I don't know if I need advice, support, or a smack upside the noggin

In My Humble Opinion
1

My husband has a host of health issues, including mental health problems including depression, anxiety, and diagnosed agoraphobia.

He seems to border on hypochondria at times, and is often insistent that he see a doctor.

He refuses to make his own doctor appointments or otherwise to contact his doctors’ offices for information, refills, etc. This led, earlier this year, to a misunderstanding that put him in the hospital. I was expected to relay complicated messages back and forth and didn’t do an entirely adequate job.

I have since refused to make any such calls. I am not a doctor and cannot ask him the correct questions. My acting as a conduit nearly killed him. I do not want to do it again.

His previous psychiatrist left him in the lurch and his internist has referred him to a new one. That doctor will not accept third-party appointments at all. They wouldn’t even allow his doctor to set up the appointment. They require that the patient call.

And, of course, he won’t.

Since the blowup, there hasn’t been any opportunity for harm to come of our policies (his refusal to call, my refusal to call), but obviously this is a brick wall. I can’t force him to do anything.

I have pretty much the patience of a rabid gopher when it comes to this topic, and am at my wit’s end.

Any help, advice, perspective, 2 x 4s, narcotics, or ice cream would be greatly appreciated.

2

This may sound goofy, but would he be willing to talk to an answering machine, if he knew that there wouldn’t be an actual person on the other end? Would he be willing to write letters requesting appointments? Or emails?

You have my sympathy.

3

Why can’t you? Force him I mean. If my wife were in serious jeopardy of bringing harm to herself by being lazy, I’d have a sit down talk with her and sternly convey my opinons. If she still insisted upon me doing the leg work for her, I’d become slightly terse and implore her that she take a proactive stance and get some work done on her own. I’d offer my help in anyway that I could, sans doing it for her. If that didn’t work. I’d have a stiff Gin & Tonic and grab my grappling hook, some gerbils, a bail of alfalfa and drag her to the large oak in our back yardd :slight_smile:

4

Oh dear. I don’t think the gerbils RJ, Zane, and Louis can get behind your plan. :slight_smile:

But really, I’ve told him how I feel. I’ve explained in great detail. Over and over and over and over and… we’ve been married for over 7 years so I need a few more “overs.”

I can inform and entreat all I want. I can’t make him do anything he chooses not to do. And if it were just the psychiatry issue, I’d be upset; but it’s all of his doctors–his cardiologist, his internist, and the pharmacy as well.

5

Is he not calling because he’s mentally ill and it’s too challenging? Or is he an attention whore that needs you jumping through hoops to get the “pity party” fix he needs? If his mental illness is keeping him from calling, the doctor is going to have to get the fuck over it and take appointments from you.

Sorry you’re having such a shitty time of it. If he’s just being a baby, maybe you’ll have to give him a dose of the ol’ tough love and just don’t do it for him anymore.

Or change doctors.

6

First of all jsgoddess I am sorry you are dealing with this situation and wish you strength and your husband better health.

I am only going by what I see in your OP and replies, so if I lack information or come across as insensitive, please forgive me.

I am inclined to side with Philosphr on this one - it really feels like, to use 90’s self-help speak, that he is co-dependent on you and you are enabling that. By having you deal with the docs, even to the point of things going wrong if you don’t, he is exerting power over you. And you are allowing it.

If he has some medical/psychological/psychochemical condition that makes his inability to fend for himself doctor-management-wise, fine (and please share it with us so we know about it) but otherwise - it sounds like a little tough love is in order.

Tell him you can’t do it - because he has to do it to make sure his needs are met, because his doing it is part of him taking control over his own health, and because it is an inappropriate burden to place on you. If he refuses, then the doctor-management stuff - appointments prescriptions, etc. - WON’T GET DONE. And stick by it.

The more I think about this the more I think he needs a relationship with a new therapist and that you need to be involved with a few of the first visits, so the therapist gets a sense of how your husband is looping you into his issues, so the therapist can use that as a starting point of getting your husband back to a controllable, stable status.

Again, if I have misinterpreted, I am sorry - it sounds like a very very tough situation. My thoughts are with you.

7

I honestly do not know if this is stemming from the mental health issue or if it is a control issue. When I’m in it, it feels an awful lot like a control issue. If I ask him why he won’t call, he’ll reply that he doesn’t want to.

If I say that we all have to do unpleasant things in our lives, and that if he doesn’t call it forces me to, he says that I don’t have to call if I don’t want to. At the same time, he expects me to call. He sent me an email at work: “Did you ever try to call the psychiatrist?”

I replied, “Did you?” No answer.
When he needed a new top for his car, he called around. That means he is capable of calling people and setting up appointments.

Obviously, I am to blame for a lot of this. As I said, we’ve been married since 1997 and early on I managed to “force” him into making his own appointments for a few months, but that didn’t last.

He has me over a barrel and he knows it. If I call, we could repeat the fiasco of earlier this year when he ended up in the emergency room with tachycardia and ended up with heart damage, all because he wouldn’t call his doctor’s office and explain things, so I ended up attempting to answer their questions in piecemeal stages and fucked everything up rather royally. (I can explain the ins and outs if anyone cares.) The way I see it, his stubbornness and my ignorance put him in the hospital. I want to make it so that neither condition is life-threatening any longer, because killing someone through ignorance would really rather suck.

I’m probably forgetting to answer questions I meant to answer. No one be scared of blaming me for at least contributing to if not actually causing this problem. I am an idiot!

8

Well if you think you are an idiot, you have some major work to do. Your husband is co-dependent. Read Melody Beattie’s Co-Dependent no more - it will give you much insight into what your husband is doing, and how he is making you look like you are the enabler. When infact you are just following suit in a text book co-dependency case. If he dies, it will not be of your ignorance, but of his stubborn stupidity. I am not scared of placing blame on you, and believe me I would if you deserved it. But you do not deserve anything of the sort. This is not your fault. Make him do what he needs to do to keep his ownself healthy. You are not his mother, and that sounds like the very thing you are being to him…Mommy.

9

Yllaria, my apologies for not seeing your reply.

This would be a good solution, we-lll, maybe not “good” but “better.” I know he would email. I don’t know about writing. He uses the net to order refills from the pharmacy.

10

At first I thought, along with all his other issues/illnesses, he has a stronger version of my mild phone-phobia (avoidance) thing. I dislike talking to some people on the phone - calling to ask questions, make appointments, etc. It feels (to me) like a stupid fear to have, so I can understand saying “I don’t want to” rather than “I’m afraid to and can’t explain why.” E-mail had been a boon to me, and I also cope by calling “after hours” and trading voice-mails, thereby not actually having to talk to people.

But then this:

makes me question that. Although, in my case, too, some calls are easy to make and some are hard. Maybe it’s just the medical calls (facing one’s frailty or “failings”) are problematic?

I’m not adding any clarity, am I? I guess I just wanted to highlight that it might not be a willful thing.

11

I’m in a similar situation with mr.stretch. Lucky for me, there is an end in sight–mr.stretch is undergoing a year of prescription drug therapy and it will be over at the end of September.

Due to the meds and side effects, mr.stretch hasn’t been able to effectively handle his medical needs. I’ve been making appointments, taking him everywhere, etc. for the last 9 months. I’m wore out. A big part of mr.stretch’s problem right now is depression, anxiety and the inability to deal with other people and focus on what he’s doing.

If he’s doing something trivial, he does it himself; nothing catastrophic is going to happen if he writes down the wrong name of some guy he talked to about gutters.

But if it’s important, like scheduling an appointment, we work together to make it happen. Right now he doesn’t like to talk on the phone. I make the actual call and do the interacting with the doctor’s office. But he’s there with me so I can ask clarifying questions or whatever. I make him be involved to the extent he can be. If he’s having an unusual reaction to the medication, I call the nurse and interact with her, while I’m with mr.stretch. Again, that way I can get clarifying information immediately. If we have to doing something while I’m at work, we conference call so that mr.stretch isn’t doing it on his own. I’m there to support him the whole time.

Again, I’m lucky and there is an end in sight for me. Sounds like you don’t have an end point to look forward to, which is something that you should work to change.

I think you should work with your husband to get him back on track to making his own appointments. Start out doing most of the work for him, but he has to be there with you while you do it. This way, he doesn’t have to do something that he is unable to do, but he doesn’t get to sit back and relax while it happens–he still has to be involved. Then gradually work up to him doing more of the interacting.

This is something he should be discussing with his therapist if he ever gets to see the new one. The new doctor should be able to understand that someone with anxiety and depression may not be up to interacting with a new person over the phone right now. Maybe the referring internist call help out with this. Or the internist can give you a referral to a therapist who is more willing to be helpful to their new patients–I would be leery of going to this therapist with the attitude currently being presented.

I don’t think that you should be tied to doing this for your husband forever. He should be taking this on himself. I just think you’re going to have to work up to it. I know that it seems like no big deal to have to call and set up an appointment, but sometimes it can be overwhelming to talk to medical people, even the receptionist.

I’m leaving out all the stuff about how you have to sit down and explain how much you love him, but you can’t do this forever, so the two of you are going to work out a way for him to take charge of his medical stuff, but you’ll do it together…

Or, you can do this: Throw up your hands and ignore the problem. Then keep beating yourself up for not being a good wife. Then get pissed at him for putting you in this position. Then be mad at yourself for not having enough empathy. Then get upset with him again. Rinse and repeat as necessary.

By the way, I read your thread in the Pit about this back in the day, and I almost posted then. Wish I would have. Take care.

12

You’re in a very difficult situation, and I’m trying to think “outside the box” for an answer. Is there any way that you could hire a third party to schedule and monitor your husband’s medical needs? Someone like a retired nurse who would be glad to earn an extra $20 a week for talking to your husband to figure out what he needs and then scheduling his appointments? Lots of retired people and SAHMs are looking for ways to make a few extra bucks.

I’ve never heard of a doctor that wouldn’t take 3rd party appointments. Either this doctor needs to bend a bit, a least at first, or you’ll need a different doctor.

13

You’re going to be hearing about it a lot more. I started encountering this within the last year or two, as I tried to deal with my mother’s medical problems. Because of the privacy requirements built into HIPAA (the Health Insurance Portability and Accountability Act), and into the regulations spawned by the Act, medical providers have become very wary about dealing with any third party when it comes to a patient’s health care needs. Care providers who violate the regulations can be subjected to stiff fines, so they’re being pretty careful.

Refusing to allow someone else to make appointments does seem to be a bit over the top, but it’s consistent with the kind of thing I kept running into. Whenever I had to call the “advice line” at the HMO, the nurse on the other end insisted upon talking to my mother, even if she was in no condition to speak to anyone. They were usually content with accepting her assurance that I could speak for her, at which point she’d hand the phone back to me. I couldn’t change my mother’s primary care physician. I can’t tell you how many times I forged her signature on consent forms, because she could barely hold a pen. Even with a very broad health care power of attorney, I still faced barriers.

14

I was going to mention this also, but resisted opening this can of worms. Now that’s it been brought up, HIPAA is the enemy of people who need to be able to interact with health care professionals on behalf of a family member.

You should consider getting a durable medical power of attorney.

We have had untold difficulties in getting responses from our insurer due to HIPAA requirements and the inconsistent way they are applied by the insurer. At this point, the only way I can be assured of being able to deal with mr.stretch’s health care provider and insurer representatives on his behalf is to get the PoA.

We’re almost done dealing with this treatment. Our stop-gap measurers of filing new information releases every 90 days is getting old. We need to plan for future health problems; mr.stretch isn’t getting any younger, so I anticipate future opportunities to run up against the evil that is HIPAA. I shudder to think what would have happened if he’d been unable to authorize the doctor to speak with me when I had to take him to the ER a couple of weeks ago.

A PoA is something you should think about even if your husband steps up to the plate and takes responsibility for his own health–he may need you to do it for him in an emergency and the PoA can give you that ability.

15

No, goddess, you do not need a smack upside the noggin. You are in a situation many “appointed caretakers” find themselves in when a spouse/partner is in distress. Disclaiming the presumption that I understand all of the facts for your particular situation, I do know one thing for sure; and that is that helping oneself is an active process and you cannot do this for him while his remains passive.

What you can do is support him in his efforts, feeling comfortable in the fact that *support * and actually *taking on his tasks as your own * are worlds apart. I don’t understand how severe his depression and anxiety are but presume from what you have written that he maintains the *capacity * to act on his own behalf. Perhaps you can explain to him that you can *assist * him when he asks for your help but that you will no longer *assume responsibilty * for the things he needs to do to be healthy. Protect yourself not only for your own sanity, but for him also, knowing that if you burnout his situation will be all the worse.

Now. Is there support for you among your family and friends? Sometimes people do not understand that the strong partner in a relationship also needs support to stay that way. We tend to identify and label people as strong caregivers and sometimes fail to see their quiet needs in the fireworks of their needy spouse. Let people support you. Tell them you need it. And make sure you are really kind to yourself.

So don’t smack yourself upside the noggin as it will hurt really bad; don’t use the 2x4s as that might land you in the pokey and don’t use the narcotics as they might land you in rehab. The ice cream? Well, a girl’s gotta do what a girl’s gotta do. I’m sending you a virtual pint of Rocky Road.

This is my first post, btw. My daughter has been a doper for a while and tells me about it frequently. Today she visited and left me reading another thread she thought I would enjoy. Then I came across your post; thought about you all day and then had to join tonight so I could respond.

Take care of yourself. Let that be a priority. Find your support and let them know you need them. I’m glad you have this venue to vent and get supported. I read a lot of caring in this thread.

16

Well, the shit hit the fan again, which either means we’re full of shit or have a lot of fans, your pick.

He never did call the psychiatrist. He saw his internist today (I was not there) and asked to be referred to another doctor, this time one who will deal with me. I picked him up and he told me that.

We were driving away and I said, “I’m not going to be the go-between.”

He said nothing. I repeated that I wasn’t going to do it and that the last time bad things happened. He shouted that the discussion was over. So, I turned around and went back to the doctor’s office. I spoke with his nurse, explained the whole situation, and she is going to work with his internist and a chosen psychiatrist for a solution.

I cried. I’m so embarrassed. I cry when I’m frustrated, upset, or angry, and since I was all three, I really REALLY cried.

She told me the same thing everyone in this thread was kind enough to tell me: Stop being a weenie and get out of the hand-holding business.

I know that it’s true, but you know what? Now she’s in the hand-holding business for my husband. How is that an improvement? I mean, it’s great because I don’t have to do it and she knows something about medicine. But she can’t force him to act on his own behalf either. None of us can.

And now I’m not supposed to do anything for him, medically, including picking up his medications. That’s fine, if he picks them up himself. But if he doesn’t? At what point, if any, am I supposed to say “enough’s enough” and step in? One of his drugs keeps him alive. Do I just shrug and assume he’ll get it if forced to?

I’m terrified.

17

Ice cream, I can do, but I don’t think I’m a qualified advice giver. You definitely have my sympathy/support. That’s gotta be frustrating as hell.

18

You do have a complicated situation and my heart goes out to you, jsgoddess.
HIPAA may be the cause of the doctor’s, “No third party” rule. It could also be a pragmatic, tough stance that a patient needs to ask for the help that they need. People can be fragile, hostile or passive-aggressive when they deal with mental health professionals. This makes a therapist’s job harder and a patient’s likelihood of recovery much less likely.
You have every right to be frustrated with him. If you are unsure of his motives and it is making you a bit crazy perhaps couples therapy would be advisable.

Getting power of attorney may be a good idea for many reasons. HIPAA will no longer prevent you from talking to doctors (if you choose to do that.) Also, it may serve as a wake up call for your husband. If he is acting incompetent perhaps he should be treated as such. You may also find out that he really is unable to care for himself this way.

Don’t let the guilt over the past get to you. It’s tough but you are in a tough situation right now.