Home Alone

Just as I was entering week two of a kick-in-the gut relapse of my pain condition, Richard needed to travel for a few business meetings. Usually he works at home and conducts business through the vast amalgam of web tools he has harnessed.

So I am hurting, alone. And he is worrying, alone.

But now, we are older and more experienced, and have lived through the darkest days of the pain, and through innumerable bursts of relapses over the past ten years.

Before he left he stocked the refrigerator with apples, and broccoli, and chicken, and Chinese take-out, and even cut up a whole watermelon into chunks. He set up videoconferencing on my laptop (his already had this capability). I made dates with friends to talk to and walk with and have me over for dinner. I upped my meds to dull the sharper edges of the pain.

Richard and I talk and text and tweet each other. It's some comfort. but it's hard on both of us to be hurting and worrying, alone.

How do you manage the daily tasks and find comfort when you and your sweetie are apart?

Caretaker Stress Affects Health of Partner with Heart Failure

From an article by Nicole Stodard in EmpowerHer

A recent study that appears in the July/August 2009 issue of Heart and Lung affirms in a broad sense what anyone in a committed relationship, particularly a marriage, already knows from experience: one spouse’s mental or physical health ailments can, and often do, tax the other spouse.

This study is particularly concerned with the implications of this dynamic when one spouse has some form of heart failure (HF), a chronic progressive condition that occurs when the heart muscle can’t pump enough blood through the heart to meet the body’s blood and oxygen demand.

The study found that a spouse’s distress had substantially greater impact on the HF patient’s overall health and the course of the patient’s illness than the reverse scenario. Considering the fact that 5.7 million Americans have HF and well over half a million new cases are diagnosed each year, this is concerning.

Relationship Stress Goes to Work

From a story by Ken Potts in the Daily Herald:

Most company-sponsored health plans do not cover marital therapy. The assumption seems to be that marital issues do not really impact job performance and, thus, should not be part of job-related health insurance. There is also a concern that marriage therapy goes on forever and doesn't really accomplish much.

Though the second assumption as to the effectiveness of marital therapy has been debunked more than a few times, the first assumption has been stubbornly held on to for decades. Employees leave their home life at home, or at least they should. Work is for work!

Of course, we all know from our own experience that is not true, but somehow that hasn't change our minds. Or, at least, until recently.

Research completed at a major university concluded that troubled marriages cost the economy $2.9 billion a year. That's right - $2.9 billion.

The study suggested that stress is known to weaken the immune system. Any relational struggles, but marital conflict in particular, result in a significant increase in stress for the people involved. The research suggested that marital-related stress resulted in a significant increase in illness and in the use of sick days by employees.

What Would You Like to Say to Future Physicians?

The blog Edwin Leap, is hosting Grand Rounds and had asked for submissions on the topic - "What would you like to say to future physicians?"

Here's what I would like all doctors to have engraved on their frontal lobes.

ILLNESS IS ABOUT NOT JUST THE PATIENT. IT'S ABOUT THE COUPLE.

When you're in a relationship and serious illness hits one partner, both lives are dislocated. Illness becomes the uninvited third party in the relationship. The changes are profound ones. Two people are suffering.

Doctors should understand that in treating the ill partner, they are also affecting the well partner. If they do this with consciousness and clarity, both partners stand a better chance of surmounting the challenges of illness.

As I was searching for help with a chronic pain condition, I once had a chance to read my medical record for a series of visits with a specialist. He wrote, "Patient appears to be nervous - she brings her husband to every appointment" -- as if nervousness and including my partner were somehow aberrant behaviors.

My partner was my driver (I was in too much pain to get behind the wheel), my memory (I didn't trust my own memory to hold onto the doctor's words), and my main support. And not only that, but he wanted to be there. He felt as much inside my experience as I did.

And he suffered -- fear, helplessness, frustration anger, loneliness, disappointment, and more fear.

Doctors should not only invite the patient to bring his/her partner into the consultation room, doctors should take a few moments to turn to the partner with interest and compassion and ask, "So how are you doing?"

That simple question can not only help the partner feel validated, but it may also help him/her find the strength to go on. And if the partner can go on, chances are, so can the patient.

ILLNESS IS ABOUT NOT JUST THE PATIENT. IT'S ABOUT THE COUPLE.

Grand Rounds is Up

Have a look at Florence dot com.

What Do You Say to Yourself When You Have a Relapse?

Damn. I had been doing so well for so many months. Then WHAM. From nowhere. The pain started snaking its way back in. Was it the stress of a presentation I had to make in front of a prospective client? Was it the humidity? The unseasonal chill in the air? The baba ganoush?

My first reaction is to churn with anger. No. Not now. Go away. Damn you to hell.

But then I realize that the anger only riles up the neurotransmitters that fuel the pain. And besides, the pain is part of me, and there's no sense in raging against my self.

So, what do I say to myself to get through this episode? This may sound a bit crystal-headed, but it works for me. I say:

"All the healing forces in the universe pass through my body."

With each breath, I take in the surrounding molecules and the ones they have come in contact with, and the ones they have come in contact with, and the ones they have come in contact with - to the end (or the beginning) of time and space. It all flows through me. And some of it must be healing.

What do you say to yourself when you have a relapse (or when your partner does)?

Grand Rounds is Up at ACP Internist

Check out this week's collection of posts from the health care blogosphere at ACP Internist.

And there's a new blog carnival for patient bloggers. Check out the first edition at Duncan Cross' blog.