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I often wonder if patients who are sick for a long period of time resign to the fact that they will be patients forever and less inclined to fight to get better.  I am a family member of a bone marrow transplant patient who has been sick for almost all of the 15 months after his tranplant.

This family member has lost 30 percent of his body weight, sleeps most of the day and says he can't eat due to pain and fatigue.  How can you tell the difference between inability or unwillingness to eat?

The lack of nutrition is probably making the pain and fatigue worse.

This patients is reluctant to push for better medical advice.  This sounds like depression but what can be done to get such a patient to get help?




Posted: 10 May 2007 02:17 PM
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It does sound like depression. Fatigue, poor appetite, poor sleep, and apathy can be symptoms of depression as well as hopelessness and inability to enjoy activities. You can request a consult with psychiatry for your family member and a consult to the fatigue clinic. Sometimes a psycho-stimulant medication can be prescribed to help with fatigue. Often people who are depressed don't have enough energy to seek help. It is also important to make sure s/he has good pain control. You can be the advocate for the patient and request these consults.

Mary K. Hughes, R.N., C.N.S.
The University of Texas M.D. Anderson Cancer Center
Psychiatry Department
1515 Holcombe, 453
Houston, TX 77030
Psychiatric Clinical Nurse Specialist
Voice Mail: 713-745-4630
Office: 713-745-3344
Clinic: 713-792-6600
Fax: 713-794-4999

This communication is not intended as professional medical advice nor is it a substitute for an office visit. The content provided is for general information purposes, not specific treatment. If you have a urgent problem, call the office immediately. Do not wait for an e-mailed response.

Posted: 11 May 2007 07:51 AM
Originally Posted: 11 May 2007 07:52 AM
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