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Managing Relationships with Family and Friends

The months after a bone marrow or cord blood transplant (also called a BMT) can be stressful for you and those close to you. Your family is glad to have you home, but may still be worried about your health. They may find you need more help and more time to recover than they expected. Your illness and recovery may also affect your outlook on life and what you want from your family and friends. Many people find that their relationships with others go through a time of adjustment in the year after a transplant. Some people who have faced a life-threatening illness find some relationships become more difficult or do not survive the strains. Others say their bonds with family or friends are stronger as a result of what they have gone through.

Re-entering family life

When you return to your home and family after a transplant, your whole family goes through a time of adjustment. After facing a life-threatening illness, people often rethink their priorities and want to make changes in their lives. Family members may also find that they have changed. Or they may want you — and family life — to be the same as before your illness. Some people feel they grow closer to their family during their treatment, but it is not unusual for survivors of a life-threatening illness to feel they have fallen out of step with their spouse or partner or other family members.

Your family may be looking forward to getting back to normal. However, it may be a long time before you can return to your old activities. On the other hand, you may be ready to resume your old roles but find your family is not ready. Older children who took on more responsibility and were more independent while you were ill may not want to give that up. Spouses or partners who handled new roles may have found they enjoyed some of them. Or they may still want to take care of you, while you want to do more for yourself.

Communication is crucial to meeting these challenges. It may help to hold regular family meetings where everyone can talk about their feelings and expectations. It may help to see a professional counselor, as a family and/or individually. Together, you may work out new ways to function as a family. These adjustments may continue as you gain strength and energy in the months after your transplant.

Your relationship with your spouse or partner

Communication is important to keep your relationship with your spouse or partner strong during your first months at home after a transplant. You will both need to be patient because your recovery may slow. If your spouse or partner took time away from a job to be with you during the transplant, it may be time to return to work. He or she may also be doing tasks around the house that you used to do and helping you take care of yourself and get to doctor appointments. For many caregivers, life is harder now than when you were in the transplant center, where your medical care, meals and doctor visits were all managed by the hospital staff.

You and your spouse or partner can talk about your feelings and support each other. He or she will also need other people to talk to — friends, family members, a caregiver's support group, or a professional counselor. Treatment for a life-threatening illness is stressful for both people in a relationship. If you and your partner are having trouble talking about your feelings, talking to a professional counselor may help.

Sexual relationships

Resuming sexual activity with your spouse or partner can be hard. Some transplant survivors do not feel interested in sex again for a long time. This could be because of low energy, not feeling well, depression or their feelings about their bodies. For some survivors, the changes in their bodies make sex difficult or painful. In addition, most transplant survivors are infertile as a result of their treatment — for more information, see Managing Long-Term Effects of Transplant.

It is important for you and your partner to talk about your feelings, what you want and what you feel able to do. Give it time. You can show each other affection in other ways. Talk with your doctor if you have problems with or concerns about sexual activities. There may be treatments that can help. Talking with a counselor may also be helpful. Do not be embarrassed to bring your concerns to a doctor or counselor. Many people have some sexual problems after a transplant, so doctors and counselors have experience helping people find ways to try to overcome them.

Your relationship with your children

If you have children, they may have special concerns. Whatever their age, it is usually best to be honest about your treatment and how you are feeling. How much they can understand will depend on their age.

Your children will probably need to adjust to changes in how you look and act. You may not feel well sometimes. You may not have the energy to do things with them — or to take care of them — in the same way that you did before. If someone else was caring for your young children during your transplant, it can take time for them to adjust to your return. If older children had more independence during your transplant, they may resist your supervision when you return. Some children may feel angry that you were gone so long or that you were sick. Children don't always know how to express their anger or fears. They may act out to test rules and see how you respond. It can take time to adjust to living as a family again.

Your relationships with other family members and friends

People who care about you may not realize you still need their help and support when you get home. Many will be willing to help if they know you need it. Let people know if you need help with getting to doctor appointments or household tasks. And let people know if you want to talk. Many people are unsure whether they should bring up your health or your transplant. If you want to talk about these things, bring them up yourself. If you would rather talk about other things, let them know that, too.

During and after your transplant, your relationships with friends and family may go through some changes. You may find some people do not want to talk about what you have been through. Talking about a life-threatening disease may make them feel anxious about you or about themselves. It reminds them it can happen to anyone. You may lose the closeness you felt with some friends you used to talk with easily. This can be a big loss. On the other hand, you will probably find some people who are able to talk with you about your experience and feelings. They may not always be the people you were closest to before your treatment.