Emotional Support
Along with the fear of losing her femininity, and possibly her life,
what a woman fears most at this time is that you, the one she loves,
will abandon her.

Emotional support is perhaps the single most important item you
can contribute. Knowing that you will be there for her, no matter
what, and that you still find her lovable, desirable, and attractive
will help her face her diagnosis and tolerate her treatments better
than anything else.
You can also help by creating a safe place for her to express her
emotions. This means allowing her to grieve in her own way, without
making judgments about the "appropriateness" of her behavior.
If you find verbal communication difficult, and choose to hide in
your job or in an outside activity, she may perceive this behavior
as a withdrawal of your love. Her well-being, and the survival of
your relationship itself, depends on your willingness to communicate
openly. You don't need to make long speeches. Holding her hand, sitting
close to her, putting an arm around her, will communicate how much
she means to you in ways words can't express.
Most people, especially men, are upset by tearful outbursts, so
your first reaction to her crying may be an attempt to "fix it"
or somehow "make it all better." But remember that tears
are a healthy response. You and she know that there is no easy fix,
and to pretend otherwise only delays the grieving that must take place
before healing begins.
Anger is also a normal response. Breast cancer is no one's fault,
but anger needs an outlet. She may lash out at the closest person
during such times. That might be you. The important thing to remember
is that despite what she says, she is not angry at you, but at her
loss of control over her life. This stage will pass, and she needs
to know you'll still be there for her. Help direct that anger into
action, to fight against the cancer and depression.
Some women withdraw and refuse to share their feelings, rejecting
your efforts at being close. This may be the most difficult reaction
to deal with, and may require outside help to reestablish open communications.

Some degree of depression is also to be expected. How do you know
if your partner's mood is normal, or if she has a severe depression
that requires treatment? This is an important question, because depression
can adversely affect her treatment.
It is normal to have short periods of sadness, "blue moods",
apathy, or loss of interest in daily activities. You can help her
overcome these feelings on your own. But a more serious form of depression,
called clinical depression, with prolonged feelings of sadness and
loss of interest in all activities, can adversely affect her treatment,
and should be managed by a professional.
Once chemotherapy or radiation treatment is completed, your partner
may be overcome with feelings of panic or powerlessness that come
from the perception that she is no longer being actively treated.
It is important to acknowledge these feelings, then focus on the positive
aspects of completing the treatment.
There is scientific evidence that a positive mind-set can lead to
an improved outcome. A supportive and upbeat attitude on your part
will be contagious, and is one of the best ways to help her through
the weeks or months of treatment.
A few simple techniques that will improve communications
• Make opening statements that let your partner know you're
willing to listen. Comments like, "How do you feel about..."
let her know that it's okay to open up on an emotional level.
• Reassure her that she has been truly understood by repeating
what you heard in your own words.
• Use nonverbal (body language) techniques to convey how
you feel about her. Hand holding, and looking directly at her when
she speaks tell her that your love and concern are real.
• Avoid judgmental comments like, "You shouldn't..."
or, "Don't say that." Such statements block true communication
by minimizing or invalidating the other person's feelings.
• Be careful with comments like, "Don't worry,"
or, "Nothing will happen." Having a positive attitude
doesn't mean being unrealistic.
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Reassurance
About Her Appearance
An unreconstructed mastectomy, or baldness caused by chemotherapy
will result in dramatic changes in appearance that will often make
the woman feel that her partner will no longer find her attractive.
A woman's acceptance of her changed body often depends on your reaction
to it. You need to prepare yourself accordingly.

Looking at the mastectomy scar or at the reconstructed breast for
the first time can be very frightening. Aside from the change in the
familiar look of your loved one, there is the shock of seeing injured
skin, perhaps bloody bandages, and drain bulbs full of drainage fluid.
If you are at all sensitive to this, it may be a little shocking.
But try to keep in mind that once it is healed, the scar will look
infinitely better. The swelling, bruising, and bandages will
be replaced by a clean white line. Try to be as sensitive and accepting
as you can. Give her the type of response that you'd like to hear
if you were in a similar situation.
Some women have no trouble looking at the surgical site together
with their partners at the earliest opportunity. Others choose to
view the scar gradually, sometimes alone, or in subdued lighting,
or under the cover of an attractive nightgown. Respect her wishes,
and be positive and reassuring when you look at her. What is important
is not how her chest looks, but the fact that she is still the same
woman you love.
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Sexual Intimacy
When is the right time for resuming sexual relations? There is nothing
about breast cancer that would prevent intimate contact, even if the
dressings and drains are still in place. The deciding factor is your
partner's, and your, readiness.

Surgery can be exhausting and debilitating. Tenderness around the
surgical site, or loss of sensation in the nipple can interfere with
physical pleasure. Wearing a natural-looking prosthesis, or having
her partner touch other areas of her body, can help a woman refocus
sensation and regain interest in intimacy.
Preoccupation with the cancer and its treatment will probably decrease
your and her interest in sexual intimacy. Chemotherapy, in particular,
can sap the energy and the motivation out of any sexual relations.
When the time is right, there are a number of small things you can
do to rekindle her sexual interest. Make a date with her, give her
a foot rub, take a shower together, watch an erotic movie. Try new
positions that may be more comfortable. But be patient and know that
for many months, perhaps even a year, your sexual interaction may
not be the same as it was before.
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Help with Daily
Activities
After she comes home from the hospital, your partner will have days
of physical and emotional exhaustion, and will need your help to handle
even the most mundane daily activities. Some women need more help
than others. The hard part may be determining how much help she wants.
Ask her what she feels like doing on a given day. Look for physical
signs of how tired she might be, but avoid "babying" her. Too much
help may be as inappropriate as too little. The goal is to return
to as normal a life as possible without causing either of you excess
stress.

In the early stages of her treatment she may be overcome with a
barrage of well-wishing friends and relatives. At first you might
feel elated by this, but soon you will find that there is such a thing
as too much help and sympathy. You will need to act as the gate keeper—"well-wisher
wrangler" as I called my role. Alternately, you can appoint a specific
person to channel all the good will coming at the two of you.
To avoid alienating friends and relatives, you might want to delegate
specific tasks to various people, such as walking the dog, shopping
for groceries, driving the car pool, keeping other friends informed,
and so on. That way, everyone feels involved, and the necessities
of life are attended to.
If you have children at home, they will need the time and support
your partner may not always be able to give them. One of the most
helpful things you can provide is a special time or activity that
all family members can participate in—for example, renting a
movie or going on a picnic.
You also may be required to deal with financial or insurance issues.
There are some things you can do to make an unpleasant task much easier:
• Contact your insurance company at the time of diagnosis
to find out their policies on hospital admissions, additional medical
opinions, filing of claims and billing, etc.
• Keep a written record of your contacts with insurance company
representatives, including names, dates, and times.
• Write down appointment dates and doctors' names. Get a
copy of all billing forms, which should include procedures, medications,
and supplies used.
• Keep all bills, charges, and related forms together in
one place for easy retrieval later.
• Don't forget to keep up insurance premiums. You'll be glad
you remembered this critical step later.
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