Brief Answer:
Good news......your memory is likely very much intact

Detailed Answer:
Good morning young lady and all the best in your ongoing studies.....let's try and smooth a few rough edges out for you though so the boat can sail a bit straighter in these choppy waters.

I've carefully read your complaints and concerns. I am of the belief that when all is said and done the root of the problem with your feeling that you are unable to access or form memories will be in issues of a NON-NEUROLOGICAL NATURE. That means that you will not be found to be suffering from any sort of dementing illness, organic brain disease, or neurodegenerative type of problem as the cause of your symptoms. I can support this hypothesis simply on the basis of your rather complex, well structured, and well thought out discourse on your complaints above. If you read between the lines you will see that you have a very good working memory which is both long and short term in nature. You'd absolutely have to in order to write what is above.

Having said that, I don't doubt in the least that you are frustrated, having difficulty accessing your memory, and likely suffering from other issues that can block, stall out, or even prevent perfect memory formation or recall but the good news is that your ANATOMICAL STORAGE area is likely very much intact and functional. You'll just need to find out how to get rid of all the "clutter" that's blocking your way to that storage area......much like a person who doesn't keep a very neat house and you can't get from the front door to the bedroom because everything is thrown across the rooms and the path it may take a person forever to safely make it to the bedroom....but once the clutter on the floor and all around is straightened out.....NOW, the passage from front door to bedroom is straight and effortless. Make sense?

I believe that you may greatly benefit from a few things:

1. Review of certain basic labs if not done in the last 6-12 months (Free T4, TSH, Vit. B12, Vit. D, D2, and D3).

2. Neurological examination to ascertain if there are any CNS axis deficiencies that need further elaboration by either bedside or testing procedures.

3. Neuropsychological examination which can very sensitively tease out the grounds for an organic type of dementing process (highly unlikely) vs. a nonorganic source of problems. This can then, help in determining the best course of action for treatment/counseling purposes.

4. Pending neuropsychological results I might reserve a brain imaging study such as an MRI of the brain (likely without contrast) just to look at architecture which is in all probability 100% normal....nevertheless, I would defer to the final results of both a neurological examination as well as the neuropsych testing results.

If I've satisfactorily addressed your question then, could you do me the kindest of favors by CLOSING THIS QUERY and be sure to include some fine words of feedback and a 5 STAR rating to our transaction if you feel the response has helped you? Again, many thanks for posing your question.

Do not forget to recontact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 17 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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Brief Answer:
Not sure the letter referred to but suggestions above can be printed

Detailed Answer:
Thank you for your questions. Please understand this service is a place where you are able to ask questions about your medical condition and obtain limited information since we cannot actually examine patients or perform tests/studies. There is capacity for any physician on this network to write or compose letters, prescriptions, lab orders, or anything that would carries any authority with any physician either locally (if in the U.S.) but especially abroad. My licensure in the U.S. allows my practice of medicine to be within the state/territory to where I am assigned but no further.

The recommendations I've made are in clear response to your clinical questions but this is not the same as assessing you formally which would require a clinical examination. It would be very possible though for you to print out what I've written as suggestions to take to your primary doctor or specialist in order to begin a dialogue or discussion of this matter. You may tell your doctor that upon inquiry of a specialist (albeit from an international location) following recommendations were made: A, B, C, D, etc.

However, your doctor is ultimately the one who decides whether or not to send you for any tests or on consult with a specialist. Remember, you are under a National Health Care Plan in Canada that only recognizes the authority of Canadian licensed doctors and perhaps, it's even by Province...I don't know. In the States, we are only allowed to practice within our respective state of licensure. Mine is Ohio.

If you would like to come to XXXXXXX (beautiful city on the edge of a renaissance) then, I could speak with you, examine you, and order appropriate tests that could even be done here if you wished or you could be seen and get orders complete with a full medical report should you desire which you could take back to Canada and see if they'd be willing to follow through with the tests and/or studies recommended. However, obviously, that's a costly solution to your problem.

I'd advise you simply print out what I've written and take it to your primary doctor for a discussion. I've heard from many patients who have successfully taken copies of what I've written and that their doctors are happy to follow the advice.

To your questions of what should the diagnosis be if not a neurological deficiency then, it would depend on the conclusions of the neuropsychological examination. I cannot predict what that may or may not demonstrate. That is usually a battery that can take 3-5 hrs. to administer. Many tests are performed and the analysis of those tests and compilation of results is very complex and detailed.

I feel that stress and tension are clearly a component of your problem and that the use of relaxation techniques and other approaches to reduce stress would be of immense help to your situation. For better direction in those sorts of strategies, again, you would want to solicit the services of your primary care physician who could then, decide the best person to refer such as a counselor/therapist, etc.

Plans then, could be modified depending upon the results of neuropsych testing, and other things I mentioned.

Do not forget to recontact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. All the best to do. I look forward to hearing about any results you may get following testing if you can be approved.

This query has utilized a total of 66 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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