Cancer and depression

THE SILENT QUESTION

Cruhnke RN, CCM

Every time that we sit in front of a TV, we are bombarded with commercials that are not discrete at all about what their intended meaning is. One is for “male enhancement”. The other is for “erectile dysfunction”. Another for explosive sex by the time the kids are home from school. It is with pure amazement that the marketing for these campaigns is based solely on what the “ideal” couple has. This is what the companies that sell you these products want you to believe. Yet we are far from a people who are willing to discuss what is going on behind the bedroom door.

Imagine, if you can, being diagnosed with an illness that in one second turns your whole life upside down. Questions, questions and more questions fill your mind. “Am I going to make it?, What are the treatments like, and the side effects, what about those? How long do I really have? I heard people die from this disease, am I going to die from this disease too?”

Life shifts upside down and sideways. Memories of the days of yore are fading fast and you are now preparing for a new “normal” life to live. A nurse comes in to discuss treatment plans with you, discussing medications, side effects, how you are going to feel, if you need to talk to someone (because of course, who would not be depressed at this difficult time). She delves further to judge your support systems, how you are going to do financially, and if you can manage to come in for your scheduled appointments. Then she hands you her/his card and tells you that they have an emergency number to call if there are any questions or problems, and your appt for treatment is in 3 days. Please get blood work today and plan on staying for 7 hours the first day, oh and bring a lunch.

You and you spouse/significant other/mother/father/boyfriend/girlfriend walk out upset, confused not knowing what happened. You thought you knew all the questions to ask, everything that you wanted answered, but as soon as you sat in that chair in front of the MD, you lost it all. The staff seemed to explain everything, or did they?

Typically the one issue that is never brought up is the issue of how your disease will affect sexual relationship with your partner. Diagnosis of a chronic and severe disease can cause strain or resentment. Unfortunately, the person who is diagnosed is the one who is trying to first deal with the diagnosis, but their body is also going through this unrecognizable change as well. It is trying to fight off this life threatening disease, and also manage to keep itself in some sort of normal balance. Add this to the treatments that most patients must have, and it becomes so difficult for them between the side effects of the medication, and the effects from the disease to manage day to day on their own.

During this time, there is a huge responsibility put on the partner to pull more weight in the relationship. They are also going through this really difficult adjustment as well, trying themselves to deal with this new diagnosis of their loved one. Also, they take on these new roles that are almost forced upon them. They become caretaker, dietician, doctor, nurse, physical therapist, social worker and counselor. In addition, they are still suppose to be the old partner that was there before any of this happened.

No one understands the difficulty involved with the position of being thrown into these new roles. It is as if you are strangers and you are meeting for the first time. Things that never bothered you now do, things you never thought you would need help with you do. The word intimacy takes on a whole new meaning and it becomes something that goes beyond the bedroom and reaches into every part of your life.

Unfortunately, the way the media puts it into our head is that it is a dysfunctional relationship if there is no sex. So it does cause a lot of issues for couples. So let’s address this head on. What should you do to know as much as you can about how things are going to change for you? Let’s start When you go into the doctor’s office, make sure you bring you partner with you and a tape recorder, so that you have something to reference at a later time. You won’t remember everything because your head will not be in that “good” place when you are discussing your diagnosis and treatment plan the first time.

Have a list of questions that you have researched with you. Make sure you take a notebook and do not be afraid to ask the questions. Some good ones would be “Could you tell me what the side effect these medication(s) may have on our intimacy? Does it cause vaginal dryness? Erectile dysfunction? What can I take, if anything, to treat that?”.

There is also a strong recommendation that I have for everyone. Speak with someone who is not your family member from a psychologist, who does more talk therapy, or a psychiatrist, which is talk therapy and prescribing medications. It is important that you speak to someone that you do not feel guilty, held back, worried, or that you are hurting anyone’s feelings. Call your insurance company and check what your benefits are as they may be different that the regular medical health benefits.

Support systems are always important as well. Make sure that there are people around who are offering support and take it. If they want to help you let them. It gives you both time to reconnect a bit and not have to worry about a dinner, a lunch or whatever it may be. You need the support. Use it.

Together, it is not an easy situation to get through. Understanding what is going on is the most difficult thing to grasp. Trying to talk together is especially important instead of busying yourselves with small tasks. You have to address what is going on. Maybe it is not just about the sexual intimacy, but finding other ways to show intimacy toward each other. Lying together, massages, going out to eat together, a movie together. Small fun activites are also intimate experiences that make us feel close to one another. These are just as important as sexual encounters.

There is also couples’ counseling which I believe is a huge help when there are major issues going on. It gives you a much better idea of what each of you is going through if you are unable to verbalize it any other way. If this is the venue you choose, again, call the insurance, these benfits differ than standard medical benefits do.

From churches, priests, social workers, friends, counselors, psychologists, support groups, it is the first step that initiates motion. Unless you do something to deal with the separation and anxiety that you are both feeling during this difficult time, then it will only get worse.

No one understands but the two of you. No one gets is like the two of you. No one made this couple like the two of you. So your commitment and resolution to protect what you made is what you need during this time. And I know, you can make it.