Monday 26 September 2016

Dear Mary: I have MS. Can I expect to have a sex life again?

Mary O'Conor

Published 21/12/2015 | 02:30

There will also be really good days, says Mary O'Connor.
There will also be really good days, says Mary O'Connor.

Relationship counsellor and psychosexual therapist Mary O'Conor offers relationship advice in her weekly column.

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I am a 32-year-old man who has had multiple sclerosis for seven years.  Due to the nature of this disease I have lost all confidence in myself as a sexual being. I got MS at a time in my life when I should have been going out and meeting women, forming relationships etc.

Instead I feel like an old man. I can no longer achieve an erection. I used to enjoy masturbation but have no feeling in my penis long enough to achieve orgasm. I suffer from urinary incontinence and despite medical treatment for it, I am still having to use adult nappies.

I ask myself why, under these circumstances, would any woman be interested in a guy like me? I feel consigned to the scrapheap, with no chance of my present circumstances changing. It is a lack of confidence in myself above all. I'm getting to the point of just giving up and not trying anymore.

I could do with some advice.

Mary replies: While it is always difficult to receive a diagnosis like the one you got, it is even more difficult to get it at such an early age and before you were established in a loving relationship where you could have faced it together.

When I'm running a workshop for young people with disabilities, almost inevitably one of the first questions I'm asked is, "When do I tell a prospective partner about my illness if it's not apparent to them?"

It's the same dilemma that is faced, although to a lesser degree, when there is a big secret in the family of origin. One wouldn't divulge, for example, that one's father is in prison on a first date, but rather when trust has been built up in order to feel secure that this fact won't affect the potential relationship.

Your sexual problem is two-fold. You cannot get any satisfaction from masturbation and you feel that you cannot be sexual with a woman because of your inability to achieve an erection.

The central nervous system is where sexual arousal begins and the brain then sends a message to the sexual organs through the nerve pathway in the spinal cord.

MS can damage these nerves, leading to impaired functioning and this is what seems to be happening with you, which must be very difficult to accept.

As I understand it, the medication for erectile dysfunction such as Viagra and Cialis work well for MS patients and this is something that you could try for yourself if you haven't already done so.

I realise that the problem is deeper than this, but it is something to be aware of. However it is important not just to see yourself as a man with a penis but rather as a man who can give pleasure in all sorts of different ways to a woman. Hands, mouth and, above all, the brain can be used to ensure that she has a satisfying experience.

Instead of focusing on your illness, try to focus on your good points. Are you a good listener? Do you have a sense of humour? Do you smile a lot? All of these things are important when engaging with women - or indeed your fellow human beings.

If you met a woman with a disability who seemed to be great fun and interested in you, what would you see first - the woman or the disability? Try to ensure that the initial impression you make on women is a positive one. I realise that it is hard to be upbeat and positive about things, but if you are feeling that you are worthless, then other people will sense that and move on to somebody more interesting.

Life can be very difficult at times but there will also be really good days. I truly hope that the future brings more good times than bad for you.

My mother-in-law wants to quit care home

Question: My husband is an only child. We are both in our mid-sixties, and his mother is 96. We live in the country, but over the past few years came to live with her in her home as her health declined. This was tough for us, but had to be done. However, it was never appreciated by her. We coped as best we could over a number of years, trying to adjust to her hostile home and her ungrateful attitude. There is no central heating or cosy homely atmosphere despite my asking regularly to update basic furnishings to enable more hygienic conditions to prevail - to facilitate her health condition.

This situation went on for years until finally her condition required A&E care. She was in hospital for three months, turned down an operation that might have helped her, and has been in an excellent nursing home since then.

Her daily care plan is quite extensive, but she dismisses all that, saying, "sure they do nothing for me here."

She is quite insistent that she is coming home, even though we remind her that we are back in the country and she couldn't look after herself. She says she wouldn't expect us to and that she can look after herself. She also has memory loss and thinks everything will be like it was years ago.

It was having this sort of conversation yesterday with her that prompted me to write, as she will not accept that she is 96-years-old - and when she does, it is to say that she is looking forward to getting home. The nursing home staff are aware of the situation. She is difficult for them to handle at times and has remained in her own private room since she got there. She will not break out of that mode to attend activities down in the dining room, etc, saying that she is not in form. I should add that when she went there first and realised where she was, she said to my husband "I will never forgive you for putting me in here." I know you can't fix it, but it feels good to actually write it down.

Mary replies: I'm sure it did feel good after you had written to me - sometimes it is very beneficial to vent. Your letter will reverberate with so many people reading this, because while their story may not be the same as yours they will have been through or are going through something similar with their own parents. Your mother-in-law sounds quite a feisty lady, and used to getting her own way, and she is not about to change now. Nobody puts their parents into a nursing home without having explored all other avenues and this is what you did. You were particularly caring as you moved in with her - no easy task, particularly so as you were without home comforts.

The role of parent/child has been reversed now for your husband as he has become the parent and is responsible for his mother, with what sounds like great support from you. And just as children are often not grateful for the sacrifices of their parents, neither is his mother appreciative of your concern. But you should remind yourself that you are doing your very best for her, and when eventually she has passed away there will be no recriminations about what you should have done or could have done better. She probably keeps herself going by imagining what it will be like when she leaves the nursing home, although the reality is that she never will. She put a lot of guilt on your husband with her few words, and he should be sure not to be affected by this. One way would be for him to write to her explaining his reasons for having her in the nursing home. He should not send the letter - he can tear it up after writing it. But, like you, he will derive great benefit from putting it down on paper.

May I wish all my readers a very happy and peaceful Christmas.

You can contact Mary O’Conor anonymously by visiting www.dearmary.ie or email her at dearmary@independent.ie or write c/o 27-32 Talbot Street, Dublin 1. All correspondence will be treated in confidence. Mary O’Conor regrets that she is unable to answer any questions privately.

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