Trying to help the unwilling
November 21, 2010 11:38 AM   Subscribe

My brother has been ill for a decade. Now there is a possibility of a real solution, but he won't try it. Any ideas?

About a decade ago, my brother began having symptoms of mental and physical illness: digestive problems, obsessiveness, rages, depression, sleeping difficulties, weight loss, lack of judgement, and allergic reactions to just about everything (he quite literally swells up when he eats). Standard and alternative medicine has left him with $50k in bills, on disability, and with no solutions.

Four years ago, my elderly father passed away from an idiopathic neurological disorder: ataxic gait, loss of the ability to walk, swallow, speak, and finally, breathe.

Two years ago, I started having the same symptoms as my brother: obsessiveness, rages, digestive issues, lack of judgement. After six months of more specialists than I care to count, my general practitioner said, "Let's test everything". And we got a hit: B12 deficiency, the symptom of a potentially genetic disorder. My life and sanity has literally been saved. My brother and father (sigh) were never tested.

There's no guarantee that my brother has B12 deficiency, but he refuses to even be tested. He also refuses to attempt treat himself (the high doses of B12 required are harmless to those without the disorder, and readily available over the counter). The combination of his allergies, mental symptoms, and rather understandable distrust of of the medical profession have led to what seems like an addiction to being sick.

I've talked to him for hours, sent him B12, done research for him, gotten other family to be involved... nothing. I have not yet pursued any form of social service intervention, nor do I know how to do so. He lives in a distant state in the US.

I'm at a loss. Does anyone have suggestions?
posted by anonymous to Health & Fitness (23 answers total) 4 users marked this as a favorite
 
Let it go. Continue to be in a regular relationship with him, but drop this subject, even in round-about ways. Either he'll be ready and ask you about it when he's ready, or he won't. You can't make him do anything, and your efforts aren't going to help this.

Make peace with knowing you are taking care of yourself.
posted by bluedaisy at 11:56 AM on November 21, 2010 [6 favorites]


How frustrating! My brother and sister both have this (pernicious anemia, right?), my doctor checks me every year.

It is so unbelievably easily treatable. I understand your brother's hesitation but it seems like a lack of trust for the medical establishment (they failed him after all) than an illness "addiction".

The best you can do is provide him with the literature and explain that it's potentially fatal and it's of little consequence to get tested (he has nothing to lose). The other problem is that he might have permanent neurological damage at this point.

Good luck to you!
posted by red_lotus at 11:57 AM on November 21, 2010


He seems to live far away (from "a distant state in the US"), so I'm not sure inviting him over for dinner is possible.

OP, I really don't know that you can get social services involved in whether he takes vitamins or not. You could maybe look into getting a judge to say he's unfit to take care of himself, but we don't really have enough info on your brother to know if that would fly.

Is he maybe sick of talking about this with you? You could try bargaining: "If you just try a day/week/month on the B12, I will shut up about this forever. If it works, we both win, and if it doesn't, at least you won't have to hear me talk about it anymore."
posted by asciident at 11:58 AM on November 21, 2010


I've had a weird disorder for several years and *everybody* has The Only Real Solution. It gets exhausting trying to sort through what's actual medicine, what's someone's pipe dream, what's actual quackery, and what's someone's mistaken correlation. At this point, I pretty much blow off anyone who isn't actually my doctor. I keep looking and keep trying, I do, but if someone comes up to me sure they've got The Answer and insisting I discard everything else and try it NowNowNow! Well, I'm much less likely to listen to them.

And I've only had my incapacitating, weird problem for a couple of years.
posted by galadriel at 12:11 PM on November 21, 2010 [14 favorites]


I was going to say something like what galadriel did--I've lived with chronic pain for 15+ years, sought multiple treatments, seen many a specialist and heard many stories from people who are sure they had the same thing and totally fixed it by taking a supplement or giving up sugar or getting chiropractic care or taking up shamanic healing or some other such thing. My pain has highs and lows, and so does my willingness to try one more thing to improve it--I've had my hopes raised so many times, and twice in the last two years actually tried treatments that provided near-miraculous improvement that turned out to be short-lived. Sometimes it feels like it's easier to live with the pain than go through another round of tests and (sometimes expensive and troublesome) treatments that some quack/expert is sure will fix me, but don't. I might go for a few years just doing the best I can to do the things that I know help a little, and then after awhile I feel ready to try again and take myself to my doctor for another round of tests and trying things and etc. I've been in the current round of trying things for several years now with no sustained improvement, and it's physically, emotionally, and financially draining.

Your brother might be in a similar place after so many years. If you've already hassled him about this a lot (sending him vitamins, talking to him for hours), if I were him I'd want you to let it go already. You might say one final time: "OK, I'm not going to bring it up again. But if you ever want to pursue this, I am ready to help you with it any time."
posted by not that girl at 12:20 PM on November 21, 2010 [2 favorites]


If Galadriel is right and this is about being weary of the hoardes of people offering solutions that ultimately don't work (or that it would be too mentally and physically exhausing to try them all), then you might take another approach. Your brother's doctor cannot talk to you about your brother, of course. However, if you know who that doctor is, you can talk to the doctor. Give the doc a call, say "I know you can't talk about my brother, but I just want to let you know about some of his family history that he might not have mentioned...I've been diagnosed.... etc. So you might want to test him next time he's in." At that point, hopefully the doctor does and this all works out without him having to take potentially quack-y advice from a non-doctor.

Oh, and you don't say WHY he says he doesn't want to try it. That might be useful information.

Worst case, I'm guessing: Eventually he will somehow lose consciousness for reasons related to his illness. When he arrives at the hospital they can pump him with vitamins (I assume consent would be assumed for an unconscious person).
posted by If only I had a penguin... at 12:23 PM on November 21, 2010 [3 favorites]


Oh, and obviously there's the possibility that if you call his doctor and he finds out that you did, he will be very angry with you. It might save his life, though, so it seems worth the cost.
posted by If only I had a penguin... at 12:25 PM on November 21, 2010


If your brother distrusts "Western medicine," perhaps he would be willing to see a naturopath? A good naturopath can recommend B-12 supplements, just as an MD would.

If you tell us where your brother is, we can probably come up with some names of quite sound naturopaths.

(I am generally anti- people saying "Oh, MDs are charlatans, so I'm going to this possibly completely uncredentialed person" but you need to start with your brother where he is--and then have us help you find some well-credentialed naturopaths.)
posted by Sidhedevil at 12:45 PM on November 21, 2010


"Look, you may or may not buy that this is what you have, but the B12 is harmless, just try it for a while. You've got nothing to lose and you might end up feeling better."
posted by L'Estrange Fruit at 12:48 PM on November 21, 2010 [2 favorites]


Don't stop trying. I mean, recognize that it might not ever work, but don't stop trying.

It's likely that the problem isn't your brother, per se, but the clinical depression that has set in after 10 years of him trying and failing. Consider treating the depression first, and then sell him on the B12 solution.
posted by Cool Papa Bell at 12:49 PM on November 21, 2010 [1 favorite]


Oh, and he probably doesn't really know what a B12 test is, from the perspective of actually having it done. As in, does he know it's only a blood test? Does he have a ride to the doctor? Does he have a day off to go to the doctor.

Many people live with illnesses because they simply can't visualize the steps required to get help. "Go see a doctor? How can I see a doctor if I don't have a car to get there?"
posted by Cool Papa Bell at 12:51 PM on November 21, 2010 [2 favorites]


Visit him for a week? Make breakfast for him every day and slip b12 supplements into his OJ?
posted by bq at 12:54 PM on November 21, 2010


The thing is that the brother may just now view MD and ODs as "people who don't know what the fuck they're doing" because they didn't know what the fuck they were doing for so long in his experience.

If you can get him to another kind of health professional to start the process of diagnosis and treatment, you can talk with him about finding an MD or OD he trusts once he's out of the health crisis.
posted by Sidhedevil at 1:00 PM on November 21, 2010


Depending on your relationship with him you can always joke about it. "Suffering from a B12 deficiency is like having scurvy. What a dumb thing to have. What's wrong with you? Join the 21st century."

Alternatively visit often and cook B12 rich meals.
posted by carlh at 1:07 PM on November 21, 2010


Alternatively visit often and cook B12 rich meals.

Pernicious anemia doesn't respond well to diet, actually (alas!) except when it is triggered or exacerbated by celiac disease or other issues that alter the digestive mucosa. You (one, me) need to take a lot of B12 to compensate for the failings of your (one's, my) gastrointestinal system.
posted by Sidhedevil at 1:09 PM on November 21, 2010 [1 favorite]


Sorry to be the voice of dissent, but I doubt there's anything you can do to change your brother's mind. My younger brother (who is now in his 40s) has long had what I can only describe as a "stubborn streak" when it comes to illness and medications. I don't know what his rationale is, it almost seems as if he believes it's some form of weakness to become "reliant" on pills. For example, on several occasions he's gotten what he thought was the flu (and even then refused to take aspirin or Tylenol) and didn't see a doctor until he was wheezing and coughing up large amounts of mucous and needed a family member to drive him to the doctor's office. And then afterward he seemed to be bitter and angry, almost like it was some sign of weakness or incompetence on his part that he required medication. Said brother currently exhibits every textbook symptom of depression but will never admit that anything is wrong, much less consider seeing a doctor for treatment.

Growing up, did either your mother or father have a similar "get over it" attitude toward illness? I know that my brother probably gets part of his attitude from our Dad, whose philosophy was always "there's something wrong with you if you get sick." That is, whenever he fell ill he always needed to place blame - it was because he'd gone to the supermarket and been exposed to germs, or (regarding his heart attack) it was because my Mom hadn't been serving him low-cholesterol meals for the past 40 years. Anyway, I don't know if there is a name for this particular mindset (other than "denial"), but from your brief description your brother sounds an awful lot like mine, and I don't know that anything can be done to open up their minds when it comes to medical intervention.
posted by Oriole Adams at 1:16 PM on November 21, 2010


Ditto Penguin: if your brother has a doctor, give them a ring and let them know you have been diagnosed with a disease with a genetic component and similar symptoms to those your brother suffers from. Any professional would be crazy not to look for B12 deficiency under those circumstances (assuming they haven't already).

No, your brother would probably never find out.
posted by nathan v at 3:56 PM on November 21, 2010


A different dissenting voice, and I've shortened the heck out of this. A chronic illness runs in my family.

Please don't be my brother. What I've asked him for is two things: to share health information openly and to be much less judgmental.

Please don't be my brother.
posted by vers at 4:14 PM on November 21, 2010


Suggestions that you sneak medical treatment to your brother are completely out of line. He's an adult and can choose to pursue or decline medical treatment, even if it's just harmless vitamins.

I'd suggest that you drop it, but anytime he complains about his symptoms, you say some variation on, "I'm sorry to hear that. I hate that you're in pain. I hope you'll consider getting tested for what I have, my life has been so much better since I was diagnosed." Because the thing is, all you can do for him, unless he's legally considered unfit to make independent medical decisions (and it doesn't sound like that's the case), is tell him what worked for you and then let him decide. He knows that you got tested, are taking B12, and feel it was the answer for you. You don't need to keep telling him. Whatever the reason he's not taking your advice may be, it isn't that he hasn't heard you or you haven't phrased it correctly.
posted by Meg_Murry at 4:19 PM on November 21, 2010


Anon, the only reason I'm chiming in here is because it sounds like you have some very real medical and scientific reasoning that is worth checking into.

Don't give up on your bro. However, you might want to try beating around the bush a little bit and not rush anything or force the issue.

Here's what I know about giving up on trying: I'm currently friends with a few guys (military vets) who have all manner of physical and mental ailments who are tired of trying because as time wears on, as humans, to survive, they have to adjust and make friends with whatever it is they have to deal with. For them it's very important to find a comfort zone and once they've found it, it's something that's really difficult to give up.

So this is a conundrum because to ask him to try again is both humiliating, a reminder that he's fucked up and is asking him to give up whatever comfort he's found.

With that known, keep up communication with him. Don't make him the focus of conversation, keep it real, and keep it cool. When an opportunity strikes, you might mention the B12.

Take as much time as it takes, take it easy and slow, but keep trying!
posted by snsranch at 6:37 PM on November 21, 2010 [1 favorite]


Just giving you a small suggestion. If you are going to contact his doctor, as some have suggested, a letter might be a better way of doing so.
posted by annsunny at 7:03 PM on November 21, 2010


Ask your doctor if he is willing to contact your brother's primary doctor on your behalf. Your brother's doctor's could then go from there.
posted by alex3005 at 12:03 AM on November 22, 2010


I'm all with the first paragraph of Meg_Murry: it's his body, it's his treatment, it's his choice.

But I would add that it isn't your place to mention it every time he mentions the symptoms -- surely it's more your place to be supportive and listen (even for the 1000th time) than to effectively cut off him expressing himself with the This Worked For Me. He is not you, even if he (perhaps?) shares the same physical condition.

Wait. Try to accept your brother for who he is, with or without the illness. Do not make him guilty for the way he deals with his body. People can take a long time to come to decisions like these - your story speaks for itself, and he, in the future, can choose whether or not to mention to his own doctor your condition.
posted by squishles at 4:19 PM on November 22, 2010


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