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Medical Forum / Diseases and Disorders / Alzheimer's / June 2007Wife's " spells "
I am going through a distressing period with my wife . I feed her breakfast at 8: 30 . and give her Meds . She usually wants to go back to bed . I get her up at lunch and help her with her bath. She is all right for about 2 hours and a half then she starts getting somewhat unresponsive . Then her eyes go vacant and she goes into a delerium . She can't really talk except saying yes and no and very short sentances at anytime. If I can get her down she will recover in a couple of hours and be all right until bedtime at 9. I just got out of the hospital where they changed her meds slightly. This has happened from time to time in the last six months but happens every day lately. She was Dxed eight years ago but it has been a relatively benign progression until about six months ago. I have her under the care of very good Doctors and Nurses at The Emory Univ. Alzheimers center but I would appreciate any advice from you folks who have been at this same place. She takes Namenda, Aricept, Seroquel and a blood pressure pill. Because she indicates pain all over they have her on Tylanol two 325 mg pills every 6 hours in 24 hour period. > She is all right for about 2 > hours and a half [quoted text clipped - 10 lines] > center but I would > appreciate any advice from you folks who have been at this same place. sounds like they need to continue to adjust the meds. >I am going through a distressing period with my wife . I feed her > breakfast at [quoted text clipped - 17 lines] > Because she indicates pain all over they have her on Tylanol two 325 > mg pills every 6 hours in 24 hour period. Grant, I agree with Dennis regarding asking about getting the meds adjusted. In the case of my mother in law, we discovered that as the illness wore on, we had to actually decrease the meds. She seemed to naturally grow more lethargic and the delusions and such were less. We reduced her medications several times over the last year in particular so she was less sleepy. She didn't have the illness as long as your wife has either. When they admitted her to the nursing home, she actually was taken completely off all of them to establish a new baseline of need. Then they reintroduced some of them as needed. So this makes me think that it is common for this to happen.  SignatureBest Regards, Evelyn >I am going through a distressing period with my wife . I feed her > breakfast at [quoted text clipped - 17 lines] > Because she indicates pain all over they have her on Tylanol two 325 > mg pills every 6 hours in 24 hour period. Grant, Everyone else addressed the AD meds issue. Whenever someone talks about global pain, it sets off an alarm for me of Vitamin D deficiency, just because I went through it. Doctors weren't really looking for it until about a year ago. They chalked the pain up to a pre-existing condition, a typical thing to do. Turns out it was an issue all to itself. We have become a society that spends less time outdoors. And when we are outdoors, we use lots of sunscreen, preventing our skin from absorbing the rays that convert to vitamin D in our bodies. When you have someone not spending time outdoors, and perhaps with a limited diet, its worth having the docs check the vitamin D levels next time they do a blood test (wouldn't recommend a separate trip for this for an AD person). The pain and fatigue are really quite debilitating, even when the level is only slightly low. And its such an easy thing to address. Adelle Adelle, its interesting you just had a bout of osteomalacia (adult rickets). I'd never heard of rickets in an adult, and yet I've heard about it twice in the last 24 hours. I was watching a TV documentary last night about a hospital program for the "super obese". There was a gentleman featured who was bedridden and house bound due to his size (several hundred pounds overweight). He was suffering terribly from bone pain - and both he and the doctors feared he had something dreadful like a cancer - and it turned out he had a vitamin D deficiency. Before going to hospital, he'd not been out of his home for months (he was of a size that there was no way his wife could have managed as caregiver to get him outside in the sun), and despite eating so much volume in terms of quantity and calories, he had a diet poor in Vitamin D. There is some recent research that suggests high levels of Vitamin D seems to prevent some cancers, such as breast cancer, and even reduces risk of Type 2 diabetes. Goodness, pass the Vitamin D tablets ! M > Adelle, its interesting you just had a bout of osteomalacia (adult > rickets). I'd never heard of rickets in an adult, and yet I've heard [quoted text clipped - 15 lines] > > M Yes, I saw the show, too. I raise the issue because I went three years in considerable pain as doctors tried to diagnose what was wrong. First they ruled out MS. But that neurologist said something amazing - he said he thought there were multiple things coming together to give the appearance of MS, but which really wasn't from a single source. That clued the other doctors in that there may have been more than one thing afoot. But because of the discomfort, I stayed on the sofa a lot. Wasn't outdoors much at all. It hurt when I didn't have my feet up. Then they treated me for Lyme disease, which helped some but not more than say 15%. Then it was rheumatoid arthritis, which we are still working on getting the medications right. But the biggest change in the quality of life was when the rheumatologist, as a shot in the dark when my pain was increasing, decided to check vitamin D levels. Bingo. In six weeks, pain levels were down 80%. Turns out my IBS contributes to the problem, as people with frequent diarrhea can have low vitamin D levels; somehow, absorption is affected. With this women's pain and fatigue, it just seemed something familiar. Adelle Grant, your wife is in the best possible hospital. as far as I'm concerned. >I am going through a distressing period with my wife . I feed her > breakfast at [quoted text clipped - 17 lines] > Because she indicates pain all over they have her on Tylanol two 325 > mg pills every 6 hours in 24 hour period. In my opinion , Emory is one of the best hospitals in North America. I've been a patient there and and carried a friend to cancer treatments there. Will pray for both of you. Gwen While I agree with what others have said about the meds, it could also be due in part to changes in her internal biological clock. Her condition or her meds may have upset the normal cycles of sleep and wakefulness, and she may need a lot more sleep than she did before. You say that you get her up at certain times. Have you tried just letting her sleep until she wakes up herself? Maybe her body and brain are shutting down because they don't want to conform to the schedule you've tried to put them on. > While I agree with what others have said about the meds, it could also > be due in part to changes in her internal biological clock. Her [quoted text clipped - 4 lines] > shutting down because they don't want to conform to the schedule you've > tried to put them on. Don, from a practical viewpoint, please consider that if you allow your loved one to sleep all day long, you may be dealing with someone who is wide awake and getting into things at 3 am. We used to give my mother in law one Tylenol PM at bedtime to insure that she'd sleep at night a little better, and we'd give her some coffee in the morning to help her stay awake in the day. Going to bed in the day for a little rest or a short nap isn't at all bad, but if they sleep all day long they can get their days and nights mixed up just like a little child would. I think it may not be an issue in a nursing home or if there is 24 hour caregivers, but if you yourself need to work or can't stay up all night, it could be very unworkable. SignatureBest Regards, Evelyn Evelyn, great minds think alike. I also was thinking about her sleeping so much during the day. I can't imagine this is good physically for her, since the lack of activity is going to cause her to spiral in terms of muscle strength - which in turn will hurt her balance, and put an end to walking sooner. You've probably seen the studies - even moderate activity levels in the elderly can pay off big time in improved mobility - it really is a case of use it or lose it. If she was my loved one, I'd be backing her off the meds and starting over, since it isn't normal (even for an Alzheimer's patient at this stage) to be quite that sleepy (and she is exceptionally sleepy if she's sleeping until noon and then having another nap in the day). Generally the advice for AD patients is to keep them moving all day so they stay down at night. M > Evelyn, great minds think alike. I also was thinking about her > sleeping so much during the day. I can't imagine this is good [quoted text clipped - 12 lines] > > M Yes, it was the first thing that popped into my mind. I recalled that Ida used to always want to go back to bed, and if we let her do that, we'd be up all night, because she'd keep getting up over and over, forgetting it was night time and that was when we all wanted to sleep. She had her days and nights mixed up. So we'd gently try and interest her in something, to gently direct her away from the idea to go back to bed. If she was dozing on the sofa, we didn't care, though. SignatureBest Regards, Evelyn |
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