Advice on dealing with a sick spouse who won't help himself? (sorry--a little long)
May 31, 2007 5:43 PM   Subscribe

My husband has Type 2 diabetes, diagnosed about seven years ago. He has quickly moved from pills to shots to an insulin pump, and he's in his late '40s. The problem is that he doesn't take proper care of himself. When he was first diagnosed, he lost about 40 pounds, but quickly put it back on. Now he won't diet or exercise. He takes plenty of medications for cholesterol, depression, and high blood pressure besides his insulin. Even on the pump, he has not gained any sort of tight control over his blood sugar.

He will never properly address an injury or get medical advice quickly for anything that goes wrong whether or not it is related to his diabetes. He is also very reluctant to address when I am ill or be helpful in getting me to a doctor, etc.

I have read that men live shorter lives because they don't take care of themselves as well as women. So, would any of you say that his behavior is normal? This situation is one reason why I struggle with this relationship. If he is typical, diabetes will take its toll slowly and painfully for most of our old age, when as far as I can see, most of the problems could be avoided. I feel resentful that he doesn't care enough about his wife and kids to take better care of himself. We will be the ones burdened by the overwhelming costs, literally and figuratively, of dealing with his choices.

Am I a cold-hearted bitch for feeling this way?
posted by SMP to Human Relations (15 answers total) 4 users marked this as a favorite
You are absolutely not a cold-hearted bitch. Not at all.

I can't speak to what's normal, but it sort of sounds like your husband's dealing with fears of illness and mortality through avoidance, which is a pretty sucky way to do things, especially when diabetes is at issue.
posted by palmcorder_yajna at 5:52 PM on May 31, 2007

um, no, you're not a bitch. these are real issues. it's no different than if he were a drug addict or alcoholic who refused to get help. at some point, he has to comply with his own care, or else he's committing suicide. you aren't obliged to help him do that, or stand by him while he does. (or make your kids watch that happen.)

one thing to consider--and this might be worth seeing a therapist about--is whether or not his health is turning into a control issue. could he feel you are being so bossy about it that he's reacting like a teenager and deliberately not addressing it? although if he doesn't even support your seeing a doctor for your own health, there might be some passive-aggressive abuse going on.

you say he is taking medication for depression. is he getting any kind of therapy? if not, he should be.

ultimately, you will have to look out for yourself and your children. he's behaving self-destructively, and you have every right to get yourself and your kids away from it.
posted by thinkingwoman at 5:57 PM on May 31, 2007

Avoidance is REALLY common in people with type II diabetes, esp. men, in my experience. I think it stems from feeling as if they don't get to live a normal life. I recently lost an uncle at 64 who lived 20 years in the exact way you describe your husband living. I think a big thing for him was that my aunt never took away the options to be unhealthy. Why eat sugar-free when no one around you is? Why go on walks or workout when no one else is? Make it a chance for your family to come together: evening walks, planning meals, everyone is conscious of how dad has to live. It might be a sacrifice for your family, but if you're all in it together, the extra years with your husband that you will gain will be worth it.
posted by messylissa at 6:17 PM on May 31, 2007

Is there something he likes to do, or did in the past that has a strong element of physical activity? If you can get him interested in something, anything to get him active, it could be the catalyst necessary to get him to turn his health around. Alternately, if it is feasible, perhaps you could try to convince him to commute by bike. I don't have a link for you, but according to at least one study I recall from last year, people who commute by bike on average enjoy their commutes more than any other mode of transportation.

Also, if you haven't already, perhaps you should consider stocking only diabetes-friendly foods in the house. Having no calorie-dense snacks available in the house will remove the constant temptation to snack out of boredom whenever he's at home.

One other thing comes to mind, and that is the medication he is taking for depression. Has he tried counselling instead? Weight gain is a common side effect of many antidepressants, and it could be contributing to his problems.
posted by [expletive deleted] at 6:30 PM on May 31, 2007

No, its not normal. The first thought to pop into my head was to wonder if he is an alcoholic - heavy alcohol use is a risk factor for developing type 2 diabetes. It is quite possible to live with an alcoholic for years and not realize that you are. I know nothing about your actual situation, of course, but living with an alcoholic is maddening in exactly the way you describe.

Progressing to an insulin pump when he's not even 50 yet is pretty fast. When they say it's common for men to not take care of their health, they are talking about guys who forget to see the dentist every year or similar. They are not talking about this level of neglect. You are right when you say that diabetes is going to take its toll slowly and painfully into your old age. Most diabetics die of complications of diabetes like heart disease. It is not fun.
posted by selfmedicating at 6:31 PM on May 31, 2007

Response by poster: I think a big thing for him was that my aunt never took away the options to be unhealthy. Why eat sugar-free when no one around you is? Why go on walks or workout when no one else is?

If the refrigerator is full of healthy snacks, he will go to the store and buy a bag of chips and a carton of dip. He often will snack on a stack of saltines and a tub of margarine. It's that bad.
posted by SMP at 6:47 PM on May 31, 2007

Response by poster: One other thing comes to mind, and that is the medication he is taking for depression. Has he tried counselling instead? Weight gain is a common side effect of many antidepressants, and it could be contributing to his problems.

He is in counseling as well as taking an anti-depressant.
posted by SMP at 6:53 PM on May 31, 2007

Would he agree to couples counseling? The two of you need to talk about this. I assume that you've tried just asking him how he feels about his disease, whether there's anything you can do to help him manage it, and whether he's thought about the effect that his health has on his family. If he's already in therapy, he might be open to the possibility of counseling for the two of you, or maybe letting you sit in on a couple of sessions with his therapist, just so that a professional can help you see where your communication is breaking down and give you some strategies for communicating more effectively about these issues.

If he won't go to counseling with you, you may want to consider going alone. Even if he does agree, you may want to go by yourself in addition. You're clearly under a lot of stress, for good reason. A sick spouse can put a lot of stress on the well spouse, especially if he's not taking responsibility for managing his illness. His reaction to his disease is pretty common among sufferers, but it's also excruciating for those who care about them, and you need to figure out how to take care of yourself so that don't end up equally run down. A good therapist can help you find ways to make that situation more bearable so that even if you can't change him, you can make the best possible decisions for you and your family about how to deal with the situation you find yourself in.
posted by decathecting at 7:31 PM on May 31, 2007

I can't believe I am writing this, but here goes.

I was in a similar situation in September of 06. A urinary tract infection spurred me to go to my doctor. I hadn't been in three years. He decided to take the time to get blood tests, etc. The blood came back and my glucose was off the charts. He then referred me to a diabetic nurse and a dietitian.

Now, I've lost 90 pounds since September and my blood sugar very rarely goes above 100. I have everything under control and blood work is taken every 3 months. I am whistle clean and my A1C is now at 6.1. I expect it to be under 6 in July.

Here comes the crazy part: I did it alone. I have been married for 20 years and have a (next year) senior in high school.

My wife didn't change her eating or exercise. She didn't take away bad foods, nor did she quit buying those things for herself. She still enjoys her Pepsi and licorice.

Me? I am on the complete opposite side. Sometimes I spend an hour at the grocery looking at labels. In an earlier question on Ask I detailed my workout plan. While I think I might be bordering on the fanatical, I wanted to explain what got me to control my glucose and improve my health.

All my adult life I was obese. When I was in the best shape of my life, football in high school, I weighed 180. Cut wasn't the word for my body. I was an Adonis.

When I got married I was at 200. It's been going up since then. When I saw the doctor he would always tell me I needed to lose weight. I blew it off. My confidence was that my weight never affected me physically (blood pressure, cholesterol normal) and that I had good genes.

Then came that fateful day in September.

When I learned the news I read everything about diabetes I could on the internet. I quickly realized through testing that my problem was insulin resistance. My body finally gave up trying to take care of the massive amounts of insulin I was generating.

I cried.

I got depressed.

I got angry.

I cried some more.

My body was broken and I did it to myself. No one else was to blame, and as a man I was singly focused on blaming myself.

It took me a week to overcome this depression and pity for myself. The key for me was realizing I had done this to myself by leading a sedentary life with no regard for what I ate.

My diabetes is a mark of shame.

The only people in the world who know are my wife, my daughter and my doctor.

It is in this shame that I saw my choice. I could capitulate and start taking medicine or I could do something about it.

The funny thing is medicine it is a gateway to injections and then the pump. Almost all Diabetes meds cause weight gain. Most type 2 diabetics don't realize that the ADA is blowing smoke up their ass. You cannot continue to live your life like you were and you definitely cannot rely on the medicine long term.

That left me with deciding to do something about it.

And this is when I changed.

Your husband is probably feeling the same things I did. He's depressed he's let himself get this way and he feels hopeless he cannot change.

He can.

The best way to change is incrementally. Cut down on the simple carbs, take small walks, track the blood a few times a day. As you incorporate those changes into your life it gets easier. In September I weighed 418 pounds. I now weight 319 pounds. I am one pound away from losing 100 pounds, and all this was done incrementally.

The insidious thing about type 2 is that the effects are cumulative. Even though you don't see high glucose causing problems in the beginning, it all adds up. For instance, the top of my feet always feel like they're lightly asleep. It's neuropathy brought on by uncontrolled glucose.

The wife has been encouraging, especially in my changes physically, but she hasn't made the necessary lifestyle changes for her ills. Nothing is lonlier than making your own dinner night after night while the rest of the family enjoys fast food.

Part of me is still living in denial about this. I have yet to tell anyone else about it, and I cannot believe I am sharing this on the internet. As a man I am embarrassed, ashamed and at times I've felt hopeless and confused.

But, I found hope and so can your husband. As a poster above stated, start living your life like you would like him to live yours. Set an example. Share your feelings with him.

If that doesn't work spend time reading wikipedia on everything that diabetes impacts on your body. It is depressing in and of itself, but that is what ultimately spurred me into action. There was no way in hell I was going to let my kidneys die, lose my eye sight or have heart trouble.

You are a brave and loving person for asking for help. Good luck to you and your husband.
posted by zymurgy at 9:11 PM on May 31, 2007 [8 favorites]

Response by poster: Zymurgy, you sound like my husband in the first year he was diagnosed--when I discovered every method known to man for cooking boneless, skinless chicken breasts and still can spend 90 minutes in the grocery store reading labels. I know all about neuropathy. No one in our family is allowed to touch his feet--ever. He often goes to bed at night in his shoes and socks because it makes his feet feel better. He has a hole in his retina. None of this seems to be more important than the bag of chips.

He is definitely suffering from depression, but he has made food his medication and his poison. I don't nag or yell at him. He teaches my son to make fun of me and my cooking because there is broccoli on the table. I ask him to come with me to walk the dog. He goes to a therapist at my insistence. We've been to couples counseling at my insistence.

Here I sit at 1 a.m. on the AskMeFi trying to get strangers to help me understand my own husband. The real truth is I need someone to understand me and my frustration level. I have been married to him for a very long time and I have to end it. I don't know how to end it because I don't want to feel guilty. I know that I can't change him, so why do I feel responsible for his mental and physical health? My 10-year-old son told him yesterday that he wasn't taking care of himself. I just couldn't believe it. I worry about what he is teaching our son--what am I teaching our son?

I hope you are able to keep up this healthy lifestyle for the rest of a long life. You are very kind to share your story with me and read this.
posted by SMP at 10:37 PM on May 31, 2007

SMP, your story is heartbreaing.

If your husband is so dedicated to killing himself, there is no reason to feel guilty about refusing to let him drag his family down with him. Maybe telling him it's over will be the wakeup call he needs to turn his life around, or maybe it's too late, and doing so will only accelerate the tailspin he put himself in. Either way, you have every right to leave. A marriage isn't a suicide pact; nobody has a right to take their family with them if they've decided to give up on life.

If he was abusing meth, or if he was a drunk with a rotting liver, you would be praised for your courage for trying as hard as you have to turn things around. No one would judge you for leaving him after all you have done. The fact that North Americans' prefer to eat themselves to death should have no bearing on your decision.

I'm sorry I can't be of more help, but to tell you the truth, my first instinct when I was writing my previous comment was to tell you this: consider leaving your husband. You should flatly tell him you are sparing yourself and your children the trauma of spending every day watching him commit suicide in slow motion. It sounds like your husband has implicitly decided he prefers indulging his gluttony and sloth to sparing his wife and children the agony of watching him self-destruct; if that is the case, he shouldn't expect your support, nor does he deserve it.
posted by [expletive deleted] at 11:42 PM on May 31, 2007

He is also very reluctant to address when I am ill or be helpful in getting me to a doctor, etc.

Oh, SMP honey, I feel for you. Someone is being cold-hearted in your relationship, and it isn't you. Don't feel guilty about leaving someone who won't help you get to a doctor when you are ill.

It seems like you are feeling frustrated by being ready to leave a relationship that you feel trapped in because your husband is ill and needs to be taken care of. You have done everything you can for him, and he won't accept your care. He seems to be running headlong into making himself unhealthy. I know that's not something I could live with in a relationship, and I for one don't blame you if you can't either.

Zymurgy has an excellent post up there, and I wish that your husband could adopt some of what he has done in his life, but you cannot force you husband to do these things.
posted by yohko at 12:33 AM on June 1, 2007

SMP, it sounds like you've done everything you possibly can to help your husband. Now maybe it's time to think about helping yourself. You know how when you're on an airplane and they're doing the safety annoucements, about how if the oxygen masks drop, you should put your own on first and then assist the person you're traveling with. Well maybe it's time for you to put on your own oxygen mask. You said you've done couples counseling. Maybe some counseling for yourself, alone, would be in order. Sounds like you could use some help in dealing with the feelings you're having, finding ways to help your son through this and maybe even figuring out an exit strategy. As others here have said, you can't control what he does. I don't think you're evil at all for feeling this way. I think you're feeling that it's time to save yourself and your child and that's natural and commendable. I wish you all the best and I'm sorry you're going through such a difficult time.
posted by Kangaroo at 3:40 AM on June 1, 2007

"I have been married to him for a very long time and I have to end it. I don't know how to end it because I don't want to feel guilty. I know that I can't change him, so why do I feel responsible for his mental and physical health?"

SMP my heart goes out to you, and I cannot imagine the helplessness and quilt you're feeling. I know it does no good to tell you that you have nothing to feel guilty about.

It sounds as if your husband has resigned himself to the fact he will die from this. Has he ever brought this up or admitted it?

There comes a point where someone bent on harming themselves shuts themselves off from everyone in their life. If this is his goal you cannot affect the outcome. It's heartbreaking, but you have to concern yourself with you and your children at this point.

You feel responsible because you love him. I think this is natural, and it's going to be the reason you stay with him and watch this spiral further out of control.

Do you think the threat of you leaving with the children would be enough to cause him to change? I suspect not. And if that is the case there is truly nothing else you can do for him. It's time to look out for yourself and your children.

Good luck and God bless.
posted by zymurgy at 4:38 AM on June 1, 2007

Type II here.

First question is "How long has he been slipping?"I think it's kinda common for a diabetic to fall into old habits some time after diagnosis due to depression and being overwhelmed at having to live a certain way for the rest of your life. It can be a daily battle at times, where you feel like it's you against the world as you constantly have to stop and think about what you can and can't eat amidst all the usual pressures of the day.

My point here is that maybe he's fallen off the wagon for a bit while he deals with all this. It doesn't mean you have to put up with it and it doesn't mean you're a coldhearted bitch, just that this may, may be a temp thing. It doesn't sound like it from your post, but it's point to consider. And, as someone else noted, he really needs to be in therapy.

You're not being coldhearted, so stop beating yourself up about it. You have tried to help him and he has refused your help. You can't fix him, he has to fix himself. You can help, but only if he wants your help and only if he wants to help himself.

Have you told him, point blank, that you are prepared to leave him? If not, it might be good for you to do it, so that when you look back you can say, with a clean conscience, that you tried help him and you told him you would leave him if he didn't stop.

Now, you need to help yourself and your son. Find youself a therapist to help you deal with the guilt of leaving him. Recognize that it will be painful, one of the hardest things you've ever done. You've been married so long, care for him so deeply, it will be very difficult to unwrap yourself from him. This is normal in longterm relationship. You can unwrap yourself and get over this guilt, but you'll need some help, hence the suggestion for therapy.

If you do leave him, realize that he may turn to you in coming years when his health declines. This will be hard on you mentally and emotionally, but it will still be his problem. Diabetes is a pain in the ass, but with diet, excercise and drugs, it can be managed and a person can lead a very full life with it. It just requires that the person care enough about themself to do what needs to be done.

Summing it all up: he needs therapy, to come to terms with helping himself. You need therapy in order to deal with your misplaced guilt, build up your emotional and mental health, look after your son and pull away from your husband. This will be hard, but you can do it. You will stumble, it is normal, but with help you can get yourself and your son to a better place. Good luck.
posted by Brandon Blatcher at 5:15 AM on June 1, 2007 [2 favorites]

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