Ask Dr. Giles:How to cope with BiPolar/Narcissistic husband with cholangiocarcinoma.

Tina asks:

My Husband was diagnosed in June ’09 with cholangiocarcinoma that is unresectable, at that time he was told that his prognosis was 9-12 months.  He completed chemo (gemzar and cisplatin) in the fall and a CT was completed at that time (Dec), which his Oncologist had stated that he was staying with his same prognosis, however they may have bought him a couple of months.  Chemo (5FU) and radiation were completed earlier this year. They tell us that the radiation continues to work for approximately 2 months after treatment is complete, therefore we expect a CT to be scheduled approximately the beginning of May.  Meanwhile, I have had numerous family members (including his parents) and friends approach me to say congratulations that my husband had told them that he is not dying and/or that he has 5-7 years to live.  We have 4 daughters and they have also heard him tell these tales.  I have told them that he is in denial and that I will keep them posted.  As for his parents, I had called his mother to let her know that he is taking a couple vicodin over his morphine every day and that he was in denial.  She got very upset with me that he would tell his family members a lie, I tried to explain that as long as he was taking his meds and living a quality of life that him being in denial was fine and that he would accept it in his own time.   My concern is that today is 9 months and it’s been months that he’s been in denial, recently he even tried to tell me this also.  I have been with him to every appt, no one has told him this.  Several years ago he was also diagnosed with Bi-Polar and Narcissism and he has been violent.  The anxiety I fear is that anger and mania may coincide.  He recently had a dream and woke up strangling me, these are his words that he told our 2 youngest daughters and myself, I actually slept through it.  I sleep on the couch now and he continues to work 12 hour days 6 days a week.  Not sure what to do or what to expect, please help!

Tina,

I think you are doing a good job of allowing your husband to deal with his illness in his own way without feeling obligated to buy into it yourself.  It sounds like you are concerned about your husband’s reaction when the reality of his limited prognosis finally dawns on him.  I would suggest that you strongly consider getting the entire family into counseling in the meantime.  This would allow you and your family to address, in an ongoing way, the issues which arise related to his illness–even while he remains “in denial,” as you say.  You and your daughters may have things which are important to talk about regardless of whether your husband chooses to engage in the discussion.  In this way, there is a platform of support in place in the event of crisis–including a downturn in your husband’s mood and/or physical health.  Ongoing counseling for the entire family makes available prompt intervention for all family members and may serve to give you some peace of mind regarding your ability to deal with what comes your way during this fight with cancer.