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Spokane, Washington  Est. May 19, 1883

Symptoms of grief can take a heavy toll on physical health

Catherine Johnston Rebecca Nappi

Q: Since my wife died a few months ago, my stomach hurts and I cannot sleep. Can my health problems really be caused by grief?

A: Absolutely. On its website, the Mayo Clinic lists the most common physical symptoms of grief: “Trouble eating and sleeping, stomach upset and nightmares.”

Jackie Kleinjans, director of bereavement services at Hospice of North Idaho, says the physical symptoms of grief can also mimic heart problems.

“People say, ‘I’m having heart palpitations. I have this heaviness in the chest and shortness of breath,’ ” she says.

“They often put their hand to their chest and say that’s where the heaviness is manifesting itself. There’s a lot of truth and wisdom in that phrase ‘heartache.’ ”

In rare instances, this heartache is an actual physical response to grief known as stress-induced cardiomyopathy, also called broken heart syndrome.

The Mayo Clinic explains: “People with broken heart syndrome may have sudden chest pain or think they’re having a heart attack.

“These symptoms may be brought on by the heart’s reaction to a surge of stress hormones. Part of your heart temporarily enlarges and doesn’t pump well, while the remainder of the heart functions normally or with even more forceful contractions.”

The condition is treatable and reverses itself in about a week.

Your first step should be to rule out physical causes for your symptoms. Make an appointment with your doctor, and be sure to tell him or her that you are newly widowed.

Kleinjans says the best physicians, once they discover everything is OK physically, refer patients to hospice and other organizations for grief counseling and support.

“It gives them permission to say, ‘OK, my doctor thinks I need some grief support here,’ ” she says. “It’s often difficult for people to say they need some help. The support of physician gives them a little nudge.”

Your insomnia is so common that those who write about grief almost always mention it. In her excellent memoir “A Widow’s Story,” Joyce Carol Oates describes her hallucinations from sleep deprivation.

Sleep deprivation weakens the immune system, so you are at risk for colds and the flu – common for people in grief, especially if they were long-term caregivers.

“You push, push, push your body and after your loved one dies, if you don’t stop and take care of yourself, your body will let you know,” Kleinjans says. “Our bodies have a way of reflecting back to us that they need care.”

Q: Why is saying “Let me know if there’s anything I can do” not helpful?

A: A general offer of help can sound a bit like saying, “We should get together sometime.” The polite comment offers no direction or detail to actually make the suggestion happen.

Instead, follow a few simple guidelines when you want to help someone.

First, think about what you are really willing to do for someone else before you offer assistance. Do not offer to cook a turkey dinner, if you suffer through that process every Thanksgiving, detesting it all.

When Catherine was treated for cancer, Rebecca told her, “I am not going to visit right now. I am going to wait a few weeks and then I will come, stay at a nearby hotel and spend the days with Alex. Will that work?”

Rebecca knew that Catherine’s biggest concern was her 10-year-old son.

Be specific. If you could easily drive someone’s children to school, shovel snow or clean bathrooms, then offer those services.

When Catherine’s friend Barbara was home with her ill husband, she was also juggling a job, a home and three young daughters. A neighbor called and told Barbara she was willing to wash their clothes and asked what day would work best to pick up and return the laundry.

Use details and timelines when offering assistance. Food can bring comfort, but not all food brings comfort, so ask questions when you offer meals.

Give people detailed choices. Ask: “I can bring you meatloaf, potatoes and vegetables on Tuesday; would that be helpful? Is anyone a vegetarian or allergic to gluten?” When you know preferences, you can accommodate others appropriately.

Allow for quirkiness and adapt. When people are suffering, little gestures offer comfort, even if these same gestures appear to have no obvious impact on a person’s recovery.

When Catherine’s husband was recovering from cancer surgery, he wore his bathrobe all day. When good friends arrived for a visit, they walked into the house wearing their bathrobes, then went straight to the kitchen to make waffles for dinner. Their mindfulness was an act of compassionate solidarity.

When you ask people specific questions, and acknowledge what you are willing to do, your kind gestures will be practical and appreciated.

Catherine Johnston, a health care professional from Olympia, and Rebecca Nappi, Spokesman-Review features writer, welcome your questions about what to do in times of illness, dying, death and grief. Contact them through their blog at  www. endnotes.