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My husband just turned 70. Two years ago he had a neuro-psych evaluation and was diagnosed with "Sluggish Cognitive Tempo." Of course, when I was told this, I thought it was malarkey! But I researched and he checks off all the boxes. We have been together 10 years, married 8 years, and none of this was evident until about 3-4 years ago when he became nasty and mean (he started an argument with me over baking soda...no joke) and his memory became horrible. His one doctor started him on testosterone injections (he does have very low T) and they made all the difference in the world!! But they caused polycythemia (high RBC, Hemoglobin and Hematocrit). So they cut the testosterone injections by 25%, which brought his numbers down a little. But now he is back to being mean, nasty and irrational, and his memory is crap again. Our bathroom remodel contractor walked away because of his irratic and nasty behavior. I honestly don't know if our marriage will survive this. Does anyone know if there are alternative treatments for SCT that work?

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"Polycythemia vera is a type of blood cancer. It causes your bone marrow to make too many red blood cells. These excess cells thicken your blood, slowing its flow, which may cause serious problems, such as blood clots.

Polycythemia vera is rare. It usually develops slowly, and you might have it for years without knowing. Often the condition is found during a blood test done for another reason.

Without treatment, polycythemia vera can be life-threatening. But proper medical care can help ease signs, symptoms and complications of this disease."

Source: https://www.mayoclinic.org/diseases-conditions/polycythemia-vera/symptoms-causes/syc-20355850

The Mayo usually isn't wrong about stuff. Are you *sure* it's the testosterone that caused it? Maybe consider getting a second opinion?

Did your hubby ever have concussions in his life, like from sports or an accident? CTE can cause people to become nasty and violent, but can only be diagnosed post-mortem. Maybe consider anxiety meds to see if they can take the edge off. I wish you much success in getting the right help.
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Monica19815 Apr 2022
Thanks, Geaton! His Hematologist says that they ruled out primary polycethemia ("vera") thru a genetic blood test....JAK2. He is the doctor who has ordered the sleep study. And he did one of the two phlebotomies my husband has had recently. His urologist had ordered the first one. I know that genetic test is not always accurate and I hope he will do the more sensitive test if the sleep study comes back okay. My husband has also lost 30 pounds in a year, without trying, and suffers from night sweats (only in the past year) that soak the sheets. Then...other times...his hands and feet are freezing. He had a brain imaging done 2 years ago by the neuro and it was normal.
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Testosterone injections are poorly absorbed, even in younger men. Polycythemia is a known side effect. Testosterone comes in transdermal patches. Androderm. Sadly, no generic. See a month of that shows improvement. Try Costco, or manufacturer's web site for a coupon. Might help with price. Ask the prescriber of the injectable form to consider a trial of patches. My partner does not produce testosterone, so has been dealing with this issue for40+ years.
Get on the waiting list to be seen by a geriatrician MD or NP. They assess patients through the lens of the changes that are normal aging, and are familiar with the 'abornormal' ones, and treatments.
Could be thyroid, metabolic, pain, sleep apnea, fears and hallucinations that are not evident to you and that he will hide from you.
This is a hard place to be, for both of you. Good luck.
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Monica19815 Apr 2022
Thank you for your response! I will ask about those patches. He used to use the lotion testosterone but started to develop a rash from it. His urologist is going to order more extensive blood work (he mentioned the thyroid possibility). He does have sleep apnea and uses a cpap all night AND when he takes a nap. He has another sleep study scheduled in 2 weeks. I never considered pain. He is NOT truthful about when he is in pain. He does have back pain and the spine doctor said a nerve block was about all they could do for him and my husband won't have one.
I truly appreciate your reply and great suggestions. Very helpful!
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I had never heard of this either but "google is my friend" and it popped up.
It does say that it is a variety of ADHD. Has the doctor tried any of the medications that are commonly used for ADHD? It might be something to look into.
It also mentions medications for anxiety as well. It is a possibility that a combination of the two would work.
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Monica19815 Apr 2022
Thank you for replying! My husband is on Wellbutrin. I think 300 mg a day in a slow release form. With the testosterone injections, it was doing a GREAT job. But now we are back to 3 years ago when all this started. 😠 He is terrible to live with now. I am a very calm, patient, happy person, according to my husband. But this is really weighing me down!
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My heart goes out to you but please get a second opinion. There HAS to be Amex or treatment to help him… and you. Best wishes💕
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Monica19815 Apr 2022
Thank you so much!! 🙂 Seems like it takes such a long time to "rule things out" so that they can focus on a diagnosis. I forgot to mention that, in addition to the sleep study and more extensive blood work bein scheduled, he is also having a colonoscopy next month as he started to have some stomach problems in the last few months. He was due this fall but the family doc wanted it done sooner. You would think that, between 5 specialists, they would be able to figure out what is going on. By the end of May, when all these tests are done, I WILL have to start looking for a second opinion or go a different direction, like having him talk with a counselor that he can be honest and open with. He may tell them more than he tells me and his doctors!!
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This one is for followup with your husband's doctor for certain.
And truth told, your marriage may NOT survive it. You may have decisions to make. I would begin by being certain there are not accounts you can be "locked out of".
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I’ve never heard of this.
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