“For better and for worse.” “ In sickness and in health.”

When we repeat these vows on our wedding day, most of us don’t give much thought to the prospect of “worse” or “sickness.” After all, it’s the most beautiful day of our life! We’re focused on the joy and the romance; the vows are merely a tradition. The truth is, life throws us curveballs—at any age. Ups and downs of all sorts, including illness and long-term health challenges, happen. 

This can strain and change even the most steadfast, loving relationships. How can you best manage these changes so the core loving bond between you and your partner stays strong and keeps growing?

This is a topic that’s very close to my heart. Several years after I married and started a family with the man of my dreams, a surgeon’s mistake altered my life forever. When I was diagnosed with a tumor on my adrenal gland, my surgeon removed my left gland when in fact the tumor was on the right. This error destroyed my health and left me with long-term medical issues that can never be fully resolved.  I write about this in my Wall Street Journal and USA Today bestselling memoir, On the Way to Casa Lotus.

The lives of my husband and three children have been altered, too, since I now struggle constantly with ongoing medical issues, trips to the doctor, and the need for new tests on a regular basis. I take medications that often leave me tired and impact many other aspects of my health and mood. With these symptoms come emotional highs and lows.

But one silver lining is that I have learned how to manage relationships and their changes through health struggles, and this has, in many ways, made my relationship stronger. Because of that, I’d like to share my hard-earned insights:

Be prepared. Talk about the possibility of curve balls with your partner from the early days of your relationship, aligning on the core values and vision that will hold you together for better or for worse.  It may feel awkward when you’re young and healthy, but it will bring you closer together and help you move toward the future on solid ground.

Focus on “we” not “me.” Whether you’re having hypothetical conversations while all is well or  discussions in the throes of a crisis, remember that it’s about the two of you: how you each feel, what you’ll decide together, what has changed for each of you. In a relationship, it’s always about “we.”

Remember that no single moment or event is permanent. As living, breathing organisms we are constantly changing.  Even after a crisis hits, we can heal, grow and reinvent ourselves. Stay focused on this, especially during moments that feel like they’ll never end.

Create new routines. You can’t ski anymore? Try snowshoeing with your partner. Does fatigue slow you down? Embrace armchair activities together. Again, it’s about the two of you. Your new routines will help strengthen your connection. For every door that closes, a window opens.

Share. Shutting down and closing out your partner when you’re down or unwell will only make you lonely and create distance between you. But opening up to one another about what you’re each going through will bring you closer and in a win-win, it offers each of you a chance to both give, and receive.

Forgive. If your partner is frustrated and angry because your struggles are slowing you down or weighing on your morale, forgive them. It’s normal for them to be grieving, too. Your losses and challenges are shared. Resentment or holding a grudge will only make you both feel worse.

Acknowledge. Let your partner know you understand things did not turn out as you’d expected; that they, that they, too, are bearing the consequences; and that things have changed for both of you or for the entire family if you have one. But remind each other of all the ways in which you can move on together.

Draw strength from stories. There’s no shortage of thoughtful, inspiring and informative stories to read, watch, listen to and learn from when you’re working through the relationship side of health struggles. TED talks, books, movies…  One of my favorites is the movie Penguin Bloom. And there’s my podcast, too: On My Way!

Every one of us has our own journey, and we are all continually on our way.

Art collector and philanthropist Lorena Junco Margain is the author of On the Way to Casa Lotus, a memoir about her journey coming to terms with the permanent consequences of a surgeon’s devastating mistake. After studying visual arts at Universidad de Monterrey, she  co-founded the Distrito14 gallery in Monterrey. She also co-founded and curated, with her husband, the Margain-Junco Collection to promote awareness of Mexican art internationally. She lives in Austin, Texas with her family.