Medical Factitious Disorder?

Does anyone have experience with a friend or partner who has factitious disorder?

I have a long-time friend who I also suspect of, at the very least, elaborating about some of her medical problems. The recent crisis has everyone stressed and frightened (including me) and it would be a relief to have some perspective from my smart Doper colleagues.

I’ll be happy to add some details if there’s interest in discussion.

True factitious disorder is extremely rare.

I am interested in more details. For example, do you have any evidence that this person has deliberately done something to make himself (or herself) ill?

Over the years I’ve seen a number of Munchausen’s and Munchausen’s by proxy patients.

It’s not a rigid line. There is something in many people that lends itself to grandiosity. Most patients love being told they had the biggest gallstone or the nastiest fracture, or whatever. And of course many patients obsess about their health. It becomes difficult to sort out who is harmlessly hypochondriachal, who is exaggerating deliberately simply to garner attention, and who is delusional enough to actually think their particular problems are real.

And many patients, like my mother, have a way of presenting facts which manages to tell the truth in a way that makes people believe something else, or forget “details”. But she does that about everything, not just her health or her habits.

Oh, she also suddenly stops complaining as soon as we start pointing out the things she does which are damaging to her health. Things like “Mom, are you sure that a glass of freshly-squeezed orange juice, an apple, two slices of melon, a quarter of a baguette with margarine, another quarter with olive oil and salt, three slices of serrano ham, a large machiatto and three no-sugar-added cookies is an appropriate breakfast for a diabetic?” (I suspect that Mom’s sugar doesn’t test high because she is a diabetic, it tests high because she tries to eat the world out of sugar)

Perhaps “factitious disorder” isn’t the correct term, but here is a long story made short: my friend, “Ann,” claimed to have brain and liver cancer nine years ago. There was not much evidence of her going through chemo (like missed work, appointments, drugs around the house), but she did throw up often.

The cancers were in remission over the following years, but there were a plethora of minor illnesses for which there was little-to-no evidence. Nine months ago she said that she had lymphoma w/kidney, brain, and liver involvement as well as MS. She said she’s gone through dialysis and now has full kidney recovery, but may have just a few months left if her liver function remains near failure. She says she is going through radiation therapy for the cancer.

I don’t live with Ann, but when I saw her last week she looked good – no jaundice, no needlemarks on her forearms, etc, and we went out to dinner. I also know that she’s holding down a full-time job and teaching at night. Given my previous suspicions and how these last nine months have been an ever-changing drama of “I’m dying in two weeks” followed by “my kidneys came back!” I’m torn between sorrow and skepticism. She won’t allow anyone to attend medical appointments with her and says that she has to do this alone.

So, thoughts? Could someone be as ill as she claims and be able to work two jobs and not look physically bad?

People on dialysis for renal failure have to go three times a week, and it usually takes 3-4 fours for a single session. They usually have a port implanted in the upper arm or near the collarbone that requires special care.
There’s no way someone could hold down two jobs and be that physically well while on that kind of dialysis.

There are home dialysis options and overnight options for those who aren’t that bad off, though.

Is a return of kidney function possible through two weeks of dialysis?

No, not if you’re doing dialysis for renal failure. You stay on it until you get a kidney transplant or until you die.
I’m an EMT and recently worked for a private ambo company, and part of what we did was take people to and from dialysis. Most of the people had been on it for quite some time, and the only reason we stopped taking a certain patient was because they’d passed away. There were staggered morning appointments and staggered afternoon appointments. Each appointment lasted at about 3-4 hours, 3 times a week, so there’s pretty much no way someone could do that and work a full-time job, let alone two jobs.
There are certain conditions where one might be on dialysis for a certain length of time and you get better (certain types of poisoning, I think - sorry, all my knowledge of that comes from watching House - :wink: )

Dialysis can be used during acute kidney failure i.e. a sudden illness that results in a short term, reversible failure of the kidneys. In these cases the dialysis keeps the patient alive until the kidneys recover. So yes, that aspect is possible.

However, it’s highly unlikely that someone could go through that while working full time and appearing physically well.

It’s been so long since I took abnormal psych, I don’t remember the distinctions among the different related disorders, but I have been close to a couple of similar situations.

Some years ago, my sister’s longtime boyfriend, with whom she had coincidentally just broken up, thought she’d like to know he’d just found out he had terminal cancer. It honestly never crossed her or our minds that this just might not be exactly true…He couldn’t work, although he also couldn’t get Disability, and had to give up his apartment. So of course my sister moved him in with her, thinking this was a very short-term thing because, after all, he was dying. It was much too late for chemo/radiation, so he went instead to other healers, and what do you know? The jerk-off lived. A miracle.

You’re doing what we should have done, which is seeing the inconsistencies in your friend’s story and learning what would be likely/possible in that particular health scenario. If we’d done that, we would have questioned why he “couldn’t” get Disability, how the cancer could have gone undetected so long, why he didn’t require pain meds, and so on.

More recently, a cousin of mine told several family members that her young daughter was having seizures due to an inoperable brain tumor. Because of my sister’s experience with her ex and also this cousin’s past history of, well, lying, my sister and I were rather suspicious from the beginning. (I have to add here that there was never any evidence that my cousin was causing her daughter to have seizures or was physically harming her in any way. Frankly, there was never any evidence at all.) My cousin had made these types of these claims before, but never over something so serious, and the more guillible family members were freaking out. One quietly began organizing a benefit. Another put the child on a prayer list at church, which in turn led to a church member who wrote a local column mentioning the girl’s condition, which was picked up by the editor and put on the front page of the local paper with no warning at all to my cousin.


My cousin never completely admitted to lying about the whole thing. She conceded that they didn’t yet have a diagnosis of a brain tumor. And that they hadn’t technically seen the neurologist yet. And that maybe the term “seizure” wasn’t exactly correct. The story quietly died, and my cousin hasn’t been nearly so dramatic since.

I don’t really have any expert advice to offer. Confronting your friend with inconsistencies (as was accidently done in my cousin’s case) might or might not work, depending on her actual mental state. It may be easier, and just as productive, to consider this a part of who she is, and then go from there in terms of deciding whether you wish to continue the friendship.