A patient with multiple admissions for heart failure was noted to have new intermittent confusion, paranoia, with disoriented and fragmented thought processes. He did complain of back pain at that time. Psychiatry was consulted for a possible disorder and recommended initiation of an anti-psychotic. Patient presented again with hallucinations and complaints of back pain which was further investigated. Noted to have multiple myeloma on imaging that was causing hypercalcemia resulting in his altered mental status.
