[Cheryl G]

Re: Delirium may be returning

by Cheryl G on Fri Sep 25, 2015 11:40 am

Hi Cindy,

I think you know your husband well enough to sense whether something is "off" or not. And it seems that it is.

It's possible that his myeloma causes changes in his body that can't be picked up through normal blood tests, but which still affect his mental well being. So I think you're right to inquire about additional testing. I suspect his doctors will ask for a PET/CT, since it might show if some of the results on the MRI are actually areas of active myeloma.

I did some reading on the issue of myeloma manifesting as mental health issues, and it seems that the disease sometimes causes such problems even when the usual markers do not really show much sign of the disease. Things like blood chemistry and blood cell counts can be normal, yet there still are mental health side effects from the disease.

It's very hard, however, to generalize, since there aren't many cases reported in the literature. If you're interested, I've listed below some articles I came across on the subject. Many already have been posted here in the forum before, so sorry if you've already seen them.

I hope you and your husband's doctors figure out what has been causing his latest problems.

Articles:

A Flynn and M Macaluso, "Secondary Psychosis 3 Months Prior to the Overt Symptoms of Multiple Myeloma: A Case Report", The Primary Care Companion for CNS Disorders, March 2014 (full text at Pubmed Central)

PM Silberfarb and GM Bates, "Psychiatric complications of multiple myeloma", American Journal of Psychiatry, June 1983 (short abstract; slightly longer abstract)

DJ Kushon et al, "Multiple Myeloma Presenting as Secondary Mania", Primary Psychiatry, Nov 2009 (full text)

G Anshu et al, "An unusual presentation of primary plasma cell leukemia as a psychiatric disorder: a diagnostic dilemma-a case report and review of literature", Indian Journal of Pathology and Oncology, April 2015 (abstract; PDF with full text of article)

[cindylouise]

Re: Delirium may be returning

by cindylouise on Fri Sep 25, 2015 9:24 pm

Cheryl,

Thank you so much for giving this such in depth thought. I really appreciate your input, as well as all the others.

This is very difficult to understand when you haven't had to experience it. I am really trying hard to not over react. But it is difficult and I feel like I am watching his every move, and that I could be reading more in to what happened in one day, then that day warrants. If it helps, it puts my husband on edge too. He has recovered well enough to feel like he handles day to day life well. Now, every time something doesn't go as it should, he is questioning himself.

I take care of other people for a living. I think with the responses I've been given, and what my gut says it is time for us to ask for more testing. I will do this Monday.

I really appreciate all of the responses. I'm not sure why it is harder to put in to practice advice I would give in a work setting, and advice I would push for, for any one else.

Thank you all so much.

[TerryS]

Re: Delirium may be returning

by TerryS on Sat Sep 26, 2015 8:46 am

Is his calcium level normal?

[cindylouise]

Re: Delirium may be returning

by cindylouise on Fri Nov 06, 2015 10:45 pm

So recent follow up shows an M-spike on SPEP of 0.01, which I know is not high. I believe that is g/dl. Kappa light chains were 22 (H), lambda were 19.10, kappa/lambda ratio was 1.15.

It has been a year since he had these tests done as he was in remission. And these were requested due to increased forgetfulness of routine activities of daily living (ADLs).

I know these numbers are not horrible. But I also don't know what they signify following remission of 1 year or more. I just need a little information so I can be prepared.

My husband was suffering from horrible delirium at diagnosis, I don't want to approach that and be caught off guard. Oh, and the kappa light chain number caught me off guard because he was originally IgG lambda. IgA, IgG, and IgM all still in normal range.