Monday, January 7, 2013

37: FTD Hallucinations Become Dangerous

"Let's play Apples to Apples" my son Blaise announced after Christmas dinner was cleaned up. That's one of our family's favorite games. Matt and me, my parents, my brother, our friend Joe, Frank, and my three sons all sat down at the table again and surrounded the game cards. Apples to Apples is a fun word game that just about anyone can play, except Frank.  There are noun cards and adjective cards. The chosen judge for the round turns over an adjective and the players select a noun card from the hand they are dealt that they believe best exemplifies the adjective. Sometimes it's funny, sometimes it's clever, and sometimes you just don't have anything and you just have to throw something out. The judge shuffles the cards so he doesn't know who submitted which card and then decides which noun they like best. The winner is the person who has the most winning adjective cards at the end.

I sat next to Frank. We were all throwing in cards, making jokes and laughing about clever connections, Frank just sat there holding his cards. I told him, "Frank just throw one in, it doesn't matter what it says." He began sorting the cards in his hand, because he really didn't know what he was supposed to do, so I picked one for him and threw it in. Somehow, Frank won that round. That continued for the entire game. He never caught on to what we were doing and just sat there holding his cards while I threw in a selection for him. We played about ten rounds in all and unbelievably, Frank ended up being the winner of the entire game. It was hard to tell if he comprehended that he won because he just sat there with a blank look on his face.
After the game was over, Matt said "Frank, you look tired. Why don't you get going."
"Yeah . . . yeah" was Frank's answer as he slowly got up and put on his coat.

He was still driving at this point. As bad as he seemed, he could still navigate and still knew how to drive well. I took photographs throughout the day, but Frank never looked up and smiled like he would have even six months ago. In 2006, he was still working at the phone store. In 2009, he brought Midge to Blaise's graduation party. He was beginning to become forgetful, but could still carry on a conversation and seemed to have a great time. In June 2010, just one year later, we had a graduation party for Brett. Frank came and sat among his aunt and uncle and brother, but he spoke very little. Now only six months later he has become a zombie. He's moving through life but there doesn't seem to be much life left in him.

The following week we had an ice storm. They were predicting dangerous road conditions and a Code Blue Weather Emergency condition. A Code Blue is called when winter weather conditions pose a threat of serious harm or death to those without shelter. Matt got home from work at 7:30 that evening, ate dinner and after seeing the weather forecast thought he had better check on Frank and bring him some groceries so he wouldn't have to go out. I packed up our leftover dinner for him and Matt slowly made his way over to Frank's house. The ice storm was beginning, the roads were becoming slippery and the wind had turned gusty making a very uncomfortable trip out. When Matt pulled up in front of the house around 8:30 pm he was shocked to find Frank standing outside in the driveway near his car. Alarmed, Matt jumped out of his car and called, "Frank! What are you doing out here?"
"Did you see him? He's running away." Frank answered.
"Frank, there's nobody here." Matt said.
"He told me I wasn't allowed inside. He told me I was going to be arrested." Frank continued. He seemed surprised that it wasn't real.
"C'mon Frank, let's go inside." Matt said, taking Frank by the shoulder.
"They're in there." Frank said.
"No Frank, there's nobody there, c'mon, let's go in." Matt said reassuringly. "Do you see anyone?" Matt asked.
"Umm, no, not now." Frank answered.
"Do you see them alot? Matt asked.
"Uh, yeah they're here all the time. The hillbillies keep telling me that I'm in trouble and I'm going to get arrested, and there's servants and some kids. They told me that I wasn't allowed in here." Frank said plainly.
"What were you doing outside?" Matt asked.
"I was going to stay in my car with my gear." Frank answered.
Matt noticed that Frank's car had been filled with a sleeping bag and blankets, and suddenly it made sense. He wondered how many times the hallucinations made Frank sleep outside.
"Are you afraid of them?" Matt asked.
"No." Frank said. But it's hard to imagine that it wouldn't be frightening.
"Uh, can I stay with you?" Frank asked.
"No Frank, you can't stay with me." Matt said. Matt and I have discussed having Frank live with us, but I felt that I needed to put my children first and I would fear for their safety having Frank in our home. Not that he would intentionally cause us harm, but he may unintentionally cause something like a cooking fire, or react dangerously to a hallucination.
He gave Frank something to help him sleep and tucked him in bed before he left.

Matt came home and told me what he witnessed at Frank's house. He was whispering so as not to alarm Joey our youngest child, but Brett couldn't help but overhear, because everything seems more interesting when it's being whispered. Brett has been our 'funny' child ever since he was a baby. When he was about a year old, before he could even talk, he put his chubby little finger inside a brass fish's mouth and said while giggling with dimples showing and bright eyes flashing, "Ow . .  oww!"
His great sense of humor doesn't always have great timing though. After Matt finished telling us what happened, Brett began retelling the story.  As he held an imaginary serving tray aloft, he regally announced "Your moonshine, sir." I stifled a giggle while Matt looked sternly at Brett and said, "You know, that's just not funny." It became his anthem though whenever we talked about this new stage in Frank's condition; the children thought Frank had become quite amusing.

Matt and I both attempted to discuss the hallucinations with Frank's psychiatrist again, and again we got the runaround from the receptionist and then the same apathetic response from the psychiatrist. Matt called another mental health clinic near his office and got Frank an appointment. It was farther for Frank to drive but he was familiar with the area. They were much more cooperative and included Matt in Frank's treatment plan. They started him on Abilify for the hallucinations, and enrolled him in a twice weekly group session, but we still did not know why this was happening.

About a week later there was another snow storm, a blizzard actually. I left work a little early at 4:00 to get a jump on traffic because the snow had become heavy already and they were predicting at least a foot of snow for our area. The first thing I did when I got home was change into something warm and cozy and get the fireplace started. The snow was already about eight inches on my patio. It was a perfect night to make some good comfort food for dinner. I was busy in the kitchen slicing beef for my famous Beef Stroganoff over egg noodles and worrying about Frank when I heard tapping on my back door. For a second I was startled, thinking who would be out on a night like this?  Then I thought, Frank, that's who. I looked out and there's Frank standing in front of my door covered in snow with no coat, just a zip up sweat shirt on. I threw open the door and said "Frank, what are you doing out in this weather?"
"Uh, I lost my keys." Frank replied. He just walked five miles through deep snow in the dark. I quickly handed him a towel and some warm, dry clothes to change into. He seemed relieved to have made it to this refuge. He had a nice meal with us and I just kept chattering on about anything I could think of to fill in the space. Eventually, I ran out of things to say and I remembered that I had one of his mother's old recipe boxes in my cabinet. I said, "Frank, how about if we make one of your mom's recipes?" I pulled out the box and we began sorting through old, yellowed index cards in Terry's familiar handwriting. I took the box from her house after she passed away hoping to find her meatloaf recipe. Hers was the best meatloaf I've ever had and I'm still hunting for a recipe that will become my signature meatloaf. Alas, I haven't found her meatloaf but there's a bread pudding recipe that seems pretty quick and simple that we settle on. I send Frank in to relax in front of the fire and the television while I whip up the dessert. In no time at all we were savoring warm bread pudding with vanilla sauce, one of my favorite things. Who knew it was so easy? I brought Frank an extra large portion, and sat down with him in the family room while we waited for Matt to come home. I was happy to make him something that reminded him of his mom who we were missing so much. He enjoyed it and enjoyed it some more. He went in the kitchen and helped himself to three more servings until it was all gone. He really enjoyed good food, but I also learned that people suffering with FTD often over-indulge in food and do not realize when to stop.

Matt drove Frank home later that evening and used his spare key to let Frank in. We couldn't help but wonder if he really lost his key or if the hillbillies told him to leave. Frank denied seeing the hillbillies and servants after starting Abilify, but I had reason to believe he wasn't being truthful.


Terry's Brown Sugar Bread Pudding

2 cups soft 1/2" bread cubes
1 1/2 cups milk
1/2 cup brown sugar
1/4 tsp salt
1/2 tsp cinnamon
2 eggs beaten
1 tsp vanilla
1 tbsp butter

Mix all ingredients except butter and pour into greased one quart casserole. Dot butter on top. Bake in slow oven (350') for one hour.





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