Couples Survive Cancer More than Singles

I thought this article was worth posting in its entirety (please forgive formatting issues).

Why being married could stop you dying of cancer: Sufferers have 'something to live for' if they have a spouse 

• Analysis of 60,000 patients showed singletons were more likely to die
• Patients' other halves are more likely to 'hassle' them to see a doctor
• For one blood cancer the unmarried had a 43 per cent higher death rate

By SOPHIE BORLAND HEALTH EDITOR IN CHICAGO FOR THE DAILY MAIL

PUBLISHED: 18:06 EST, 7 June 2016 | UPDATED: 03:00 EST, 8 June 2016

Being married increases your chances of beating cancer, experts have revealed.

An analysis of 60,000 patients over ten years found single or unmarried patients with the disease were a fifth more likely to die.

Researchers say having a spouse or family gives sufferers ‘something to live for’ and makes them far more determined to beat the illness.

Patients’ other halves – particularly wives – are more likely to ‘hassle’ them to see a doctor about any worrying symptoms or remind them to go to chemotherapy appointments.

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Being married increases the risk of beating cancer. Researchers said having a spouse or family gives sufferers ‘something to live for’ and makes them far more determined to beat the illness

Researchers from the University of California in San Diego presented their findings at the American Society for Clinical Oncology conference this week. They looked at the records of 60,000 men and women with leukaemia and other types of blood cancer between 2000 and 2009.

On average, patients who were not married were 21 per cent more likely to die than their married counterparts.

But among those with follicular lymphoma – a rare blood cancer – the unmarried had a 43 per cent higher chance of dying. And the figure was 37 per cent for Hodgkin lymphoma sufferers.

‘If you are single you don’t have someone at home nagging at you to get checked out.

‘This is particularly true with men. Women tend to have more support even if they are single.’

He added: ‘Married people and people with families are more likely to stick to treatment. They have a support system making them go to chemo, reminding them to take their medication.

‘They are also more motivated to seek out healthcare. To put it bluntly, they have something to live for. These results show that health services need to take more care of single patients – they need to be the surrogate for a spouse.

MARRIED PEOPLE ARE ALSO MORE LIKELY TO SURVIVE A HEART ATTACK 

Married people are more likely to survive a heart attack, according to British research.

Having a spouse to care for them ‘in sickness and in health’ improves patients’ survival chances by 14 per cent, experts found.

They were also, on average, likely to spend two fewer days in hospital after an attack.

Scientists studied more than 25,000 people with a heart attack diagnosis over a 13-year period, drawn from a database of more than one million hospital patients.

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Married people are more likely to survive a heart attack, a study has found. Having a spouse to care for them ‘in sickness and in health’ improves patients’ survival chances by 14 per cent

The researchers, from Aston Medical School and the University of East Anglia, suggested marital partners may offer the kind of physical and emotional support that bolsters patients’ determination to live. Presenting results at the British Cardiovascular Society conference in Manchester yesterday, the UEA’s Dr Nicholas Gollop said: ‘Our results should not be a cause for concern for single people who have had a heart attack.

‘But they should certainly be a reminder to the medical community of the importance of considering the support a heart attack survivor will get once they are discharged.’

There could be financial implications for the NHS as the average cost per day for patients on a surgical ward is £400. Reducing length of stays could save £10 million.

A recent British Heart Foundation study found one in three heart attack survivors has suffered anxiety or depression. Dr Mike Knapton, BHF associate medical director, said: ‘A heart attack can have both devastating physical and psychological effects … These findings suggest the support offered by a spouse can have a beneficial effect on heart attack survivors, perhaps helping to minimise the impact of a heart attack.

‘But when you have your heart attack, whether you’re married or not, it’s important to remember that you are not alone … a cardiac rehabilitation course, for example, will help you to recover physically, psychologically, and also help you to meet people who know what you’ve been through.’

About 188,000 people a year are admitted to UK hospitals as a result of a heart attack. 

‘Single people often don’t look after themselves.’

The university’s Professor Maria Elena Martinez, who was also involved in the study, said: ‘Being single should be a red flag for doctors. If a cancer patient comes in without a family member or spouse it should be a warning sign.

‘Medical staff need to ask the patient about the support at home. Doctors need to go that little bit extra with single patients.’

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Patients’ other halves – particularly wives – are more likely to ‘hassle’ them to see a doctor, researchers said

Previous research has shown that married couples are more likely to survive heart attacks, overcome high-risk surgery and also tend to live longer.

Adrienne Betteley, interim head of health and social care at the charity Macmillan Cancer Support, said: ‘We know that a cancer diagnosis can leave people feeling very lonely and that this can have a detrimental effect on their lives, with many forced to skip meals or attend vital appointments alone. At worst it can result in patients refusing treatment altogether.’

Cancer Research UK’s senior clinical adviser, Professor Arnie Purushotham, said it is ‘unclear why married people in this study seem to have better outcomes’.

But he added: ‘It may be that cancer patients who have close support of partners do better and this may be due to sticking with their treatment better and a network of social support. Developing such a network of support may benefit all cancer patients.’ 

Cohabitation or Marriage: Which is Better for Your Health and Happiness?

My guess is that this study did not look at couples living with serious illness in one or both partners. I wonder what the findings would have been if they had? I'm not suggesting that marriage weathers the stress of illness better than cohabitation, or vice versa. Nor am I suggesting that the legal ties of marriage mean couples tend to stay together during illness (nor am I suggesting that staying together is the right thing for all couples). It's just interesting, and not surprising, to me that the inevitable period of illness in a long-term relationship is not part of a study like this.

What are your thoughts? The study summary is below:

Study finds few well-being advantages to marriage over cohabitation

Benefits of marriage reduce over time while cohabiting couples experience greater happiness and self esteem

A new study, published in the Journal of Marriage and Family reveals that married couples experience few advantages for psychological well-being, health, or social ties compared to unmarried couples who live together. While both marriage and cohabitation provide benefits over being single, these reduce over time following a honeymoon period.

"Marriage has long been an important social institution, but in recent decades western societies have experienced increases in cohabitation, before or instead of marriage, and increases in children born outside of marriage," said Dr Kelly Musick, Associate Professor of policy analysis and management at Cornell University's College of Human Ecology. "These changes have blurred the boundaries of marriage, leading to questions about what difference marriage makes in comparison to alternatives."

Previous research has sought to prove a link between marriage and well-being, but many studies compared marriage to being single, or compared marriages and cohabitations at a single point in time.

This study compares marriage to cohabitation while using a fixed-effects approach that focuses on what changes when single men and women move into marriage or cohabitation and the extent to which any effects of marriage and cohabitation persist over time.

Dr Musick drew a study sample from the National Survey of Families and Households (NSFH) of 2,737 single men and women, 896 of whom married or moved in with a partner over the course of 6 years. The study focused on key areas of well-being, considering questions on happiness, levels of depression, health, and social ties.

The results showed a spike in well-being immediately following both marriage and cohabitation as couples experienced a honeymoon period with higher levels of happiness and fewer depressive symptoms compared to singles. However, these advantages were short lived.

Marriage and cohabitation both resulted in less contact with parents and friends compared to remaining single – and these effects appeared to persist over time.

"We found that differences between marriage and cohabitation tend to be small and dissipate after a honeymoon period. Also while married couples experienced health gains – likely linked to the formal benefits of marriage such as shared healthcare plans – cohabiting couples experienced greater gains in happiness and self-esteem. For some, cohabitation may come with fewer unwanted obligations than marriage and allow for more flexibility, autonomy, and personal growth" said Musick.

"Compared to most industrial countries America continues to value marriage above other family forms," concluded Musick. "However our research shows that marriage is by no means unique in promoting well-being and that other forms of romantic relationships can provide many of the same benefits."

Does Lisa Swayze (wife of actor Patrick Swayze) Have Super Powers?

Lisa Niemi Swayze has written a book about her experiences loving and losing her husband Patrick Swayze after a 21 month battle with pancreatic cancer. The book is titled: Worth Fighting For.

One review I read said:

"...The memoir reveals just how much one woman can change, when forced to confront the horrors of illness and the inevitability of those final moments. We witness the transformation of Lisa from a terrified creature who begs her just-diagnosed husband ‘Please don’t make me do this’, to the superwoman who refuses to give in, confronts every grim aspect of his nursing care and brings him home to die..."

They were two exceptional and normal people, as we all are, who loved each other and did the best they could. I confess I find it unfair to Lisa, and to the rest of us, to characterize her as a "superwoman." This makes it seem that her efforts came from some special source of rare super power she has access to, as opposed to the power that naturally derives from love and empathy - and that she is in a different class of being than the rest of us who live in the realm of illness with our partner.

What do you think?

What Couple-Related Decisions Have You Made Because of Illness?

There is so much uncertainty that accompanies illness, but one thing is certain -- illness brings change into how you think about yourself and your relationship. Illness can be a suppressant, but it can also be an activator. Illness can become a box into which you and your partner put your dreams; or it can be a catalyst to accelerating plans and making new decisions.

My illness led to our getting the most amazing dog in the universe (as is yours). It also led to writing a book about couples and illness. And it deepened Richard's and my ability to talk about the hardest topics.

Below is an excerpt from an article about a couple who decided to get married because he was about to undergo surgery for a cancerous tumor.

Geneva couple marries days before life-threatening surgery

by Frank Vaisvils, 8/31/11

David Bieszke of Geneva wasn’t going to give up on asking his girlfriend of 18 years, Jennifer Pedersen, to marry him, and she returned that persistence by insisting doctors treat her would-be husband for his chronic illness even when they were told nothing was wrong.

David’s health slowly deteriorated in recent years, and his family doctor was perplexed about the cause. Meanwhile, David experienced chronic fatigue and pain began growing in his abdomen.

In April, Jennifer’s persistence led doctors to diagnose David with a 10-inch cancerous tumor choking a major blood vessel in his chest.

He underwent a six-hour surgery on April 29 at Loyola Hospital in Maywood.

Fearing she might regret not marrying him if anything happened during surgery, Jennifer finally said “yes” to David and the two were married in front of a Kane County judge three days before the surgery.

At a time when most newly married couples would be celebrating their future together, this pair’s fate was anything but certain as David entered the operating room.
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What significant positive plans or decisions have you and your partner made because of illness?

Is There a Cure for Divorce?

While this article doesn't refer to illness, I thought it might be interesting to you for it's take on how to thwart divorce. Divorce and serious illness are not strangers to each other. In one study, when the man became ill, only 3 percent experienced the end of a marriage; but among women, about 21 percent ended up separated or divorced.

Excerpts from:
IS THERE A CURE FOR DIVORCE?
by David Wygant
Huffington Post
8/22/11

.....A relationship does not just end over night. It takes time. But there is that point in the relationship where the marriage "jumps the shark," as they say. It's often that one thing that happens over and over again, without the ability to change or compromise, and both partners emotionally close down on each other.

So when that one thing comes up, instead of shutting down, putting up your dukes, or setting down your battleground lines--basically letting your ego take over--what if that moment, when everything started going haywire, you actually do the exact opposite of what you normally do? What if, instead, you thought to yourself, "What does my partner need right now, what does my partner need today that makes them feel loved, and how can I provide that for them?"

So many times we really do know how to love the other partner, we know what they need and how to provide it. But we refuse to do those things because they're not doing things for us, they're not giving us what we want. That's probably how the majority of relationships end. The If-you-don't-do-it-for-me-I'm-not-going-to-do-it-for-you syndrome, and then a couple years later you're divorced, angry, pissed off, and ready to start over with the hope of a fresh new relationship. One that will probably repeat itself if you did not learn the lesson the first time around.

We refuse to love our partner the way they need, so the battlegrounds are drawn. Once the battlegrounds are drawn, you can kiss that relationship goodbye because there is no way in the world you're going to give in at that point. And neither is your partner. It often becomes a very dangerous tit-for-tat game that has no chance in hell of ever surviving or finding the love in the relationship again.

Relationships are a beautiful thing, and we could cut down on the divorce rate dramatically if we just spent a little bit of time every single day loving our partners instead of responding by how they treat or have treated us.....

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Your thoughts?

Health of Older Couples is Linked to Each Other

As if we didn't already know this........ (quoted from an article on the University of British Columbia's web site):

Physical and emotional health of older couples linked for better or worse, study finds

A study of older married couples that gives new meaning to the matrimonial adage “for better or worse” finds that spouses have a much greater impact on their partner’s health than previously known.

The study, published in the current issue of the American Psychological Association’s journal Health Psychology, finds strong associations between the physical and emotional health of older married couples – and provides important new information on the psychological toll of physical limitations in old age.

Researchers from the University of British Columbia and Pennsylvania State University tracked the emotional and physical histories of more than 1,700 older couples over a 15-year period, using data from a major U.S. survey. Participants ranged in age from 76 to 90 and many had been married for more than 40 years.

In individuals and couples, the researchers found a strong relationship between “depressive symptoms” (unhappiness, loneliness and restlessness) and “functional limitations” – the physical inability to perform such basic tasks as climbing stairs, picking up objects, cooking and shopping. While previous studies have linked physical and emotional health in individuals, this is the first study to show the phenomenon in couples.

“This study shows how important marital relationships can be in determining old age health,” says lead author Prof. Christiane Hoppmann of UBC’s Dept. of Psychology. “In addition, we show that many of the associations between functional limitations and depressive symptoms that have previously been found in individuals are in fact related to spouses.”

The researchers found that spouses’ depressive symptoms waxed and waned closely with those of their partners. Functional limitations in one spouse was not only associated with their own depressive symptoms but also with depressive symptoms in the other spouse. Increases in depressive symptoms in one spouse were also associated with greater functional limitations in both spouses.

“When people are depressed, they tend to want to stay at home – but that causes a spouse to stay home more too,” says Hoppmann. “That’s a problem, because when older adults stop being active – going for walks, socializing, shopping – they risk losing that functional ability. It’s that old saying, ‘use it or lose it.’”

“These findings help to illuminate the often vicious cycle between depressive symptoms and our physical abilities,” Hoppmann adds, noting that associations remained after controlling for individual (age, education, cognition) and spousal covariates (marriage duration, number of children) and did not differ between women and men.

Surprisingly, the researchers found that the relationship between depressive symptoms were slightly stronger in couples than some individuals, suggesting that a spouse’s physical or emotional health can have a greater impact on their partner’s health than their own in some cases.

“Being married for a long time is a very specific situation, it really ties your lives together,” says Hoppmann, whose previous research has explored happiness in older couples. “These findings show just how interdependent, emotionally and physically, long-term couples can become.”

Hoppmann says the findings point towards a greater need for holistic healthcare approaches. “This interdependence suggests that we cannot simply focus on individual patients, while disregarding the major impacts their illnesses can have on the people in their lives,” she says, noting studies have shown caregivers to be at a greater risk for mental and physical health problems.

The researchers – which include Anita Hibbert, a graduate student in UBC’s Dept. of Psychology, and Prof. Denis Gerstorf of Pennsylvania State University – say further studies are required to determine whether these spousal associations are specific to long-term married couples and whether they generalize to aging Baby Boomers who enter old age with more diverse relationship histories, including divorces and remarriages.

Is Marriage Good for Your Health? Maybe...Maybe Not

Excerpts from a New York Times article entitled: IS MARRIAGE GOOD FOR YOUR HEALTH? about research findings on the impact of relationships on health:

"Scientists have continued to document the “marriage advantage”: the fact that married people, on average, appear to be healthier and live longer than unmarried people. Contemporary studies, for instance, have shown that married people are less likely to get pneumonia, have surgery, develop cancer or have heart attacks....."

"New research is increasingly presenting a more nuanced view of the so-called marriage advantage. Several new studies, for instance, show that the marriage advantage doesn’t extend to those in troubled relationships, which can leave a person far less healthy than if he or she had never married at all...."

"One recent study suggests that a stressful marriage can be as bad for the heart as a regular smoking habit. And despite years of research suggesting that single people have poorer health than those who marry, a major study released last year concluded that single people who have never married have better health than those who married and then divorced...."

"...a second marriage didn’t seem to be enough to repair the physical damage associated with marital loss. Compared with the continuously married, people in second marriages still had 12 percent more chronic health problems and 19 percent more mobility problems."

"... results suggest that there are important differences between men and women when it comes to health and the style of conflict that can jeopardize it. The women in this study who were at highest risk for signs of heart disease were those whose marital battles lacked any signs of warmth, not even a stray term of endearment during a hostile discussion (“Honey, you’re driving me crazy!”) or a minor pat on the back or squeeze of the hand, all of which can signal affection in the midst of anger....Men were at risk for a higher coronary calcium score, however, when their marital spats turned into battles for control. It didn’t matter whether it was the husband or wife who was trying to gain control of the matter; it was merely any appearance of controlling language that put men on the path of heart disease."

"The solution....isn’t to stop fighting. It’s to fight more thoughtfully. “Difficulties in marriage seem to be nearly universal,” he said. “Just try not to let fights be any nastier than they need to be.”"

"...research shows that some level of relationship stress is inevitable in even the happiest marriages. The important thing...is to use those moments of stress as an opportunity to repair the relationship rather than to damage it. “It can be so uncomfortable, even in the best marriages, to have an ongoing disagreement,”... “It’s the pit-in-your-stomach kind of thing. But when your marital relationship is the key relationship in your life, a disagreement is really a signal to try to fix something.”"

Spinal Cord Injury and a Wedding

From an article on CNN.com:

A bride-to-be is joking around with her girlfriends at her bachelorette party and is pushed into a swimming pool. She hits her head and suffers a C6 spinal cord injury with paralysis from the chest down. She can use her arms and wrists, but not her hands. She is committed to adapting as well as she can and to leading a vigorous and full life. Her fiance is committed to her. They plan on marrying as soon as her complicated insurance situation is resolved. He says, "We are built to last.

When I read about a situation like this I am horrified and amazed. Horrified at the fates who can inflict such cruel tricks on us. And amazed at people's resilience and ability to continue on with a sense of possibility.

I also can't help but wonder about what the future holds for this couple.

What do you think they need in order to make it as a couple?

Early Love and Illness

A recent story in Parade entitled, The Only Time We Have Together is Right Now, is about the joy of a couple in their thirties who recently married. The male partner was diagnosed three years earlier with a rare and aggressive form of cancer.

"Bahar and Nick met at a bar in October 2008 after a University of Illinois football game in Champaign, where he was living. She noticed that her pal Matt had brought along “this really cute, well-dressed, quiet guy.” He wasn’t drinking, so she teasingly asked him why. “I’ve got cancer. I can’t,” Nick replied. “Can I buy you a drink?” Unfazed by his answer (“I’m an oncology pharmaceutical sales rep. I see people with cancer every day,” she says), Bahar shot back, “Really? That’s the worst pickup line ever!” He laughed, and they started talking"

They dated, fell in love, and decided to marry, as his health was declining.

"Wish Upon a Wedding (WUW), a new nonprofit that stages ceremonies free for couples in which one person has a serious illness or has had a life-altering experience. Explains WUW founder, San Jose, Calif., wedding planner Liz Guthrie, “You shouldn’t have to put your life on hold because you’re sick.” ....In her application, Bahar wrote, 'I don’t know what Nick’s current life expectancy is, but I do know I want him to be my husband forever.' "

Here are the questions this story raised for me:

• When serious or chronic illness is part of your relationship from the outset, or early on, what does it take to sustain Bahar and Nick's kind of live-and-love-in-the-moment joy?
• Is that even possible; or do the demands and constraints of illness eventually chip away at that joy and turn it to complacency and sadness?
• Or does illness act as an accelerant, clearing away the debris and pushing love to the foreground?

Did you and your partner get together when one of you already had an illness? Or did the illness appear soon after your relationship solidified? What has been your experience about the impact illness has on love and joy?

Is Marriage Good For Your Health

From an article in 4/12/10 New York Times by Tara Parker Pope. The essence of the article is that a good marriage is very good for your health; and a bad marriage is very bad for your health. The permutations and nuances of these findings are very interesting. Here are some excerpts from the article:

Is Marriage Good for Your Health?

"...scientists have continued to document the “marriage advantage”: the fact that married people, on average, appear to be healthier and live longer than unmarried people. Contemporary studies, for instance, have shown that married people are less likely to get pneumonia, have surgery, develop cancer or have heart attacks. A group of Swedish researchers has found that being married or cohabiting at midlife is associated with a lower risk for dementia. A study of two dozen causes of death in the Netherlands found that in virtually every category, ranging from violent deaths like homicide and car accidents to certain forms of cancer, the unmarried were at far higher risk than the married."

"....Several new studies, for instance, show that the marriage advantage doesn’t extend to those in troubled relationships, which can leave a person far less healthy than if he or she had never married at all. One recent study suggests that a stressful marriage can be as bad for the heart as a regular smoking habit."

Finally, an Article about the Caregiver

No news to most of us who either are the caregiver and know how powerful and endearing and demanding a role that is, or are the ill partner who witnesses the caregiver's fatigue. But this article in the New York Times articulates well how vital it is, especially for health professionals, to pay some attention to the caregiver.

Offering Care for the Caregiver

"......For all our assertions about the importance of caring in what we do, doctors as a profession have been slow to recognize family members and loved ones who care for patients at home. These “family caregivers” do work that is complex, physically challenging and critical to a patient’s overall well-being, like dressing wounds, dispensing medication, and feeding, bathing and dressing those who can no longer do so themselves.

Many of these caregiving tasks were once the purview of doctors and nurses, a central component of the “caring professions.” But over the past century, as these duties increasingly fell to individuals with little or no training, doctors and even some nurses began to confer less importance, and status, to the work of caregiving.

It comes as no surprise, then, that physicians now rarely, if ever, learn about what a family caregiver or health care aide must do unless they are faced with caring for their own loved ones. We doctors don’t know or aren’t always fully aware of what it takes to care for a patient after we leave the room......"

"........“Normally everyone is always focused on the patient, patient autonomy and the patient’s wishes in terms of the ethical standpoint,” said Dr. Virginia L. Hood, chairwoman of the Ethics, Professionalism and Human Rights Committee of the American College of Physicians and one of the paper’s authors. “But family caregivers are an important part of the health care team, too. We need to value these caregivers better, think about their needs and consider how they are central to the patient’s care, not just someone who happens to be pushing the wheelchair.”

Of particular importance is understanding how the work of caregiving can also give rise to a new set of medical issues: those of the caregiver....."

Ailing Couples One-Up each Other

From an article on MSNBC about the competition and shortened fuses that can happen when both partners in a couple fall ill with the flu. As I read it I couldn't help but think of all of us who don't get over our illness in a couple of weeks. We have to continuously craft new ways of relating to our partner, and to ourselves.

It's an interesting read -- Sniffle Wars: Ailing Couples One-Up each Other

"When a partner falls ill, empathy can have an expiration date. And in relationships that are taxed or struggling to begin with, it comes sooner rather than later."

What Makes Relationships Work?

From an article in the Guardian in which Kate Figes', author of a new book, Couples: The Truth, discusses her research into modern relationships:


"In the course of her research, Figes cheerfully demolished a number of long-standing myths about ­couples. One in three marriages ends in ­divorce? Not true. The risk of divorce varies hugely according to age, class and length of marriage. Once you've survived the first seven years, the risk of divorce drops dramatically. Marriage kills passion? Not true. People in long-term relationships have more and better sex than single people. A lack of commitment is to blame for relationships breaking down? Not true. On average, couples stick together for six years before taking steps to bail out."

"A key component of successful ­relationships, she discovered, is flexibility. "It comes through very clearly from the interviews: the most successful ­relationships are flexible enough to change and adapt. Nobody is perfect, and no relationship is perfect. Unless you can change your expectations, you're bound to be terribly disappointed."

"Another fundamental ingredient for success seems to be honesty. Figes nods vigorously. "Being honest about who you are and what you want is ­vital. Otherwise, how do you each know where you stand? Without real honesty, you don't stand a hope in hell."

"You have to learn to ask yourself, 'what is it about me that's making me feel this way?', not just blame things on the other person."

"Bad relationships are clearly harmful in many ways, but one of the things I've learned from writing this book is the overwhelming power of good that comes from good relationships – mind, body and soul. We don't give that nearly enough credit."

Why Men Leave Ill Partners

Excerpts from an article in the 10/15/09 Times Online

Until her sickness do us part: why men leave ill partners

Men are seven times more likely than women to leave a seriously ill partner, a study has found. So why are males less able to cope?

According to the Office for National Statistics, there were 144,220 divorces in the UK in 2006-07 (the latest figures available) and, of those, about 18 per cent (25,959) were due to “family strain”, a term that includes serious illness. In the US, a survey by the National Centre for Health Statistics found that 75 per cent of first marriages end in divorce if one of the partners develops a terminal or chronic illness.

Although it is not stated in these divorces which partner was ill, a study published last month in the journal Cancer found that a man is seven times more likely to leave than his wife if the other becomes seriously ill.

What causes this apparent chasm in emotional coping mechanisms between the sexes is intriguing experts, and the theories are plentiful.

Indeed, a study in the Journal of Oncology last year reported that spouses were lonelier than their ill partners and had lower levels of wellbeing and marital satisfaction. There is an immediate shift in a relationship when an illness is diagnosed. You stop being partners as you knew it and move to being patient and carer. That can lead to feelings of fear, not just about the disease, but about the relationship and the well partner’s ability to cope. Feelings of anger and resentment about life and the situation can quickly arise.

A few researchers have suggested that men are more likely to walk out on a wife whose condition is newly diagnosed because the illness is more than they bargained for when they married.

There are suggestions, too, that traditional roles shift more significantly when a woman becomes ill. Men may still be working full time, but may have to cope with additional tasks such as ferrying their wife to appointments, arranging childcare, cleaning and doing household duties.

What a women wants most of all when she is ill is not so much for her husband to take charge, but for him to listen to her feelings and to express his own more often. Men have an urge to ‘fix’ things. They want to get in there and make it better when what they really need to do is shut up and listen. Even if you have heard it one hundred times before, your wife needs you to respond by saying that whatever happens, you are there for her.

For some people, illness proves a positive factor in bringing a couple closer together. One recent study at the University of Quebec found that 42 per cent of couples thought that the experience of breast cancer had strengthened their partnership. Accepting the changes that take place is a process that takes time and effort. But many people do find their love grows stronger as a result.

45,000 Deaths a Year Linked to Lack of Health Insurance

45 to 50 million Americans are uninsured. That's a big number and hard to get one's mind around it. A recent study from Harvard Medical School turns this number into a tragic and sadly logical reality:

45,000 people die each year in the US because of lack of health insurance coverage.

I usually don't blog about health policy, but this study was so stunning, I had to write about it. Not only does lack of health insurance contribute to 45000 individual deaths, but one has to wonder -- as a result of this tragedy, how many couples and families are destroyed?

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Here's an excerpt from an article in the New York Times by Reed Abelson:

"Researchers from Harvard Medical School say the lack of coverage can be tied to about 45,000 deaths a year in the United States — a toll that is greater than the number of people who die each year from kidney disease.

“If you extend coverage, you can save lives,” said Dr. Steffie Woolhandler, a professor of medicine at Harvard who is one of the study’s authors. The research is being published in the December issue of the American Journal of Public Health and was posted online Thursday.

The Harvard study found that people without health insurance had a 40 percent higher risk of death than those with private health insurance — as a result of being unable to obtain necessary medical care. The risk appears to have increased since 1993, when a similar study found the risk of death was 25 percent greater for the uninsured.

The increase in risk, according to the study, is likely to be a result of at least two factors. One is the greater difficulty the uninsured have today in finding care, as public hospitals have closed or cut back on services. The other is improvements in medical care for insured people with treatable chronic conditions like high blood pressure.

“As health care for the insured gets better, the gap between the insured and uninsured widens,” Dr. Woolhandler said.

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Here's a link to the actual report:
Health Insurance and Mortality in US Adults

Advice Columnist Tells Well Partner To Leave

Advice from a Boston Globe columnist, Meredith Goldstein, about the well partner separating from the ill partner. I would be very interesting in hearing your perspective.

And very interested in hearing from those well partners who did choose to leave -- what was the tipping point for your choice and how ha our life been since the separation?

And I would be interested in hearing from those ill partners - what was your life like after the separation?

HERE'S THE ADVICE COLUMN:

Q: I enjoy reading your columns everyday -- it provides such a welcome distraction at work. I find myself in a difficult, sad situation, and would appreciate any advice you and your readers have to offer.

I have been in a relationship for about four years. My boyfriend and I are very young -- we started dating when we were about 20 -- and we’ve had a great relationship and are very much best friends. We agreed early on there was no need to rush and get married, but we frequently discussed our desire to be together for a very long time. Two years ago we moved in together and it was wonderful; we had a great life, great experiences, great friends.

My boyfriend has always had health problems, but a little over a year ago, things really got bad. There’s no need to go into the details, but suffice it to say, it isn’t going to go away, and it has impacted every aspect of our lives. Because it is often difficult for him to move around, we started going out less and less. Our home became less social as he didn’t like having people over as much. His interests narrowed, his mood soured (he’s being treated for depression). Our sex life dried up. I took it upon myself to do whatever I could to make life better for him; I have taken on more and more responsibilities; I physically take care of him; and I have been patient, accommodating and understanding as our lives changed.

Now I’m at a point where I have accepted that this is not temporary, and I feel increasingly hopeless. I have all of the responsibilities in the relationship, with no help from him; I ask for help when I think it is reasonable, but the general rule is, if I don't do it, it won't get done. What's more is that we basically have no lives. His only real interest now is sitting on the couch watching our favorite TV shows, and it’s the only activity we really do together anymore. I’ve told him on more than one occasion that I miss the things we used to do together and with others, and that despite his pain, I hope we can try to have some fun again, even if it’s limited. He tries sometimes, but even if he manages to get out the door with me, we usually can’t stay out for long before he wants to come home. I’ve tried to broaden his interests beyond the TV even within our apartment (books, board games, video games, anything) but that hasn’t really worked either. His interest in other people has also reached new lows, so socializing beyond the infrequent visits of our few remaining close friends is rare. I have started going out on my own from time to time just to escape the negative and monotonous atmosphere of our home (I always make sure to invite him), but it’s not the same, and since our jobs take up much of our time, it doesn’t feel right to spend a large portion of my limited free time elsewhere. I’ve brought up all of these problems separately on numerous occasions, but I have to be delicate about it because he quickly begins to feel massively guilty and depressed, and sees himself as inadequate.

I feel isolated, stuck, and sad, and have been fighting the urge to flee. I think he may suspect my feelings, because he is reminding me more frequently how he loves me and couldn't go on without me. But I just don't know. On the one hand, I have all the responsibilities of the relationship, and none of the emotional or physical joy that should come with it. I don't think he is either willing or capable of living beyond the lifestyle we currently live. I’m 24 and I am terrified at the prospect that this is it, that this is going to be my life. On the other hand, he’s still my best friend, and I love him and deeply care for him. He’s in pain, both physically and emotionally, and he needs me. If I left, it would break his heart, and when I think about the reality of that, it absolutely shakes me.

What should I do? It’s been over a year, and I feel I have tried everything, and things are not getting any better. Am I a horrible person to be thinking about leaving him?

-- Stuck and Hopeless, Boston

A: S&H, You’re allowed to leave. You’re 24. You didn’t sign up for this. I fear the longer you stay, the worse it will be when you bolt.

He’s your friend. You owe it to him to be honest. Tell him you’re not up for this. You can’t commit to this life, at least not as a romantic partner. You can explain that part of your decision is about age and place in life. I truly believe it’s not just his illness. You want to discover more of the world. You want to get to know yourself better. That's what unmarried people do at your age. You will feel like a jerk -- but being a jerk is better than being a martyr.

Give him the whole picture. Explain that you’ve thought about leaving for a number of reasons, but that his health and depression has kept you around. Tell him you've lost track of how serious the relationship would be if his illness wasn't a factor.

If he can’t get his mind around losing you -- if he begs you to stay (and he probably will) -- assure him that you’ll be there as a friend if he wants you around in that capacity. Remind him of all of the other people in his life who care for him. Tell him to seek out as much support as possible. Dealing with a chronic is miserable. He needs to learn to cope without alienating everyone he loves. If you fear that leaving him will send him into a dangerous depression, talk to his friends and family -- even his doctor. It's their job to get him through this.

There’s no way to avoid feeling like a bad person. It's going to be ugly and there's going to be a lot of guilt and shame. But that's life. You can’t always be the good guy. And frankly, I’m not sure that sticking around would make you the good guy. It would just make you miserable.

Go be 24.

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.

Kept From A Dying Partner's Bedside

What a senseless infliction of suffering on a couple already in pain. What is it going to take to put compassion before politics, prejudice, stupidity, and insane legalities? What is it going to take to change laws that are just plain wrong?

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From a May 18 New York Times article by Tara Parker Pope

KEPT FROM A DYING PARTNER'S BEDSIDE

"When a loved one is in the hospital, you naturally want to be at the bedside. But what if the staff won’t allow it?

That’s what Janice Langbehn, a social worker in Lacey, Wash., says she experienced when her partner of 18 years, Lisa Pond, collapsed with an aneurysm during a Florida vacation and was taken to a Miami trauma center. She died there, at age 39, as Ms. Langbehn tried in vain to persuade hospital officials to let her visit, along with the couple’s adopted children.

“I have this deep sense of failure for not being at Lisa’s bedside when she died,” Ms. Langbehn said. “How I get over that I don’t know, or if I ever do.”

The case, now the subject of a federal lawsuit in Florida, is being watched by gay rights groups, which say same-sex partners often report being excluded from a patient’s room because they aren’t “real” family members."

Caring for an Ill Partner May Extend Your Life

We know how stressful providing care can be, especially if it's your partner who is ill. Here is info from a study reported on MSNBC that found that caregiving may actually lead to a longer life for the caregiver.

What do you think?
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To see if caregiving was truly beneficial to the caregiver, Stephanie Brown (a social psychologist and an assistant professor in the department of internal medicine at the University of Michigan) and her colleagues scrutinized data from 1,688 couples who were at least 70 years old. Over a seven year period, the elderly couples were surveyed four times. During each survey, husbands and wives were asked whether they either provided or received help with such daily activities as eating, dressing, bathing, walking across the room, or using the toilet. They were also asked who performed household tasks such as grocery shopping, managing money and meal preparation.

Brown and her colleagues found that if you accounted for the negative impact of stressing over a loved one’s illness, that caregiving actually led to longer life. During the course of the study, people who spent at least 14 hours a week caring for a sick spouse were almost 30 percent less likely to die during the study period than those who spent no time helping, according to the research recently published in Psychological Science.

The research by Brown and her colleagues fits in with results from studies showing that animals release higher levels of a hormone called oxytocin when they are parenting. That hormone leads to lower levels of stress-linked substances, Brown says. It also makes sense in light of studies showing that people who volunteer tend to live longer than those who don’t, she adds.

Here is an advice column written by Boston Globe columnist Meredith Goldstein. Do you agree with her advice to the letter writer? What's your perspective?

Too much weight

Q: I love your column and would love to get some opinions on this. I don't know how to say this without sounding shallow, so here goes. I am no longer attracted to my husband because he has gained quite a bit of weight in the 6 years that we've been married (I would guess 40 lbs) and he was already short and on the big side when we started (which was fine with me, that's how I loved him), but this gain takes him from overweight to, well, obese. I am not slender either and have gained weight myself in the past few years (mostly due to having kids) but I do watch what I eat, go to the gym, jog, and am losing the pounds, albeit slowly - so I'm not expecting perfection. He, on the other hand, is just getting worse and worse and it disgusts me - won't go to the gym, use our treadmill or weights or boxing equipment and snacks on chips, soda, and greasy foods even thought I shop for and cook healthy meals.

The weight exacerbates other health issues such as his depression, high blood pressure, high cholesterol, etc. so it's more than just how he looks. We talk about the health issues but he doesn't actually DO ANYTHING to get started on the road to weight loss and better health. Anyway, this is affecting our sex life because he repulses me to the point where I flinch when he comes near me. Lately it hasn't been an issue because his antidepressants kill his libido but even hugging, kissing, cuddling etc. make me recoil. I don't see him changing any time soon and we aren't splitting up, so how can I change my reaction to him so that we can maintain at least some minimal contact and not grow even further apart? Would it be cruel to just lay it on the line and let him know that his weight is coming between us? Would that perhaps motivate him to get moving or just make him hate me for being mean and critical? I've tried the soft-sell (let's go biking, let's go for a walk, hey wasn't this dinner great it was only 300 calories!), we've been to couples counseling and individual counseling, he has had life coaches and career coaches, and I've tried ignoring the problem and no approach has gotten any results so I'm trying to shift the focus on how I can change my own reaction to him and find a way around the un-attraction.

Thank you,
Turned-off wife, Danvers

A: Turned-off wife – I don’t think it’s your responsibility to change your reaction to him. He’s putting his physical health at risk. His emotional health is already suffering. You have every right to demand a change. You ask if it’s cruel to put it on the line and tell him his obesity is killing your relationship. My answer is: no, it’s not cruel, it’s necessary.

I think you should go back to counseling, both as a couple -- and alone. Coping with a marriage that puts you in the position of having to love someone who is depressed must be overwhelming.

When you go to therapy as a couple, be frank. Be clear. Say everything you said in this letter – even the part about recoiling. And then tell him what you’ve also said in this letter – which is that despite all of these horrible feelings, at no point have you thought about leaving. He’s a lucky guy for that. And it means you love him.

I get the whole clinical depression thing, but he should want to keep you around and to keep himself alive.

-- Meredith