<prompt> Human: My spouse is scary ill. For the past two months shes been having chest pain, dizziness, and weakness on a daily basis and has been to the ER multiple times and seen multiple doctors and so far we have no real clues about what is going on except that its not heart failure. She is understandably afraid to be alone while Im at work and realistically needs someone here to watch over her since shes bedridden. Neither of us have family that is willing to help at all. We dont have many friends, and theyre busy with their own lives and cannot provide the support we need. I took 4 weeks unpaid leave in October to take care of her. I had to go back to work because were basically broke. Ive been back at work for almost 4 weeks but Ive had to take off multiple times to take care of her or to take her to doctor appointments. My work has been incredibly understanding but with the amount Ive taken off, Ive been requested to take more unpaid leave. If I take unpaid leave then I have to use COBRA continuation coverage which will cost about 1000 a month or Id could switch to a cheaper Health Marketplace plan as long as I lose my coverage before November 30th, otherwise wed have to wait until January 1st to get a Marketplace plan. Either way I dont see how we could afford to pay for insurance if Im on unpaid leave. I dont see how we could afford really anything even if I got some work at home job since I seriously doubt I could make even close to what I make now and the budget is already tight. Heres a breakdown of our current debt: Student Loans: 50,000 cannot defer loans anymore Credit cards: 6,000 nearly maxed out Medical bills: 3,000 Monthly expenses: Rent: 400 Utilities: 130 Food: 400 Wife has dietary issues. She cant eat cheap food. Im eating cheap beans, rice, and frozen veggies Loan Payments: 1,800 Credit Card Payments: 80 Car Insurance: 40 Laundry: 20 Gas: 30 Total: 2900 Income: About 3200month after taxes and health insurance I looked up about how much it would cost to hire a caregiver for 40 hours a week, which would be about 600 per month after insurance. I know I can apply for financial hardship with student loans, but even if I can bring the payment down, itll still be really tough financially. Also, my wife is very uncomfortable with the idea of a in-home caregiver for legitimate reasons I do not wish to discuss. I dont know what to do. I feel like Im in an impossible situation. Any advice?  <response>: I think there is more to the story here. Your wifes symptoms sound severe, meaning if there was significant disease there, somewhere in the multiple evaluations shes had, they would have found something. Between her chest pain, dizziness, and weakness, along with her unwillingness to be left alone and aversion to having in-home help, I am wondering if she has anxietydepression or some other psychiatric issue. All of this is not to pry, but to suggest that I havent heard a legitimate reason she cant be left at home while you work and bring home some money to pay the bills. Bottom line is that it doesnt sound like you can continue to take time off. 