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    I think my wife is faking her “chronic illness,” and more advice from dear prudence

    Dear Prudence is Slate’s advice column. Submit questions here. (It’s anonymous!)

    Dear Prudence,

    My wife (“Laura”) and I have been together for 10 years and we’ve mostly had a good relationship until the past couple of years. Laura is a hypochondriac. In the beginning, it was really minor and barely noticeable—she insisted any cold she got was actually pneumonia or an upset stomach was appendicitis. As time went on, she became convinced she was suffering from an undiagnosed illness and after years of seeing doctors and getting tested, a doctor diagnosed her with a syndrome that mostly consists of a collection of symptoms with no other cause, no test to confirm the diagnosis, and no treatment except lifestyle and diet changes. I had hoped by getting a diagnosis her hypochondria would calm down.

    It has not and I fear it is getting worse and turning into Munchausen syndrome. It was brought to my attention recently that Laura may have written into this column about an incident that happened a few weeks ago where she was vomiting and I wouldn’t take her to the hospital and prevented an ambulance from coming to get her. In the letter, she changed some identifying information—but the other details matched an incident that happened between us. My concern with the letter was her presentation of her diagnosis with medical terms derived from the CT scan and not the actual diagnosis the ER doc gave her, as well as leaving out key information, such as the questionable leftover chicken she had eaten earlier that day and the UTI she was diagnosed with earlier in the week and was supposed to be taking antibiotics for. She wrote that she was diagnosed with “acute colitis, cystitis, and a kidney infection”, however, except for alluding to her UTI moving into her kidneys, the doctor told her that she likely had food poisoning (acute colitis) and needed stronger antibiotics for her UTI because of the slight bladder and kidney inflammation (cystitis). He gave her new antibiotics for the UTI and when I went to throw away the old ones when we got home, I noticed that they were much fuller than they should be and asked her if she’d been taking them. She said that she may have missed a “couple of doses” but there were a lot of pills remaining.

    I’m really scared that she is trying to make herself sick. If she did write the letter, then I am also scared that she is trying to get public validation and sympathy and that she may continue to escalate. I’ve alluded previously that this is all in her head and it did not go well so I hesitate to ask her outright but I need to do something. I don’t want her to hurt herself and I want her to get the help she needs. Should I try to talk to her therapist about my fears? I know he can’t break doctor-patient confidentiality but can family members tell them about their fears so they can do some probing? Should I mention my fears to her physician? Her family? Even before this incident, I knew some sort of intervention needed to happen as we have nearly $10,000 in medical debt from her various tests and medical visits. Her health is more important than the money, but if this is Munchausen and it can be fixed by therapy, then I’d prefer that than to keep adding to our debt.

    —In Love With a Hypochondriac,

    Dear In Love,

    Well this complicates things… Sorry for telling her to leave you. I don’t know what a therapist or doctor will do with the information you provide, but it can’t hurt to share your concerns with them as well as a couple of trusted family members. I will add that, whether she made herself sick or not, she was actually sick and you should have helped her get to the hospital. If your suspicions are true, I hope she can get help but in the meantime, you should make it a priority to respond to her very real illness and suffering, despite your belief about its origins.

    Dear Prudence,

    My brother-in-law loves Hawaii and frequently talks to my husband and me about traveling there. While Hawaii sounds amazing, we dislike traveling with other people and have always deflected. Recently, my brother-in-law told me he wants to plan a week-long trip to Hawaii with just my husband as a Christmas gift and will be contacting me to ask about dates. I know this will not go over well with my husband but do not know how to reject the offer without hurting my brother-in-law’s feelings. Not only is that way too extravagant of a Christmas gift, but my husband gets easily annoyed by the brother-in-law and prefers to adventure alone. Why can’t he just buy my husband some socks for Christmas? Or get him the gift of space?

    —Burnt Out

    Dear Burnt Out,

    This is his brother! Not a co-worker or neighbor. He should know better. But he doesn’t. Unfortunately, you have to ruin the surprise, tell your husband what’s being planned, and come up with a response together. Maybe he’ll say, “He’s my brother, I’ll just do it to make him happy.” Or maybe you’ll come up with a brilliant white lie about how his chiropractor told him air travel will not be a good idea for his back for the foreseeable future. Whatever it is, you shouldn’t have to manage this alone.

    Dear Prudence,

    I’m very close with my sister’s kids, who are now 7. I’m happily now pregnant myself, and my sister is really happy for me too. We want to roll the news out to my niblings as best as possible as she expects them to take it hard – they like babies but they’re used to having a lot of my (and my partner’s, whom they also adore) attention and energy. Already as I slowed down in my first trimester they’ve wondered why I’m not playing with them as much. Do you have any advice for making them know they’re still important even when my and my partner’s attention and energy for them will be majorly reduced? I’ve been reading advice but it’s all geared toward parents telling a kid about a new sibling, and doesn’t quite hit the mark.

    —Expecting Auntie

    Dear Expecting,

    I love how concerned you are for the kids and how sensitive you’re being to their needs, even though I wonder if you’re overthinking this a tad. For a 7-year-old child, 40 weeks is a lifetime. By the time you have the baby, they’ll barely remember what life was like before you got pregnant. I don’t think there needs to be a big announcement about a new relationship format. The answer to why you’re not playing with them as much right now is that you’re not feeling well. And instead of “I’m having a baby and will have less time for you,” I think your angle can be “Our family will have a new member and he or she will be your cousin!” along with some talk of how they might interact with the baby. Remember they’re not just losing some of your bandwidth, they’re gaining someone who they will really love and have a lot of fun with.

    Catch up on this week’s Prudie.

    More Advice From Slate

    Several years ago, a very close friend of mine commissioned a bespoke handgun from a very well-regarded custom shop—he spent about $5,000 specifically so he could create a new family heirloom, which he hoped would be passed father to son for several generations. Unfortunately, he was taken by an illness at an unexpectedly young age and passed away when his son was too young to be responsible for a handgun. He gave the gun to me before he died, with the understanding that I would give the gun to his son when he was old enough…

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