Tuesday, February 24, 2015

Good Results, More Questions

Yesterday was Thomas's follow up appointment with his primary care provider and this was really the moment of truth in terms of finding out the bigger picture of what is going on with Thomas and his chest pressure that he once believed was created by a demon living inside of him. At his last appointment they had done an EKG and they took a ton of blood to test for all sorts of things and yesterday was about finding out about what the blood tests revealed.

His PCP, Christie, came in and pulled up Thomas's labs on the computer and begun going through them piece by piece.

Thyroid--normal
Blood sugar--really good
Pancreas--good
Liver--normal
Cholesterol--LDL a little high but we'll watch and wait on that
Kidney's--good

And so on and so forth. There wasn't a bad reading in the bunch except for the cholesterol one. Right then and there I was so relieved. I had dropped the ball big time when he came out of his last hospitalization when while he was in the hospital they tested his blood and his thyroid was low. They had put in the discharge instructions to follow up with that and I never did. Now, with all of these tests having been done, I felt much better. His PCP felt that we couldn't have gotten a better result. I agreed.

Then the conversation came back around to his chest pressure. It's still there. So what the heck is causing that?!?!? His PCP said she could try and get an electrocardiogram (an ultrasound of the heart) past the insurance company but she didn't think it would go through and besides, she said, there is really no reason to do that. Basically his heart is cleared at this point and watching and waiting is the order of the day.

Still concerned about the chest pressure I requested a chest x-ray. His PCP felt that was well within reason and she got Thomas over to radiology to get that done. After he left the room I called her in. I told her that I believed that this could possibly be a somatic hallucination and she agreed. She said that her primary goal, knowing that Thomas has schizophrenia, was to make him feel better about what's going on with him and I really appreciated the compassion she shared. What I loved about her was that his records stated that he does have schizophrenia and she acted just as a medical professional should and she ordered tests that would help Thomas to feel better about what's going on in his body. She didn't write him off as just some mentally ill man and not do the necessary things to examine him fully. I know that it's not always that way in the world of medical professionals and I couldn't thank her enough for caring so much about Thomas.

The x-ray came back and he was the picture of health. His heart is a normal size, his spine looks good and his lungs and ribs look good.

So....nothing to explain the pressure.

Ugh.

While he was deemed "the picture of good health", for the rest of the day I couldn't shake this whole chest pressure thing. Thomas and I had talked during the appointment and he said that it really upsets him that he has this feeling inside of him. How do I fix this?

As my day wore on I found myself in familiar territory. Schizophrenia territory--where you know you're up against something that isn't real and you have to figure out a way to help. If it's a hallucination, here I am, again, back in uncharted schizophrenia territory where I'm once again fighting something that just isn't real. I really thought he was done with all of this for a while.
By evening time I was beside myself and talking to my husband running back through all of the medical tests and any other reason the pressure might be there. I couldn't shake the uneasy feeling that this is Thomas's schizophrenia at work. I am so disturbed because I would like for him to just have some peace.

We do live to fight another day, however, with his physical health having been checked out and him having passed with flying colors. How to remedy the chest pressure is a whole other animal though. Thomas has claimed that he no longer thinks he has a demon inside of him but he does still wear his tiger eye (it's meant to protect him from evil) around his neck so I'm not sure if he's totally let go of that belief. Really, at this point, though, we must just move on and hope that the pressure will go away. It doesn't change that I am worried about him and worried that this is a little bit of schizophrenia hanging on but for now I am powerless against it.

1 comment:

  1. Melanie
    From your comments on this last post, it is apparent that you believe that schizophrenia is behind Thomas' feeling of having pressure in his chest. Please do not worry yourself and jump to conclusions until you conduct a more thorough research on the subject. Please go to the Mayo Clinic or Merck websites and research non-heart related chest pressure. You will find that chest
    pressure can be caused by a number of things. One very likely culprit is gastro-esophageal reflux
    disease (GORD). You will be interested in knowing that there is a nih.gov. study that strongly suggests that the prescribing of clozapine was associated with the onset of GORD. You may want to check with Thomas and see if he has any symptoms of an acid reflux problem. Another cause of chest pressure can be stress. Does Thomas feel more pressure when he is anxious or worried? These are just ideas to explore.
    On a personal note, my husband (who does not have schizophrenia) was concerned about chest pressure and went to a cardiologist and had the complete battery of tests (EKG/Electrocardiogram/Stress Test) and was thrilled to learn he had " No" heart-related issues. The cardiologist had no explanation for the chest pressure, but my husband does have acid reflux issues and takes medication for it.
    Thomas is doing so well these days and you should enjoy each and every moment with him! Being a mom of a schizophrenic son, I know how easy it is to examine every comment and behavior wondering if schizophrenia symptoms are returning. Please try to put the schizophrenia on the back burner and live in the moment with Thomas. Celebrate and have fun without the worry!

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