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Psychotic episode, anxiety, now in a state where he can't walk by himself... urgent help needed

this is about an 18 yr old male.
health 100 lbs.
History:  
-born premature
-gets B12 shots every month, because of necrotizing entercolitis
Recently:
-oral surgery to remove wisdom teeth and a growth on his tongue; used a general anesthesia and was given follow up meds(Ibuprofen, amoxicillin, and methylprednisolone)

Day after surgery:
-insomnia (he didn’t sleep at all)
-had to settle for a liquid for his mouth to heal, but then began to lose his appetite completely…  when he did try to eat, he made facial expressions that made it seem as though its flavor was unpleasant, but this could be due to the sores
-grew paranoid over his health and insisted on getting multiple tests done, but tests showed no unusual results

Next Day:
-he had lost 9 lbs since surgery.  It was to the point where sit was uncomfortable on his tailbone… and this worried him.
-continuation of symptoms above
-discontinued surgery meds, because we felt that he might’ve been having a bad reaction to it

Day 3:
- same as above
-began going around to his friends and family, saying “I love you” in a sad/fearful manner
-pacing around and showing signs of much anxiety

Later that night:
-went up to his brother and said “this is the night, I’m going to die”
-began to have a psychotic episode:
~began to cry
~told us to stay away from him, get out of the house, “get away from me, I might hurt you”, “im going to die”… later…”are the cops coming?”, “don’t do it”, “don’t kill me”… etc….  he was trying to make himself vomit… was making a “dry heave” noise??... like metal music… etc black metal growl noise… ???
~was dragging himself around the room… and at a certain time, was trying to bang his head against the wall  
~still no sleep that night

Day 4:
-seemed to have calmed down
-took him to a psychiatrist, and he got nervous…
-difficulty communicating
-rocking…
-blank stare, but responded to his name…
-said he wasn’t hearing voices when we asked
-stiffened up when nervous
-wanted to go home, repeated it, continuously asked “where am i?”..
-responded only to the family and closer friends
-psychiatrist suggested to take him to a college psych hospital
Car ride to ER:
-one of his favorite songs came on the radio, and he started to dance… and began to act like he was at a party and started to get excited and told us to dance with him… we got excited and started to play along… this lasted until the music was turned off… immediately after the music was shut off, he calmed down and was quiet again.

ER:
-nervous… stiff… but able to play tetris on gameboy…
-was given benadryl and atavan(sp?) and calmed down to the point where he could explain to us that he remembers everything.  Described the past few days as a dream, explaining that the dream was vivid and at times he even thought of himself as an alien…
-while talking, he seemed to be normal, but a little nervous about being in the ER and was acting a little loopy… possibly due to the meds or the fact that he still hasn’t slept at all…
-psych evaluation member came to evaluate his mental state…  wrote down that he was hearing voices even though when asked he said “no”
Taken to the psych hospital:
-anxiety and nervousness stiffened him up a bit, but with comfort from his brother, he calmed down a bit…
-when the family left the psych hospital, he seemed even more normal than how he acted at the ER, except he mentioned that he dreamt of dying in that very place

Day 2 of psych hospital:
-stiffened up, still no sleep.
-we were told that he was pacing around the hospital… probably at an extremely slow pace
Morning visit:
-seemed to have reverted back to an out of reality experience, but did respond to family… however his responses had slight delays…
Afternoon visit:
-we arrived to find that he was taken to the ER because his pulse shot up to 200+
ER visit:
-family to ER, doctors tried to give him meds to calm down, restrained him to bed because he was stiffening up and freaking out and the doctors thought that he was going to hurt them… but he began to calm down when he saw his family..
-they later gave him benadryl and atavan and a tranquilizer in an attempt to make him sleep… at first, he was fighting sleep.  While he was still awake, they got a urine sample. A staff member from the psych hospital who was there to monitor threw away the sample “thinking that it was already tested”. He later slept for about 4 hrs…   I believe he was also hooked up to an IV, but not positive…
-woke him up for ANOTHER urine sample and CAT scan
-while awake, he was anxious and delusional… most likely hallucinating because he was saying that he was doing things that he really wasn’t…
-once again calmed down once his family talked to him then he was given the same meds to calm him down from before
-he attempted to sleep but he would often wake up every few minutes while they were waiting for the test results from the urine sample
-when the test was finished he got the clear to return to the psych hospital

Day 5
-he was returned to the psych hospital
-When I visited him he was unable to walk w/o help, he trouble
eating, he was back was arched back, very tense, he kept his arms up (in a similar manner to a t rex), he was rigidly bobbing his head, when he tipped over his chair he was unable to help him self back up, he was mumbling to himself the same phrase over and over
-That night he stayed in the psych hospital

Day 6
-He was sent to the ER once again  for another CAT scan
-he is going to get a spinal tap to check for brain infection

side notes: he is not completely frozen in a catatonic state.... just in case you think that's what I mean...
we are really baffled by the fact that over the course of 6 days he's only had 4 hrs of sleep.
we know that this could possibly be schizophrenia, a reaction/allergy to medication, and possibly just a psychotic episode due to sleep deprivation... you can ellaborate on the obvious, but new ideas would be greatly appreciated.
19 Responses
685562 tn?1447155231
What was the phrase that he was mumbling?

I think the Docs should take a different approach, rather then giving him the same medicine over and over.
That is, in definition insanity, what the Docs are doing
"to do the same thing, expecting different results" kinda makes me think the Docs dont know what there doing.
Anyways, Wisdom teeth can play a huge roll on people sometimes, some people they dont ever effect, others get huge migraines, etc.. So it could just be that????
I also think the sleep deprivation is  definitely playing a huge roll in this.
When I first got all of my constant anxiety, I couldnt sleep, would be up all night, and it was only getting worse from the lack of sleep.
The first step they need to do is get the man sleeping.
Lack of sleep can produce a Hallucinogenic state, and thats a fact.
I think personally, It does have something to do with the meds possibly, and the lack of sleep "caused by the meds"
Strange reactions can happen from pretty much harmless meds, or even other things.
The Docs wont agree, but  Thats my opinion.
If I were you, I would ask the Docs to give him a longer lasting benzodiazapine "or barbiturate" I bet he would have a better response from Valium, or Klonopin.
For them to give him ativan for basically a mental breakdown, tells me they dont know jack.
Ativan only last for about 4 hours.......he needs a steady state inside him to keep the nervousness down, and possibly break the cycle.
Right now hes having this "if its nothing medical, which I dont think it is" and it keeps getting worse because the symptoms are feeding it. Its a self surviving mechanism.
The Docs need to break the cycle, so he can regain his strength.

I know exactly what hes going through.."to a lesser extent"
When I started, I too told my wife to Watch me, because I wasnt understanding what I was feeling, and I had a FEAR of going crazy. Kinda like those people who just start killing people, or themselfs out of nowhere.
I often wondered if what I was going through, was what they went through, so that scared me.
After I broke the cycle though, it got SO MUCH BETTER.
Does he have a history or mental illness?
Avatar universal
The phrase he was repeating that day was "I'm bad."

No, he has no history of mental illness.

Here's an update:
"Day 6
-He was sent to the ER once again  for another CAT scan
-he is going to get a spinal tap to check for brain infection
-afterwards, he was given something to calm him down… I’m not exactly sure what it was, but he got some sleep

Day 7
-spinal tap results came in negative… it did show that he had one extra pus cell

Due to the fact that we aren’t allowed inside until visiting hours, we do not know at this point what his current state is… "

458072 tn?1291415186
Hello, sorry you are having to go through this. I can't even begin to imagine the pain and heartache.


Is this the first time he has had this type of episode? If so, Have they done any testing to see if he has a brain tumor that might be causing this? If not I would call the dr and insist.

Could it be a reaction to some of the meds they gave him for they surgery? You will have to be pro active here. Unfortunately drs just like to give a pill, not solve the problem. That is much harder than taking pen to paper.

Please keep us posted and you and your family are in our thoughts and prayers.
Avatar universal
No, this is the first time he has had such an episode...
Wouldn't a CAT scan cover as a test for a brain tumor??
The first thing the doctors thought it could be was an allergic reaction to the general anesthesia used during the oral surgery.  I looked it up online and found that it is the reason why they used the benadryl(antihistamine) to reverse the effects.  

Yes, I am going to be keeping everyone posted here...

So speaking of that:

-currently not accepting food, but the mother has just been sent in to try and see if he'll accept it from her

Things I looked up:
-complex partial seizures  
          his behavior reminds me of the symptoms listed on wikipedia... the staring off in space and the muscle spasms...  *shrugs* i really don't know...  but seizures can be caused by sleep deprivation and allergy to anesthesia.. but if it was from the anesthesia, would it be happening on the spot or this late in the game??

Really, it would be deeply appreciated if you did some research...  I personally am freaking out, and I don't know much about this...

Is he having seizures or panic attacks??
585414 tn?1288941302
Sounds like an adverse reaction to the methlprednisolone. I cut and pasted this from a clinically valid article. Speak to his doctor about it.

SIDE EFFECTS: Adverse effects of methylprednisolone depend on dose, duration and frequency of administration. Short courses of methylprednisolone are usually well-tolerated with few, mild side effects. Long term, high doses of methylprednisolone may produce predictable and potentially serious side effects. Whenever possible, the lowest effective doses of methylprednisolone should be used for the shortest length of time to minimize side effects. Alternate day dosing also can help reduce side effects.

Side effects of methylprednisolone and other corticosteroids range from mild annoyances to serious irreversible bodily damage. Side effects include fluid retention, weight gain, high blood pressure, potassium loss, headache, muscle weakness, puffiness of the face, hair growth on the face, thinning and easy bruising of the skin, glaucoma, cataracts, peptic ulceration, worsening of diabetes, irregular menses, growth retardation in children, convulsions, and psychic disturbances. Psychic disturbances may include depression, euphoria, insomnia, mood swings, personality changes, and even psychotic behavior.
Avatar universal
We've considered that.
I've heard that it can take 7 months to get back to normal... Do any of you know if that's true??
We were thinking that it would be that too, especially since the dosage was for an 100lbs person not 91 lbs.  To someone else, losing 9 lbs is nothing, but for him its basically 10% of his weight.  right??
could that be a factor?
we mentioned it to the doctor, but he said that it was okay... maybe he was thinking 9 lbs is okay to be off by for the AVERAGE person, forgetting his patient isn't exactly average??
585414 tn?1288941302
If you believe that the appropriate guidelines weren't followed as regards anaesthesia that might be the case but I am not aware of what they are. You could post in the specific forum where you could ask about that and research information about it online and if reccomendations were not followed speak to a supervisor or hospital complaint line but by all means find out first. And I would suggest changing doctors as even if this is an unfortunate accident, its too unnerving to continue with the same provider at this point but this isssue is beyond what could be suggested as regards anyone's knowledge in this forum. I don't want to hazard a guess although it sounds like things went wrong in my opinion but medical judgment is based on facts so best to find out the facts. Thanks.
Avatar universal
Unfortunately, we do not have any control over what doctor we have...
My friend is being held under a 5150, and the doctor he sees is whatever doctor is at whatever ER they take him to...
They've taken him to a different ER each time... :-\
We have no control over how long he is kept at the ER, because the psych hospital has FULL control over him.
It's a frustrating situation, obviously.
We are very suspicious of the place he is at... they don't seem to be taking proper care him.  We are also baffled as to why they would dump his urine sample without a thought of it not possibly being for them...
I'm sure its probably just worrying too much, but we were thinking it was done so we couldn't see something they may have given him...??  
I don't know... a little paranoid.. haha...
Avatar universal
No, your not being paranoid at all. This young man is going through alot and the Drs. don't seen to be helping much. I would be very upset too if this were a friend of mine. I hope they find out what's going on, and soon. Take care. Remar
Avatar universal
thank you for your support.
Avatar universal
He seems to be in better condition...
He's not shaking anymore, bobbing his head, or anything like that..
He seems to be having unpleasant taste, but that could be because of the oral surgery...
He didn't say a single word the whole time we were there, and he was ignoring everybody.  I asked him to look at me for a second and he did, so I guess he can hear us.  Maybe he is just choosing not to respond??
Does this point to anything else??
433412 tn?1232554456
i can't believe i have found somebody who has wrote a post like i did over 12months ago, is this your son whom you have been talking about? it was 19th december 2007 when i had a visit to my dentist for treatment and had to have a local anastetic, i was fine through out as i normally am, as iv been through it so many times before. 21st december went out like normal with my sister and my 2 children came home normal and that afternoon went funny and ending up having a panic attack never in my life before had i had one, was taken to A&E where they did test and found nothing to be wrong with me and i put down to the visit to the dentist and still to this day i blame that. i now suffer from anxiety and depression and take anit depression tablets for which have helped me so much i think there the best. i went through everything what your talking about with him, no sleep,wouldn't eat it was like being in your own world and it is horrible my family didn't know what to do with me they wanted me sectioned but i refused for my childrens sake, my husband really helped me through alot of it saying its all in your mind and once the tablets kick in you'll be fine and here today i am and nobody can believe it i'm back at work expecting my 3rd child in 7 weeks and feel great, please don't give up on him, it takes time to heal and i'm sure he will do, have you asked your doc to put him on any meds, i'd ask for an anti depresson med and it will take its time, it took me 8 week to start feeling the effect. if you want to know anything more please ask me, i'm hear for you and you son if he wants to talk to me i will be happy to talk to him, med help is the best for people who want to talk. well anyway for now send him my love i know what he's going through and how he must be feeling  and you keep strong for your self and him regards jessica x
Avatar universal
no, he is just my friend.  wow, I'm glad that you can relate.  I'm not sure if your situation  is EXACTLY the same, but it sure does point more to the anesthesia.  When you were going through that time, did you hallucinate?  The first few days, I'm not sure about now, he was experiencing hallucinations.  Some as vivid as him being another creature, literally.  Do you know anything about that?
It's so amazing what the mind can make you see... Fascinating and very frightening.

I'll post an update later.
Avatar universal
okay.
where to start.
so we visited him at the psych hospital, he seemed better.  the first night he started communicating with me, he couldn't talk much.  i came u with the idea of just asking him yes or no questions about how he felt.  i tried to listen to him, and in return, he listened to my advice.  in our little chat, he explained to me that he thought the meds were making him feel bad/worse. etc. (i asked him a lot, and we finally got the opportunity to listen to him)....    

More recently:
he's been talking, asking to see people, asking for cherry limeade from denny's and just expressing a lot more than the previous nights. two nights ago, he pretty much ate everything anyone told him to eat, and since he hasn't eaten in FOREVER, his stomach freaked out.  he spent the night in the ER vomiting.  
we were told on sunday that he was being discharged from the psych hospital.  we were all pretty excited.  he stayed at the hospital over night into monday.  MONDAY, we were told that he might be sent back to the psych hospital.  the doctors at the ER think it is something in his head.  he will be seeing a neurologist today...

as far as his behavior goes...
he's acting a lot more like himself, although i will admit that he is not completely the same.  his motor skills are definitely slower.  he takes longer to respond.
im not really sure if the hospital is giving him meds, though.
im kind of scared that the way he is acting now is the new permanent him.  
:-\

well... i'll be checking in and out.
Avatar universal
Please do, and GOOD LUCK.
Avatar universal
brief:

he's home.
he's acting pretty normal, but not as natural as he was at the hospital.
he laughs at random things that arent funny.
&&
he has trouble stopping himself from eating.
we have to say "dude, put the food down"
he doesnt realize that he is full...
and then if we dont stop him, thats when he starts throwing up...


Avatar universal
how is your son now?  Our daughter had dental surgery in Nov with the same follow-up meds.  When I read your posts, it was like reading our experience...the hallucinations, insomnia, strange behaviours, the suicidal thoughts...she's out of the hospital now, but she is not the same...I'm not even sure that she is okay.  She definitely has delayed responses and sometimes socially inappropriate responses.  Before the surgery, she was an "A" student and an athlete, in good health.  Anyway, I'm wondering if your son has recovered from this.  How is he doing?  
Avatar universal
Whoever told you this isn't a medical issue is an idiot. Everything has a biological event, and from the looks of it the precipitating event was the anesthetic and the visit to the dentist. If he has colitis or any kind of inflammatory bowel disease that indicates autoimmune involvement, it's highly likely that allergic responses to drugs would be a higher risk, and adverse side effects to treatments that involve the central nervous system are likely to occur. Schizophrenia is not well understood and it is a box that people put symptoms in that overlap into brain damage as well as "psychiatric disorder." He probably had some kind of hormonal or otherwise brain damage or neurological disruption from the anesthetic or other drug given to him by the dentist that caused this to happen.  The fact that he couldn't eat or sleep definitely indicates to me that he is having digestive issues that could be the connecting factor between his endocrine system malfunction and cognitive malfunction. Often times antibiotics can cause psychotic side effects, but doctors will never mention it. I have experienced psychosis when taking oral medications like antibiotics before, and have since put them on my list of allergies. Some antibiotics act more heavily on the central nervous system, especially sulfa drugs like Bactrim and fluoroquinolone class antibiotics like Ciprofloxacin.

My recommendation would be to look into testing for further autoimmune and inflammatory markers, brain swelling/mri/fmri/etc and look into dietary changes regarding these issues. What your son experienced is a very real medical issue that doctors either won't admit to or make themselves ignorant about, which is that the drugs they prescribe can have very serious longlasting and unusual psychiatric side effects. But, these ARE medical events not just some random "psychological" event. The brain is part of the body, its symptoms are not separate from the body, and should be looked at as originating in a physical cause first and foremost. Good luck to you.

Avatar universal
Also if he needs a B12 shot that also means he probably isn't able to absorb it from foods. So it sounds like some inflammatory/autoimmune bowel disease may be at the root of these issues and others. Proactive awareness of this may help prevent these episodes from happening again in the future.
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