk
· Forgetfulness and confusion
· Mood changes
· Depression
· Difficulty responding to questions
· Loss of bladder control
The condition is incurable but can be treated with a shunt installed by a neurosurgeon, which drains excess cerebro-spinal fluid into the abdominal cavity. If nothing else proves fatal in the interim, the disease slowly devolves into non-Alzheimer’s dementia. In my case, my history of cancer, heart attacks, strokes, COPD etc, will almost certainly take me before the NPH strikes.
Diagnosis
The disease is typically diagnosed with a CT or MRI. The resulting image is almost indistinguishable from both Creuzfeld-Jakob Disease, the human version of mad cow disease, and brain atrophy. CJD is very rare, but brain atrophy is not. It shrinks the brain but does not necessarily reduce cognition. The most famous case of brain atrophy is Stephen Hawking.
MRI of NPH Brain
This would explain why MRIs and results of cognition tests have not been released. An MRI could most certainly be misinterpreted by a lay person, and even medical professionals do not always get it right. Cognition tests, however, are easy to understand. In medicine we classify cognition as an orientation scale of Zero to Five. Zero is brain dead. Five is fully aware. I am oriented x4; my estimate is that the President is oriented x3. However, even I don’t fully trust my judgement.
Indecisive
If Dr. Siegle is right (I suspect he is) then what we’ve seen is explainable by the complication resulting from the interplay of symptoms: indecisiveness. That is the real danger to the country from Joe Biden. It’s always easier to let someone else (Jill, Chuck Schumer, a Chinese Case Officer) make the decision. It just terrifies me that Dr. Jill might be running foreign policy.
Mrs. Jill Biden.... this is your husband. #stoptheelderabuse.
I was (and remain) a huge fan of BOSTON LEGAL. Denny Crane's belief that he had Mad Cow were entertaining. When I read that POTUS 46 probably has it and that his power mad wife "the DOCTOR" is now making the decisions that impact (and may destroy) the world is troubling.
Your writing is, as always, impeccable. God bless you, my friend.