Sunday, April 22, 2012

There's An Old Saying ...

by Leann

There's an old saying I learned when I worked in psychiatry years ago: the behavior engulfs the field. This was a meant as a caveat. Just because it looks like a duck and quacks like a duck--guess what? It MIGHT NOT be a duck. Certain psychiatric conditions are dramatic, with behavior that is so over the top, that doctors and other mental health professionals may make a diagnosis without checking out all the possibilities.

I saw this happen once when we had a patient with severe delusions and hallucinations. He was admitted as a paranoid schizophrenic to the medical psychiatric ward I worked on. He was so out of control he had to be restrained to keep him from hurting himself or others. Only when he fell into a coma and started running a fever, did the questions begin. Turned out this man had encephalitis. He was treated with the appropriate medications and made a full recovery. His behavior blinded everyone to a severe underlying condition. It probably started with a headache, but by the time we got to see him, he couldn't tell us about what led up to him seeing the pink elephants. He was too sick.

I have now learned, through personal experience, that this caveat doesn't just belong in psychiatry. I have what are called "invisible illnesses." You cannot look at me or do a simple blood test and learn that I have fibromyalgia, chronic fatigue syndrome and chronic Lyme disease. The doctor does know I have all these things. I have been taking all kinds of treatments for years, both traditional and non-traditional. But I like to solve mysteries. I actually make a living solving fictional ones. :-) This past month, I went for my regular 3 month appointment with a laundry list of tests I wanted my doctor to do. Why? Because I am NOT getting better and I am very frustrated. But unless I ask for something extra, my behavior--the fatigue, the pain, the insomnia, the headaches--those symptoms "engulf the field." They are all part of the illnesses the doctor knows I suffer from.

But when my lab work came back, what a surprise! It's sort of like the bad news and the good news all rolled into one. One of the tests I asked to be done was a vitamin D level. Normal blood levels run between 30-74, but 50 is a good number. My number? SIX. 6. Just  6. That is considered a severe deficiency. What are the symptoms of severe vitamin D deficiency? Fatigue, pain, insomnia, headaches and more of what I experience on a daily basis. My behavior engulfed the field and if I'd given up on me, I still wouldn't be on the right track. I just started taking 50,000 IU of vitamin three times a week. I am almost afraid to believe that in 6 months to a year, I might feel normal again.

Thank goodness I love a mystery. :-)