Good morning! My day started with a bit of disappointment today – kids school closed due to the winter storm and today was Mother’s Visitation day! :(.
But, as I was browsing my website, I came across some reviews of my work. This one immediately warmed my heart. Not just because of what it says about my work, but also the words used by this mom to describe her son: “he lives with schizophrenia,” not, “he is schizophrenic (or bipolar or etc).”
He and his family are breaking out of the shackles of identification with the disease!
Here is the review:
“Dr Tummala is my son’s Psychiatrist and he couldn’t be in better hands. He lives with Schizophrenia and has improved under Dr Tummala’s exceptional care. Prior to her care he felt like he was not heard or listened to and just handed a prescription. He really believes in Dr Tummala because she actually cares about his health, his future and has a vision/plan for better health for him. She treats the entire person, physiologically and emotionally. She is exceptional by all standards.”
He was on medication for over 10 years – two antipsychotics and a mood stabilizer. But when I first met with him he was very symptomatic: delusions, hallucinations, severe thought disorder (his sentences were so disjointed that he did not make much sense when he spoke) and very poor self care. So, what worked?
Addressing the root cause. Per my evaluation, I found him to be in a state of severe systemic inflammation, moderate to severe nutritional deficiencies, poor gut and digestive functioning, and on and off drug use (due to manipulation and exploitation by a heroin addict “friend”).
- Do everything possible to reduce inflammation in the body and the source of it. Beginning with his diet – FM’s elimination diet. When he was so psychotic, how was I able to reach him? Being fully present in the situation with him and actually trying to make sense of his convoluted sentences. Later, he stated that this effort of mine established the basis of our therapeutic relationship. At first, I felt I was trying to connect with someone who was in a deep fog. I even wondered if I was connecting with him. But I persisted and I’m so glad I did! Mom played a huge role with the diet aspect.
- Nutritional Supplementation.
- Regular psychotherapy. Along the lines of cognitive therapy for psychosis.
- Addressing social causes: Changed his apartment, got a restraining order against the “friend” who was physically abusive. It also became clear that this patient used drugs only when with this friend. Enrolled patient in a drug rehab program.
- Now, he is off one antipsychotic and working on tapering the mood stabilizer. I’m not entirely sure he will need the other antipsychotic long term. After all, long term studies of antipsychotics from Europe are showing that antipsychotics are good in the short term, but in the long term they cause more disability and dysfunction (not to mention metabolic syndrome). He is engaged with the world. Speech is normal. No delusions or hallucinations (or rather a pact between us that he will “ignore” the delusional ideas and focus on the real world – #CBTforpsychosisworks!), and engaging with DVR. We have reduced his long term risk for metabolic syndrome and even early mortality, while increasing his potential for a more productive, happier life.
- Our work is ongoing and I am so hopeful for him, as he is for himself, and his family is for him!
- It was not always easy, though. Midway during this treatment, after I had begun to reduce one antipsychotic, he became more psychotic – agitation, delusional, irritable. His case managers (“the system”) were quick to point fingers at me and say the relapse was because I reduced one antipsychotic. I began to question myself but stopped short of increasing his antipsychotic in a knee jerk fashion. I waited to get the story from mom and patient. It turns out that the “friend” has once again free loaded in patient’s apartment. The patient was beaten up badly during this time but he also used IV heroin, which led him to have severe thrombophlebitis (infection in the vein). He was actually in delirium due to sepsis (spreading of infection and toxins throughout the body).
His mom was getting concerned about his behavior. He was not meeting with her face to face. She insisted on him doing so and when she met him, his arm was so badly infected that it smelled putrid. He was taken to the ER right away and needed ICU admission with IV antibiotics. His doctors commented that any more delay and we would have lost him or the arm. Once the infection cleared, his “psychosis” cleared. Again, this worsening of symptoms was not “schizophrenia coming back,” but rather inflammation worsening his brain functioning. His recovery seemed to pick up where it was interrupted. That’s when I asked for a restraining order, change in apartment, and enrolled the patient in drug rehab. All of which he fully co-operated with. The rest is as above.
- Bottom line #recoveryfromschizophreniaispossible!