Crazy Moodswings, Irrational Behaviour Of Addisonian Partner, Any Help, Advice?

kitrat

I don't know if this helps at all to understand a little background, I looked up Addison's disease in my old lecture notes.

It's usually caused (but not always I'm guessing) by autoimmune destruction of the adrenal cortex - part of the adrenal gland. This means that there is a reduction or elimination of the amount of all steroid hormones secreted by the gland.

These hormones include aldosterone and cortisol (not sure where adrenaline comes into play - no mention in my notes).

Cortisol is relevant to his diabetes because it is involved in the 'mobilisation' of glucose. Basically Addison's left untreated leads to a decrease in blood glucose (amongst other things).

Perhaps adrenaline is also not produced due to destruction of the gland but I don't think it's the main player in regards to all his symptoms. It's a cascade of events that follow when there is a deficiency in aldosterone.

FBaby

What a difficult situation. It seems that all three conditions (including the head injury) can have a significant effect on his mood. Adding to this the likelihood of depression, frustration with not being able to do what he used to and it is not surprising he gets so angry.

How aware is he of his mood swings? If he is, it is something he needs to discuss with his doctors as linked to his conditions. Whether any medication change, new formula or counselling etc.. could help is for the doctors to decide. If however he doesn't recognise that he has a problem, that will make it all more difficult for you to help him in any way. Good on you to stick by him. I have a friend who suffered from bipolar disorder. Before the illness got a hold of her, she was a lovely and fun person and I loved her company. When she got very ill, she turned into an angry, aggessive, short-tempered unreasonable and unpredictable person and she alienated most of her friends. I was studying mental health at that time and held on to the belief that it was her illness speaking rather than herself, but at times I did have doubts too. Thankfully, I stood by her and sure enough, once she got the right medication, met a man who treated her much better than her previous boyfriend, she gradually became the wonderful person she was and has remained as such for over 15 years now. I'm glad I stood by her. She now knows that she wasn't an easy person then!

Person_one

Tygermoth wrote: »

My days of ward craft are very rusty but in the old days...

Sliding scale insulin. Used when diabetics came in unwell. When unwell a diabetics regime or good practice of their own medication can be altered as well as the bodies reaction to sugars and the insulin while its fighting and infection. If the patient had for example a severe chest infection you would normally find just being unwell their sugars would be all out of whack.

So you would be set up on a pump that would give you a constant slow low dose of fast acting insulin. The blood monitoring is done regularly - every 15 mins/once a hour/every four hours (depended in the severity of the illness or the seriousness of the blood sugar readings) the insulin is tapered on a sliding scale in response to the results. This in theory would smooth out any massive highs or lows leaving the patient to just concentrate on the recovery from the chest infection.

In my day it worked just fine. Never had any issues in treatment or on the patient side. However as advised previously this was some time ago and the NHS is a different place now. Not the fault of the Nurses or the Doctors, In my very humble opinion.

A little off topic and not related to the OP but this might explain the resistance a bit in regards to patient knowledge...I spent a day volunteering on a specialist unit recently and was outraged at what stresses the staff were working under and the general publics attitude and how they spoke and treated them.

It seems like doing a bit of research on Google makes every tom,!!!!!! or harry more qualified that the very experienced staff and rather than a reasoned discussion will demand treatment in line with what they have researched. One lady was adamant that for burns you put butter on it and just wouldn't listen to reason in the treatment of her small daughters large serious burn.:mad: This was an extreme example but in most cases the information supplied was incorrect or outdated in the worst cases just dangerous.

The staff were good gentle souls hard-working people that just shrugged off the frankly mindboggling level of aggressive behaviour off as part of the job but it was an eye opener to why they become closed down and less empathetic over time. honestly, it was unremitting!

Sliding scale still works just as you say. It's not a long term insulin regime, it's a temporary measure to get blood glucose back on an even keel, very effective when people arrive in DKA of course! There's no reason why it would cause a hypo. I understand it can be hard for diabetics to hand over control, but sometimes it's necessary for their health.

As for ward staff just dying to snatch insulin, well certainly not on any ward I've ever worked on. Type 1s are always expected to manage their own condition unless there's a reason they can't such as bring too unwell or having dementia. They might still want to check your CBG with the wards testing kits, but that's because ours record the data and save it, it's for accountability and record keeping.

OP, I admit I don't know a great deal about Addison's, but certainly type 1 is no excuse for any of his appalling behaviour. Not unless he was dangerously hypo for every single incident and I very much doubt that.

I'm curious as to why you believe him over the girl who said he assaulted her, has she later retracted the allegation?

ciderwithrosie_2

I don't have any experience of Addison's but have been married to a type 1 diabetic for 25 years. The sudden mood changes, selfishness and acting totally irrationally, sound exactly how my OH gets when he's hypo (tends to go in phases) or hyper (rarely).

I've had windows and furniture broken, plates smashed, things thrown at me and the walls, been spat at, nearly pushed down the stairs. Once he threw a plate of cheese and crackers at the wall because the cheese wasn't square with the crackers, another time he put his fist through a window because we didn't have any cornflakes. Sometimes however, he can just get really silly, making daft noises and cantering about or other times he'll be wailing and upset.

Thing is, because I've been with him so long, I know before he does that his blood sugar is low (as he rarely tests it). Getting him to do anything about it though is another matter as it's the nature of the hypo to deny anything's amiss because they're already befuddled.

Does your partner have any glucagon kits to inject him with a glucose releasing agent into the muscle? If I have to use it on the OH, because he's unconscious I usually jab it in his backside.

I think that is shocking treatment by the police, after they were informed of his conditions. I would be complaining most strongly.

LouLou

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LouLou

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Person_one

LouLou wrote: »

Without wanting to sound "off", it's very easy to Google symptoms or have knowledge about one of the conditions (I have done it myself, and I did know a woman with Type 1), but having the two must make things more complicated (?).



There is a sense of (some) doctors thinking "they know best"

Without wanting to sound "off", maybe that's something to do with their medical degrees and years of experience practicing medicine? You were dismissive of the sliding scale treatment and convinced it was wrong despite admitting that you didn't even know what it was for!

They're not infallible, by any stretch, but viewing the NHS and the medical staff as some sort of enemy certainly won't be helping his health improve. We're all on the same side, doctors and nurses don't go into those careers to hurt people you know!

You've only been together for a year, you haven't made any unbreakable commitment to this man. It sounds like being with him won't be an easy life and will involve a lot of unpleasantness directed at you. Whatever the reason for that, whether it's his conditions, his personality or a combination of the two, only you can decide whether he makes you happy enough to put up with the poor treatment.

Humphrey10

Person_one wrote: »

I understand it can be hard for diabetics to hand over control, but sometimes it's necessary for their health.

As for ward staff just dying to snatch insulin, well certainly not on any ward I've ever worked on.

If you don't mind, I'm going to go with the advice of the consultants and diabetes nurses at both diabetic clinics I attended - which was keep control of your insulin etc, and contact the diabetes clinic if the ward staff start trying to interfere. They (and Diabetes UK, see the link I posted earlier) wouldn't need to warn of such things if they never happened.

This problem isn't limited to diabetes by the way - it's a problem with Parkinson's too - sometimes the ward staff take control of the medication and then give it at drugs round times, rather than at appropriate times.

LouLou

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Carer

ciderwithrosie wrote: »

I don't have any experience of Addison's but have been married to a type 1 diabetic for 25 years. The sudden mood changes, selfishness and acting totally irrationally, sound exactly how my OH gets when he's hypo (tends to go in phases) or hyper (rarely).

I have to agree with this, my OH is type 1, so was his Dad and so is our 18yr old son. All of them exhibit the same symptoms when blood sugar is low.
The sweating is also part of it in our case, my OH will soak the bed when he's going into hypo, he is never cold, nor is son ever cold, they are t-shirts in winter people.

OH's dad was a really violent diabetic and regularly made a complete !!!! of himself in public, smashed up the house,had major depressive issues and regularly tried to commit suicide, all when hypo, he ended up in a mental health unit in the end and OH's mum divorced him after years of abuse.

OH on the other hand is a very chilled, mild mannered man and his hypos are far more often the silly kind, not the violent ones. He had a rotten childhood, he watched his dad abuse his diabetes and watched his mother suffer from it so he is very careful to be on top of his diabetes the whole time.

The only person that can really help your OH is himself. It's very easy to monitor sugar and keep stable with the modern insulin regime of one 24 insulin injection and then a top up whenever you eat (it was much harder and we had many more hypos when on 2 insulin jabs a day).
I'm sure the Addisons doesn't help matters either but a lot of what you said seems to be classic type 1 bad control issues.

And as for the doctors - forget it, they are completely hopeless when it comes to type 1. OH and son been in hosp many times and each time it's a complete nightmare. When son was 10 they stuck him on glucose drip and then were surprised that his blood sugar kept rising. I made them stop the drip and made an official complaint about that one!