I mentioned some of this on my ongoing rambling thread, but was hoping for some insights from anyone who has seen it. On Saturday C's arthritis got worse out of the blue. I gave her paracetemol, though she is on Ibuprofen gel and butrenorphine patches anyway. On Sunday she could not get out of bed for the pain and was struggling to breathe. 111 sent an ambulance, and she was fine once they checked her out and got her out of bed. Of course the happy face was back again when she had someone in and she just wanted to be nice and apologise for being so much trouble. On Monday she was normal again, or at least what I call the new normal. On Tuesday she was bad again, though her chiropodist who has nursing experience thought it may be partly in her head. The on call doctor came out to the house and asked for urine sample and blood test to check kidney function. On Wednesday we cancelled a trip to the new day centre while we waited for the test results which won't actually come until Monday. C was in a bit of pain, but not as bad as Sunday. Today she was really bad again, sat for half an hour or so muttering about being on fire. Her face was drawn and she looked so ill. The ambulance crew came out, doctor had suggested calling them if she got worse again. She was in the toilet when they arrived and was suddenly a lot better again with her old happy charming personality to the fore. Could she have been constipated and something cleared ? Would that make such a dramatic difference ? Ambulance crew spoke to the surgery, as I was on the phone chasing up test results, but the nurse practitioner checked for a UTI and she was clear. There was blood in the urine and a bit of a rash down below. Now she is sitting happily listening to Andre Rieu on DVD. Has anyone else seen such a dramatic change from hour to hour and day to day. Is it the constipation or can bad pain confuse someone with vascular dementia so much they act and look so ill. I was writing it all down in the diary earlier, and even now writing it here again cannot understand what is happening over the last few days. Thank you reading and for any help or insights.