Spouses of ppl with blood sugar issues
October 30, 2023 6:53 PM Subscribe
How do you deal when your partner can’t or won’t manage their blood sugar issues?
Context incoming, but ignore if you have an answer to the top-level question!
My partner has multiple GI issues that complicate eating. (Doesn’t know when he’s hungry, has no appetite, is often nauseated due to a medication he has to take, is super sensitive to taste and texture, has gastritis and frequent diverticulitis, and severe TMJ.) All that means his blood sugar gets away from him before he can plan meals for the day.
So I do the meal planning, shopping, and cooking. It’s tough because he can’t even handle talking about food when he’s nauseated. So I have to guess at what he might want, and it might not work for him that day. And something he liked last week, he probably won’t want this week. (I think 3-4 weeks rotation is about it for him.)
I do this because otherwise the moods are too much for both of us. (He has BPD and is tapering off a medication.) He becomes just impossible to be around, and I can’t get any of my own stuff done. (I’m doing ok in school, but I really need more time to read. It’s tough to do on the commute.)
Sometimes he only feels hungry quite late in the day, and either I haven’t shopped or he hates what’s there. So then we have to get takeout - because he’s been spiralling for a while already - which frankly we can’t afford at the frequency it’s happening currently.
Like he does usually make a Greek yogurt smoothie for himself in the morning, drink that over four hours, and maybe eat half a boiled egg by 2pm (two eggs will have been cooked). Maybe a bowl of corn flakes at 2 on a really good appetite day. That’s it until 4-5 pm. Can’t even discuss food until then. Sometimes he vomits whatever he ate.
By 4 he’s hangry and the food needs to be there asap.
He’s doing his best, and I can’t see a way around me doing this. Obviously this is unfair and imbalanced and isn’t the way either of us would prefer it.
Right now I’m taking courses plus spending 3-4 days a week with my dad, so the meal planning is slipping.
Today was great actually because yes I got takeout for dinner, and then he happened to be up for shopping with me. (Usually he hates shopping there, because he’s probably already edgy, and the aisles are narrow and people can be thoughtless about space)
So now we have a fridge stocked with snacks and a couple meals, great. If the stars align the same way in three days I’ll be happy but very surprised.
*****
So if your partner has similar issues, how do you (alone or together) manage the food piece?
Context incoming, but ignore if you have an answer to the top-level question!
My partner has multiple GI issues that complicate eating. (Doesn’t know when he’s hungry, has no appetite, is often nauseated due to a medication he has to take, is super sensitive to taste and texture, has gastritis and frequent diverticulitis, and severe TMJ.) All that means his blood sugar gets away from him before he can plan meals for the day.
So I do the meal planning, shopping, and cooking. It’s tough because he can’t even handle talking about food when he’s nauseated. So I have to guess at what he might want, and it might not work for him that day. And something he liked last week, he probably won’t want this week. (I think 3-4 weeks rotation is about it for him.)
I do this because otherwise the moods are too much for both of us. (He has BPD and is tapering off a medication.) He becomes just impossible to be around, and I can’t get any of my own stuff done. (I’m doing ok in school, but I really need more time to read. It’s tough to do on the commute.)
Sometimes he only feels hungry quite late in the day, and either I haven’t shopped or he hates what’s there. So then we have to get takeout - because he’s been spiralling for a while already - which frankly we can’t afford at the frequency it’s happening currently.
Like he does usually make a Greek yogurt smoothie for himself in the morning, drink that over four hours, and maybe eat half a boiled egg by 2pm (two eggs will have been cooked). Maybe a bowl of corn flakes at 2 on a really good appetite day. That’s it until 4-5 pm. Can’t even discuss food until then. Sometimes he vomits whatever he ate.
By 4 he’s hangry and the food needs to be there asap.
He’s doing his best, and I can’t see a way around me doing this. Obviously this is unfair and imbalanced and isn’t the way either of us would prefer it.
Right now I’m taking courses plus spending 3-4 days a week with my dad, so the meal planning is slipping.
Today was great actually because yes I got takeout for dinner, and then he happened to be up for shopping with me. (Usually he hates shopping there, because he’s probably already edgy, and the aisles are narrow and people can be thoughtless about space)
So now we have a fridge stocked with snacks and a couple meals, great. If the stars align the same way in three days I’ll be happy but very surprised.
*****
So if your partner has similar issues, how do you (alone or together) manage the food piece?
Response by poster: Sorry just to add, he did speak with a hospital dietitian who just gave him generic healthy eating advice. His next scope is end of November.
posted by cotton dress sock at 7:12 PM on October 30, 2023
posted by cotton dress sock at 7:12 PM on October 30, 2023
Best answer: To answer your top-level question: Mr. Blah and I both have some dietary restrictions, and we generally keep them in mind when making a grocery list via an app we both have access to. Whoever's doing the marketing picks up what we both want. But if either of us finds ourselves without something we want to eat, it's on us to figure out a workaround or get the thing we need.
To answer the question you didn't ask: This seems totally unsustainable and it puts way too much of the burden on you. He either needs to step up and take more responsibility for his groceries, or he needs to accept some items that you can always have on hand that he'll always eat. Even if it's as basic as crackers or plain toast or whatever. You can't singlehandedly be a personalized grocery and meal delivery service that magically always provides exactly what he wants when he wants it.
posted by BlahLaLa at 7:14 PM on October 30, 2023 [72 favorites]
To answer the question you didn't ask: This seems totally unsustainable and it puts way too much of the burden on you. He either needs to step up and take more responsibility for his groceries, or he needs to accept some items that you can always have on hand that he'll always eat. Even if it's as basic as crackers or plain toast or whatever. You can't singlehandedly be a personalized grocery and meal delivery service that magically always provides exactly what he wants when he wants it.
posted by BlahLaLa at 7:14 PM on October 30, 2023 [72 favorites]
Best answer: He’s an adult. He is responsible for feeding himself.
If he’s too much to be around when he hasn’t eaten, then you need to be elsewhere. Study at the library, silence your phone.
My partner had unmanaged food issues and while it wasn’t the reason we separated, it was one of the top 3.
You can support him by getting him a new dietitian that deals with disorders in eating and can deal with executive dysfunction around food. But you cannot do this for him, he has to do this himself.
posted by shock muppet at 7:39 PM on October 30, 2023 [42 favorites]
If he’s too much to be around when he hasn’t eaten, then you need to be elsewhere. Study at the library, silence your phone.
My partner had unmanaged food issues and while it wasn’t the reason we separated, it was one of the top 3.
You can support him by getting him a new dietitian that deals with disorders in eating and can deal with executive dysfunction around food. But you cannot do this for him, he has to do this himself.
posted by shock muppet at 7:39 PM on October 30, 2023 [42 favorites]
Your partner is behaving immaturely and unreasonably. Maybe he legitimately cannot feed himself, shop for himself, or regulate his blood sugar and mood, but regardless... he could participate in finding a solution that is workable. It doesn't sound like he has done any of that besides sometimes have a snack.
I'll skip further editorializing, but the picture you've painted is not a sustainable relationship dynamic.
posted by so fucking future at 8:03 PM on October 30, 2023 [14 favorites]
I'll skip further editorializing, but the picture you've painted is not a sustainable relationship dynamic.
posted by so fucking future at 8:03 PM on October 30, 2023 [14 favorites]
Best answer: I had to leave the partner who refused to control their diabetes. His rage at the disease and refusal to do anything to help himself turned into abuse aimed directly at me.
In your shoes I guess I would start by asking yourself what your pie-in-the-sky, most ideal outcome is and then find out what your partner's ideal outcome might be. If they have features in common you can work together to create a plan to reach those goals. If there is little in common it might be time for some therapy (couples or individual) and/or or a re-evaluation of the relationship.
posted by MagnificentVacuum at 8:06 PM on October 30, 2023 [5 favorites]
In your shoes I guess I would start by asking yourself what your pie-in-the-sky, most ideal outcome is and then find out what your partner's ideal outcome might be. If they have features in common you can work together to create a plan to reach those goals. If there is little in common it might be time for some therapy (couples or individual) and/or or a re-evaluation of the relationship.
posted by MagnificentVacuum at 8:06 PM on October 30, 2023 [5 favorites]
Best answer: Yeah I mean in brief, I have had to do a certain level of just being really direct: "I need you to take this action on this" and a certain level of accepting that the person I love might struggle with this issue and I have to accept that if I want a peaceful life. But big picture your question does not seem to be about "how to talk to my partner about how their choices are impacting me?" but more like, "how do I get my partner to do this thing I want them to do?" which is sadly impossible. I don't know, I think you have a right to say directly to your partner: "this is harming me, will you please pick an achievable action to take about this and take it?" But I think you might have bigger relationship issues that would benefit from unpacking and getting support around..
posted by latkes at 8:13 PM on October 30, 2023 [5 favorites]
posted by latkes at 8:13 PM on October 30, 2023 [5 favorites]
Best answer: Avoiding the relationship issues, hangry and low blood sugar are situations that can generally be relieved with a lot less than a fully prepared meal. What diabetic-friendly snack foods does he tolerate or even like? Meal replacements, protein bars, pepperoni sticks, cheese, whatever works.
Work with the nutritionist and help him find as many things as he will even consider eating in those moments and ensure that you work together to keep as many of them on hand as possible so that at any given moment there should be something he will tolerate. Once he's had a bit to eat and gotten his blood sugar back in line, then you should both have a little more breathing room to deal with his hunger in a more manageable, less angry way that doesn't need to involve takeout.
posted by jacquilynne at 8:18 PM on October 30, 2023 [4 favorites]
Work with the nutritionist and help him find as many things as he will even consider eating in those moments and ensure that you work together to keep as many of them on hand as possible so that at any given moment there should be something he will tolerate. Once he's had a bit to eat and gotten his blood sugar back in line, then you should both have a little more breathing room to deal with his hunger in a more manageable, less angry way that doesn't need to involve takeout.
posted by jacquilynne at 8:18 PM on October 30, 2023 [4 favorites]
Best answer: Blood sugar solution: glucose tablets, I keep them on hand too due to a medication thing. Small, very inexpensive, work quickly, taste like candy. Hunger afterwards is his problem and manageable.
posted by mireille at 8:38 PM on October 30, 2023 [7 favorites]
posted by mireille at 8:38 PM on October 30, 2023 [7 favorites]
How do you deal when your partner can’t or won’t manage their blood sugar issues?
"Partner" implies that both people are putting in a comparable degree of commitment to the cause.
Something to think about, you might not actually be "partners" in this effort.
posted by mhoye at 8:46 PM on October 30, 2023 [8 favorites]
"Partner" implies that both people are putting in a comparable degree of commitment to the cause.
Something to think about, you might not actually be "partners" in this effort.
posted by mhoye at 8:46 PM on October 30, 2023 [8 favorites]
Best answer: So I'm the person with blood sugar issues and my diet is complicated by digestive issues and sensory issues that makes it so I can't always eat a lot of the things that would otherwise be good for me.
The way I've managed this is that I've been able to identify a number of safe foods that I always try to have on hand, including a few things I can almost always manage to eat even if I don't feel like eating. One of the most basic is kefir. Tartness is generally something I can handle even if I'm a bit nauseous, drinking is easier than eating, and it comes ready-made in a bottle so I don't have to mess around with preparation (unlike a smoothie.) It will usually settle my stomach enough that I can eat something else later.
Other safe foods for me include eggs, swiss cheese, frozen pizza, chicken nuggets, canned chicken noodle soup, applesauce, ice cream, dill pickles, and V8. I also keep cans of Progresso soup in a variety of flavors so I can usually find one that sounds kind of good in the moment. These are also items I know won't upset my digestive system.
I eat a variety of other things when I have more of an appetite, so my diet isn't TOO restricted. The safe foods just get me through times when figuring out what to eat is challenging.
I don't think you said if your spouse's blood sugar issue is too high or too low, but either way if your insurance will pay for a continuous glucose monitor it might be helpful. I use Libre2 and it has alerts that sound if your sugar goes too high or low. You can customize the alert to sound to a number of your choosing which could help him to catch it before it goes too high or low.
posted by Serene Empress Dork at 8:49 PM on October 30, 2023 [13 favorites]
The way I've managed this is that I've been able to identify a number of safe foods that I always try to have on hand, including a few things I can almost always manage to eat even if I don't feel like eating. One of the most basic is kefir. Tartness is generally something I can handle even if I'm a bit nauseous, drinking is easier than eating, and it comes ready-made in a bottle so I don't have to mess around with preparation (unlike a smoothie.) It will usually settle my stomach enough that I can eat something else later.
Other safe foods for me include eggs, swiss cheese, frozen pizza, chicken nuggets, canned chicken noodle soup, applesauce, ice cream, dill pickles, and V8. I also keep cans of Progresso soup in a variety of flavors so I can usually find one that sounds kind of good in the moment. These are also items I know won't upset my digestive system.
I eat a variety of other things when I have more of an appetite, so my diet isn't TOO restricted. The safe foods just get me through times when figuring out what to eat is challenging.
I don't think you said if your spouse's blood sugar issue is too high or too low, but either way if your insurance will pay for a continuous glucose monitor it might be helpful. I use Libre2 and it has alerts that sound if your sugar goes too high or low. You can customize the alert to sound to a number of your choosing which could help him to catch it before it goes too high or low.
posted by Serene Empress Dork at 8:49 PM on October 30, 2023 [13 favorites]
Glucose tablets as suggested by mireille are a good idea to raise blood sugar quickly, but for some reason I can't handle them when I'm even slightly queasy (which I generally am during a low.) I keep cans of regular Sprite in the fridge as I find that easier on my stomach, and it does bring my blood sugar up. Just a suggestion if he doesn't care for the tablets. They do taste like Sweet-Tarts though so maybe I'm just a weirdo.
posted by Serene Empress Dork at 8:58 PM on October 30, 2023 [2 favorites]
posted by Serene Empress Dork at 8:58 PM on October 30, 2023 [2 favorites]
Best answer: I agree with many of the concerns stated, but you live your life and are making choices and doing your best. When my Mom was old, cranky, getting chemo, I would just make food every couple hours and put it in front of her. Small portions. A piece of cinnamon toast, half a banana, crackers and cheese, pureed squash, a cup of soup. She needed calories; you need to be cautious about blood sugar, but you get the idea.
Make a list of foods he can eat and that he often likes. Try to keep many of them on hand. I would try to stop negotiating about food and spending so much effort on trying to figure out what he might want. Make something appropriate and reasonable available; then it's up to him to do his part to take care of himself. He can eat a small amount to address the blood sugar issue. The key with my Mom was small portions and to not discuss it, just bring a little plate or bowl. She'd usually eat at least some of it.
You sound so overwhelmed. I hope there's a little bit of self-care and pleasantness in your life; you deserve it.
posted by theora55 at 10:32 PM on October 30, 2023 [18 favorites]
Make a list of foods he can eat and that he often likes. Try to keep many of them on hand. I would try to stop negotiating about food and spending so much effort on trying to figure out what he might want. Make something appropriate and reasonable available; then it's up to him to do his part to take care of himself. He can eat a small amount to address the blood sugar issue. The key with my Mom was small portions and to not discuss it, just bring a little plate or bowl. She'd usually eat at least some of it.
You sound so overwhelmed. I hope there's a little bit of self-care and pleasantness in your life; you deserve it.
posted by theora55 at 10:32 PM on October 30, 2023 [18 favorites]
Best answer: I have most of the same issues your partner has and I keep the freezer stocked with a bunch of Saffron Road frozen dinners for when the I HAVE TO EAT A MEAL RIGHT NOW OR I WILL DIE hits me out of the blue. That brand makes a mix of Indian and Thai dishes so it scratches my "mmmm takeout" itch for a fraction of the price.
Also lots of snacks on hand like crackers and things that can go on crackers like olives, hummus, sliced cheese, charcuterie, smoked oysters, sardines, nut butters, etc. Sometimes I need to eat something small first to regain the cognitive ability to figure out what to eat for a meal.
And I also bottles of SlimFast (I prefer the taste to Boost or Ensure) on hand for when the texture and chewing of food is too much for me but I need slam down some calories immediately.
If despite all this I reach the point where my stomach is already too empty to function and I've begun vomiting up acid then my recovery food is toast buttered with salted butter and a cup of ginger lemon tea with honey. My husband has to make that for me if I get that far because I'm vomiting too much to function.
Regarding timing, we feed out cats several small meals throughout the day. They are quite insistent about letting us know when they're hungry, which reminds us to eat something at the same time. They also scold us when it's bedtime. The cats are basically in charge.
posted by Jacqueline at 11:28 PM on October 30, 2023 [10 favorites]
Also lots of snacks on hand like crackers and things that can go on crackers like olives, hummus, sliced cheese, charcuterie, smoked oysters, sardines, nut butters, etc. Sometimes I need to eat something small first to regain the cognitive ability to figure out what to eat for a meal.
And I also bottles of SlimFast (I prefer the taste to Boost or Ensure) on hand for when the texture and chewing of food is too much for me but I need slam down some calories immediately.
If despite all this I reach the point where my stomach is already too empty to function and I've begun vomiting up acid then my recovery food is toast buttered with salted butter and a cup of ginger lemon tea with honey. My husband has to make that for me if I get that far because I'm vomiting too much to function.
Regarding timing, we feed out cats several small meals throughout the day. They are quite insistent about letting us know when they're hungry, which reminds us to eat something at the same time. They also scold us when it's bedtime. The cats are basically in charge.
posted by Jacqueline at 11:28 PM on October 30, 2023 [10 favorites]
Op doesn't mention diabetes and I wonder if the blood-sugar comment is colloquial rather than a medical term. Can you confirm OP? Based on my understanding your man gets hangry. He can get a box of ensure or or a box of Snickers and take care of, or not, his own feeding. He's not going to starve (again this is assuming he's not got actual diabetes). I would be inclined to let him get his own place for a while if his moods are so unpleasant, but I understand you would be afraid for him due to the BPD (again, not your responsibilty, btw I'm reading that as borderline personality disorder, if it's bipolar you might want to clarify that too).
You're taking care of your dad too? Maybe take care of your own needs first, it doesn't sound like you have a team backing you up.
posted by Iteki at 3:14 AM on October 31, 2023 [4 favorites]
You're taking care of your dad too? Maybe take care of your own needs first, it doesn't sound like you have a team backing you up.
posted by Iteki at 3:14 AM on October 31, 2023 [4 favorites]
Best answer: Oy, I lived this with one of my kids for the better part of 18yrs. Even down to the BPD and no meds (except kid decided to stop cold turkey and not mention it to anybody). That was a blast.
I realized that the entire house was walking on eggshells, because the food needs were out of control, changed on a whim, and were never consistent. We were also blowing through grocery money like Grant took Richmond. I mean $200-300/wk - and that was just at Wegman's (not including Target, TJs, Costco, etc.). We had more protein snacks than any PTA in the country at any given time. Most were turned down because "that was last week's food, I'm not eating that anymore", and the deer were exceptionally well fed with product and fruit.
I just stopped buying extra stuff. Unless it was very specifically asked for and written in a textrequesting purchase at the grocery store, it wasn't purchased (I send out a family text when I'm leaving the house *and* when I get to whatever store I'm at saying I'm there, **DO YOU WANT/NEED ANYTHING**. If there is no response by the time I leave, oh well. Asked and answered, even if it's by omission.
Your partner is (hopefully) cognizant of his behavior and needs to take responsibility for it. Have you had an outright conversation about how his actions are affecting you? It isn't as though he's a small child (dealing with hypoglycemic rage at that age truly sucked). You are already doing everything right. Perhaps suggest to him that he needs to set an alarm every 3-4hrs to have a small snack if he can't remember that he needs to eat. Also, my guess is that the med that he's taking that causes nausea probably is meant to be taken with food. Otherwise, see if it can be moved to bedtime so he doesn't experience that side effect.
Big, big hugs to you because I know what you're dealing with. Stay strong, my friend!
posted by dancinglamb at 4:07 AM on October 31, 2023 [18 favorites]
I realized that the entire house was walking on eggshells, because the food needs were out of control, changed on a whim, and were never consistent. We were also blowing through grocery money like Grant took Richmond. I mean $200-300/wk - and that was just at Wegman's (not including Target, TJs, Costco, etc.). We had more protein snacks than any PTA in the country at any given time. Most were turned down because "that was last week's food, I'm not eating that anymore", and the deer were exceptionally well fed with product and fruit.
I just stopped buying extra stuff. Unless it was very specifically asked for and written in a textrequesting purchase at the grocery store, it wasn't purchased (I send out a family text when I'm leaving the house *and* when I get to whatever store I'm at saying I'm there, **DO YOU WANT/NEED ANYTHING**. If there is no response by the time I leave, oh well. Asked and answered, even if it's by omission.
Your partner is (hopefully) cognizant of his behavior and needs to take responsibility for it. Have you had an outright conversation about how his actions are affecting you? It isn't as though he's a small child (dealing with hypoglycemic rage at that age truly sucked). You are already doing everything right. Perhaps suggest to him that he needs to set an alarm every 3-4hrs to have a small snack if he can't remember that he needs to eat. Also, my guess is that the med that he's taking that causes nausea probably is meant to be taken with food. Otherwise, see if it can be moved to bedtime so he doesn't experience that side effect.
Big, big hugs to you because I know what you're dealing with. Stay strong, my friend!
posted by dancinglamb at 4:07 AM on October 31, 2023 [18 favorites]
Best answer: The specific medical issues in our household are different but have some of the same impacts. On the particularly bad days when whatever we had planned for dinner just won’t work, we either do takeout or agree that it’s a foraging day where we’re each responsible for ourselves. We always have some bottles d protein smoothies and frozen fruit around and when my partner can’t manage anything else, he can pretty much always manage those. And I’m easy, if I don’t feel like cooking for one I’m perfectly happy with a bowl of cereal or a smoothie or my own.
Like you I do wish we spent less on takeout, it’s by no means a perfect solution, and we’re working on leaning harder away from it and relying more on each of us handling our own dinner from what we have.
Our lives are also set up so that apart from the specific tasks I do because he truly medically can’t, most of the other day to day chores are his responsibility to help balance out the extra things I do for him. I know that your time management isn’t the main issue here but since it did come up - you might also look at your shared chores and consider whether there are more other things he could be doing to help alleviate your overall stress levels since this one thing is falling entirely on you.
posted by Stacey at 4:17 AM on October 31, 2023 [1 favorite]
Like you I do wish we spent less on takeout, it’s by no means a perfect solution, and we’re working on leaning harder away from it and relying more on each of us handling our own dinner from what we have.
Our lives are also set up so that apart from the specific tasks I do because he truly medically can’t, most of the other day to day chores are his responsibility to help balance out the extra things I do for him. I know that your time management isn’t the main issue here but since it did come up - you might also look at your shared chores and consider whether there are more other things he could be doing to help alleviate your overall stress levels since this one thing is falling entirely on you.
posted by Stacey at 4:17 AM on October 31, 2023 [1 favorite]
Best answer: We have a rice cooker. We keep the fridge stocked with portioned amounts of pre-cooked rice in meal-sized containers. A person can add a protein (which we also keep in pre-cooked, chopped, portionable sizes) to the rice and put it in the microwave with a sauce. Good, healthy, food is not more than 5 minutes away. We find that adding a little more water than usual to the rice during cooking helps it be better on re-heating later.
Prep can make a huge difference. If I have to drop my tasks and make a meal for someone who is having cognitive failure, it's not a big burden to me or a long wait for them.
This is just one facet of your problem space. Definitely look at other means of helping your person be more self-sufficient, and clarifying your relationship.
posted by seanmpuckett at 4:35 AM on October 31, 2023 [3 favorites]
Prep can make a huge difference. If I have to drop my tasks and make a meal for someone who is having cognitive failure, it's not a big burden to me or a long wait for them.
This is just one facet of your problem space. Definitely look at other means of helping your person be more self-sufficient, and clarifying your relationship.
posted by seanmpuckett at 4:35 AM on October 31, 2023 [3 favorites]
Best answer: Your spouse has very serious eating issues. They are almost certainly not issues that can be fixed and will most likely get worse. There is no victory end game here, and if there were, you wouldn't be the one winning the game, it would be the person who learned to perceive some patterns to manage his own condition, based on his ability to finally recognize cues that you never will be able to recognize because you inhabit a different body.
Right now you are living day to day in a pattern that is not a good one for either of you, and your BPD spouse is entirely dependent on you. Having someone with BPD dependent on you is a risky thing. Because of the nature of their disorder they have trouble telling apart the things you are capable of with the things they want you to be capable of. This means that when you fail to do the things they want you to be capable of they can end up feeling like you are choosing to not do those things. It can become your fault that you couldn't find something for them to eat.
And then instead of trying to figure out something they can eat, they can focus on forcing you to find them something to eat. Of course you can't find something for them to eat, and they get more and more frustrated with you because THEY NEED HELP. The end game turns into a pattern where they spend all their effort trying to force you to fix the situation and you spend all your efforts trying to fix the situation while they turn their anger and pain on you. Both of you can spend hours and hours in pain fighting over them blaming you for their digestive issues. Both of your lives can turn into a struggle where they try to force you to fix something you can't fix.
It is imperative for BOTH of you that you don't get into this pattern and that you get out of it, if you are in it. It sounds to me like you are well into it. He gets hangry, you strive desperately to feed him. With every iteration on a new day he gets more hangry, because it works to manipulate you into feeding him. He almost certainly isn't consciously manipulating you, of course. The worse he behaves the harder you strive to feed him. The pattern has him eating something late in the day and you geting credited with having solved the problem and then held responsible for solving it the next day. Soon both of you are blaming you when he gets hangry because if you had only managed to figure out the right food and got it into him a few minutes earlier they never would have gotten hangry... Chances are if you didn't feed him, he would find something around the same time of day.
You are vulnerable to falling into this pattern because of your parenting instincts. With an infant it's a healthy pattern. The baby shrieks with rage and hunger, you feed it. After a few months the baby and you grow out of the pattern. It's great for three month olds and ensures they get enough food and thrive. But now two adults are stuck in the pattern with an angry dependent who will never grow out of it and who will get harder to feed with every iteration. You've run out of obvious solutions, unlike with the baby that can merely be glomped onto a breast, your spouse is becoming a more and more picky eater...
If this was a situation that could be solved with a few suggestions: "Try rotisserie chicken! Try this nutrition drink! Try small meals! Try precooked food they can microwave!" HE would have already solved the problem and you wouldn't even be part of the equation. But when he can't think of something he can eat, you are required to be a mind reader who can read his mind and somehow figure it out? That's adding magical thinking to the problem. And the problem is nausea, gastritis and frequent diverticulitis, and severe TMJ. How on earth could you solve that for him? He is stuck with an appallingly bad situation and you can't even really do a damn thing to alleviate it anymore.
I'm going to suggest that you propose that two days a week you don't feed him at all and declare those two days your day off. That's entirely NOT the solution you were asking for, but it is a diagnostic and it is the respite you need. If your spouse gets unpleasant to be around - crying quietly in the bathroom, or stomping, no matter what it is and how it tugs your heart strings or frightens you for their sake or your own, you merely remove yourself from the house and go spend the rest of the day at the library or some internet café so you can't hear it and become so anxious that you attempt rescue them.
If he can't deal with you taking two days off a week from the never-ending task of feeding him, then the problem is much bigger than him needing help to feed himself. The problem is that he is eating you alive. And if he ends up hospitalized from not eating that is a GOOD thing, because the sooner he gets that kind of help the better, before another year of this kind of struggle leaves him with so much scar tissue that he ends up with a permanent colostomy.
Your problem is not feeding him; That's never going to go away and you can't fix it. The problem is that you can't sustain living like this. Huge amounts of your mental energy and executive functioning are going into care taking without you having enough success and getting enough in return for you to be enjoying it. It's miserable. Your spouse is sharing his misery and destroying your quality of life without getting any reliable benefit from it. And all that care taking is wasted because whether or not you do it, the next day he will be having anxiety and anger melt downs triggered by hunger.
For your own safety and mental health you should not be around someone who is hangry. We get hangry so that we can kill something small and defenseless and eat it, or so that we can bully our way to a bigger share from the berry bush. Getting hangry makes us move quicker, think less and ignore consequences. If someone else can't control what they do, you are going to damage yourself putting up with it. Sure you love your spouse... but structuring your life to manage someone else's anger is VERY VERY VERY bad for you.
posted by Jane the Brown at 4:59 AM on October 31, 2023 [67 favorites]
Right now you are living day to day in a pattern that is not a good one for either of you, and your BPD spouse is entirely dependent on you. Having someone with BPD dependent on you is a risky thing. Because of the nature of their disorder they have trouble telling apart the things you are capable of with the things they want you to be capable of. This means that when you fail to do the things they want you to be capable of they can end up feeling like you are choosing to not do those things. It can become your fault that you couldn't find something for them to eat.
And then instead of trying to figure out something they can eat, they can focus on forcing you to find them something to eat. Of course you can't find something for them to eat, and they get more and more frustrated with you because THEY NEED HELP. The end game turns into a pattern where they spend all their effort trying to force you to fix the situation and you spend all your efforts trying to fix the situation while they turn their anger and pain on you. Both of you can spend hours and hours in pain fighting over them blaming you for their digestive issues. Both of your lives can turn into a struggle where they try to force you to fix something you can't fix.
It is imperative for BOTH of you that you don't get into this pattern and that you get out of it, if you are in it. It sounds to me like you are well into it. He gets hangry, you strive desperately to feed him. With every iteration on a new day he gets more hangry, because it works to manipulate you into feeding him. He almost certainly isn't consciously manipulating you, of course. The worse he behaves the harder you strive to feed him. The pattern has him eating something late in the day and you geting credited with having solved the problem and then held responsible for solving it the next day. Soon both of you are blaming you when he gets hangry because if you had only managed to figure out the right food and got it into him a few minutes earlier they never would have gotten hangry... Chances are if you didn't feed him, he would find something around the same time of day.
You are vulnerable to falling into this pattern because of your parenting instincts. With an infant it's a healthy pattern. The baby shrieks with rage and hunger, you feed it. After a few months the baby and you grow out of the pattern. It's great for three month olds and ensures they get enough food and thrive. But now two adults are stuck in the pattern with an angry dependent who will never grow out of it and who will get harder to feed with every iteration. You've run out of obvious solutions, unlike with the baby that can merely be glomped onto a breast, your spouse is becoming a more and more picky eater...
If this was a situation that could be solved with a few suggestions: "Try rotisserie chicken! Try this nutrition drink! Try small meals! Try precooked food they can microwave!" HE would have already solved the problem and you wouldn't even be part of the equation. But when he can't think of something he can eat, you are required to be a mind reader who can read his mind and somehow figure it out? That's adding magical thinking to the problem. And the problem is nausea, gastritis and frequent diverticulitis, and severe TMJ. How on earth could you solve that for him? He is stuck with an appallingly bad situation and you can't even really do a damn thing to alleviate it anymore.
I'm going to suggest that you propose that two days a week you don't feed him at all and declare those two days your day off. That's entirely NOT the solution you were asking for, but it is a diagnostic and it is the respite you need. If your spouse gets unpleasant to be around - crying quietly in the bathroom, or stomping, no matter what it is and how it tugs your heart strings or frightens you for their sake or your own, you merely remove yourself from the house and go spend the rest of the day at the library or some internet café so you can't hear it and become so anxious that you attempt rescue them.
If he can't deal with you taking two days off a week from the never-ending task of feeding him, then the problem is much bigger than him needing help to feed himself. The problem is that he is eating you alive. And if he ends up hospitalized from not eating that is a GOOD thing, because the sooner he gets that kind of help the better, before another year of this kind of struggle leaves him with so much scar tissue that he ends up with a permanent colostomy.
Your problem is not feeding him; That's never going to go away and you can't fix it. The problem is that you can't sustain living like this. Huge amounts of your mental energy and executive functioning are going into care taking without you having enough success and getting enough in return for you to be enjoying it. It's miserable. Your spouse is sharing his misery and destroying your quality of life without getting any reliable benefit from it. And all that care taking is wasted because whether or not you do it, the next day he will be having anxiety and anger melt downs triggered by hunger.
For your own safety and mental health you should not be around someone who is hangry. We get hangry so that we can kill something small and defenseless and eat it, or so that we can bully our way to a bigger share from the berry bush. Getting hangry makes us move quicker, think less and ignore consequences. If someone else can't control what they do, you are going to damage yourself putting up with it. Sure you love your spouse... but structuring your life to manage someone else's anger is VERY VERY VERY bad for you.
posted by Jane the Brown at 4:59 AM on October 31, 2023 [67 favorites]
Would he starve to death if you weren't doing all this? If yes, he needs to get in-patient treatment asap. If no, then just stop all this tap dancing. Let him solve his own problems. You go stay with your dad, or study at the library, or go wherever you need to go in order to not be the convenient focus of his wrath. You are locked in a super abusive cycle that is only going to get worse.
posted by ananci at 5:28 AM on October 31, 2023 [14 favorites]
posted by ananci at 5:28 AM on October 31, 2023 [14 favorites]
Response by poster: His A1C is usually 6.0-6-5, but his body is very sensitive to most things (eg medications) - I think whatever’s going on internally probably affects him more than it would others. BPD = borderline personality disorder. (When he’s good about eating, he actually manages the BPD responses very well, he’s been working hard on this for a long time now. But, yeah when he hasn’t eaten for 6+ hours, of course his threshold for managing emotions is lower.)
The drug that has destroyed his appetite (and amped up his sensitivity to food taste and texture, among other things like light, and caused muscle pains, and increased anxiety) is lamotrigine. He’s tried taking it at night but that messes with his sleep (just no winning with that awful drug). Takes it in the morning after synthroid which makes timing hard. Sometimes I get lucky and can get eggs into him between the synthroid and the lamotrigine, then he’s fine. But the timing is tricky, I have a hard time myself with iron supplements, like I get that. When it wears off is when he can eat.
He’s tapering off it (with doctor’s blessing) but it’s slow. (Doc originally wanted a fast taper, it quickly became apparent that was going to land him in the ER.) The gastritis seems to correlate with him starting that drug, too.
Re the food “games” - it’s not that he consciously wants me to be the one to solve meals for him, it’s that he doesn’t want to discuss food at all, says he isn’t hungry, he’ll puke if I mention anything. I suggest things (“hey, how about a snack”).
Really great tips here about being more strategic with food, thank you so much everyone.
Oh yeah - very important to mention - the lamotrigine has also affected his short term memory. So he’ll make oatmeal, get distracted and forget it’s in the microwave. Or he’ll put some grapes out for himself and *forget they’re on the counter*.
He has a year to go at a 5% dosage drop every 2-4 weeks. There is a light at the end of this tunnel.
(Re equity here, just want to mention that when he feels ok he does cook. He’s thrilled to be able to help me when he can. He actively loves cleaning, which I loathe, so 95% of that’s his thing, when he’s ok to do it.)
posted by cotton dress sock at 8:33 AM on October 31, 2023 [1 favorite]
The drug that has destroyed his appetite (and amped up his sensitivity to food taste and texture, among other things like light, and caused muscle pains, and increased anxiety) is lamotrigine. He’s tried taking it at night but that messes with his sleep (just no winning with that awful drug). Takes it in the morning after synthroid which makes timing hard. Sometimes I get lucky and can get eggs into him between the synthroid and the lamotrigine, then he’s fine. But the timing is tricky, I have a hard time myself with iron supplements, like I get that. When it wears off is when he can eat.
He’s tapering off it (with doctor’s blessing) but it’s slow. (Doc originally wanted a fast taper, it quickly became apparent that was going to land him in the ER.) The gastritis seems to correlate with him starting that drug, too.
Re the food “games” - it’s not that he consciously wants me to be the one to solve meals for him, it’s that he doesn’t want to discuss food at all, says he isn’t hungry, he’ll puke if I mention anything. I suggest things (“hey, how about a snack”).
Really great tips here about being more strategic with food, thank you so much everyone.
Oh yeah - very important to mention - the lamotrigine has also affected his short term memory. So he’ll make oatmeal, get distracted and forget it’s in the microwave. Or he’ll put some grapes out for himself and *forget they’re on the counter*.
He has a year to go at a 5% dosage drop every 2-4 weeks. There is a light at the end of this tunnel.
(Re equity here, just want to mention that when he feels ok he does cook. He’s thrilled to be able to help me when he can. He actively loves cleaning, which I loathe, so 95% of that’s his thing, when he’s ok to do it.)
posted by cotton dress sock at 8:33 AM on October 31, 2023 [1 favorite]
It can help to discuss food & eating in the context of "food is another form of medication, you need to manage it just like all your other medications". (which really, it is)
It sounds like they have(?) a method to track and take their medicines, they need to extend that to foods, in combination with identifying some basic & boring but nutritious and energy-dense foods, like Ensure or other protein shakes/drinks. E.g. add "drink 1 Ensure" to their pill schedule for AM & PM.
posted by jpeacock at 9:48 AM on October 31, 2023 [4 favorites]
It sounds like they have(?) a method to track and take their medicines, they need to extend that to foods, in combination with identifying some basic & boring but nutritious and energy-dense foods, like Ensure or other protein shakes/drinks. E.g. add "drink 1 Ensure" to their pill schedule for AM & PM.
posted by jpeacock at 9:48 AM on October 31, 2023 [4 favorites]
Best answer: My A1C is in the 6.4 range. I have a CGM so I can see what most things do to my blood glucose level, and oatmeal, grapes, smoothies with any fruit other than just berries, cornflakes are all terrible options for me. They make my blood glucose skyrocket and then crash from the insulin response. It may be tough with the nausea (I know I want mostly carbs when I am nauseated), but it could help (based on my experience) to find some foods that are more protein/fat to start the day with. Also, if he can get a CGM that may really help to provide live feedback to foods, maybe make some correlations.
posted by miscbuff at 11:23 AM on October 31, 2023 [4 favorites]
posted by miscbuff at 11:23 AM on October 31, 2023 [4 favorites]
OK, I know this may sound a little extreme, but so is your situation. Would he consider self-admitting for a week or two to get off the lamotrigine? My kid was also on it, but definitely didn't take a year to go off it. That's a LOOOONG time to taper. Inpatient will allow a faster taper under supervision and they can also deal with these food issues.
Has he seen a gastroenterologist or is this all going off his last ER visit? Has he tried Pepcid or talked to a doctor about when he can take Sucralfate?
Jane the Brown, I can't favorite your post enough. I've always loved what you contribute in threads, but wow, you described my experience with frightening and precise clarity.
posted by dancinglamb at 12:00 PM on October 31, 2023 [8 favorites]
Has he seen a gastroenterologist or is this all going off his last ER visit? Has he tried Pepcid or talked to a doctor about when he can take Sucralfate?
Jane the Brown, I can't favorite your post enough. I've always loved what you contribute in threads, but wow, you described my experience with frightening and precise clarity.
posted by dancinglamb at 12:00 PM on October 31, 2023 [8 favorites]
whatever’s going on internally probably affects him more than it would others
Hey, I recognise this sentence! I said or thought many versions of this to cover for my drug addicted and/or narcissistic family members.
While we are all individuals I now know there is no special, unique, most-tenderly-sensitive-person-on-earth who also happens to be in my life depending on me to keep their day going smoothly. And when I tried to stand up for my boundaries and needs, I was regarded as an internalised feeling selfish, unsupportive, spoiled, and unhelpful.
Just a data point. But so much rang similar it seeemd amiss to not say something.
posted by Ardnamurchan at 4:50 PM on October 31, 2023 [3 favorites]
Hey, I recognise this sentence! I said or thought many versions of this to cover for my drug addicted and/or narcissistic family members.
While we are all individuals I now know there is no special, unique, most-tenderly-sensitive-person-on-earth who also happens to be in my life depending on me to keep their day going smoothly. And when I tried to stand up for my boundaries and needs, I was regarded as an internalised feeling selfish, unsupportive, spoiled, and unhelpful.
Just a data point. But so much rang similar it seeemd amiss to not say something.
posted by Ardnamurchan at 4:50 PM on October 31, 2023 [3 favorites]
Response by poster: Inpatient would be awesome - our systems are just so broken. Even active SI and HI are sometimes turned away from the ER (but those would be the situations justifying inpatient here). He did have a consult with a GI in May, scope scheduled for end of next month. Tums and some other stomach acid minimize (prescribed, forget which) do help sometimes with some symptoms, but not the main ones that bother him. Yeah it’s a long and hellish taper, no doubt. Very nice to feel understood - thank you for writing, dancinglamb ❤️.
Edit: on preview - I get you, but it does seem to be the case that there’s a congenital, temperamental component to BPD that does involve just like a heightened CNS sensitivity.
posted by cotton dress sock at 4:52 PM on October 31, 2023 [1 favorite]
Edit: on preview - I get you, but it does seem to be the case that there’s a congenital, temperamental component to BPD that does involve just like a heightened CNS sensitivity.
posted by cotton dress sock at 4:52 PM on October 31, 2023 [1 favorite]
Best answer: A lot of people have mentioned CGMs already but I can’t emphasize enough how much getting one and leveling out my blood sugar helped with my mood and general well-being. Taking a glucose tablet or eating oatmeal or a smoothie is all well and good if you are in an actual blood sugar crisis, but switching to eating mostly protein, fat, veggies and cutting out a large part of carbs is ultimately going to be much more helpful. For pretty much my whole life I was on a blood sugar rollercoaster of good -> hangry, desperate, ravenous, shaky -> eat carbs, feel better. I didn’t realize the carbs were just feeding into the next blood sugar crash. It was astonishing to cut carbs and learn that I could be hungry without it being a crisis. I know there are a lot of other food issues going on with your spouse, but I would highly recommend a CGM for at least a month or two (FreeStyle Libre is the cheapest I know of) to check on how certain foods affect blood sugar and how that corresponds to things like energy, mood, nausea, executive function, etc.
That might help solve the puzzle of what foods are sustainable and helpful. I know for me, eating a bowl of cereal when hangry would feel like I was solving a problem, but in reality it was only creating a different problem for future me.
Good luck. It sounds like an absolute nightmare, but I’m glad to hear there’s a temporary component to this. Still, you need to set some boundaries and take care of yourself. I hope some of the good and insightful advice in this thread helps you to do that.
posted by music for skeletons at 7:19 PM on October 31, 2023 [4 favorites]
That might help solve the puzzle of what foods are sustainable and helpful. I know for me, eating a bowl of cereal when hangry would feel like I was solving a problem, but in reality it was only creating a different problem for future me.
Good luck. It sounds like an absolute nightmare, but I’m glad to hear there’s a temporary component to this. Still, you need to set some boundaries and take care of yourself. I hope some of the good and insightful advice in this thread helps you to do that.
posted by music for skeletons at 7:19 PM on October 31, 2023 [4 favorites]
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You wrote things including "I do this because otherwise the moods are too much for both of us" and that you are short on time for studying. Consider examining whether you are in a codependent dynamic, and whether rather than focusing on how to manage your partner's blood sugar issues, it may be helpful to think through whether you are taking on inappropriate responsibility.
posted by virve at 7:11 PM on October 30, 2023 [75 favorites]