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“Hot and bothered!” For most people these words create images of being twisted up in sheets, breathlessly reaching out to the one you love. For those with chronic illness, however, “hot” is more likely to refer to one’s thyroid condition, night sweats, or a heating pad on high. “Bothered. . .” Well, let’s just say when your body aches, everything makes you feel bothered: a cat that won’t move off your leg, a joint that continues to throb, and a spouse that is able to snore through minor earthquakes. It can be hard to be romantic!

Nearly 1 in 2 people live with a chronic illness in the U.S. which means that a lot of marriages are disrupted by this uninvited third party of illness, often including mental illness as well. Seventy-five percent of them end in divorce. Romantic ideas don’t have to be used just on Valentine’s Day.

So! How are some ways to get the spark back? Here are some creative romantic gift ideas and ways to say, “I love you.”

If YOU have the chronic illness:

1. Make an effort. Stop with the excuses. “I’m tired, I don’t feel good. I am in so much pain.” I’ve said them all. Guess what? You’ll probably always be tired. Put on some music, sit back and relax. You’re in pain? If you can push past some of the pain you’ll soon be distracted and forget at least a good part of it.

2. Make romance a priority. That means not spending the whole Saturday cleaning your house and then being exhausted. Rest up, even if it’s just so you can have a conversation without falling asleep.

3. Be enthusiastic during your romantic evening. Even if you’re just going out for dinner, don’t say, “I’m doing this just for you. I don’t really feel like it.” (Oh, yeah, that will turn him on.) Smile and talk about pleasant memories or dreams you have. Promise yourself not to talk about your illness for just one night.

4. You don’t have to write romantic love poems. Just put together a mini-album of your favorite photos and include notes about your memories and how much he means to you.

5. Make a list of all the things you notice he does that you don’t usually thank him for: taking out the garbage, getting you medication in the middle of the night, giving your child a bath, cleaning out the litter box. Type out a sheet of all of this stuff in fun fonts and different colors.

6. Get over feeling self-conscious and buy some underwear that don’t look like your grandma’s.

7. Text message him something daring or outrageously romantic that you would have said when you first fell in love—and text-messaging didn’t exist.

8. Give him a home-made coupon for something he would like but doesn’t splurge on very often such as, “Good for 5 guilt-free hours with your friends watching football.” Avoid making him feel guilty whenever he wants to do something you can participate in (like going hiking or riding a roller coaster.)

If YOUR SPOUSE has the chronic illness:

1. Buy her food that she can eat without guilt–even if you have to hunt it down. Did you know chocolate contains phenylethylamine, a chemical that produces the feeling of “being in love”? Look at your pharmacy for Russell Stover’s sugar free chocolate. Starbuck’s just introduced a heavenly new drink, a sugar-free Cinnamon Dolce’. Now that’s romantic!

2. Hold her hand, rub her back, call her a pet name you haven’t used in five years, don’t pressure her for more. Cuddle, snuggle, and cuddle some more like you will never let her go.

3. Tell her all the things you love about her: how strong she is, how much you admire her strength in coping with illness, how you’re sticking around no matter what. Who needs romantic poetry? Speak from the heart!

4. Buy her something she wouldn’t buy herself like a $20 bottle of lotion, a CD she’s mentioned or a rocking chair for the patio. What is something that she could enjoy when she isn’t feeling well? Pamper her.

5. Give her a romantic getaway. In short, take the kids out of the house an entire day and don’t say anything when you come home at 4 p.m. and she’s still in her pajamas.

6. Write her little love notes and hide them around the house. Or give her a romantic card (just because… like 3 days before Valentine’s Day) and write in it, cover one whole panel with your own words.

7. Looking for a romantic dinner idea for staying home? Buy an electric fondue pot and pledge to dip something in candlelight one evening a week and just talk.

8. Need conversation starters? Buy a game such as “To Know You … Better” or buy a book. Just do a search on “book of questions” for dozens of options. There are still a million things you don’t know about each other, and yes, talking does create intimacy.

There is no such thing as a perfect marriage. But a marriage where both people are involved in keeping it alive, despite the existence of a chronic illness, can be one of the most rewarding joys in your life. Romance comes in many forms. I loved my husband more than ever before the night I literally couldn’t move because of a rheumatoid arthritis flare. I “slept” sitting on the couch and he slept on the floor beside the couch to comfort me every time I moved and screamed from the pain.

Love comes in many forms. One of the books I’ve bought all the couples in my life is “Love & Respect: The Love She Most Desires, the Respect He Desperately Needs” by Emerson Eggerichs. Men want to feel respected, women want to feel loved. Usually we are offering our spouse what we want—not what they need. Being aware of all of the little things we do each day that give one another love and respect, add up to romance when you least expect it.