Diabetes and Marriage. Defining "In Sickness and in Health" and When Is It OK to Say You're Done?

Diabetes and marriage or dealing with a chronic illness and marriage can bring some extremely tough situations and issues. What does it mean by "in sickness and in health" in your marital vows and is there a time that you are justified for saying 'I've had enough! I'm done!' 

When my Dad was in his thirties, he began having massive health problems. His kidney function was at 30% of normal. Lines were connecting on what it might be but after going to several doctors, he grew tired of going. He ignored the problem.

My mom went back to work full time in an effort to alleviate the financial burden on him a little bit. He took a lower paying and less high stress job. We went from having a mom greet us everyday when we came in the front door from school to having two parents who we didn't see until 6 at night and then were so exhausted when they walked through the front door they were both asleep by 8:30 or 9 at night. I cleaned the house, watched my sister and took care of the lawn every week to help my parents out.

My Dad ignored the problem and lasted another fifteen years before he had a massive heart attack at the age of 55. This time, the heart attack affected his ability to work a full time job. He left his career behind and placed that burden on my mom. When their newly empty nester friends started to go off on trips, my Dad couldn't even walk around the block without becoming short of breath.

A lifestyle change and diet gave him ten additional years, but he passed away at 65 leaving my Mom a widow at 56. She often talked about the struggle it was being a widow so young. Many of her other widowed friends are in their 70's and 80's. There was a lot of bitterness for awhile as she was angry that he chose not to deal with the health problems he had so many years ago. She said it was difficult because she couldn't leave him to go and visit her children and grandchildren who lived several hours away. She couldn't travel with him--something she had dreamed of doing once they got to the golden years. The strain on their marriage was incredible. She tried to hang in there, but there were times that she was done emotionally. She wondered if the massive stresses placed on her were going to affect her health and ability to care for him. If she would suffer the same fate he inevitably would. And who would be left to care for her kids and grandkids.

I can empathize. All too well.

I've seen the stories on different diabetes forums or websites that talk about spouses who don't care for themselves. Who choose not to take care of themselves. Maybe they opt to allow their blood sugars to run higher because they are road warriors and fear the low's. Maybe they choose not to take their insulin. Maybe they don't check their blood sugars nearly as often as they should (or at all!) or have consistently higher than normal A1C's because they don't care for themselves.

I think as spouses and children of those with diabetes we deal with a lot. One of my favorite articles and the way that I feel so many times is one written by David Edelman entitled "Marrying into Diabetes." So many times I take the kids to the park or activities on my own because he's been battling a high blood sugar all day. I often have the kids sneak over to me and ask "Is Dad really mad at me today because of diabetes, or because he's mad?" They deal with the mood swings, the missed activities, the cancelled dates and the sick days in a positve manner, but you can tell it hurts.

It's hard for all of us, but we love Dad so it's easy for us too. In our relationship I've tried to adopt these "6 Ways to Support a Spouse with Diabetes" into our own married life. I was the nagging wife when we first got married and it caused a lot of resentment in our marriage. He didn't need or want that. He wanted a partner. So I switched gears over the years and worked to become that. I got off his back and instead internalize a lot of things so our marriage stays strong and he feels like he has that partner.

But how do you feel when you put in the countless hours of blood sugar checks when he's sick and not able to do it for himself, the finding him unconscious on the kitchen floor, the missed dates, cancelled activities with the kids and the Superbowl spent in the ER (hey, that's BIG. You know how epic the Superbowl is in our house) and you just do it willingly. You chose in sickness and in health when you got married and you knew what it would entail when you married this person. It's hard sometimes, but you just do it because you love that person and understand that no matter what you are going through in that moment it pales in comparison to what they go through on a daily basis. You balance it all. You just do it.

But where does "in sickness and in health" have a dividing line? Where are you allowed to say, "I can't do this anymore because you choose not to meet me even close to halfway?" So many times on diabetes forums and in articles I can empathize with spouses who are at wits end and wondering the very same thing I write about today. They write about going to doctors appointments and finding their spouses have blatantly ignored taking their insulin. They find their spouses have high A1c's because they haven't even attempted to check their blood sugars at all...for months and months on end! They find that their spouses have completely ignored the fact that they have diabetes. When their doctor asks questions like "What do you want me to do for you if you choose not to do anything for yourself?" and makes statements like "It seems I've heard these stories before.." when they make excuses for why they can't take care of themselves it can make those hours, those days and those missed activities seem completely in vain on the part of the spouse. You can feel like your marriage is broken. You can feel like vows aren't being honored or respected.

When I teach school the students who come to me at the beginning or middle of the semester telling me they're struggling get met with a lot more empathy than those who come finals week with sob stories of why they couldn't get their research paper that was due a month before into me.

Same for when I worked at the hospital. Those that took care of themselves and tried and still had complicatons got met with a lot more empathy on my part. They were the ones that ate at me on my ride home that night from the hospital when they passed away. They were the ones that years later still had an impact on me. They were the ones whose obituaries I shed tears over. It was a lot harder when I had the same patients over and over and over again who came through and had the same stories of why they couldn't quit smoking, or why they couldn't even make the smallest of changes to impact their health in a more positive way. While I cared for them and gave them the same care as that person who tried their hardest, it sometimes was with gritted teeth and a pursed smile as I listened to yet again another similar story of "why they couldn't."

But what does "in sickness and in health" mean? When you've shed blood, sweat and tears on someone who you find hasn't done that for himself...not even a little bit! are they taking the marital vows they made seriously? Especially if they knew going in that they had an illness. We all suffer burn out and diabetes is especially one of those diseases that is a full time all in effort. Technology has helped a lot in the management and care, but it still requires a lot of time and energy and is a major balancing act. I think any spouse can empathize with burnout and that's where we are happy to help step in where needed. I'm talking about ignoring. Avoiding. Refusing. And not just for a month or two here or there while you recharge your batteries. I'm talking years. I'm talking about knowingly refusing to care for themselves at even half of what they should on a consistent basis.

What would you or do you do in a situation like this when one spouse chooses to not care for themselves and puts themselves and your family at risk? 

I choose to stay. Everyday I choose to stay. And for the most part I can ignore it and I continue to love and care for him in those moments when he cannot. I can pretend now while we're young that everything is okay. But I can't help but not get angry at times. I can't help but not be hurt at times. I've seen on forums where people have said it's okay to leave. I've had others argue passionately it's not. I don't know which is right or wrong but I choose to stay for now.

I do believe there are situations where it is warranted to leave your marriage if a spouse is not taking care of himself. Physical and verbal or emotional abuse are definetely situations where you need to consider leaving. A trained counselor, doctor or clergy member would be a good avenue to go through to help you decide and how to take the steps to leave should it be necessary.

For those who choose to stay, there are some things that I do to feel that I am prepared and emotionally ready should my husband's health (knock on wood) get worse. These things also help to offset the negative feelings that I may feel at those doctors appointments. Hopefully these can help someone else going through the same thing. And please feel free to comment and add what helps you!

Surround Yourself With an Army

You can't do everything. As much as I totally wish that I could, I just can't. I remember reading an article years ago about a group of firefighters who made an agreement or pact with each other that if something happened to one of them, the others would step in to make sure their families were taken care of. When several of these firefighters died in a fire, the remaining firefighters in their area stepped in and cared for the families and can often be found helping the widowed wives with handyman chores around the house or taking the kids on campouts in these men's absences.

Surround yourself with an army. I am so grateful that I have friends I can call on or my brother in law to call on when my husband is out of town or physically is unable to be there for my son. While never the same as Dad, to know he is surrounded by an army of good examples and men in his life is priceless to my husband and I.

Having a good group of friends you can get out and socialize with is also important. Hang out with friends who share your same interests, get out to that girl's night movie, or hang with the Mom's in your playgroup. Your life should not revolve around diabetes 24/7.

Allow Yourself to Feel

There are so many times I tell myself not to feel emotions because I have no idea what it's like to be in my husband's shoes. And I don't. I often find myself trying to stop my emotions and to not share how I really feel with him because we are parallel bars that will never intersect when it comes to certain diabetes issues in our marriage so why even try at this point to get them to intersect?

While I am not a great example of this and need to learn to better deal and talk about my emotions I am in awe of those that I read about who are constructively able to do this with their spouses. I'm taking notes!

Allowing ourselves to feel helps us better be able to handle the tough situations at hand. We have to allow ourselves to feel angry after that appointment where you can't see more than a handful of blood sugar checks in a month's time. We have to allow ourselves to feel exhausted tired and emotional after several nights of caring for a spouse who is sick while juggling the kids and their emotions that they have when they see their Dad sick. As a spouse, it's not healthy to bottle it up. I know that we do. I know each of us probably has that pit in our stomach. The one you don't want to bring to the surface but it's all the unspoken words bottled up in there tight. Talk to someone. A counselor, a friend. Allow yourself to feel. You do deserve to feel emotions. You do have a lot on your plate and your load is full. You need to feel.

Prepare, Prepare, Prepare!!

 You need to prepare. And that burden may be shared between you and your spouse or you may have to carry that burden on your own. Finish your schooling, get that life insurance policy in order, make sure your retirement account is started and do what you need to do to feel prepared. Security can be your best friend and a great source of comfort. It allows one less burden in your life. At times, it has allowed me to better take care of my husband knowing that if and when that time comes I will be okay. I can enjoy the time I have now knowing that I don't have to worry about the later.

Enjoy the Time You Have

Every single one of us knows that our time with our spouses is precious. It's what keeps many of us in our relationships. The worries that we have are much greater than other couples. But the worries are also the same. The great thing about diabetes is that you know your time is precious. You have the statistics staring you in the face. Dr. Doomsday appointments loom and your heart races before every doctors appointment whether you want it to or not. You will never stop worrying, you will never stop caring and you will never stop loving your spouse regardless if you stay together or not. You've invested so much. You internally roll your eyes at times when you hear the struggles of other couples knowing the list of things you deal with trump's their list.

And it often comes down to this. You enjoy every moment of every day with your spouse because you know your time is precious. You love that person because every six months to a year when you are greeted by your lab coat wearing doctor you are reminded that your time might be shortened--significantly if they don't care for themselves or even significantly if they do. It's a gamble but no matter how long the time you have left with that person, you won the million dollar jackpot. No one else could teach you the lessons of patience, long suffering, service or unconditional love like your spouse with diabetes (or a chronic illness) can. So you just keep doing it. And you just enjoy the time you have.