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Fatigue and AnemiaFatigue and Anemia
          
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Quality of life - difficult decision.
Jun 17, 1999

Dear Doctor,

I'm 28, newly diagnosed after a severe ITP. I'm a strongly career oriented person, two week in the hospital drove me crazy. They told me I was close to die because my platlet count was <1000. Difficult to believe for me; I was coming back from a job trip, like usual. Two planes per week, thousand of km driven every month, talks, conferences, "big deals". I'm one of those kids who were gifted with a very high IQ, started everything early, running since always for career, success, new goals every day. In the hospital I understood I'm fragile, like all the people. If a small vein in my precious brain would have broken, no myself anymore, without even an advice. Then they told me that I'm HIV+. Life had a new meaning then. I felt "lucky" because at least I've been adviced. Now it's time to give improtance to quality, I said. So today, two months later, I ask myself how comes that I'm tired, I'm working like hell, I have no time for living; there are days were getting up from the bed is difficult, and consider I'm taking no drugs yet(CD4 >1000 VL 1700). I know myself well enough; without stress I cannot live, but how much this stress could damage me? How much I'll be tired in the future? How can I fidn a compromise between my life as it was and my life as it is with HIV?

Thanks first of all for listening and for any advice you could give me.

Anne

Response from Mr. Molaghan

Hi Anne

Whew! I think you answered part of your question yourself when you said ", I'm working like hell, I have no time for living; there are days where getting up from the bed is difficult." I appreciate the fact that you are quite used to living under "stressful" conditions. You don't have to give up the hectic life totally, but it is important to listen to your body. There is a difference between stress and mental stimulation. Try to modify your schedule so that you can reach a compromise. If you can't get out of bed in the morning, you can't make big deals, go to conferences etc. no matter how high your IQ is. Try substituting exercise for one of your high stress tasks. You are fortunate to have developed the insight to understand that the ITP was a serious situation and that perhaps you need to slow down, a bit. Immunologic suppression secondary to stress (either physiological or psychological) has been well documented.


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