Maintaining friendships is hard enough.
Trying to maintain them while literally fighting to live is even harder.
Over the years, I have struggled to keep or maintain friendships. Not because they did something wrong. Not because I did something wrong. But because most people cannot relate to what I am going through.
They don’t understand why I can’t always show up.
Why I don’t answer the phone.
Why text messages sometimes go unanswered for weeks or even months.
Why socializing often falls to the bottom of my priority list.
For years, I have been famous for saying, “The phone works both ways.”
Recently, someone whose friendship I truly treasure hit me with that exact line.
Ouch.
I had reached out after learning about a major life decision she had made and asked why she hadn’t told me about it. Her response was simple:
“The phone works both ways, ma’am.”
And she wasn’t wrong.
Suddenly, I looked like the hypocrite.
The reality is that I hadn’t reached out in months.
I briefly tried to explain everything that had happened since we last spoke. The unexpected interruption in my Rystiggo treatment. The decline in my health. The struggle just to breathe. The exhaustion that consumed my days. The fact that I was only recently starting to feel some sense of normalcy again.
She wasn’t having it.
And truthfully, maybe she shouldn’t have been.
As much as I wanted her to understand everything I had been going through, the reality is that my absence still had an impact on her. Chronic illness may explain why I disappeared, but it doesn’t automatically erase the hurt or disappointment that can come with being left in the silence.
And honestly, that’s one of the things I love about her.
She is a no-nonsense friend who tells it like it is.
The kind of friend who loves you enough to tell you the truth instead of simply telling you what you want to hear.
To her, they sounded like excuses.
To me, they were the reality I had been living.
What many people don’t understand is that when you live with chronic illness, your energy becomes a precious commodity.
Every day begins with choices.
Do I use my energy to shower?
To work?
To cook?
To clean?
To attend a doctor’s appointment?
To advocate for myself?
To simply make it through the day?
The truth is, I haven’t just been absent from friendships.
In many ways, I’ve been absent from my own life while trying to survive it.
For the past few years, my focus has been on finding answers, attending appointments, managing treatments, advocating for myself, fighting insurance companies, monitoring symptoms, and trying to breathe.
Survival became the priority.
Everything else became secondary.
Most days, I barely have enough energy to take care of my personal needs and show up for work. By the time I finish doing those things, there is often nothing left in the tank.
Not because I don’t care.
Not because I don’t value my friendships.
Not because I don’t miss the people I love.
But because surviving has become my full-time job.
Living with Crohn’s Disease and MuSK+ Myasthenia Gravis means constantly balancing what needs to be done against what my body is capable of doing.
And unfortunately, friendships sometimes become collateral damage in that battle.
The hardest part is knowing that while I am fighting a battle that consumes so much of my physical and emotional energy, life continues moving forward for everyone else.
People get married.
They change careers.
They move.
They have children.
They become grandparents.
They celebrate milestones.
And while I genuinely want to be present for all of it, sometimes I am simply trying to make it through the day without collapsing under the weight of my own health challenges.
Chronic illness can be incredibly isolating.
Not because people stop caring.
But because eventually the gap between your reality and theirs becomes difficult to bridge.
The truth is, there are friendships I miss.
People I think about often.
Conversations I wish I had.
Moments I wish I hadn’t missed.
And if I’m being completely honest, there are friendships I’ve quietly mourned.
Not because anyone did anything wrong.
But because life, illness, time, and distance slowly pulled us in different directions.
There are friends who may never fully understand what it feels like to spend your days juggling doctor’s appointments, treatments, medications, fatigue, and uncertainty.
Just as there are days when I don’t fully understand what is happening in their lives because I have been consumed by my own fight.
Friendship is a two-way street.
My friend was right.
The phone does work both ways.
The truth is, despite constantly apologizing for my failure to communicate and promising to do better, I don’t.
Not because I don’t care.
Not because I don’t value the people in my life.
But because every time I start feeling better, another flare, another setback, another treatment, or another health challenge seems to demand my attention.
Before I know it, weeks or months have passed, and I find myself apologizing once again for my absence.
Her words forced me to look in the mirror and acknowledge that while chronic illness explains my absence, it doesn’t erase the impact that absence can have on the people I care about.
It was a reminder that relationships still need nurturing, even when life feels overwhelming.
I have also learned that friendship during chronic illness requires grace.
Grace from the person fighting the illness.
And grace from the people who love them.
Because neither side always gets it right.
The reality is that chronic illness doesn’t just affect the person who has it.
It affects every relationship attached to them.
Spouses.
Children.
Parents.
Coworkers.
And yes, friendships.
I think that’s one of the hardest lessons I’ve learned.
When you are the one living with the illness, it’s easy to focus on your own suffering.
But the people who love you experience it too.
Not in the same way.
But in their own way.
They miss you.
They worry about you.
They wonder if you’re okay.
And sometimes they grow tired of always being the one to reach out.
If you’re reading this and you’ve ever felt forgotten by me, please know it was never intentional.
And if you’re living with chronic illness and struggling to maintain relationships, please know you’re not alone.
Sometimes silence isn’t neglect.
Sometimes silence is survival.
Sometimes the strongest thing a person can do is simply make it through another day.
And sometimes, when the strength returns, you pick up the phone and try again.
I’ve often talked about grieving the life I once had before Crohn’s Disease and Myasthenia Gravis.
What I didn’t realize is that sometimes we grieve friendships too.
Not because the love disappeared.
Not because the friendship wasn’t real.
But because chronic illness has a way of changing the rhythm of our lives and the relationships within them.
Still, I remain grateful for the friends who stay.
The friends who understand.
The friends who pick up where we left off.
The friends who continue to call, text, check in, and love us even when we haven’t been the best at returning the favor.
The friends who understand that sometimes surviving takes everything we’ve got.
Those friendships are a gift.
The older I get, the more I realize that friendship isn’t measured by how often we talk, but by who is still there when we finally do.
To the friend who inspired this diary entry, thank you.
Thank you for being honest enough to call me out.
Thank you for reminding me that friendship requires effort from both sides.
And thank you for being the kind of friend who loves me enough to tell me the truth, even when it isn’t what I want to hear.
Sometimes the people who love us most are the ones willing to have the uncomfortable conversations we need to hear.
I intentionally omitted your name because I didn’t ask your permission before sharing this story.
But if you happen to read this, please accept my apology—not only for sharing our conversation without asking first, but for the many times I disappeared and left you carrying more of the friendship than you should have had to.
You deserved better communication from me.
You deserved more than promises to do better.
You deserved the version of me that wasn’t constantly exhausted, overwhelmed, and fighting for her health.
And while I can’t change the past, I can acknowledge it.
So thank you for the lesson.
Thank you for the grace you’ve shown me over the years.
Thank you for still answering the phone when I finally called.
And thank you for reminding me that some friendships are worth fighting for too.
I’ve spent years fighting for my life.
Maybe it’s time I fight a little harder for the people who have stood beside me while I did.
Maybe that’s the real lesson here.
The phone works both ways.
Sometimes one person calls.
Sometimes the other does.
And sometimes true friendship is found in the people who answer, no matter how much time has passed.
💜
Reflection Corner
Have you ever lost touch with someone because of your health, responsibilities, or life’s challenges?
Or have you been on the other side, wondering why someone disappeared?
Friendship can be complicated, but understanding can go a long way.
I’d love to hear your thoughts.
💜
The Dual Diagnosis Diaries
Founder & Author: Kia Lorice
“Living with Crohn’s Disease and MuSK+ Myasthenia Gravis has taught me that some battles are visible and others are fought in silence. Through The Dual Diagnosis Diaries, I share the realities of chronic illness, resilience, advocacy, and finding hope on the hardest days—so others know they are not alone.”
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