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My 80 yo mother has been having memory issues and tremors. I took her to a neurologist for a full work up. EEG normal. MRI normal with two notes pasted below (TIA damage from years ago and volume question). A litany of blood work also came back all normal. Is a PET scan really necessary or might we be better off experimenting with diet (increase omegas, etc) and possibly look at RX interactions since all the aforementioned tests have been normal? The neurologist suggested it was maybe early dementia or Alz but that was before everything came back normal. I am just confused about whether or not to do PET. ** The hippocampal volumes are within the normal range when compared to age-matched controls for this patient. The total hippocampal volume measures 5.75 mL which is at the 62nd percentile when compared to age-matched controls. **There is mild to moderate chronic small vessel ischemia and mild generalized volume loss. Thanks!

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If her insurance pays for it and she and you are OK with it, I’d say go ahead. They inject dye and then watch the progression of the dye throughout the body to see if the dye highlights diseases present (if any), etc. I know with my husband, we had to jump through all the hoops and do all the recommended tests, which showed nothing and gave us no prognosis or diagnoses. But we had to do it anyway. On the other hand, if your mom says no, respect her wishes. It’s not unusual for someone of her years to have memory issues. The tremors would concern me, though. Could they be controlled with meds? Maybe. But before prescribing, her doctor would probably order more tests. Unfortunately, as it worked out for us, they could tell us what it wasn’t, but couldn’t tell us what it was. I would definitely leave it up to Mom and ask her what she wants to do.
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I'd ask the neurologist what the PET is being used for. The answer is probably
" to look for amyloid plaques" which are markers for Alzheimers. They don't show up on CTs or MRIs.

She's already got some vascular changes going on, which can affect cognition.

Have you considered neuropsychological testing, which will show if this is "only" memory loss or loss of reasoning abilities as well? And may give you a sense of how able she is to manage day to day on her own?
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If her insurance approves, and she is cooperative have it done.
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Hey Barb, that's an interesting perspective, thank you. I am going to research neuropsychological testing. Her reasoning is mostly spot on (for 80). It's primarily memory loss (short term) and the tremors that we are concerned about resolving.

Previously, (several years ago) her rheumatologist and her primary were non-communicative which led to many RX problems with very bad interactions. I bring that up only because it caused so many problems that seemed more dire than they actually were, but were really just about poor management of meds (and communication) among the providers.

She is very fortunate and has amazing insurance that will pay for anything. But she's just tired of the tests. I can definitely talk her into it, I just wondered about the value of it with everything else coming back negative plus I didn't want to waste time not examining the alternative remedies.

Thank you for your feedback and perspectives.
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Yes, it’s really up to your mom. My husband was tired of the constant tests as well. And, I could usually convince my mom to have the recommended tests too. In her case, the MRI I talked her into did show Alzheimer’s.

If Mom is done, she’s done. She’s old enough to know what she wants and she wants to be left alone. Explain that to her PCP and ask to explore other avenues for her.
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Make sure before any dye is used her kidneys are checked. Dye effects the Kidneys. This was recommended by the Nurse Practitioner to see what a lump was in Moms neck. As soon as she said she would check Moms kidneys I told her Mom only had one and it worked 1/2 capacity.
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