Alzheimer’s or NPH?

Alzheimer’s.   You undoubtedly know someone who has it, or had it.  We all know the symptoms and how sad it is to watch our loved ones forget and fade away.  We know what it can do to families.  But do you know about NPH?  It stands for Normal Pressure Hydrocephalus.  This condition mimics Alzheimer’s!  It is thought that approximately 10% of those diagnosed with it actually have NPH.  And, the most amazing thing – it can be cured.

My mother-in-law was diagnosed originally with Alzheimer’s and for the past 4 years, her active life virtually stopped.  At 75, Mary was downhill skiing!  At 79, she was in a wheelchair.  And, now, at 80, with her 81st birthday right around the corner, she is up and walking, around the house – and around the block! 

Mary was one of the lucky ones – a stranger spotted her walking across the street with her caregiver last Father’s Day.  The man who saw her (we call him our special angel) noticed the cardinal sign of NPH – her shuffling gait.  He approached her husband and asked if she’d been tested for NPH.  He explained what it was and that his mother-in-law had just gone through the procedure.  She was out of her wheelchair, too, and now, he was out there in the world making sure anyone and everyone knew what to look for.

Mary had the test – a simple CAT scan – and sure enough, she had NPH.  Just what is this anyway?  Simply put, we all have about one ounce of fluid on our brains.  People with this condition have ten ounces, thus the pressure placed on the brain causes three things:  memory loss, the shuffling gait and incontinence.  The next step was to drain a small amount of fluid off her brain to make sure she was a candidate.

The day she had the test done, she sat up alertly in her bed and for the first time in years, spoke clearly and seemed more alert.  Her son sat by her bedside, chatting with her, hoping she’d say something that would give him a sign.  She looked straight into his eyes and said, “They gave me memories.”  Small flashes had already started coming back – a day at the beach, an old friend, feelings of familiarity.  A few weeks later, the procedure was scheduled.  A small shunt is placed in the head, just behind the ear, with a tube the size of a pencil lead that drains the fluid off and down into the abdomen. 

We arrived at the hospital the morning after the shunt had been implanted.  She slept most of the day.  That evening, we went to visit.  She was confused and irritable, insisting her husband “bring the black car” so she could go home.  She was not pleased being in the hospital – again.  Her daughter helped her eat her dinner, spoon feeding her every bite. We said goodnight and went home. .

Morning came.  The doctor called telling us she could be released that afternoon.  On this day – just 24 hours after surgery – she sat up in bed, her hair looking a bit like a punk rocker – they had to shave a good portion to place the device.  Her breakfast arrived – pancakes and eggs.  This time, she sat up, eating on her own and with gusto – big chucks of pancake dipped in syrup and every speck of egg.  She just kept eating!  By afternoon, she was ready to go home.  The therapist came in to ask her all the routine questions. His name was James and he was gentle and kind.  “Do you know your name?” Mary Frances, she stated, very matter-of-factly.  “Do you know what month it is?”  Not a clue, she said.   Then, he asked her:  “Do you know what day it is?”  A smile broke across her face and she glowed like the sun rising in the east, “It’s a good day,” she said.  James smiled, too.  That’s the best answer I’ve heard all day, he said.  Indeed it was.

 ** If anyone you know has been diagnosed with Alzheimer’s, please pay attention to these three signs:  the shuffling gate is #1; memory loss and incontinence.  Have them tested – you could save their lives.  Contact me at and I will put you in touch with a doctor in any state.


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