Imaginary ailments?

Soul Mate

Is it possible for a PWD to have imaginary ailments?

 

 

I took my DH to the VA on Friday.  The first of four appointments was an eye exam at 8 am.  In the waiting room he declared he had chest pains on the left side and was having a heart attack.  Immediately we were escorted to the VA emergency room.  We spent the rest of the day there while he had a number of different tests done, heart and non-heart.  At 4:00 they dismissed us without any diagnosis, they couldn’t diagnose the problem.  They just advised to follow up with our family physician. 

 

It was quite a challenge to tend to him because he complained of one thing or another the whole 8 hours – he was too cold, too hot, too uncomfortable, wanted food or had intermittent pain.  

 

He is about stage 5 according to Tam Cummins scale.  I know he has visual spatial problems, like not knowing which side of the car is the passenger or driver’s side or trying to put a sock on his hand.  Just wondering if the chest pains are really on the right side even though he is pointing to left side.  Maybe he actually has acid reflux or something?  

 

I’m also disappointed that we are going to have to reschedule the appointments.  I was very lucky to get four scheduled in one day.  Could now wind up having to make multiple trips to the VA plus getting an appointment with our family doctor. Sigh.

JoseyWales

We went through a couple of years with imaginary and non-imaginary pain / problems. I had a horrible time figuring out what was real and what wasn't. He constantly complained of stomach pain. Lots of testing (colonoscopy, ultra sounds, etc.) and there was nothing the doctors could find. I think it was just gas. There were tons of other medical complaints. I think we were at the dr. at least every couple of months for something.

But then, in the later stages, he was complaining of stomach pain AGAIN (probably 3 years into his complaints). I finally took him to the ER at 6 am on a Sunday. Turns out he had a really bad case of constipation and things were seriously backed up in there.

There's just no telling if the complaints are real or not.

Ed1937

I agree that unless they can find something wrong, you just don't know if it's real or not. It could be that the mental pain of progression seems to be felt as physical pain in some part of their body. But that's just a guess.

Faith,Hope,Love

My DH also complains about a lot of ailments.  It seems to me that his body has just gotten more sensitive to things.  He complains about these things for a while and then they seem to magically disappear.  He had pain in the heel of his foot for a couple of weeks and now it's gone.  He also has stomach cramps from time to time along with things feeling itchy on his skin.  I also notice that his sense of taste and smell is changing too.

MN Chickadee

My mother had something similar. She called it chest pain. We had numerous trips to the emergency room and specialists and found absolutely nothing. Eventually we started giving her a Tums and half an aspirin during these episodes and this seemed to help. Whether it was an anxiety thing where she wanted to feel heard and be attended to or acid reflux or the brain misfiring and thinking the body is in pain I don't know, but after a few months it did pass and never happened again. Given that hers happened in stage 5 when there were numerous changes in her cognition coming quickly but she was still somewhat with it enough to know something was wrong I suspect it was a manifestation of anxiety.

Paris20

My husband is in a care facility. I visit him almost every day. Each day is the same. He refuses to get out of bed. I call the aides. He finally agrees to leave his bed. He then spends whatever time we have together complaining about anything and everything. He doesn’t want anyone to touch him except me. Since he is paralyzed on his right side after a stroke three months ago, he must have two people taking care of him at a time. He screams and curses at them telling him they hurt him as soon as they touch him. He tells me «I don’t feel well» dozens of times. When I ask him what hurts or what’s bothering him, he can never identify a problem. It’s very frustrating.

Iris L.

Chronic constipation can be painful.  Work on managing the diet for more fiber and whatever else is needed for stool softening.

People  with arthritis are stiff after laying in bed all night, they need help getting out of bed in the morning.  Personally, I take my pain med at bedtime so it will be working in the morning, and I do stretches in bed before I get up.  These help a bit.

Iris

JoseyWales

Iris - you're right. It can be painful. That hadn't really been a problem with all his complaining for 3 years, but once it was a problem it was painful. We cleared it up, and then worked with his diet (and some occasional Miralax) to control it. Luckily it hasn't been an issue since he went to MC.

harshedbuzz

With my dad he had both imaginary and real ailments.

The imaginary ones were more of a manifestation of stage 6. FWIW, I would consider putting one's socks on their hands to be more of Tam Cumming's "wears clothing inappropriately" example than a "visual/spatial glitch" which is a stage 6 behavior. 

Sometimes ailments were a bid for attention. Other times, it was conflated memory. He once told me he'd had his knee replaced; he hadn't but he was very "inconvenienced" by my mom having hers done when he was in stage 5. 

That said, for the longest time, he swore he'd broken his ribs and would discuss it with all his doctors. This really stuck with him because he thought it happened when he missed a curb (again with the spatial reasoning issue) and fell-- he was angry that my mom leapt out of the way rather than allow her body to break his fall. I once saw mention of an inflamed gallbladder on a CT he'd had done for something else. He was supposed to have had his gallbladder removed some 35 years prior. He got turfed to a gastro who determined that the surgeon hadn't gotten it all and the tissue remaining was not managing his high fat sweets and fried food diet. In this case, the pain was real. 

Over time, trips to the doctor's office become more and more stressful. We elected to go with a more palliative model of care as dad hit stage 6 allowing his PCP to oversee almost all of his care. We stopped appointments with the dentist, pulmonologist, cardiologist, allergist and ophthalmologist. 

HB

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Nowhere

In my husbands case the pain felt real, but there was no physical cause. He had about two and half years of “somatic delusions”. Brought on by stress of Alzheimer’s disease and his brain’s inability to recognize that he had dementia. He knew something was wrong but couldn’t recognize his disease. Headaches for almost a year followed by stomach aches. We of course sought medical explanations with scans, X-rays, scopes, prescriptions, etc. He would wake up in the morning asking to go the hospital or doctor not remembering we’d just been. He’d call 911 or the police thinking I was poisoning him. The last trip to the ER he went in with a headache and doctor was going to send him home saying he was constipated (he wasn’t). I refused to take him home and asked for a psychological evaluation. An emergency room social worker listened to his medical history and diagnosed the problem- somatic delusions!!! He was prescribed Seroquel  It worked within two mornings. There was no return to his headaches or stomachs. My husband measured about a 5 during this stage. 

Wishing you and your spouse peace. 

Belldream

My goodness, this post kind of goes along with one I just posted myself about stomach pain each day. Along with his "stomach pain" he complains his stomach is gurgling - almost daily lately he's been saying this. I ask him, do you need to go to the bathroom and he says no. I remind him to drink more water and get it out of the fridge for him. He also is hot, then freezing cold, then hot again ... he's worse than when I had hot flashes! On top of that, his latest nighttime complaint is "I hope I make it to morning". I ask him what he means and he says "I can't breathe, or I can't swallow". I ask him if he feels he is choking right now? "No ...  I don't know". Mind you he has nothing in his mouth or throat, hasn't eaten in a few hours, and is breathing fine. I think it's anxiety and stress of having this horrible disease, since he is very aware he has it but feels out of control of it.

Jo C.

Pain is a difficult thing not to address.   I always took all complaints of pain seriously as we never know what is happening and we would not want anything less done for ourselves.  However, it is possible for pain to be wrongly interpreted and as we found with my step-dad, he actually had terrible stomach pain that went on and on.  Many runs to the ER.   He saw two different GI specialists; was scanned, was scoped up and down several times - nothing found.  One day, following his periodical Dementia Specialist appointment; the physician asked how things were going; I mentioned all was fine if it wasn't for the stomach pain that no diagnosis could be found for.  The Neurologist asked a lot of quesitions about the pain, the test results, etc. Then said, "It is possible the pain is a delusion."  Let's see if we can help this. He prescribed a very low dose of Seroquel, and after just one pill, never one single complaint again.  All pain disappeared and added to the quality of life for step-da.

Just a word about pain and extra sensitivity even of skin following a stroke; that is not unusual and can even start awhile after the healing process..  Lots of information written about this. 

"Up to 20% of people who have a stroke may develop central post-stroke pain (CPSP). This problem may occur if structures in the brain that interpret pain are affected by the stroke. It's often diagnosed by excluding other more common causes first. This is also known as neuropathic pain, or central pain syndrome."

Sometimes the pain is neuropathic in soft tissue and sometimes that pain will be in muscles or muscle groups and it is really, real pain.  There are meds that can be helpful.  So always take it seriously and accommodate dressing, etc. as much as possible.

 J.

 J.

Jo C.

Another LO with chronic complaints of pain AND drug seeking.  Oh boy.  All sorts of workup with testing, nothing found. I got the doctor's permission since it was all about med seeking to do a fiblet sort of medication.

I got Tic-Tacs and put them in a prescription bottle; I put the bottle on the kitchen table for easy access and he could take a pill whenever he felt he needed one.  He did.  I would ask if he pill was helping, and he said it was and the pain was gone.

Whatever works after physical issues are ruled out.

J.