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General questions and discussion about multiple myeloma (i.e., symptoms, lab results, news, etc.) If unsure where to post, use this discussion area.

Re: Husband newly diagnosed after suffering delirium

by Dr. Peter Voorhees on Fri Mar 21, 2014 5:58 am

Dear Cindy Louise,

That is an amazing story. It is great to hear that your husband is doing so much better.

To Dr. Valent's point, was a serum viscosity level ever checked? You mention that the calcium was on the high side of normal -- do you know if the initial serum albumin was low? When estimating calcium levels, one has to correct for a low albumin. What may seem a normal calcium level is not necessarily always the case.

Lastly, given the prior anoxic brain injury, it may be that any physiologic stress (be it myeloma, pneumonia, urinary tract infection, etc) may be more apt to cause these kind of mental status changes compared with someone who has not suffered that kind of event.

Regardless, he is better, and that is what matters. Good luck on the rest of this journey!

Pete V.

Dr. Peter Voorhees
Name: Peter Voorhees, M.D.
Beacon Medical Advisor

Re: Husband newly diagnosed after suffering delirium

by tropicdiver on Fri Mar 21, 2014 1:09 pm

This does not address your question about delirium, but tell your husband to watch for signs of neuropathy. I sure wish my oncologist would have stressed this more with me, while I was on Velcade. By the time I realized what was going on, it was too late for me. Am very glad I am no longer on Velcade.

tropicdiver
Name: Bob Phillips
Who do you know with myeloma?: Myself
When were you/they diagnosed?: June 2013
Age at diagnosis: 60

Re: Husband newly diagnosed after suffering delirium

by cindylouise on Sun Mar 23, 2014 5:05 am

To respond to a couple things, to my knowledge they did not check for serum viscosity. But at the time of initial testing he was an inpatient and those labs are harder to come by. I'd have to do some research on where his albumin levels were at that time.

When this post came back up we were up at Mayo, planning to do a stem cell harvest. Unfortu­nately, that is no longer the case. My husband has had a huge change in his heart's pumping function. The ejection fraction (EF) is 29%, and the doctors do not believe that even harvesting the stem cells is a good idea for him.

That was tough to hear. The good news is the cancer is in remission. They have decided to do no maintenance at this point. That makes me a little nervous. But at the same time, the heart issue is severe, and maybe no drugs for a while is a good idea.

cindylouise

Re: Husband newly diagnosed after suffering delirium

by Janis Weaver on Wed Mar 26, 2014 6:41 am

Cindy Louise,

I just read your post concerning your husbands heart problems and stopping of the stem cell procedure. It is good that he is in remission and I am sure he will be watched closely for signs of need for further treatment. Mayo seems to be highly regarded by former and current patients and other members in the medical community.

You had ask about my husbands work up. We are under the care of the Multiple Myeloma Institute in Little Rock Arkansas. His work up included bone marrow testing, PET/CT's MRI's, extensive lab work. We send in new labs and 24 hour urine every month for more testing. His levels are all about the same as they were when he was diagnosed. His second MRI and PET/CT were just performed in December with no changes or lesions in the brain.

I just sent them an email asking for the hyperviscosity test to be run on his next lab work and also if there is any medication he can take for the hallucinations. The hallucinations are very debilitating and take over our life in ways that only you can relate to having been through them with your husband.

I will let you know when I know more. I will continue to check on you and your husband and pray he stays in remission.

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

by cindylouise on Wed Mar 26, 2014 7:33 pm

Janis, you are right to request the hyperviscosity testing. Actually you are right to pursue all reasonable roads to clearing your husbands hallucinations.

I think it important though to note that my husband had a definitive diagnosis of delirium. The cause of the delirium was the myeloma in his case. But it's important for your husband to have a diagnosis for his hallucinations regardless of the cause.

A very important step for us along the way was to learn that it was delirium, and that delirium has a medical cause. Once they determined there was a medical cause for what were very much psychiatric symptoms, it referred us to a medical psychiatric doctor. I would think a facility as reputable as Little Rock would also have some similar departments.

For us, we went from our local, small hospital to the University of Iowa's med psych unit. They were fabulous. He went in on Friday, out the following Friday, not just with a diagnosis of delirium, but also of myeloma. And while the myeloma diagnosis was frightening, I never thought my husband was going to be able to return home again!

We had many more difficulties with the delirium after that, until the myeloma was starting to be controlled. But at least he was home, he was improving.

We don't know at this point what the future holds for him, and it is currently frightening. But I've watched him die once. I've been told more than once that he may never be mentally well again. But here he is.

I've learned to be a very vocal advocate. If I don't understand or agree with a diagnosis or treatment, I speak up. If I'm not feeling heard, I speak again.

Keep fighting, you know your husband better than anyone.

cindylouise

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