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hypochondria
jesse
Posted: Friday, February 3, 2012 8:44 PM
Joined: 2/3/2012
Posts: 3


I'm new to this forum.  My father has Alzheimers but what is making things extremely difficult at this time is hypochrondia.  Has anyone experienced that along with Alzheimers or dementia?  Any advice will be certainly appreciated.
Lorita
Posted: Friday, February 3, 2012 11:36 PM
Joined: 12/18/2011
Posts: 10724


Good evening, Jesse,

 

My husband has a lot of complaints from time to time.   I don't know if it's the AD or if something is really wrong - it's hard to tell.   Maybe they don't have much more to think about or do except think of what might feel strange to them or might hurt.

 

From  time to time he complains of something being on his head.  Once it was bothering him and he put medicated shampoo on his head and face without any water and it really made it hurt for a long time.  I can't always tell if something is really wrong so I keep the Neosporin handy and that seems to work.   He scratches himself sometimes and bleeds quite a lot - he takes Plavix - so I use Neosporin and bandades on those places.   Who is to say is they really do hurt?   I just try to do something to try to make things better for him.  I guess we just have to assume something is really wrong and check into it to see if it really is something.


norm-p
Posted: Saturday, February 4, 2012 3:37 PM
Joined: 12/20/2011
Posts: 41


My wife was diagnosed 6 years ago and is mostly in stage 6. She complains every day about one or more pains. It is usually her stomach but some times her throat,her back,her hands or legs.In the past she has been to an ER twice, she has had MRI's,cat scans and various other tests. Nothing serious was ever found.

These complaints are almost always when we are here at home with nothing going on. If one of the grown kids shows up they say Hi Mom how are you . She says fine and she is fine so long as they are here. I can take her for a long car ride and the pains usually go away after 10 minutes only to come back again as soon as we get back home. This has become much worse in the last year as her dementia has gotten worse. It's like boredom and there is nothing else to think about except herself. It is very difficult to come up with activities to keep her from getting bored.She doesn't read anymore and cannot follow the story on a television show.

 


JAB
Posted: Saturday, February 4, 2012 5:39 PM
Joined: 11/30/2011
Posts: 740


Hi, jesse, welcome to the boards.  We might be able to answer your question better if you explained what you mean by hypochondria (e.g., what sorts of symptoms he's complained about), how advanced your father's Alzheimer's is (i.e., what stage he's reached), and what meds he's on.

 

My husband has parkinsonism along with his Alzheimer's.  I've found that it has many non-motor symptoms, one of which is ... pain.  In fact, the first symptom that may develop in Parkinson's patients is pain, sometimes shoulder pain that is so severe the doctors operate, not realizing what's actually causing it. He periodically has pain in his eyes (consistent with parkinsonism), his back (ditto), and his abdomen (also ditto).  He sometimes gets those nasty cramps in the calves of his legs which, if you've never had them, lemme tellya, they hurt like the dickens.  They're also readily relieved by pushing up on the toes to stretch the calf muscles.

 

One time, he started complaining more and more frequently of pain in his hands and feet, abdomen, and back.  I eventually discovered that all of this was due to an adverse reaction to a med he'd recently started taking.  I stopped the med, and his problems cleared up.  (Yay)

 

The other day, he was fussing about discomfort alongside his nose, on both sides.  I finally realized he's been having a lot of nasal congestion -- something very common in Alzheimer's patients -- and had been blowing his nose a lot, and the skin was raw.  I used a little Vaseline lip balm, and the look of relief on his face ...

 

Pain isn't something one can readily detect with any standard test.  That doesn't mean it isn't real.  So like Lorita, I try to figure out what's going on, and if it isn't something obvious, I use Aspercreme (which is a topical pain ointment), and that often helps.  Maybe it's the constituents in the Aspercreme, maybe it's the gentle massage, maybe it's just the attention that soothes him.

 

A ride may help distract a loved one from discomfort, that's a great idea.  So can a visit from the kids.  (And how unusual is it for a parent to insist they're fine, even if they're not, when the kids start fussing?)  That doesn't mean the discomfort is hypochondria, it means that distraction may be a good way to deal with discomfort if we can't figure out what's behind it.

 

Of course, all of this assumes that your father is complaining about pain ... but maybe it's something else entirely ... ?

 

This post has been edited by the ALZConnected Moderator on February 14th, 2012. 

 


jesse
Posted: Saturday, February 4, 2012 9:17 PM
Joined: 2/3/2012
Posts: 3


Thank you for your replies.  More about my father.  He was formerly diagnosed with AD a year ago.  Right now he seems to vascilate between stages 4 and 5.  He takes multiple medications for chronic conditions but the psych meds include Paxil, Aricept, Klonipin and Mysoline which was added around 5 months ago for essential tremors.  Neuro is undecided if he also has mild Parkinsons but he's had essential tremors for as long as I can remember and he's 78.  That condition runs in his family. Multiple meds that have been tried tend to increase the tremors and were stopped.  My mother passed over 11 years ago.  Hindsight he's been depressed ever since.  I noticed driving issues around 3 years ago.  His driving priviledges were revoked by the physician thankfully over a year ago which, combined with repeated falls and known medication errors, led to placement in assisted living.  I say thankfully because I was having trouble with that decision.  Once in the facility, he did ok for awhile but has progressively withdrawn in recent months. 

Loritta, Dad also takes Coumadin and he recently developed a bruise on his forearm that he seems to think is something more.  He also developed itching all over without a raised rash. A prescribed cream has helped intermittently. 

Norm, once Dad was in assisted living, we made repeated trips to the emergency room mainly over stomach pains.  He's obsessed with bowel movements but can't remember when he goes so is constantly wanting laxatives.  A few times his complaints were justified but for the most part, I think it's because of nerves.  However, I try my best to not discount anything that may possibly be going on. 

JAB, I had not heard that about pain and Parkinsons.  Dad's to be reevaluated by neuro soon so hopefully I'll know more.  I agree that boredom and isolation are aggravating factors with the complaints.  That has been the case for many years despite our efforts to get him involved in activities. 

Thank you all again. 


JAB
Posted: Sunday, February 5, 2012 1:53 PM
Joined: 11/30/2011
Posts: 740


It would help to know all the meds he's on, to look for adverse effects and also drug interactions.  However, based on what you've told us to date, I'd guess your father is one very unhappy camper.

Bless the poor man, itching can make anyone miserable, and there doesn't have to be a detectable rash for it to be all too real.  There are all sorts of possible reasons.  See:
http://www.alzcompend.info/?p=233


Many meds can cause itching as a side effect, for example.  It's also entirely possible he has stomach pains due to his meds. 

 

 Gastrointestinal discomfort, especially epigastric pain, is very common with Aricept, to the point many loved ones simply cannot tolerate the drug.  It can cause gastrointestinal bleeding, bloating, gallstones, diverticulitis, gastritis, irritable colon, epigastric distress, gastroenteritis, hemorrhoids, stomach and duodenal ulcers, and ileus (obstruction of the intestine).  It can cause pain "in various locations", and muscle cramps, and arthritis.  It can frequently cause pruritus (itching), and paresthesia, i.e., an abnormal sensation of the skin, such as numbness, tingling, pricking, burning, or creeping on the skin (such as the feeling there are insects crawling on or under the skin).  


"Essential tremor" is tremor when the person is trying to use the muscles, e.g., his hand shakes when he is trying to pick something up or hold it steady.  That is not a Parkinson's symptom.  Parkinson's patients have "resting tremor", i.e., the tremors are worse when the patient is not trying to use the muscles.

Tremor and constipation are among the most common side effects of Paxil.  It can also frequently cause paresthesia (see above, the abnormal skin sensations), myalgia (muscle pain), arthralgia (joint pain), abdominal pain, and dyspepsia.


Klonopin can cause tremor.


Hemorrhaging from coumadin can cause paresthesia and pruritus; headache, chest, abdomen, joint, muscle or other pain (the abdominal pain can include cramping and flatulence/bloating); and skin necrosis.


Interactions:

Major interactions are possible between coumadin and mysoline.  Barbiturates such as mysoline reduce the effects of oral anticoagulants by inducing their hepatic metabolism.  Anticoagulant dosage requirements may be increased by 30% to 60%. After the barbiturate is discontinued, excessive anticoagulation and bleeding may occur if the anticoagulant dose is not reduced.

Barbiturates such as mysoline may also reduce the effectiveness of Klonopin; conversely, Klonopin may increase the activity of barbiturates.

Concomitant administration of Paxil and coumadin has been associated with an increased frequency of bleeding without apparent changes in the disposition of either drug or changes in the prothrombin time.

Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking Klonopin and Paxil, or Mysoline and Paxil.

Mysoline can decrease the blood concentrations of Aricept, thereby decreasing its efficacy.

My favorite site for looking up potential drug interactions is:
http://www.drugs.com/interactions-check.php


If it were me, I'd start looking at cutting back on or getting rid of some of his meds.  See if you can remember which symptoms started up after beginning each drug (either a short time or a long time ... chronic adverse effects may not be noticeable right away.)

 

Mysoline makes me very nervous, given that it's so incompatible with all the other meds you've told us he was already on.  Plus, Klonopin and/or Paxil may be the reason for the tremor, so cutting back on one or both of those might resolve that issue, or at least make the tremors tolerable.  (Note that these two drugs given concomitantly can make the tremor caused by either one much worse.)

I'd also consider switching from Aricept to one of the other cholinesterase inhibitors.  Both Razadyne / galantamine and Exelon are less likely to cause acute and chronic side effects than Aricept.  And many patients who do poorly on Aricept may do much better on a different med.  See:
http://www.alzcompend.info/?p=244




 


cathyjm
Posted: Sunday, February 5, 2012 6:13 PM
Joined: 12/2/2011
Posts: 160


Some forum members have reported success with activities, by hiring a person to do things with the LO in the facility, one on one. That way the activities are more personalized -- based on individual interests -- and the LO has a lot more control over what to do when and how. It's depressing to most of us to feel less and less control over ourselves and our environment -- so just the combination of caring, interesting things to do and increased control can be very therapeutic.


Also, look for someone who's basically reassuring. You know how you just automatically feel better in the presence of some people? Your dad deserves that, too, and there are people who can help him feel better about himself and about life.


jesse
Posted: Thursday, February 16, 2012 8:24 PM
Joined: 2/3/2012
Posts: 3


A little more about my father.  He has hereditary essential tremor that became evident as a teen.  Now he also has resting tremors.  A huge problem that complicates everything is diabetic gastroparesis.  He can't go without Reglan.  As other medications were added, tremors worsened and that med would have to be discontinued.  This week Mysoline was decreased and Aricept was changed from AM to PM.  There is long standing severe sleep apnea for which he briefly used CPAP and refused to after that..long before dementia issues started.  That issue has improved with weight loss.  Has anyone had experience with Buspar?  It was mentioned as a possible alternative for anxiety.  He remains on Paxil and Klonopin.  We're back to the internist next week to see if any other changes are needed with other meds for chronic conditions.  Of all the symptoms, his anxiety seems to be the one he's most concerned with and of course the confusion.  He's spending more and more time in the bed and is very debilitated.  Thank you all for your much needed advice.
Dot
Posted: Friday, February 17, 2012 12:03 PM
Joined: 12/19/2011
Posts: 60


My DH has always been a complainer.  He is 79, and has had arthritis for years, but insists the back pain and leg cramps come from medicine.  But these pains aren't recent.  I constantly hear "look at this bump" or "what is this knot on my ear?" and at least once a week, "Which side is your appendix on?"   This morning, it was "Do you have cough syrup?  I think I'm catching a cold."

 

Some days I just say shut up and go see your doctor if it concerns you.  I really do care, but I know that when we get old, we are bombarded with this little crap that is gone in a couple of days.

 

We have dr's appointments next week.  We shall see.

 

Dot

 

 


jules
Posted: Tuesday, February 21, 2012 6:58 AM
Joined: 2/19/2012
Posts: 7


I am experiencing the same symptons from my husband. Everyday it is something new that crops up!