Neuropsychology Central

NurseJulie · Joined: 02 May 2005 Posts: 2

I am a nursing student going for my BSN (RN) and I've had this percistant problem all my life of forgetfulness, blanking out (recently 6mths), unaware to the point where I'm oblivious to my surroundings, etc...The list goes on. So basically, I need to get tested by a Neuropsychologist but am deathly affraid that I might not get by RN license because of something the doctor might put on my medical record. I've spoken to a neuropsych over the phone and he says I have "complex partial seizures" and if that EVER was to be put on my medical record I would never be able to obtain my RN license. He states he would not put that on my record even if I was diagnosed with the disorder, however I don't trust anyone and I still want to be cured of whatever it is that I actually have. Should I go ahead and see the Neuropsychologist and risk not getting my RN license, or should I play it safe and not even go? PLEASE HELP.

Helix · Joined: 11 Oct 2004 Posts: 19 Location: Germany

Hello NurseJulie,

I am amazed about your phone-counselling NP! What a tough job, doing this highly complicated diagnosis by just a single phone call! An epileptic disorder has to be diagnosed by a neurologist and has to include a long-term EEG observation. Of course, the phenomenology of complex partial seizures could explain your symptoms, but other neurological/psychological/psychiatric disorders must be excluded. This can't be done by phone.

As far as I am concerned, there are three questions you should ask yourself: First, do I want clarity about my situation, my symptoms and how to treat them or can I live with not knowing what's going on inside of me? Second, can I manage this highly stressing job, knowing that stress is the number-one-trigger for my symptoms? And if I decide not to contact a NP and not having my symtpoms treated, can I take the responsibility if things go wrong while I am in charge (e.g. because of a black-out)? Concerning this last question, you must not fool yourself, so imagine the worst-case scenario of someone dying.

If your symptoms are caused by epileptic seizures this can be treated by antiepileptic drugs in conjunction with psychological counseling concering stress-avoidance/relaxation, day-structuring, sleep hygiene, diet...

Bye,
Helix

tob7799 · Joined: 28 Apr 2005 Posts: 6 Location: Los Angeles

I just wanted to reinforce what Helix said. I think that you NEED to go ahead and find out what the underlying cause of your symptoms are. As a health care professional you are responsible for your patients' lives. If your condition goes untreated your symptoms could cause harm to someone else, or cost them their life.

If you consult a doctor regarding your condition, it is likely that he or she will be able to treat you with medication, and you will be able to live a healthy and normal life. That's not a guarantee of course, but is sacrificing someone else's life worth the risk??

Guest · Posted: Tue May 10, 2005 3:08 am Post subject:

I understand completely. I need to get checked up because this problem continues to effect me and everything around me. I have done a lot of research these past 48 hours and in my opinion I do not have seizures, rather Anxiety. However, I am not a professional and cannot make that assessment. I've also read that Neuropsychologists and doctors have misdiagnosed patients and have distroyed their lives. I suppose that is a risk I'll have to take and hope that this turns out for the best. Today I called my neuropsychologist back and told him I'd make an appointment, however the earliest he can see me is in a month. He also wants to charge $1500 for the first visit which includes a 6-8 hour evaluation. Does that sound accurate?

NurseJulie · Joined: 02 May 2005 Posts: 2

I understand completely. I need to get checked up because this problem continues to effect me and everything around me. I have done a lot of research these past 48 hours and in my opinion I do not have seizures, rather Anxiety. However, I am not a professional and cannot make that assessment. I've also read that Neuropsychologists and doctors have misdiagnosed patients and have distroyed their lives. I suppose that is a risk I'll have to take and hope that this turns out for the best. Today I called my neuropsychologist back and told him I'd make an appointment, however the earliest he can see me is in a month. He also wants to charge $1500 for the first visit which includes a 6-8 hour evaluation. Does that sound accurate?

Also, (I don't mean to make this real lenghty), but I haven't stopped thinking about this and I realize this has been going on ever since I can remember. Even as early as Elementary school I can recall instance after instance of these same problems occuring. Its scary.

dbabbage · Posted: Tue May 31, 2005 8:02 pm Post subject: Clarify your needs

Greetings NurseJulie,
It may be that events have passed by now, and this is no longer relevant. However, if you are yet to go through with your assessment, I wonder whether it would be useful for you to take a step back and clarify your needs at this point?

I agree with the previous respondent. It is vitally important that you clarify what is happening for you, and seek appropriate input. You would be putting both yourself and others at inappropriate risk if you were to ignore your symptoms in order to try and protect getting your registration. Would you really want to become an RN if you knew you were unsafe to do the job? On the other hand, it may be that the symptoms you are experiencing would be deemed to not affect your work at all, or might be entirely treatable. In such circumstances, it would be excellent for you to find out.

However, is a full neuropsychological assessment the first step? In neither of the two possibilities you outlined—complex partial seizures and anxiety—would a neuropsychological assessment of your cognitive functioning be what you require. In the first, a neurological assessment with EEG would be indicated, in the later, a psychological assessment and consideration of treatments including some form of therapy and/or medication may be warranted. However, I also wonder how these two possibilites were identified. It sounds like the first was suggested from a phone call, and the latter is your own diagnosis.

I would encourage you to invest some time, and money, in getting a clear diagnosis of what is going on. If that involves a neuropsychologist, that should certainly involve an interview with you prior to deciding whether it is necessary to administer 6-8 hours of tests (which would, of course, be at your expense). If your neuropsychologist is not willing to consider this, perhaps it would be useful to consider seeing another psychologist first? An initial consultation over one to two hours might give a much clearer picture about whether neurological, neuropsychological, or psychological issues should be pursued. If anxiety is indeed identified as the underlying issue, you may never need to see the neuropsychologist and could possibly put that $1500 into making progress on addressing the issue.

I would encourage you, regardless, it will be better to face these issues than to attempt to keep them quiet. If these are ongoing difficulties for you, they will be seen in your workplace in the future anyway. It is better to manage this proactively, than to have to answer difficult questions later.

All the best as you work through these issues.