My husband was recently diagnosed with multiple myeloma while being hospitalized for delirium.
Background: Ron suffered cardiac arrest in 2011, required 25 minutes of CPR, resulting in an anoxic brain injury. He had been unable to work do to lack of organizational skills from the anoxic injury, but was able to function well at home while I worked. The delirum slowly evolved until he ended up in a med-psych unit. There they discovered the multiple myeloma. He was hospitalized for one week. Delirum was treated with trazadone for sleep and came home as well as he had been. Home a few days and the delirium returns.
He has over 20 percent myeloma cells in his bone marrow, but on xrays of his whole body his bones seem fine, calcium is fine. Kidney function is weak but not horrible, and not necessarily caused by multiple myeloma.
So my question is, at this stage, has anyone seen any evidence of these mental health issues? He is hallucinating, paranoid, and just overall afraid for his safety and those around him, even the dog. Chemo started this past monday on the off chance that multiple myeloma is contributing to his delirium, but they really can't be sure. He is currently receiving Velcade and cyclophosphamide for treatment. Dexamethasone was not included for fear of worsening his delirium.
I still have a lot to learn about this disease so any information would be helpful. Definitely not fully versed on all the lab tests and results yet. But I'll get there! Thanks for any insights!
Forums
Re: Husband newly diagnosed after suffering delirium
I'm so sorry to hear of your husband's problems, cindylouise.
I have definitely heard reports of myeloma patients experiencing mental health issues as one of the signs of their disease. In fact, I believe people have reported on this here, in various places, in the forum. I may dig around later and see what I can find, but perhaps others recall and can point out some of the relevant discussion threads.
If you do poke around the forum a bit, you'll almost certainly come across postings discussing "chemo brain" -- confusion, or lack of concentration, that can occur when a myeloma patient is undergoing treatment. But I realize that's not the issue here. Your husband's issues started before his treatment was initiated.
I have definitely heard reports of myeloma patients experiencing mental health issues as one of the signs of their disease. In fact, I believe people have reported on this here, in various places, in the forum. I may dig around later and see what I can find, but perhaps others recall and can point out some of the relevant discussion threads.
If you do poke around the forum a bit, you'll almost certainly come across postings discussing "chemo brain" -- confusion, or lack of concentration, that can occur when a myeloma patient is undergoing treatment. But I realize that's not the issue here. Your husband's issues started before his treatment was initiated.
Re: Husband newly diagnosed after suffering delirium
Here is a really quick article for you
http://primarypsychiatry.com/multiple-myeloma-presenting-as-secondary-mania/
http://primarypsychiatry.com/multiple-myeloma-presenting-as-secondary-mania/
-
dnalex - Name: Alex N.
- Who do you know with myeloma?: mother
- When were you/they diagnosed?: 2007
- Age at diagnosis: 56
Re: Husband newly diagnosed after suffering delirium
The one thing that can contribute to delerium for a newly diagnosed patient is hyperviscosity. This is a condition in which the blood becomes too thick due to the elevated protein levels. A viscosity level on the blood can be checked and this may be worth doing. I agree with the initial treatment without the dexamethasone for now but would consider addition of dexamethasone if the delerium clears.
-
Dr. Jason Valent - Name: Jason Valent, M.D.
Beacon Medical Advisor
Re: Husband newly diagnosed after suffering delirium
A quick update for everyone ..
I posted about my husband back in June. Ron was newly diagnosed in June after a complete mental break. My question at that time was about having hallucinations and delusions with multiple myeloma. Ron also has a mild brain injury due to Sudden Cardiac Arrest and I wondered if the combination of these two things would be causing his mental health issues.
I'm updating to say that yes, the myeloma did seem to be the cause. Once we saw the oncologist, she immediately started Cytoxan and Velcade. She witheld the Dex due to the mental health issues. With each weekly treatment we saw improvements to his mental health. By the 4th of July my husband felt like he had just woke up, and we had to go over everything that had happened to him in the past month and a half. His response has been remarkable in all aspects. We reached the point where we could start the Dex, but since his response is so good we are waiting on that. He did just start monthly Zometa
So, just an update, and a little info to put out in cyberspace in case someone else should find themselves in this peculiar situation!
I posted about my husband back in June. Ron was newly diagnosed in June after a complete mental break. My question at that time was about having hallucinations and delusions with multiple myeloma. Ron also has a mild brain injury due to Sudden Cardiac Arrest and I wondered if the combination of these two things would be causing his mental health issues.
I'm updating to say that yes, the myeloma did seem to be the cause. Once we saw the oncologist, she immediately started Cytoxan and Velcade. She witheld the Dex due to the mental health issues. With each weekly treatment we saw improvements to his mental health. By the 4th of July my husband felt like he had just woke up, and we had to go over everything that had happened to him in the past month and a half. His response has been remarkable in all aspects. We reached the point where we could start the Dex, but since his response is so good we are waiting on that. He did just start monthly Zometa
So, just an update, and a little info to put out in cyberspace in case someone else should find themselves in this peculiar situation!
Re: Husband newly diagnosed after suffering delirium
It's great to hear that your husband is doing so much better, Cindylouise. I hope his health continues to improve and that he has a very very long response to treatment.
I also really appreciate your posting the update on his health. It's very helpful.
I also really appreciate your posting the update on his health. It's very helpful.
Re: Husband newly diagnosed after suffering delirium
Cindy Louise,
My husband was diagnosed with smoldering myeloma in August of 2013. He has all of the symptoms your husband had when he was diagnosed. Would you mind sharing in what stage your husband was when he was diagnosed and where he is being treated?
My husbands treating facility does not believe these symtoms are related to his myeloma. They requested a neurology consult and every test came back negative. They are still not reccomending treatment.
Our family is very concerned and want to make sure he has the right treatment in a timely manor.
I hope your husband is still doing well.
Thank You,
Janis Weaver
My husband was diagnosed with smoldering myeloma in August of 2013. He has all of the symptoms your husband had when he was diagnosed. Would you mind sharing in what stage your husband was when he was diagnosed and where he is being treated?
My husbands treating facility does not believe these symtoms are related to his myeloma. They requested a neurology consult and every test came back negative. They are still not reccomending treatment.
Our family is very concerned and want to make sure he has the right treatment in a timely manor.
I hope your husband is still doing well.
Thank You,
Janis Weaver
-
Janis Weaver - Name: Janis Weaver
- Who do you know with myeloma?: My Husband
- When were you/they diagnosed?: August 16, 2013
- Age at diagnosis: 72
Re: Husband newly diagnosed after suffering delirium
Janis, my husband received his initial treatment at the University of Iowa. We are currently at Mayo doing a stem cell harvest. That post was just as he was diagnosed.
What I can tell you now is the kidney problems were caused by the myeloma. He was also anemic. And his calcium was elevated but not out of range -- just the high end of normal. He was stage 2 multiple myeloma.
After 3 weeks of Cytoxan and Velcade his delirium improved. It was almost like flipping a light switch. And what I posted previously doesn't even begin to describe the nightmare we went thru. We drove an hour and a half each way to the university once a week. During those trips he was sure we were being chased by the semi's because they wanted him for some horrible thing he had done. Again, only the tip of the iceberg.
I had to change my work situation because he was no longer safe to be alone, not even for a moment. I'm telling you this so you can get a grasp of what his situation was truly like -- these were no small things for us.
How old is your husband? No one knew how to help us at all until we were referred to the University's medical / psychiatry unit from our local psych unit. They were the ones who were convinced that there was a medical cause for his symptoms.
Once we followed up with oncology, treatment was started immediately. Our doctor could not say for certain that the myeloma caused the delirium, but watching the treatment turn him around proved it. And my husbands mental status is better today than it's been in 2.5 years.
Good luck to you.
What I can tell you now is the kidney problems were caused by the myeloma. He was also anemic. And his calcium was elevated but not out of range -- just the high end of normal. He was stage 2 multiple myeloma.
After 3 weeks of Cytoxan and Velcade his delirium improved. It was almost like flipping a light switch. And what I posted previously doesn't even begin to describe the nightmare we went thru. We drove an hour and a half each way to the university once a week. During those trips he was sure we were being chased by the semi's because they wanted him for some horrible thing he had done. Again, only the tip of the iceberg.
I had to change my work situation because he was no longer safe to be alone, not even for a moment. I'm telling you this so you can get a grasp of what his situation was truly like -- these were no small things for us.
How old is your husband? No one knew how to help us at all until we were referred to the University's medical / psychiatry unit from our local psych unit. They were the ones who were convinced that there was a medical cause for his symptoms.
Once we followed up with oncology, treatment was started immediately. Our doctor could not say for certain that the myeloma caused the delirium, but watching the treatment turn him around proved it. And my husbands mental status is better today than it's been in 2.5 years.
Good luck to you.
Re: Husband newly diagnosed after suffering delirium
Cindy,
Thank you so much for replying so quickly.
I do hope your husband is doing well with his stem cell process. I have read the Mayo Clinic is a very good place to be and wish you and your husband a quick return to your home.
You ask how old my husband is. He was diagnosed with smoldering myeloma a week before his 74th birthday this past August.
I am searching to see if there are any myeloma clinics who have treated smoldering patients and if so what were the outcomes. Also, if any other clinics acknowledge that hallucinations and extreme mental confusion can be caused by multiple myeloma. Your post about your husband's symptoms matched the amount of mental confusion and hallucinations that my husband has.
I will continue to search and hope we are able to help him. As of today I am also afraid to leave him alone due to his hallucinations and confusion.
I wish you and your husband the best. I appreciate your post so much. You have given me affirmation that his mental situation is related to his multiple myeloma.
Best Regards.
Janis
Thank you so much for replying so quickly.
I do hope your husband is doing well with his stem cell process. I have read the Mayo Clinic is a very good place to be and wish you and your husband a quick return to your home.
You ask how old my husband is. He was diagnosed with smoldering myeloma a week before his 74th birthday this past August.
I am searching to see if there are any myeloma clinics who have treated smoldering patients and if so what were the outcomes. Also, if any other clinics acknowledge that hallucinations and extreme mental confusion can be caused by multiple myeloma. Your post about your husband's symptoms matched the amount of mental confusion and hallucinations that my husband has.
I will continue to search and hope we are able to help him. As of today I am also afraid to leave him alone due to his hallucinations and confusion.
I wish you and your husband the best. I appreciate your post so much. You have given me affirmation that his mental situation is related to his multiple myeloma.
Best Regards.
Janis
-
Janis Weaver - Name: Janis Weaver
- Who do you know with myeloma?: My Husband
- When were you/they diagnosed?: August 16, 2013
- Age at diagnosis: 72
Re: Husband newly diagnosed after suffering delirium
Hi Janis,
What was the basis for your husband's diagnosis of smoldering myeloma? Was it based on very thorough testing?
The main reason I ask is that, as Dr. Valent mentioned up above, myeloma can make the blood thicker than it should be. When the blood is too thick, I think it is not as good as it should be at getting oxygen and other nutrients to the brain, which then causes confusion and hallucinations.
There are probably tests that your husband's doctors can do to see if his blood is too thick and, if it is, if it's due to myeloma.
You also asked about centers that treat smoldering myeloma. Normally, smoldering myeloma is not treated because many smoldering myeloma patients never develop multiple myeloma. So the thinking has been: Why give chemotherapy to people who may never progress to a point where they actually need treatment?
There is research going on now, however, that is trying to identify which smoldering myeloma patients are at a higher than normal risk of developing multiple myeloma. There is also research that suggests that treating these "high risk" smoldering myeloma patients could be beneficial.
But it's a controversial issue. You can find lots of postings on the subject over in the new part of the forum focused on smoldering myeloma.
Good luck to you and your husband and please let us know what you find out and how you are doing.
What was the basis for your husband's diagnosis of smoldering myeloma? Was it based on very thorough testing?
The main reason I ask is that, as Dr. Valent mentioned up above, myeloma can make the blood thicker than it should be. When the blood is too thick, I think it is not as good as it should be at getting oxygen and other nutrients to the brain, which then causes confusion and hallucinations.
There are probably tests that your husband's doctors can do to see if his blood is too thick and, if it is, if it's due to myeloma.
You also asked about centers that treat smoldering myeloma. Normally, smoldering myeloma is not treated because many smoldering myeloma patients never develop multiple myeloma. So the thinking has been: Why give chemotherapy to people who may never progress to a point where they actually need treatment?
There is research going on now, however, that is trying to identify which smoldering myeloma patients are at a higher than normal risk of developing multiple myeloma. There is also research that suggests that treating these "high risk" smoldering myeloma patients could be beneficial.
But it's a controversial issue. You can find lots of postings on the subject over in the new part of the forum focused on smoldering myeloma.
Good luck to you and your husband and please let us know what you find out and how you are doing.
15 posts
• Page 1 of 2 • 1, 2