Did you hear something?

I fly in for the appointment armed with a list of questions.

I sit with my mom and probe her for a list of symptoms.

All of a sudden, peculiar things from the past become clear.

After Christmas she called to say there was a rat sitting on the couch. I have never seen an actual rat in my parent's house - but they live on 13 acres - so it would not be shocking. She told me how she sat there and watched it sunning on the back of the sofa for hours.

Another day she called my brother at work. There was an animal making a nest in the living room. She has a beautiful tall bookcase in a corner and this black animal was weaving some type of nest on top of the bookcase. It kept spinning. She could see it from her bedroom. Would my brother mind coming by after work to get rid of the animal. She didn't seem scared.

Occasionally my mom would mention strange sounds or hear something hiding in her closet or feel like there was a person in her house. Sometimes the doorbell would ring - but when she went to answer it - there was no one there. None of us really took it seriously, and maybe that is part of the problem - that this quirky part of her personality did not seem to concern us.

And once - a mentally handicapped man from a nearby neighborhood actually did walk into her house - he was walking upstairs when my sister-in-law walked into him. Lucky guy - he was not harmed. My sister can shoot a rifle better then most men - and after serving in the military, she would have no problem defending her family. He was fortunate there was not a gun laying around (this is in Texas). She escorted the man out and called the police. But you can see why we might think seemingly strange occurrences might actually be true.

Someone once said our house was haunted and occasionally a visitor would mention seeing a strange image upstairs - so when my mom mentioned she saw a women in a blue dress come into her room - we were not shocked. (you can go ahead an say what you are thinking - could we be anymore stupid?).

But here I am armed with a new definition.

Visual and audible hallucinations.

These new words make me feel sick. I'd rather have the ghost.

Mini-mental state exam

After the diagnosis, everyone has an opinion. And most of them have an opinion about the Mini-mental state exam that is used to diagnose Alzheimer's.

How can a few simple questions be used to diagnose such a difficult disease.

And seriously - all she missed was the math question. But it was a hard question! She would have probably missed it even if she wasn't sick. She is notoriously bad at math!

My brother is furious. What a stupid diagnosis. He thinks maybe if she was on anti depressants her symptoms would all go away. Could be true - depression can mask itself as Alzheimer's.

Her friends call me in disbelief. Clearly she has been misdiagnosed.

I call a friend who owns an Elder Home Care company in Dallas. We talk through some of the issues. She gives me the name of a highly recommended Neurologist.

I call to make an appointment. I begin to research. I feel like information might be the only key to understanding what is going on.

Experts and Alzheimer's

My mom makes an appointment with her internist.

My Dad does not seem very concerned. Denial - it ain't just a river in Egypt! He lets her drive herself to the doctor.

She misses the exit. She gets lost. She arrives late.

The doctor calls her in. He asks her about her symptoms and gives her a very short physical exam.

Then he gives her a Mini-mental state exam (MMSE).

• Just a few simple questions - but the answers can change your life.

  Examples of questions include:

  • Remember and repeat a few minutes later the names of three common objects (for instance, horse, flower, penny)

  • State the year, season, day of the week and date

  • Count backward from 100 by 7s or spell “world” backwards

  • Name two familiar objects present in the office as the examiner points to them

  • Identify the location of the examiner’s office (state, city, street address, floor)

  • Repeat a common phrase or saying after the examiner

  • Copy a picture of two interlocking shapes

  • Follow a three-part instruction, such as: take a piece of paper in your right hand, fold it in half, and place it on the floor

  The maximum MMSE score is 30 points. A score of 20 - 24 suggests mild dementia, 13 - 20 suggests moderate dementia, and less than 12 indicates severe dementia. On average, the MMSE score of a person with Alzheimer’s declines about 2 - 4 points each year.

  My mom can't count backwards by 7. Since our family has never been good at math, this is not a big shocker! I would have trouble counting backwards by 7!

  The doctor announces he thinks she is in the early stages of Alzheimer's.

  She is shocked. She can barely stand up from the table. She didn't see this coming.

The A word

I deal with things by researching them. After the flurry of phone calls began, I hit the internet and library.

It's Alzheimer's.

I feel like the word itself is horrid. I can barely say it. It is the word that we do not say. I don't actually say the word to anyone but my husband. Give me almost anything else.

Give me a disease that is treatable. That we can valiantly battle with medication. Give me something that we can fight.

But Alzheimer's. To me, it is almost worse than a death sentence.

It makes the person you love slowly disappear into a shadow of them self. And there is no weapon that you can use to disarm it.

It is a losing battle.

More phone calls

My brother is calling constantly.

Something is wrong with Mom.

But he doesn't not know what to do. He does not know what to say.

Finally he asks, "It seems like you are not OK".

She agrees. Now what do we do?

Phone calls of concern

The three sisters are meeting in Dallas for lunch.

My mom gets lost. She shows up very late and visibly shaken. She is tense. She is cross with everyone and feels like they are making fun of her. She can't believe they picked a place to eat that was so difficult to find.

My aunts start calling, "We are concerned about your mom."

The day after Christmas

No one mentions the Christmas mix ups.

With the stress of Christmas off her shoulders, my mom is back to her old self.

Was it just a fluke?

She seems totally OK today.

It is ok Mommy, I don't care if I don't get a gift

It is present time.

The 9 grandchildren can hardly wait. They gather around the tree.

This is the moment they have been waiting for! They have given all the adults the expected hugs and kisses. They made small talk with the grown-ups. They patiently sat through lunch. Now it is their moment! What treasures await in all those shiny packages under the tree?

My mom mentions that there are a few presents she needs to get out of her closet. OK - this may seem strange to some people, but perfectly normal in our house. My mom has a huge walk-in closet, about the size of my daughter's bedroom. She has always hidden things behind her close so our curious eyes would not find them. A peak behind her clothes will reveal a gift stash that could stock a whole toy store. Her shelves are dripping with beautiful trinkets - just waiting to be beautifully wrapped for a grandchild or friend.

She disappears into the magic closet for a few minutes... And then a few more.

I tell my husband to start sorting the gifts between the kids and I will go check on her.

I find her sitting in a chair looking bewidlered. Presents are strewn across the floor. Some presents are half opened. Others not wrapped at all. A yellow tablet of paper has some names scrawled on it in no particular order.

Mom, do you need help?

I got some of the presents mixed up - I am not sure what belongs to who.

That is ok, let me help. Do you know who gets the spy set?

John. He loves spy things.

My husband walks in. There seems to be a problem. Some of the grandchildren - like my daughter and the oldest grandchild have 5 presents. What a haul!

Some of the grandchildren - my two sons - have no presents.

Oh my. How do we cover this up? It is not that I care about my kids accumulating more toys - in fact - the less the better, as far as I am concerned. But try to explain to a 5 year old boy why his cousin is sitting there with a pile of gifts, while he gets

NOTHING.

Try to explain that Grammy loves him so much, but just happened to forget to buy him anything.

My mom starts to defend herself. "You have no idea how difficult it is to buy presents for so many grandchildren! And then there are birthdays. It is so hard to keep everyone straight."

Yes, yes, I understand - I try to be sympathetic - but right now I am working on damage control.

Change the name on this gift and give it to Evan. Thanks goodness one of the aunts brought an extra gift. We try to arrange things so it is not so obvious.

But it is obvious.

My boys each get one gift.

My daughter gets several.

John opens the spy kit and announces, "Oh boy, now I have 4 of these."

My mom was right - it was a perfect gift for John. So perfect, she had given him the same gift 3 other times.

My six year old son scoots next to me. He puts his head on my shoulder. He had done the mental count (like all kids do) in his head. He has tears in his eyes, but he whispers in my ear,

"It is ok, Mommy. I don't care if I don't get a gift."

I hug him really close. I can't help feeling proud of him. I will try to explain it better when we are alone.

That night I fall into bed with my husband and cry.

Not so perfect

I go into the dining room to check out the table. Here is one thing you should know about Southern women. They know how to set a table. This might be a lost art in many parts of the country - but is still going strong in the South. My mom may not even have the guest list finished for a party - but she already knows what the centerpiece will look like.

And in her large, rambling country house - there is the perfect dining room. A gorgeous 9 foot rustic table - bought even before rustic style was popular. A shining antique silver set on the buffet. A chandelier hangs from the ceiling casting a glow on the bark blue walls. A wall of framed art and old prints from my grandparents homes. And china... my mother has 12 (no, that is not a typ0) TWELVE sets of china! She is crazy about china.

The dining room centerpiece is always well thought out. It will include some natural things like stones or leaves. There will be candles and glass. It will make a statement - but not be so large that it inhibits conversation. It would make Martha Stewart proud. If I am not at the party, she will take a picture of the centerpiece so I can appreciate it later.

When she threw a party when I moved to Europe, she stacked old suitcases, passports and hats on top of the table. She crazy for themes. No candle shop is safe when she is looking for something unique to decorate with.

I walk into the dining room...

and see...

papers.

Papers stacked on the table. Papers stacked on the chairs. Bags stuck in the corner. I have to make a double take. Did I step into the twilight zone? In 40 years, my mom has always set a perfect table. This was not perfect. And there is no way I could get it cleaned up before everyone arrives.

I am not Emily Post. And seriously, I am just as happy to eat on paper plates (it means no dishes) and could care less about a well set table. But this is my Mom. And this is not normal.

"Hey Mom", I ask, "Where did you think we might sit for dinner?"

I thought we might just all sit around the kitchen table.

She doesn't see any problems with having 20 people squished around a table built for 6.

The issue is not that the table is not

perfect...

the issue is it makes

perfect sense

to her to have ever cousin, uncle, aunt and child gathered around a tiny kitchen table.

Making Christmas Dinner

We made plans over the phone. My only request, would she mind buying some dough so I could make cinnamon rolls. She planned the rest of the food - and it was a very ambitious menu: ham, eggs, bacon, biscuits, side dishes, crab toast, etc.

She wouldn't listen to any of my suggestions.

We arrive at the house Christmas Eve. No dough in the house.

Mom, didn't I ask you to buy dough?

Yes, and I looked at it in the store - but it just seemed so confusing.

But you don't have to do anything with it - I was going to make the cinnamon rolls. All you had to do was buy the dough and I will do the rest.

But I don't like cinnamon rolls.

They aren't for you - they are for the kids.

I couldn't figure out which ones to buy.

No problem, I will call my husband and ask him to pick some up.

My mother is very concerned about cooking the meal. She is stressed, but not willing to hand over any of the meal to me. I suggest we wake up early and I will help cook everything. She takes me up on it.

She waked me at 5 am - I didn't mean THIS early. I drag my travel tired body out of a warm bed. I am sleepy, but happy to help.

We start cooking. She looks at me and says, do you mind if I go wrap a gift really quick and I will be right back... I don't see her again for 5 hours.

I make the ham, scramble eggs, finish my beloved cinnamon rolls, cook - cook - cook. I am feeling a little like Cinderella - just here for the work. It feels very strange. Somehow this went from a shared experience to me all alone preparing a meal for 20.

Where are you?

Flying for Christmas

My family was leaving Denver and arriving in Dallas Christmas Eve. The holiday was exciting - presents to wrap, children to pack, a visit to Santa. I was hustling around with 3 small children who were very excited about the season.

2 days before departure:

Phone rings

Well, are you at the airport?

No, why would we be at the airport. We don't leave for two days.

What do you mean?

We still have two more days.

Someone said you were coming today. Aren't you suppose to be here today?

No Mom, two more days.

1 Day before Departure

Phone rings

Well, are you at the airport?

No, Mom. We don't leave for another day.

What do you mean?

We don't leave for one more day. We are arriving Christmas Eve.

Now stop messing with me. Who is playing a trick on me. You are suppose to be here today. Your Dad is on the way to the airport.

No he isn't Mom, he knows we are coming tomorrow.

Well, I can't believe you are doing this to me. Why are you trying to mix me up? Why did you switch the day?

Mom, we were always coming on Christmas Eve. We will be there tomorrow.

Fine.

Appointments

I live in a different city from my mom, but we talk often. Here is a normal conversation.

I went to my hair appointment and they screwed up the times so I had to wait 2 hours.

I went to get my nails done and got the days mixed up.

I showed up for a funeral and sat there and waited for an hour before I realized it was the next day. I went back the next day and waited an hour - I must have gotten the time mixed up.

They changed the time and didn't tell me.

The receptionist was so mean to me and acted like she didn't have an appointment for me.

I went to Dallas and got lost on the way to the doctor's office.

Since my mom does not work full time, she does not have appointments every day - maybe one or two a week. But she is repeatably getting lost and mixing up times.

Each screwed up appointment is a small clue to the bigger picture.

Let me be very clear...

Let me be very clear as to who my Mom was.

My Mom was the beautiful one.

Yes, she has lots of different characteristics and qualities - but the one you couldn't ignore was that she was always beautiful.

Tiny - she was a size 2 when I got married.

Makeup - perfect. After all, she was a Texas woman and Texas women are always dressed to the nines. Her hair cut by one of the top stylist in Dallas.

And clothes... don't even get me started. Well, the woman taught me how to shop. We took two huge shopping trips a very. We arrived when the stores opened and many bags of clothes later, we left with our treasures.

I told someone later, I should have known something was wrong. She arrived at my house in jeans. That might not mean much to most people - but my mom does not do jeans.

And the next day she wore jeans. And every day after that she wore jeans. And a really ugly striped jacket that was 2 sized to small.

I remember telling my husband, "She doesn't look like my mother." But that was before we knew.

There were small signs.

She would start talking to one of my friends and not know when to stop. She would monopolize the conversation. But that could be anything.

She started to gain weight. She has always been very careful about what she ate and never weighed more than 112. Now she ate everything. She did not even seem to notice she was eating. She would snack on chocolate or bread and then announce she hadn't eaten all day and was hungry. She gained 10, 20, 30, 40 pounds... and so on.

But the signs were subtle. Hidden behind the mother that I knew.