Read story D11: Not his usual illness (image and text)
Not his usual illness
Marcus has longstanding schizophrenia. New thirst, drowsiness and disorientation are different from his usual experiences. Urgent physical assessment finds very high blood sugar and delirium.
A person with a mental illness can develop delirium from a physical illness. Describe what is new, when it began and what the person is normally like. Sudden confusion or reduced responsiveness needs urgent medical help. The physical and mental health teams should coordinate care, including a review of regular medicines.
Story text
Panel 1. Marcus has lived with schizophrenia for thirty years. He knows his voices well.
Panel 2. This week he is drowsy and very thirsty, and does not know where he is.
Panel 3.
- Mental health nurse: It sounds like a relapse. His medication may need increasing.
Panel 4.
- Leon: His voices aren't new. This is different. He didn't know me this morning.
Panel 5.
- Mental health nurse: You're right. This needs a doctor now. I'm calling an ambulance.
Panel 6.
- Doctor: His blood sugar is very high. He has diabetes, and delirium.
Panel 7. Fluids and insulin bring his sugar down slowly. His usual medicines are reviewed with his mental health team.
Panel 8. A week later.
- Marcus: The voices are the same as ever. But I know where I am.
Bottom band. In someone with mental illness, new confusion needs an urgent medical check for delirium.