What the heck is this?!?

[SuZir]

Ache has been home few days, will stay few more. When he came he seemed to be okayish. Bit slow, bit tired, just a little bit off in the way I can't really put a finger on. And it seemed that acting focused and sharp took some extra effort. But if I weren't looking, I would probably not noticed anything. Or I may even imagine, hubby thought he seemed just normal and doing well.

Next morning he woke up with sore throat, but still everything was okay all morning and I thought that sluggishness I noticed night before was because he was getting ill. Then at the afternoon it became clear he was not feeling well. Delusional thinking, apparent hallucinations, really off. He also had a high fever. He refused ER and because he was not threatening himself or others, involuntary admission would not had been a possibility. We did ask a family member who is a MD to visit though. She wasn't able to talk him to the hospital either, so just tried to get a fever down hoping that would clear his head. Fever was easy to get down with paracetamol (physically he seems to be suffering from common cold) and that helped some to his mental side. But even the next day he seemed to have quite a difficult time with reality checking and was still having some rather bizarre thoughts he was stuck at, but still, clearly better than when having fever. Next day was better and today he has seemed to be in control again.

He admits delusions and hallucinations during the fever (and those earlier episodes that have been caused by substances) but denies he would otherwise have those thoughts. Then again admits having lots of derealization and depersonalization and other dissociative issues, but says he knows those are not real.

He has been seeing a new psychiatrist, who was worried the earlier episodes could had been manic and who has been reducing his Lexapro. That has worsened Ache's anxiety and sleep. Also Seroquel is now daily and not prn. Ache doesn't like nor trust this psychiatrist and is considering going back up with Lexapro against her orders. We were able to get him appointment with psychiatrist we found him a year ago for second opinion later this week and Ache has agreed to go.

Ache is dead scared and I can't say I would be faring any better and neither is hubby.

 

[Tanya M]

It wouldn't surprise me if he has been fighting getting sick for a while. Being in your home where it's safe and warm his body relaxed and the illness set in. It doesn't surprise me either that you picked up on it. They don't call it mothers intuition for nothing. I'm glad you were able to be there for him and get the fever down.

I think getting a second opinion is a good thing. Let us know how it goes.

 

[InsaneCdn]

Another supporter of second opinion.

One possibility is cumulative brain damage - without getting a full concussion, certain sports carry a risk of minor but cumulative brain damage. He won't want to know, of course, because it would likely end his career... doesn't account for the fever, but at least that brought an MD into the picture.

 

[TerryJ2]

Hmm. My next-door-neighbor has Parkinson's and he has "episodes" where he spikes a fever, his muscles freeze, he has delusions ... and then the fever goes away and he's better.
My question is, is the fever the cause? Or a red herring?

I would take him for a second opinion.

Either way, I know how frightening and frustrating is must be for you and Ache.
{{hugs}}

 

[SuZir]

Physical illness he is currently having is without doubt common cold. All the symptoms, sore throat, some fever (with him always rather high fever), sneezing, snot, just a bit elevated crp and so on. It is prime time for that around here anyway and while they have been practically swimming in hand sanitizer lately, they have quite an epidemic in his team.

What is odd is the mental change and symptoms fever seemed to cause in him. This is fourth clear delusional episode he has had during this fall during which he has no control and his reality checking is quite amiss. First, and worst, was followed by some (lightish) mixed substance abuse and lasted much longer than those substances could had been in his body. Second one started from one or two beers and again lasted much longer than it takes him to be totally sober again. Third one was after lightweight, small doze benzo, given to him by a doctor to treat him. And this one seems to have been caused by just fever (it is very unlikely he would had taken any psychoactive substances this time.)

At the moment Ache is not delusional and if he has hallucinations, he is not telling and is able to tell the difference between those and reality. He is not quite himself either, though. There is something lacking, some sharpness and quickness, vitality - I do not know and it may well be just because his head is full of snot, no one is on their best in that circumstance.
But his talk and behaviour during the weekend was really worrisome.

he will have a psychiatrist appointment tomorrow for second opinion.

 

[Tanya M]

There is something lacking, some sharpness and quickness, vitality - I do not know and it may well be just because his head is full of snot, no one is on their best in that circumstance.

I think you are spot on with this. I know when I have a head cold I feel like I'm in a dream state, everything is fuzzy.

I hope all goes well with the second opinion.

 

[BusynMember]

One possibility is cumulative brain damage - without getting a full concussion, certain sports carry a risk of minor but cumulative brain damage. He won't want to know, of course, because it would likely end his career... doesn't account for the fever, but at least that brought an MD into the picture.

Brilliant, Insane. The topic of head injries is huge in the U.S. Sports put anyone at risk for those and you can get a concussion, mild, and not know it, but they are cumulative. Maybe a neurologist?

 

[SuZir]

Brain damage is always a threat for an athlete in many sports and it something to be considered with Ache too. However it is a type of issue they are nowadays very aware. Ache has met with neurologist also this fall and his tests do not seem to indicate change to the baseline.

The psychiatrist Ache saw yesterday evaluated situation to be quite different from the psychiatrist he saw in his town. Ache left his medical case summary to our kitchen table after an appointment and fled and we were only able to talk about it with him today. That may have been a good thing - it was not reading for fainthearted. Biggest disagreement seems to be over level of depression Ache is suffering from, but Ache did say today, that he wasn't exactly honest with the psychiatrist on his town (wanted to be cleared to play, I assume.) Ache had also now told to the psychiatrist that he sometimes, under influence, very tired, half sleep and so on, does hear angry voices telling him ugly things that sometimes feel like self talk but sometimes feel like they would come outside of his head, so that goes to the side of auditory hallucinations, I assume, which leads to possible diagnose of depression with psychotic symptoms ('to be considered' in case summary at this point, though.)

This psychiatrist would like to make medication changes to other direction than the other. I'm not sure how Ache will sort that one out, he really can't go behind the backs of his team doctor and psychiatrist they provide for him without consequences. At least it happened that both these psychiatrists work for same chain of private clinics and so can also share patient information (with Ache's permission of course.) We very strongly advised Ache to be open about it with the other psychiatrist, but to be honest, sneaking behind his back would be very much like him.