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Friend of stroke victim with Thalamic Pain Syndrome

Question: I have a friend who had two strokes about 12 yrs ago and has suffered with horrible migraine type pain that he says is 24/7 365 days a year at the level of 7-10 on the pain scale. He does not remember before his strokes, and he loses a lot of memory day to day. It just slips away. I sometimes don't understand why he even remembers me at all. Our relationship when we met was intense and we talked many hours a day as he can't work and I was only working part time. But slowly he has been falling away from me and says he can't remember most of what we have done together and just recently sort of admitted he doesn't remember how he feels about me although he still talks to me almost every day and calls me pet names that he has had for me. I am having a hard time dealing with this. I want to be very helpful and caring and understanding but he is falling away from me and I have put a lot of effort into this relationship and he is forgetting it. It feels like he is being a jerk ... could he be using his illness to pull away from me or is he really losing his memory of me and doesn't remember how close we have been? I feel so bad for him, his life is mostly sleeping because he is on so many meds and can't function because of the pain. I was trying to be a helpful person in his life, I love this man, but I am heartbroken that it has come to this and wonder if I should completely stop expecting him to live up to the standards of what I deem to be appropriate behavior for keeping friendships and living up to what you have said and have acted in the past... obviously this is quite complicated but I don't want to just walk away because I care so much, but this breaks my heart and I feel like I have been taken for granted.

Answer: If it has been 12 years since his stroke, then your friend's condition is most likely not a symptom of his original stroke. It's more likely due to changes in his brain over time. He may have some dementia setting in or he could have been having ischemic events that have affected his memory over time. Based on the symptoms you describe, I doubt he is trying to use his illness as an excuse. I think he is slowly losing memory. This can be tragic for family and friends especially when a loved one begins to forget relationships and even people. I don't know who else is in his life that can help, but it sounds like he may need evaluation by a physician and that he should be monitored closely to make sure he is safe at home. If he is beginning to forget relationships and people, his memory in other areas is most likely affected which can be dangerous when living alone (e.g. leaving on ovens or hot appliances, forgetting keys or directions to home, forgetting to pay bills, etc.)

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