How much does stress really count?

[Maestro]

If you have been following our latest dilemma, my Uncle is understandably under a tremendous amount of new stress.  He tells me he wont sleep for 3 days, I know he is not eating well, and I am sure other horrible habits are going on that he won't tell me about.

So my question is this:  How much do you think stress actually will affect his immune system?  He already has very low #'s and is on meds.  Is this the sort of thing that can push him over the edge?  Or just this make life more difficult?

I realize there is not really a quantitative answer to this, but just looking for some opinions/personal experiences.

Regards,
M

[Boo Radley]

Maestro,

From what you wrote it sounds as if he is having problems already, like not sleeping for 3 days.  Neglecting nutrition isn't wise, either, especially if your immune system is compromised.  Are you worried about about substance abuse at all?  Some recreational drugs are not user-friendly to HIV infected people when used too often.

In my experience chronic stress and anxiety hampered my immune response but when the stress was greatly decreased my health improved.   But like I say all the time, each person is different in the ways his/her body reacts.   What is unmanageable stress for me might not harm your uncle if he has a higher threshold, as it were, against stress.  Sorry to be so wishy-washy.

Is there some way you could "sit down" with him (you live in different states, right?) to make a list of issues to be resolved and work with him to accomplish each task?  I know that sounds simplistic (or even stupid) but I have been able to marginally function when necessary by writing down every issue and working on the list one item at a time.  I'm talking about basics like reminders for blood work, docs appointments, prescription refills, etc.  I know he has some major issues but if he can qualify/quantify them in his mind he might be able to concentrate on number 1 and work from there. 

I hope someone can offer more concrete advice.  Good luck!

Boo

[Miss Philicia]

Isn't this the guy with the oxycontin problem?  I'd think he's be nodding off left and right.

[Maestro]

Isn't this the guy with the oxycontin problem?  I'd think he's be nodding off left and right.

He's taken so much oxycontin its like baby aspirin to him now!

[Maestro]

Boo,

The main obstacle here is that he refuses to admit anything is wrong.  He has been through hell and back during the last year and he acts like everything is great.  3 doctors have told him he is depressed and needs help.  He refuses.  There is no way I could have any kind of sit down.  The second I try, he would just jump down my throat about how he doesn't need any help...

Well, without my help he would have:
Died in Austria
Died in Tampa
Died in California
Gone Broke
Alienated EVERYONE
No hope for insurance
and on and on and on...So all these things keep building up, the stress of keeping it bottled up must be mind numbing...not to mention he pushes it further down with his pain killer addiction...

Bear said it is like watching a train wreck and more now than ever I feel like the train is about to come to off the tracks!

M

[Ann]

M,

One thing you haven't mentioned in a long time is the death of your uncle's partner. From what I remember, he died while your uncle was ill in Austria. I can't help but wonder if a lot of this "depression" every one keeps telling him he has is more to do with unexpressed grief than any stress. Has anyone sat and reminisced with him? It seems to me like his life partner has all but been forgotten about. And this is difficult for me to write, but I think it needs to be said - is it possible that your uncle misses his partner so much that he wants to join him? Just something to think about.

Ann

[Boo Radley]

Maestro,

Having very porous pumice for a brain I often forget aspects of other people's situations, like the fact your uncle's partner died.  I think Ann may have hit the nail on the head -- grief over the death of a loved one, especially one's spouse, can sink people into the lowest depressions.

Your uncle needs an intervention, which I realize is impractical for several reasons.  Besides his refusal to listen and his drug use you're too far away to implement such an action.  It's possible for anyone going through such turmoil to snap back to wanting to live with time, but time doesn't appear to be a commodity he can waste.  He's too sick physically, mentally, and emotionally. 

What is his source for the oxycontin?  If it's a doctor can you call him/her to discuss the situation?  With patient confidentiality laws as they are the doctor may not be able to disclose information to you unless your uncle has given you legal/durable power of attorney (I think that's it...) but you can still inform the doctor of your uncle's situation in general and with the oxycontin specifically. 

There may be nothing to be done as one cannot be coerced into a hospital except for life and death psychiatric problems (i.e., legally declared a physical danger to oneself or the public).  You are doing the best you can and I hate to sound negative, but you can only do so much.  Your uncle has to admit to his problems and seek help to resolve them.  Until he is ready to do that you're powerless.   You have been and are a blessing to him and he undoubtedly realizes it but is trapped in his present dilemma no matter how you try to help him.

I guess your uncle doesn't see a psychiatrist, does he?  If he does the psych might be able to declare your uncle a danger to himself but that's a really long stretch -- a patient has to clearly state an intention to harm himself before a doctor has legal authority to have the patient committed to a mental health facility.  Doesn't sound like your uncle would bother saying that since he's passively committing suicide without recognizing or acknowledging the facts.  If he could be hospitalized in a general hospital with a mental health ward he could start receiving therapy, addiction recovery assistance, treatments for HIV-related conditions, and whatever else he needs.

I apologize for hashing through options that are probably not available to you but I can't think of anything else.  Your uncle needs immediate care but won't get it until he admits it or his health declines so much he has to be hospitalized. 

Your uncle is extremely blessed with you to help him.  You have done and are doing everything you can.  No matter what happens you should  acknowledge your compassion and care and realize you cannot change his problems without his help. 

Good luck and take care of yourself as you struggle with all of these difficulties.

Boo

[Maestro]

Boo, Ann,

You are correct, his long time partner (30+ years) did die and that is what set this all in motion.  The amazing thing is he won't even admit it is sad.  He acts like it is nothing.  Very odd.  I once sat him down and told him that while he might not think this is sad, I lost my Uncle and I think it is sad. 

He gets his Oxy from a variety of pain doctors who most likely don't know he is shopping around.  He has the $$$ to buy the drugs on his own insurance obstacles are not a problem at this point.  He couldn't be more alone.  He has zero friends in California. 

I have finally come to the conclusion that there is indeed only so much I can do.  However, that doesn't make it any easier.  All I can say is that if February ends and I don't have any insurance for him, he is going to bring the insanity to a whole new level...And so may I !!!

Thanks for all your help...
M