The words "hot and bothered" may spark images of twisted sheets and breathlessly reaching out to the one you love for most people. But if you have a chronic illness, "hot" likely refers to a thyroid condition, night sweats, or a heating pad on high. "Bothered" is everything else that happens in bed. Like achy joints that pop when you roll over, a cat that insists on sleeping on your leg, or a spouse who snores through thunder and lightening. Romance may be hard to find in your home!

You may be surprised to know that nearly 1 in 2 people live with a chronic illness in the U.S.A. That means a whole lot of marriages have a third bed partner called "illness"--including mental illness too. Sadly, seventy-five percent of marriages that include illness end in divorce. Valentine's Day romance is a year-round requirement to keep the communication and joy going in your relationship.

So, how do you create that romantic environment when you are in physical pain? I've got some creative romantic ideas to get some of that spark back!

Put forth some effort. No more excuses. "I'm so exhausted, I don't feel that great. My body feels like it was run over by a truck." I've said them all. But guess what? If you have an illness you'll probably always be tired in a way normal people aren't tired. So put on some music and relax. The distraction of romance can make you forget about a great deal of the pain!

Make romance a priority in your house! Rather than cleaning your house all day and mopping those floors, take a nap so that you have some quality time with your spouse that night. Make sure he feels valued and important and not just "one more thing to take care of."

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.

Poetry can be over-rated, so don't worry about being eloquent. Instead, just write some of the things you love and appreciate about your spouse in a mini-photo album, or frame your favorite photo on a large matte and write your favorite memories of that event around it.

Surely your spouse does some things for you without complain. Does he bring home your favorite ice cream? Throw in a load of laundry? Never expect you to iron or serve a five course meal? Write down all of the things you notice he does that you don't usually thank him for and give it to him as a special appreciation note.

Women, get over feeling self-conscious and buy some underwear that doesn't look like your grandmother's.

Text message him something daring or outrageously romantic that you would have said when you first fell in love. Back before text-messaging existed.

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.)

Perfect marriages don't exist. But they can be one of the most amazing experiences in your life when both people are involved in keeping it alive. In fact, the existence of a chronic illness in a marriage can make your relationship even stronger. Romance comes in many forms. I know I loved my husband more than ever the evening I literally couldn't move when I had a rheumatoid arthritis flare and he slept on the floor beside the couch to comfort me every time I moved or screamed out in 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. It talks a lot about "love languages" and how men feel loved when they feel respected, while women want to feel loved with emotions and words. Oftentimes we are offering our spouse what we desire rather than the "love language" they need. Being aware of all of the small ways we can show each other love and respect add up to romance when you least expect it.