Posted by:
Nightingale
(
)
Date: August 17, 2013 06:11PM
I echo the advice to seek medical help (which I always do, I know) and which I know you will do anyway, as you're so clued in that way.
If the meds are a new Rx (like, only since the surgery) especially narcotic pain meds, the temper issues *could* be related to those. It may happen when he is a longer way out from his last dose (i.e., ready or overdue for the next dose). Of course, this is not ideal and should be discussed with his MD. (He may need a new Rx or a dose adjustment or maybe he's addicted or addictive, etc).
Could it be temper flares from sleep deprivation (maybe due to pain)? Sleep deprivation can severely affect one's mood (leading to temper flares as well as going the other way, into depression) and personality (sudden changes easily noticed, as you're describing).
Could he have an occult infection (from the surgery)? This can also have detrimental effects, aside from the purely physical problems related to underlying medical issues, if any exist.
Even something like a bladder infection can cause cognitive symptoms, although there would likely be other, more obvious, symptoms too, but this depends on age. Often in the more elderly a bladder infection can go undetected at first and cause a misdiagnosis of memory impairment, confusion, etc. (Not that I'm saying your husband is elderly!)
As for the psychiatrist, s/he may be unaware of some of the ?new? realities with your husband and may not review or change meds or re-evaluate diagnoses unless made aware of the changes that are concerning you both.
I would swiftly seek medical advice on all of the above, especially due to the safety concerns for the family and for your husband himself.
My uncle had very early onset Alzheimer's (in his 50s). He was known in the family as a gifted academic. He worked as a professor at a London/U.K. school. He was always a bit "different" in that he was distant and seemed moody and none of us kids thought he enjoyed our company, etc. It was hard to talk to him as you always felt you needed to provide intellectual conversation, not always easy for young nieces with such an uncle. He was a very handsome man and had a wonderful huge laugh that showed off his beautiful teeth, which is an aspect of him that I always noticed and enjoyed. He and I had some kind of connection in that through high school I sent him excerpts from my favourite poems and he sent me postcards from all over the world where he travelled as a Lieutenant in the Royal Navy.
The last time we visted the UK before he was diagnosed I did notice that he was giving odd answers (even for him) to simple questions and he reacted with some anger to some of my non-confrontational comments. We just put it down to the usual - that Uncle C was being Uncle C (a bit off and challenging to make conversation with).
His diagnosis was made while he was still working as a professor due to him needing medical leave because of not being able to keep up with all the marking requirements. In retrospect he was confused and couldn't keep the marking and student records straight. It was a terrible time for him and my aunt when he ended up being let go, as he had always been so high-functioning and productive. The MD once remarked that he wasn't formally diagnosed until later on in the disease progression due to his high IQ and history of being so highly functioning, which made his test scores artifically high (thereby resulting in him consistently testing high/normal for a longer time than may otherwise have been the case).
When I visited a few years later, when we knew his diagnosis, he had deteriorated markedly. The police had called my aunt several times due to finding him on the railway tracks. Initially they thought he was suicidal but she thought it was just him getting lost. I guess we won't ever really know. I found out that my aunt was allowing him still to drive and against my better judgement got into the front passenger seat when we went out one day. I was terrified because he drove so fast, way over the speed limit. I observed that he couldn't stand to have any vehicle in front of us and for as far ahead as he could see he thought he had to catch up and pass them. I thought maybe it had something to do with spending so many years on the high seas when he could see a clear horizon, or something.
My aunt didn't want him to lose his driver's licence because he loved to go for drives and for her, it was the ultimate in him losing his independence. Also, I believe, when you live with someone and see them all the time, you get used to gradual deterioration and may not note how severe it has become.
It was one of the hardest things I've ever had to do to take my aunt into the GP's office and gently suggest that my uncle shouldn't be driving. The MD was shocked as he had thought, I guess, that my aunt would have put a stop to it long since. He told her that as of then his licence was revoked (he had to send in the paperwork as it's not really in his power to implement that). I felt guilty for a very long time that I was the one that caused Uncle C to lose his licence/car/enjoyment of life, although I knew it was a serious safety issue, for my aunt and uncle but also for the driving and pedestrial traffic out there. My aunt was only finally convinced when I asked her if she wanted her ill husband to end up killing someone. Not a good legacy to contemplate.
Another thing was that he suddenly started craving ice cream, as much as you would feed him. My aunt was concerned about him gaining weight and so she would argue with him (arguments don't work with A's patients!) that he shouldn't keep eating ice cream. I said I thought she could ease up on that as did it really matter so much about a little weight gain. So she did and that stopped at least those arguments and the ice cream made my uncle happy, at least.
He developed a blood disorder (I don't know the diagnosis) which caused a lot of pain. It wasn't connected to the Alzheimer's. It was very upsetting to us all. Like he didn't have enough problems or suffering? That was his eventual cause of death. A mercy at the end as with Alz it can be lingering, as we know.
I guess I'd suggest that a medical opinion is definitely the way to go, quickly. Then of course, just dealing with the day to day from there. It *is* frightening, any such symptoms or even just the thought of such a diagnosis. But not knowing sucks too. So, that's where I'd start.
I'd say, as a word of comfort, that *usually* it's the simplest explanation. My money for now is on the Rx's. That is what I'd check out right away. And go from there. Good luck to all of you.
Edited 3 time(s). Last edit at 08/17/2013 08:01PM by Nightingale.