DELIRIUM : Dear All, Just so you know... - Pernicious Anaemi...

Pernicious Anaemia Society

31,973 members23,121 posts

DELIRIUM

Narwhal10 profile image
17 Replies

Dear All,

Just so you know, in medicine, we use the acronym PINCH ME for this symptom.

P - Pain We can experience severe pain due to P.A./B12 deficiency needed to make the

outer covering of nerves.

Similarly, joints can be inflamed too because of raised homocysteine.

I - Infection Such as h.pylori, Small Intestinal Bacterial Overgrowth.

N - Nutrition THIS IS THE BIG ONE FOR US.

C - Constipation. P.A./B12 deficiency originates in the gut but causes so many problems in all

systems of the body. So, it is a clinical sign, likewise so is diahorrea. Toxins

may leach into the body too.

H - Hydration. The body and brain like plants need water to thrive.

M - Medication. We can react to all types of tablets, inhalers, patches (thinking B12, HRT).

Environment. Too hot, too cold, bright lights, intense sounds especially our little ones and

elderly. Please be aware that in the elderly, those with the diagnoses,

Alzheimer’s disease and Dementia may experience something called

sundowning’. It is concerned with our body clocks and shadows can make

them even more confused.

🐳

Written by
Narwhal10 profile image
Narwhal10
To view profiles and participate in discussions please or .
Read more about...
17 Replies
Nackapan profile image
Nackapan

Interesting. Thank you 😊

autumngreen profile image
autumngreen

Thank you for sharing that, really helpful information.

Orimini profile image
Orimini

Are all these signs that one is deficient in B12? More clarification please.

Narwhal10 profile image
Narwhal10

Hi Orimini,

No, is the short answer. So, when a person becomes delirious quickly (say overnight), the health professionals should be checking ALL those causes by ordering tests and investigations straight away.

So, as an example, elderly patients are prone to water infections. A urine sample with show the ‘nasties’. Therefore, the treatment is antibiotics not vitamin B12.

Similarly, if someone is dehydrated then treatment is not vitamin B12. Depending on how badly a person is dehydrated the treatment is either encourage fluids. We keep charts of ‘Input/output’ charts. We may have to give fluids via a drip.

With regards to vitamin B12 deficiency, it is complex because people may have diagnoses. Using ‘Parkinson’s disease’ as an example. A person’s coordination becomes impaired. So, the ability to feed themselves and the ability to swallow is impacted. Without proper nutrition, they can become vitamin B12 deficient too. BUT, Carers, doctors will just believe their Parkinson’s disease is worsening. So, the medications for that will be increased.

In cases, where delirium occurs over a matter of months, year. Doctors should be made very aware, how many times that person has gone back and for doctors. People know there is something desperately wrong with their bodies and they are simply are not being heard.

That poor person may loose capacity (being disoriented, having delusions, and hallucinations) and then be detained in a psychiatric ward where they are subject to ‘forced treatment’ of antipsychotics, mood stabilisers or ElectroConvulsive Treatment. That poor person might have had an autoimmune disease, thyroid issues or have vitamin B12 deficiency/Pernicious Anaemia. Unfortunately, because they have been labelled as a ‘hypochondriac’, then further tests will not have been performed. It has dire consequences for the person, their families and friends.

🐳

tomdickharry profile image
tomdickharry in reply to Narwhal10

'forced treatment’ of antipsychotics, mood stabilisers or ElectroConvulsive Treatment'

Are these methods still being used? I thought they would be illegal nowadays.

Absolutely barbaric.

Rexz profile image
Rexz in reply to tomdickharry

Sometimes with the nerve issues and pain I think ElectroConvulsive Treatment sounds rather soothing in comparison. 😂

tomdickharry profile image
tomdickharry in reply to Rexz

Yes, I've been there with those issues, but they are from within. I have no personal experience of ECT but have read reports from the past of the results. It destroys the brain. Surely our intent is to cure, not destroy.

Rexz profile image
Rexz in reply to tomdickharry

Of course, my comment is purely meant as a joke. Keeping our sense of humor that is what will get us through this PA quagmire that we've found ourselves in.

Narwhal10 profile image
Narwhal10 in reply to Rexz

Rexz,

In April 2020, I started experiencing cluster heads and my goodness, I couldn’t move from my sofa but my goodness, just to get some relief, I stared at my living room wall wishing I could head butt it to take the excruciating pain away.

Then I would have had to re-plaster the wall. 😘

Narwhal10 profile image
Narwhal10 in reply to tomdickharry

Unfortunately, yes. Psychiatry/ Mental Health are very, very separate compared to physical (medical) health. They have different computer systems, different notes, totally different ways of working and everything can be explained away by way of a Diagnostic and Statistical Manual of Mental Disorders manual. They document on the way people dress, talk, their eye contact, their homes or if they came to a ward that I was in charge of, the state of their room (it was my job to delegate to staff to give rooms the once over. So, needless to say I had a few choice words).

Lots of psychiatrists are Mental Health Act (1983) approved. So, they have the power to detain, hold and treat a patient however, they see fit. The length a person is kept can initially be up to 6 months depending how delusional they have become. Then it is reviewed, if the person is still suffering , then another 6 months. From then on, it is reviewed annually on the proviso, that the person remains mentally unwell.

Although, the term ‘diagnostic overshadowing’ is one that people ought to know. It means that people with diagnoses of ‘learning disabilities’ and/or mental health (MH) diagnoses will have severe delays in very real physical health problems such as Pernicious Anaemia/vitamin B12 deficiency. Their symptoms will have been attributed to their learning disabilities and/or MH illness. In literature that delay can be up to 25 years. However, there are many more lengthier and serious cases. 😞

thyr01d profile image
thyr01d in reply to Narwhal10

These comments are troubling me, having worked on a psychiatric ward and seen the benefits of ECT on people who prior to having it and despite being given all medications available and other therapies suffered years of deep, deep depression often with attempts at suicide, such attempts leaving them very injured, wheelchair bound for instance. I believe that psychiatrist alone cannot force admission on anyone unless they are a threat to themselves or others, there has to be at least one other properly qualified person in agreement, such as the GP. Isn't that right? Likewise medication cannot be forced on anyone. I have a poor friend who suffers from paranoid delusions to the extent that she slept under a tent outside for fear of people coming to harm her and then moved from place to place like a vagrant to escape. If she would just take her medication she would feel okay again, but she refuses, even while hospitalised. I think there is a careful balance set up using the law and doctors and that it is designed to work in the patients' interests and in good, intelligent hands it usually does.

Kirsty360 profile image
Kirsty360 in reply to tomdickharry

There are 4 known ECT machines available at my local hospital, it is just performed under safer guidelines. You are placed under a general anaesthetic where they then induce the seizure, still destroying your brain but you're not conscious! Madness!

Cherylclaire profile image
CherylclaireForum Support

Thanks, Narwhal.

Always something new... "sundowning" - term I've never heard before.

Kirsty360 profile image
Kirsty360

Working in the mental health field I have often wondered how many 'patients' have deficiencies and hormonal imbalances rather than mental ill health. Many times a psych will prescribe folic acid alongside other medications to someone having a psychotic episode as levels are often low. I get there are mitigating circumstances of the biopsychosocial model but if there is an organic cause as in a deficiency, does that give right to label someone with a mental health disorder 🤔

Narwhal10 profile image
Narwhal10 in reply to Kirsty360

Thank you Kirsty360,

I was 21 when I was diagnosed by a G.P. as having an ‘eating disorder’ without any tests, put on antidepressants and sent to a psychiatrist. Any further presentations to doctors was attributed to my Mental Health (MH).

This year, I have finally been diagnosed with coeliac disease. I also have :-

Small Intestinal Archea/Bacterial Overgrowth.

Hypochlorida (no stomach acid).

Slow transit. (My gut doesn’t contract properly, food just sits in my GI tract).

Ileocaecal Valve dysfunction (the valve between the small and large intestine doesn’t work properly).

I am deficient in everything.

The amount of misdiagnoses, misconceptions, drug errors which have been made over 3 decades is laughable. Fortunately, for me, I have had some quality of life over those decades because in summer, my diet naturally changes to just meat, fish, vegetables and fruits plus I have taken supplements for sport.

Just a funny. One psychiatrist kept telling me to walk 5 kilometres a day to ‘improve my mood’. Needless to say, I used 2 choice words and left the appointment. Each time, he had suggested this, I stated about my spinal injury. He simply would not listen. I knew he had to provide ‘holistic care’ but he refused to.

On my right clavicle (collar bone) is tattooed, ‘Know Your Rights’.

Article 14 of the European Convention on Human Rights is Discrimination. He had breached that. I had a physical disability. So, after leaving that appointment, I reported him.

Kirsty360 profile image
Kirsty360 in reply to Narwhal10

Wowzers Narwhal10,That is a tale and a half to tell, but one you shouldn't have to had you have been listened to and heard. So sorry that you were cast aside by medics who instantly go to a medicine/pill like it is the only solution.

You hit the nail on the head about being treated holistically. One approach does not fit all!

Glad you gave that psych a taste of 'his own medicine' and reported him!

Narwhal10 profile image
Narwhal10 in reply to Kirsty360

For me, it’s all learning. I wouldn’t have all the knowledge that other members from this awesome community provide. Contributions from Sleepybunny, jade_s, Wedgewood, CliveAlive (may have typos in handle) to name a few.

The other discrimination, I also address is discrimination upon the grounds of gender. Assumptions are made upon us females because we have XX chromosomes. We have different anatomy, physiology and this, silly, pathetic conclusion that women are more emotional is null and void.

So, Mr doctor shall we have a nice conversation about Occam’s razor. ‘Entities are not to be multiplied without necessity’.

Without us, females, the human race would be extinct because we carry a baby for 9 months, give birth. Then nurture the next generation. So, give us a bit more credit and respect.

You may also like...

Broccoli - the answer to B12 deficiency

comments on B12 deficiency guess what I had for dinner tonight :) Just think after having had P.A...

Having Other Autoimmune Diseases.

People new to Pernicious Anaemia/vitamin B12 deficiency who have no choice to self inject are...

Culture & Sensitivity

They can be ordered for body fluids such as urine, blood or stools. Some of us with P.A. or B12...

Implications of elevated HoloTC (active B12) and HoloTC > 20% of serum B12?

(active B12) is generally up to 20% of serum B12. Mine is not (in my case: HoloTC = 31% of serum...

Curious, pondering questions about alcohol, PA and B12

alcohol can irritate the mucosal lining of the stomach and intestines. And in the stomach, this can...