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wundayatta's avatar

Which is more important to you -- your marriage or your kidney?

Asked by wundayatta (58321 points ) February 17th, 2010

It is very challenging to be married to someone with bipolar disorder. When they get manic or depressed, they can attack you in any number of ways. It can be very scary and anxiety provoking. So if your spouse said they wanted to go off the medicine that controls their bipolar disorder, you might put your foot down. You might tell your spouse that they have to stay on their meds, or you’ll leave them.

Your spouse is on Lithium. Lithium, over time, degrades kidney function. Eventually, after maybe fifteen or twenty years, they would need a new kidney. After that, they would have to live with drugs that suppress their immune response, and they will, in all likelihood, no longer be able to take drugs for bipolar disorder.

Your spouse wants to stop taking Lithium, and their psychiatrist says there are no other effective alternatives. You decide you can’t take the stress of living with someone with active mood swings. So, you put your spouse in a difficult position—they have to keep taking meds and lose a kidney, or stop taking meds and lose you.

If you were that spouse, what would you do? Is a marriage more important than a kidney? Or is the kidney more important than the marriage? Why?

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44 Answers

DrBill's avatar

If you truly love someone, no price is too high.

lilikoi's avatar

It depends on a number of things like how much you want to be with this person, how crazy you get when you are not on the medicine, whether or not you currently have two healthy kidneys (you can live on just one). What stumps me is how you’d only lose one kidney; why wouldn’t it equally degrade both? You could always make a compromise – you stay on bipolar meds, and spouse agrees to give up kidney in the case it degrades (assuming a match).

oops, i reversed it – ive written “you” have bipolar when in fact your question says “spouse” has it…too lazy to rewrite…you know what i mean.

davidbetterman's avatar

Kidney…is far more important than any selfish bastard who would rather see the other lose it just to keep them on the deadly poison lithium.
After all, when they lose the kidney they will be taken off the lithium and the result will be the same, only you caused her to lose a kidney..

If you really love her, you would help her off the lithium. If she becomes the bitch from hell, be a man and walk, or are you such a coward that you would hurt her so badly just to keep her?

hungryhungryhortence's avatar

If the love is still reciprocal in the marriage then I’ll choose that start and start planning for a kidney.

faye's avatar

I would encourage testing with other drugs because there is always a new one. I would not want to hurt someone if I truly loved them, would I? So then I wouldn’t want them to endanger their health either.

Dr_Lawrence's avatar

A spouse who would abandon you because you made a wise decision to discontinue taking a drug that could kill them is not very concerned about you. Life without kidneys is difficult and uncertain. Many people on dialysis for several years die waiting for a donor kidney. This is no trivial matter, but then neither is life with an unregulated bipolar individual.

In sickness or in health, remember?

Hawaii_Jake's avatar

I would continue to take the lithium and trust that medical science would one day come up with a better alternative treatment for bipolar disorder. Hopefully, that could happen long before I had kidney failure.

I am bipolar and currently take Abilify. Perhaps you could talk to your psychiatrist about it. There is also Depakote (valproic acid).

There are many other drugs as well. I have had many friends who took lithium and got good results from it.

DrC's avatar

You are making the assumption that because you are on Lithium, you will have kidney failure. That is a big assumption and the worst-case scenario that is very rare. More common is that if you are taking a high dose of Lithium for 10–15 years, you might start having difficulty concentration your urine. So basically, you will pee more and drink more water. Even though this is much more common, it only happens about 10% of the time . The interesting part, though, is that Lithium doesn’t seem to have the same effect in people after a decade or so, and many times people are switched to a different medication. Rather than be paranoid about your kidneys and assume the worst, you could speak to your doctor about dosing it once a day, and/or having your kidney function tested every 3–6 months (if you’re really concerned) which is a simple blood test that can be done at the some time you have your Lithium level checked. That way, you and your doctor can be on top of it. No sense in creating ultimatums with your spouse.

wundayatta's avatar

@lilikoi yes, both kidneys are affected. I’m not totally clear on the details, but several people in my group are working on new kidneys (kidney?). Not sure.

@DrC you may be right. However, I’d like to know what you would do if you were faced with this choice, whether or not it is likely.

DrC's avatar

@wundayatta I don’t think that you can just make such a black and white choice. First of all, everybody’s relationship is different. Some marriages are not worth as much as your kidneys, but some are. I guess my point is that there are so many choices available to you before you reach this drastic choice. Plus, you don’t even had any kidney problems. Just keep checking your BUN and creat. It’s not like it happens overnight.

SeventhSense's avatar

Man you’re on your own on this one.
I’ll just add my favorite kidney comic relief video

MRSHINYSHOES's avatar

My marriage. I have 2 kidneys, like 2 of almost everything else (lol), but only one wonderful wife and family. Nothing can replace that!

Jack79's avatar

My marriage has been dead for several years, so it’s not even a dilemma personally. But reading your explanation, in this hypothetical situation, I might actually pick the marriage, assuming it was a person I loved and supported me in all aspects of life (including my health problems). After all, staying alone is probably worse than losing a kidney (especially since you only need one anyway).

Of course I’m not in that situation, or even close, so I can’t really know for sure.

Hawaii_Jake's avatar

As the healthy spouse, I would get counselling for myself to cope with the difficulties of living with a bipolar person. I would also look into support groups.

JONESGH's avatar

I wouldn’t force my spouse to make that decision.

casheroo's avatar

Interesting question.
I feel like I’ve been faced with a similar situation, although not as severe. My spouse feels I’m a completely different person when I take antidepressants/anti-psychotics. He hates it when I take them. But, I hate how I am when I’m so depressed that killing myself actually sounds like a good idea. Living with the obsession of wanting to die, but not being the woman my spouse wants me to be (and I’m not referring to just sexually, although those medications significantly lower my sex drive.) So, whenever I feel that I’m slipping, and I mention that I may need to go on medications, he gets very upset and tries to do all he can to “fix” whatever it is that might be a stressor. He also would be willing to let us spend thousands on therapy if that made me better, without medication.

I’m trying to imagine him wanting me to be on the medications, and the alternative would be him leaving me. I just don’t see that happening. But, I think in that situation, I personally would want to be on the medications. I don’t understand why there is no alternative. There are plenty to Lithium, aren’t there?

Judi's avatar

Having lived with someone who eventually died because his bipolar was NOT treated, I would continue to put my foot down.
I would also work with the doctor to make sure they were taking the lowest theraputic dose possible.
My first husband died at 27. Me and my children would gladlwy give him one of our kidneys to have kept him around.
Untreated bipolar is potentally very fatal. Stay on your meds.

tinyfaery's avatar

I’d want her to make the choice. It is her life. I would be with her no matter what.

Captain_Fantasy's avatar

If a psychiatrist says Lithium is the only option, a second opinion might be in order.

jonsblond's avatar

My marriage. I would be miserable without my husband.

wundayatta's avatar

If the tables were turned, and I were in that situation, I think I’d prefer she save her kidney rather than insist she stay on meds. Then again, I always feel like I can help people, even if it hurts me. Interestingly, my daughter’s teacher said exactly the same thing about her, today, in our meeting.

I don’t know if that’s just a value we have instilled in her, or if it’s something in the genes. I can’t say I have succeeded in my desire, but I do have that intention. But I digress.

If it was me, outside this hypothetical, I doubt if my wife would insist I stay on meds if I really couldn’t stand it any more. Although I know it would make her very anxious. I’m sure we would research other ways to cope with my illness long before that. Many people do cope without meds. And, while it doesn’t seem very likely, it is also not that unlikely that I would try to leave so they wouldn’t have to deal with me being depressed (or manic). I often think of it, but I can’t imagine actually doing it. Too many people depend on me. I can’t let them down.

YARNLADY's avatar

I don’t believe that kidney failure is a given. With the improvements in medications coming out all the time, and no need to make the decision immediately, I would say, hang in there, make sure there are no alternatives (second and third opinions required here), and relax.

In other words, I don’t answer your question, because this is not the black and white situation you are claiming it is.

davidbetterman's avatar

Lithium is a deadly poison. Anyone advising you to stick with it obviously doesn’t have your best interests at heart.

Just_Justine's avatar

I don’t think it’s really about the kidney. It’s about all the fears they have that you mentioned above. There are medications without lithium. I could be wrong but mine was not lithium based. I am off meds now as you know, it has been about two weeks. I must say all the plans I had, I haven’t done, like Omega in large doses, Yoga and therapy. It is partly a time and partly a money issue. All said and done, I would not damage my kidney for nothing. However, my illness is my problem, that I need to take care of. I think that is why I have stayed single. So I don’t inflict myself on others on a long term basis. Being alone doesn’t give me the issues married people could face. So it’s a hard question to answer. But all in all not really because married or not, I have to sort my self out.

Dr_Dredd's avatar

@davidbetterman I wouldn’t go that far. Sure, lithium can have toxic side effects, but what medication doesn’t? As someone else above said, close blood level monitoring needs to be done. If the drug levels in the blood are not too high, the risk of kidney failure is lessened greatly.

Hawaii_Jake's avatar

Lithium is not a deadly poison. It is an elemental salt.

OneMoreMinute's avatar

OMG, here I go again…...An idea came into my head so powerful. I feel so compelled to share with you. I DON’T KNOW WHY, BUT I MUST GIVE YOU THIS INFORMATION!!! If I don’t, I won’t ever eat or sleep!!

My idea is Holistic, and would be to consult with a Wholistic Natural Path Doctor. (Medical Doctors are not trained in holistic methods, nutrition——they are trained to drug, cut, radiate.)

With the intent to seek information on how to “Cleanse and Fortify” your Kidneys. There are Kidney Cleanse, and Liver Cleanse, and Colonics and Colon Cleanse products (some are good and some are junk-consult the professionals for which brand is most effective) My idea is to cleanse your kidneys naturally. And nutrition to strengthen.

Also, “Kidney Cleanse Soup” from the Max Gerson Therapy recipe.
It’s easy to make, in a big pan: (Use Organic) Cut up these into a pan:
Potatoes, tomatoes, onion, leek, parsley, celery, garlic cloves and pure water to cover in pan. Boil for awhile until soft. Then put through a sieve. Eat a bowl every day. I made this soup for a family member-it’s easy.

There are foods that serve the kidneys better nutritionally. I have read that eating large amounts of protein is hard on the kidneys. But I don’t know why, something in the digestion. Sugar and salt and all soda pop, alcohol are hard on kidneys. Fried foods is just bad for any organ.

Avoiding the Aspirin/Ibuprofrin/advils etc can cause kidney damage with prolonged use.

I am possessed to give you this information.

OneMoreMinute's avatar

Aaaahhh, there. I feel much better now. My oxygen has returned!

good luck!

davidbetterman's avatar

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision; confusion; diarrhea; drowsiness; excessive weight gain; fainting; giddiness; inability to control the bladder or bowels; increased thirst; increased or decreased urination; involuntary twitching or muscle movements; loss of consciousness; loss of coordination; muscle weakness; persistent headache; persistent or severe nausea; ringing in the ears; seizures; slow or irregular heartbeat; slurred speech; swelling of the ankles or wrists; unsteadiness; vision changes; vomiting.

davidbetterman's avatar

Central Nervous System

tremor, muscle hyperirritability (fasciculations, twitching, clonic movements of whole limbs), hypertonicity, ataxia, choreoathetotic movements, hyperactive deep tendon reflex, extrapyramidal symptoms including acute dystonia, cogwheel rigidity, blackout spells, epileptiform seizures, slurred speech, dizziness, vertigo, downbeat nystagmus, incontinence of urine or feces, somnolence, psychomotor retardation, restlessness, confusion, stupor, coma, tongue movements, tics, tinnitus, hallucinations, poor memory, slowed intellectual functioning, startled response, worsening of organic brain syndromes. Cases of Pseudotumor Cerebri (increased intracranial pressure and papilledema) have been reported with Lithium use. If undetected, this condition may result in enlargement of the blind spot, constriction of visual fields and eventual blindness due to optic atrophy. Lithium should be discontinued, if clinically possible, if this syndrome occurs.

davidbetterman's avatar

Cardiovascular

cardiac arrhythmia, hypotension, peripheral circulatory collapse, bradycardia, sinus node dysfunction and severe bradycardia (which may result in syncope)

davidbetterman's avatar

Genitourinary

glycosuria, decreased creatinine clearance, albuminuria, oliguria, and symptoms of nephrogenic diabetes insipidus including polyuria, thirst and polydipsia.

wundayatta's avatar

Involuntary twitching or muscle movements; loss of coordination; vision changes; hallucinations, poor memory, slowed intellectual functioning, decreased creatinine clearance… and I get constipation instead of the other way around. So far.

Dr_Dredd's avatar

OK, here’s another side effect profile. From Clinical Pharmacology Online:

hepatic necrosis, jaundice, bleeding and encephalopathy. After acute overdose, 2 or 3 days pass before maximum liver damage becomes apparent. Nausea/vomiting, anorexia, and abdominal pain usually occur within 2—3 hours after ingestion of toxic doses. Elevated hepatic enzymes and hypoprothrombinemia are seen. GI bleeding can occur secondary to low prothrombin levels.

acute renal tubular necrosis and chronic analgesic nephropathy, which is characterized by interstitial nephritis and renal papillary necrosis, in patients receiving high doses (e.g., 2.5—10 g/day) chronically or after acute overdose. Acute renal failure (unspecified) may occur in 25—30% of patients secondary to liver dysfunction.

urticaria, erythema, generalized pruritus, rash (unspecified), maculopapular rash, and fever. Anaphylactic shock, angioedema, and anaphylactoid reactions have been rarely reported with acetaminophen. Toxic epidermal necrolysis (TEN) occurred in a 7 year old girl after she took 3 doses.

This is for tylenol, an over the counter medication. My point is that all medications have risks and benefits. Only the person and his or her doctor can balance those.

davidbetterman's avatar

You have to be a fool to take tylenol, or any aspirin type meds…These are the beginning of the American Medical Death Trap.

Dr_Dredd's avatar

@davidbetterman Oh, yes. The great Medical-Industrial Complex conspiracy. ~

andrew's avatar

As the son of one parent who had a kidney transplant and another who is bi-polar, I think this question is a bit alarmist.

The benefits of lithium are real and will have a tangible improvement on your life and relationship, much moreso than any possible future problem with your kidneys. Take dr_c’s advice, and get your bloodwork done.

Having just taken care of my father as he got a new kidney after dealing with degenerative kidney disease for 17 years, it might be more beneficial to deal the problems you currently have, rather than the ones you think you might get.

Of course, examine all the options, and weigh the risks, but honestly, it sounds like you just don’t want to take your meds.

davidbetterman's avatar

@Dr_Dredd Laugh all you want. I hope you are taking your aspirin a day…

Do you even know how they make aspirin?

Dr_Dredd's avatar

Sure. But that’s just the last step, making acetylsalicylic acid from salicylate. The salicylates themselves can be found in willow bark.

Why do you bring that up?

faye's avatar

@davidbetterman read your link and no I don’t know how. Aspitin benefits far outweigh its cons.

davidbetterman's avatar

@faye Aspirin benefits far outweigh its cons.

Not for the people killed or maimed by aspirin.

Silhouette's avatar

If my mood swings were slowly eating away at the person I loved I’d take the medicine and deal with the kidney thing if and when I had to. We’d try to work something out and I wouldn’t feel like I was being asked to choose between a kidney and my man. Here’s what I know about bipolar people, they aren’t having a good time when they are off their meds either. They are in pain, deep, constant emotional pain. I’d take the meds for him and for myself.

thriftymaid's avatar

Today, I’d have to say my kidney.

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