Brother: Extreme Psychosis & Suicidal w. + ANA NUCLEOLAR+More

@sophiaurtis, it is clear that you are very concerned for your brother. Mayo Clinic Connect is a community of patients and caregivers like yourself. If you would like a medical professional to review his case, you may submit an appointment request at Mayo Clinic here: http://mayocl.in/1mtmR63

Is must be so hard to keep your brother safe. Do you live close to your brother?

@sophiaurtis
How long has your brother had his symptoms? What are all of his symptoms?

Does your brother have any other medical conditions/diagnoses, treatments, medications, etc.?

Does your brother have high blood pressure? Has he been to a cardiologist, vascular/vein specialist and pulmonologist to check for heart/lung/circulation health? This can affect the brain. The changes in the brain may not necessarily be caused by autoimmune issues and may be vascular/circulation/viral issues.

Did your brother have Covid infection and the shots the last few years?

Does your brother smoke, vape, drink, or do drugs (cocaine/marijuana/heroin) that can negatively affect his heart/lungs/brain? Has he had any abuse of painkillers after an injury? Did he ever have a concussion or accident where he hit his head?

@sophiaurtis
1. https://www.mayoclinicproceedings.org/article/S0025-6196(19)30075-8/fulltext
2. https://radiopaedia.org/articles/cerebral-cortical-t2-hyperintensity?lang=us
3. https://www.ajnr.org/content/early/2021/10/07/ajnr.A7302
4. https://psychscenehub.com/psychinsights/white-matter-hyperintensities-mri/
5. https://www.wjgnet.com/1949-8470/full/v12/i5/48.htm
6. https://www.ajnr.org/content/early/2021/10/07/ajnr.A7302
7. https://psychiatryonline.org/doi/full/10.1176/jnp.13.2.261
8. https://www.sciencedirect.com/science/article/pii/S0278584623000854
9. https://neurolaunch.com/flair-hyperintensities-in-brain/
10. https://www.verywellhealth.com/what-are-these-spots-on-my-mri-2488902
11. https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-016-0720-5
12. https://www.psychiatryonline.org/doi/10.1176/appi.ajp.2018.18050568
13. https://psychiatryonline.org/doi/pdf/10.1176/appi.ajp.2018.18050568

These articles are extremely helpful thank you so much for sending. I am glad to read something that the hyperintensities in white matter on MRI can be interpreted as not normal - because the overall medical interpretation that was given to us said it was normal.

I will continue to read through all of these. They help. Thank you.

Symptoms since 2021, He has slightly high arsenic in his urine, he has supposed damage to his long thoracic nerve that healed improperly that a shoulder specialist diagnosed him with prior to all of this and said he needed surgery to correct by lifting his scapular, which he has not gotten the surgery yet because we want to figure out the rest of this first.

I am not sure about high blood pressure and no cardiologist or vascular specialists or pulmonologist. He does have trouble breathing - he complains constantly of not being able to take a full breath, and the shoulder specialist said this is because of his sagging scapular - I'm not sure if that's it though considering the full picture - but could be.

He never tested positive for covid, but he was in a household where everyone had covid and my mom showed no symptoms when she got covid, so could have been that he was asymptomatic there. he did get one covid vaccine shot.

He does nicotine by form of zyn and vape. he does not drink or do any drugs - he has smoked marijuana in the past. no painkillers at all. He was a hockey player and did have concussions - I believe one bad concussion, but seemed to heal and was fine for a long while after.

Thank you - I will do so if the neurologist at Northwestern is unable to help further.

Yes I do and he does live with my mom, who is his primary caretaker. We just want to help him the best we can to live a higher quality of life, whatever is going on with him.

@sophiaurtis
First off, you are an amazing sister! Thank you for caring so much for your brother to seek help for him and his health struggles. You are a true blessing to him! 🙂

Do you know what happened about 4 years ago to trigger his symptoms he has had since 2021? Did he have an accident/injury and/or something happening to significantly impact his life? Did he have a loss of a family/friend or major stressor? Did he have a hard time after graduating high school?

He needs to get to the source of his high arsenic in his urine. I think this toxin can wreck havoc on his health. It is in his vape products. He needs help to stop as soon as possible. It is damaging his lungs and possibly his brain chemistry due to toxic exposures.

1. https://medshun.com/article/why-would-arsnic-show-up-in-urine-sample
2. https://factor.niehs.nih.gov/2022/2/feature/3-feature-e-cigarettes-and-toxic-metals
3. https://publichealth.jhu.edu/2024/researchers-find-toxic-metals-in-e-cigarettes
4. https://cen.acs.org/safety/consumer-safety/Vaping-exposes-users-toxic-metals/98/i12

For your brother’s long thoracic nerve damage, did he have an accident? Did he injure his head/neck at the same time? If he didn’t have a MRI of his cervical spine, he should see an orthopedic spine specialist for this. He can have cervical spinal cord/nerve root compression that is causing him symptoms in his head and below the level of compression (affects arms/hands, legs, etc.). Has he had physical therapy for his shoulder? Did he see a neurologist for EMG/nerve conduction studies of his upper and lower limbs to see if he has any neuromuscular impact.

In addition to stopping gaping, your brother should see a pulmonologist to check in lung health/function, oxygen levels and determine if he has sleep apnea.

Covid and the shot has been known to cause nervous system and heart/lung issues, especially in teen boys and young men. My teen son has a heart defect so I did not get a shot for him but he did have Covid 2 times and has long covid symptoms now.

Your brother may need inpatient mental health support and evaluation and assessment. He matters. He needs to not feel embarrassed for getting him the mental health support he needs. He may need talk therapy and antidepressant and/or antipsychotic medication that a psychiatrist can help him with.

Your brother may also benefit from seeing a dietitian/nutritionist to help him detox the arsenic, etc. from his system.

I pray that God will guide you, your brother and family on the best way forward for better health overall. It is all overwhelming so just take one day at a time while walking closely to God.

@sophiaurtis
The more I am reading about long thoracic nerve injury, it seems tied to the cervical spine. It is important that your brother’s cervical spine is looked at if it hasn’t already been by an orthopedic spine specialist.
1. https://www.sportsinjurybulletin.com/diagnose--treat/long-thoracic-nerve-injury-the-shortest-route-to-recovery
2. https://radiopaedia.org/articles/long-thoracic-nerve
3. https://www.imaios.com/en/e-anatomy/anatomical-structures/long-thoracic-nerve-1557861152

This is not a diagnosis but it does affect the brain and cns (central nervous system)
Testing for Sjogrens
Lip biopsy by ENT
Go to eye doctor have him tested for dry eyes and cornea abrasions
Sjogrens can cause problems with the brain white matter T2 flares
High ANA looking for autoimmune disorders. I have a huge list of autoimmune diseases to be checked for.
https://ajronline.org/doi/10.2214/AJR.10.5984#:~:text=MRI%20of%20patients%20with%20primary,impairment%20%5B7%E2%80%9310%5D.