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Transcripts-7/31/00
Men's Health With Walt Hanks, CHES
(WARNING: Part of this transcript
contains conversation about sexual issues)
Due to the issues discussed in this
chat, a transcript was not going to be posted. However all of the
participants agreed that posting it was a good thing. We hope to have
another men only chat sometime soon.
This was an informal chat so little
editing was done.
InsightHostRon> You ready to start walt, looks like a small crowd
Walt> Sure, whenever you're ready.
InsightHostRon> Well, the first question I was asked was what are walts credentials, want to talk a bit about that first
Walt> Sure. CHES stands for Certified Health Education Specialist. It is a national certification for health educators. I have a BS in health education and will have an MS if I ever get done with my thesis.
InsightHostRon> you are getting ready to try to do some phd work too
Walt> Yes, I am - in a year. I will be attending either John's Hopkins or Maryland, College Park for my PhD.
TRANSAM> So, does that include the phycology aspect of it too?
Walt> I am not a psychologist, but I do have trining in health psychology. Specifically, I have training in the effects of psychological states on physical health. I am also trained as acrisi interventionist.
InsightHostRon> explain the last walt please
TRANSAM> Excellent. I have some phycology background myself. Try to analize myself all the time
JstJeff> lol
InsightHostRon> While he is typing, since there are so few of us why don't we make it an informal chat..
TRANSAM> Soiunds good to me
JstJeff> sounds go to me too
Jimmy> great
JstJeff> i am not too good at the formal
Walt> The Mind-Body connection is a fairly powerful one. Our state of mind, and specifically our levels of stress, can have dramatic effects on our physical well-being.
Walt> Just don't overwhelm me with questions all at once - OK?
TRANSAM> I have had that experience many a times Walt and I think we all have
Jimmy> so can the meds
Walt> And the meds and the state of mind can interact.
TRANSAM> But certain meds can also help with the state of mind, right?
JstJeff> what are things we can do to help our mental health, specifically when we are down about life?
InsightHostRon> Walt, I just started with a pain clinic here in Indy..the first thing they did is put me on duragesic plus pt, shrink and counsellor...they take that kind or approach
Walt> Yes, it is a two-way street. For example, antidepressants help the state of mind, but meditation and stress management also improve the effectiveness of antidepressants.
Jimmy> If it's state of mind can hipnosis help?
InsightHostRon> that is one of the tools that they use at the pain clinic Jimmy, they say it helps with pain management..
Walt> Everyone get's down, especially when you are dealing with a chronic illness. But there are things we can do. Exercise is an excellent way to get rid of abad mood, as are meditation and other relaxation techniques.
InsightHostRon> when you say relaxation techniques are you refering to imagery
TRANSAM> When you are in bad enough pain Walt, it does not help
Walt> There are many other tools as well. for example, keeping a journal can help to put things back in perspective.
Walt> There are many relaxation techniques Ron, of which guided imagery is only one. It's one I happen to enjoy, but it is only one.
JstJeff> i think trans that sometimes we force ourselves to excercise and it has a negative effect on the days we hurt the most
InsightHostRon> I agree walt
Walt> You can always overdue things Jeff, but most psychiatric hospitals now include aerobic exercise in their treatment regimen.
InsightHostRon> How does keeping a journal help...if day after day your entries are I hurt
Walt> Ron, if that is all you write down, it won't help. But most journal writing exercises ask you to force yourself to write down the positive things that are happening as well.
InsightHostRon> so basically a diary of your activities?
Walt> Journals are also not a quick fix. You have to keep at it for it to help.
Walt> Not just of your activities Ron, but how you felt after them.
TRANSAM> I have to disagree with the imagery thing. When I hurt, or my vertigo is really on the lose, all I want is to have a pill to put me to sleep .
InsightHostRon> K, thanks
JstJeff> is this method just writing your thoughts down, or is there a time to read back through that is uspposed to help as well?
Walt> No tool will work for everyone TransAm. If it doesn't work for you, find something else. But guided imagery is very effective for many of us. Just think of it as having permission to fantasize.
TRANSAM> Yes Walt, thats called taking Lorazepam, going to sleeep and fantasizing
Walt> yes Jeff, reflecting on what you wrote is part of teh process. It helps to clarify your thoughts, to release feelings we often keep bottled up, and to see that everything isn't always bad.
Walt> But what do you do when you can't go to bed TransAm?
JstJeff> would you recomend involving a spouce in the process, as a way to better communicate what is going on with our illness and feelings?
TRANSAM> Ive had this arth since I was 23 Walt. Ive tried all kind of things. Im 50 now and life sucks more with each year that passes.
Walt> Jeff, that depends upon your relationship with your spouse. It can be helpful, but it can also be a minefield. Your journal should be a place where you feel safe to say whatever is on your moind.
Walt> Yes TA, I've had arthur since I was 14, and I am now 40. I know what you are saying.
JstJeff> it seems to me fantasizing can have a negative effect as well... I am 26 and newly diagnosed, but even with all the break through meds out there it still seems like eventually the disease wins
Walt> That depends upon how you define winning Jeff. The truth is that you can have a good life4 with arthur, as long as you don't define lifesolely on your physical abilities.
JstJeff> I can understand that, but it is very trying. especially to know that choices you make now may not be soemthing you can accomplish or live out later
Walt> Any relaxation technique requires some self-discipline. Fantasizing over something that makes you feel bad is not healthy fantasizing.
JstJeff> I was diagnosed the day i started school for electronics and now my hands are deforming to the point where i can't do that type of work anymore
Walt> So Jeff, have you considered what else you can do with your training?
JstJeff> well i have since stopped school, not only because of my hands but because i moved to a new area when i recieved a promotion
JstJeff> now i am looking to get into more management, which was not the area i wanted to go into at first
Walt> So along with the pain of arthur, you got a promotion. How did that happen?
JstJeff> i was not doing a physical job previously and do not now
Walt> TA, in what ways does your life "suck" right now?
JstJeff> although i wanted a more hands on job, which i do not see as ever possible now
Walt> Jeff, can you find something you like in managment?
TRANSAM> Been on disability for 12 years Walt.
JstJeff> probably, but it is still very hard to deal with when it seems like arthritis has shut many doors for you
Walt> OK TA, so financially you are having a hard time. Have you found anything you can do to feel productive?
JstJeff> i know there are other doors, but it is still hard
TRANSAM> In every way. No job, am a burden, complain too much wife says, no real support emotionally
Walt> I know Jeff, but you can't let the arthur win. If you dwell on what you can't do, the arthur wins. To fight back, find a way to be happy anyway. That's what I had to do.
JstJeff> understood
InsightHostRon> Walt, someone has to bring it up...how do you deal with the effects of both the arth and the meds on your sexual life
JstJeff> good question ron
Walt> Finally, what everyone really wanted to discuss!!!
InsightHostRon> thought that might break the ice
JstJeff> that is an important issue no matter the age of the person
Conormc> Are there any arthritis medications that cause sexual dysfunctions?
InsightHostRon> YES
Walt> I know that, for me, severe pain and sex don't go together well. But there has been almost no research done one the effects of arthur on a man's sexuality. So let me turn that question to all of you. How has arthur affected your sexuality?
Walt> That's OK Ron. You had teh right answer.
JstJeff> for starters there are many times when i am too tired to even be in the mood...
InsightHostRon> Mine has been mostly the effects of the meds, difficulty in ejaculation is a common side effect
TRANSAM> Mine was pain, but am a stud again for the time being,lol
JstJeff> i have noticed lately as I have gotten worse it is harder to get in the mood, especially when pain is involved with sex
InsightHostRon> I would have to look at my sheet. but many of the mood altering or depressant drugs can have that effect
TRANSAM> Been there with that too Indy
Walt> OK, one issue at a time. MEds - Pain meds can inhibit erection and orgasm. NSAIDs can cause problems for some men as well, and Azulfidine dramatically reduces semen production.
Walt> Jef and TA, have you tried shceduling sex for when you typically feel better, like late morning?
rob> I am new to all this stuff I am not on any medication yet but I think I will be soon
TRANSAM> Id have to find another woman Walt.
JstJeff> there is no late morning for my wife and I, we both work at the same place and commute an hour to work, it is get up early and leave
InsightHostRon> I know when I first realized the problem it was difficult to talk about...Is there an easy approach to this
Walt> OK Jeff, but the idea is that late at night is often our worst times. Sex shoudl be a priority when we are doing better. Any chance for a long lunch break?
JstJeff> i think it is a cycle sometimes, we are either too much in pain or too tired for sex, which in turn brings us down
JstJeff> like TA only if i found another woman
TRANSAM> Sex is only difficult for me when the collar bone and ribs are flaring
Walt> Yes Jeff, and their our partner get's upset, often thinking that it is their fault, and the cycle continues. But we have to do something to break teh cycle.
rob> i don't mean to be rude but I really don't know who you are walt can you fill me in ?
Walt> Don't dismiss masturbation. We all do it, if we will admit it, and it does provide some physical and emotional benefit.
Walt> Rob, I am a health educator and one of the health advisors for this site.
TRANSAM> Only when your hand will co-operate Walt
JstJeff> yes but that doesn't always help our partners
JstJeff> lol trans
Jimmy> lol
rob> oh thank you I was just curious
Walt> My wife is often willing to provide the hands TA.
Jimmy> Lucky man
TRANSAM> Thats where the vibrator comes in JstJeff, for Ur partner
InsightHostRon> Oral sex can also be less strenuous...
JstJeff> as is mine, my wife is almost always in the mood as I used to be, but when it is painful before during and after it is hard for me to be in the mood as often
JstJeff> i have my moments and try to make them as special as possible for my wife, but i do get down because of it
Walt> Yes TA, just because you can't perform normally, doesn't mean you can't help your partner. That's called consideration of her feelings and needs.
TRANSAM> Its call lots of batteries too,lol
JstJeff> lol
JstJeff> maybe if you and I trans buy them in bulk we can get a good deal
Walt> You know Jeff, most men lie about how much sex they get. Most men do not have sex every day.
TRANSAM> Nooo, but seriousley, thats how I compensate a lot of the time when I cant perform up to par.
Jimmy> Just buy stock in duracell Might help you financialy TA
JstJeff> i know this walt, if my wife had it her way i would have sex everyday
Walt> Have you talked to her about this Jeff?
stJeff> i am not saying i need to perform everyday and i have to say my wife is as understanding as anyone can be
JstJeff> a little, but it is hard to fully discuss it when i do not fully understand
TRANSAM> Makes U feel inadequte when you cant please her when she is in the mood
Walt> Good Jeff. But you obviously feel the need to do more.
JstJeff> sometimes i can be in the mood, but know that i will suffer for it so i do not initiate anything
JstJeff> i just feel bad, i have a wife that wants sex when many men do not, i love my wife and wnt to please her
Walt> The tought strikes me that an awful lot o fpsychologists would be really suprised to see where this dicussion is going tonight. You guys do not fit the stereotype at all.
TRANSAM> My wife does not initiate either for fear of hurting me.
InsightHostRon> Have you tried different positions that don't put as much stress on the achey parts
Walt> And have you tried hot baths or hot-oil massages before intercourse?
TRANSAM> She did hurt me one night and it really frightened her, so she was very apprehensive for a long time
JstJeff> usually when i am at my worst she gets on top, these days she always tries to be on top because i know she doesn't want me to hurt
JstJeff> so when i feel up to it I get on top
JstJeff> and when i feel like bing a man, lol
TRANSAM> Been there done that JstJeff
Walt> Jeff, there are many side-to-side positions that are better than her being on top.
TRANSAM> And then there is the chandelier
JstJeff> i have tried some, lately it seems like even being on bottom hurts, i guess i do not feel i have the strength or energy
TRANSAM> How old are you Jeff?
JstJeff> i am 26
JstJeff> it is soemtimes very depressing
Walt> It sounds like the only thing that is missing Jeff is some communication.
Jimmy> There's your thesis Walt Making love with RA
TRANSAM> Ohhhh, still in the rabbit stage if you didnt have the arth
JstJeff> i try but don't even know the words
Walt> Not at BYU Jimmy! I can here the administration now. LOL
TRANSAM> Its hard Jeff, just to try and explain what the arth is like, never mind the sex aspect of it
JstJeff> and i am usually very open, but when you constantly have to have your wife help you with dressing or help you get off your knees it is hard to discuss help when it comes to sex
Walt> Jeff, how about printing the record of this chat and having her read it?
JstJeff> we do talk about that, although i probably don't enough, she is always telling me i do not tell her enough that i hurt
JstJeff> i do not want to be someone that talks about pain all the time tho
Walt> Jeff, are you being seen by a rheumatologist? Maybe the most important thing you need is better managment of your disease.
JstJeff> yes, i just started seeing a new one that is more aggressive then the last
TRANSAM> I got mine at 23 Jeff and am 50 now. The arth has gotten better and the sex has too. So dont get discouraged too much. Have been in your predicament over the years and IM sure everyone else has too
JstJeff> so hopefully that will help
Walt> Good Jeff, you may find that the pain eases soon, as does the problems associated with it.
InsightHostRon> I certainly have
JstJeff> i know, i think the biggest thing that gets to me is how fast i seem to be getting worse
JstJeff> ok enough of my whining
JstJeff> lol
Walt> You know Jeff, my wife and I don't have sex anywhere near as often as when I was your age, but we have learned to enjoy it more. Some things do get better with time.
JstJeff> i understand walt
Jimmy> So true Walt I'm 48
InsightHostRon> you are not whining jeff, that is what this time was set aside for
So, in the time we have left, what else do you want to talk about?
JstJeff> it is nice to be able to talk with people that have had it since my age or before
TRANSAM> A man is not defined by how much sex he can provide. A man is determined by his compassion and understanding towards his mate.
InsightHostRon> we have about 5 more minutes of walts time any other topis anyone wants to touch on
JstJeff> i read a really good book called living with rheaumatoid arthritis
JstJeff> but one thing with a lot that i have read it seems they center more on womens issues
Walt> YESS Jeff. That is a BIG problem.
JstJeff> is there anything out there that discusses more what a man goes through
TRANSAM> Thats because women are more open than men Jeff
Walt> THis discussion would contradict that idea TA.
TRANSAM> And I guess they have more data on it because of that
JstJeff> is it also because it affects more women than men?
Walt> There isn't a lot Jeff, because there has been very little research done. We need to demand more.
TRANSAM> Yes Walt this is unusual for guys to open up this much
InsightHostRon> Because of the nature of the conversation here and the honesty that we have seen this transcript will not be posted..
Walt> But let's make it available for those here who want it Ron, OK?
TRANSAM> Geee, the women will feel left out Indy.
JstJeff> in some ways that is too bad ron
TRANSAM> Most women think men cant be this sensitive
InsightHostRon> well I will leave it up to youall...I don't mind
JstJeff> i agree trans
Walt> I have no problem with it being posted Ron. Does anyone else want it kept confidential?
JstJeff> i do not mind and i said a lot of personal stuff
InsightHostRon> I don't mind
TRANSAM> Not me, print it Ron
InsightHostRon> K, consensus seems to be to post it
Just clean up my spelling, would you?
InsightHostRon> Walt, thanks for your time. I would like to do another of these sometime in the near future....znd you know KJ will not touch the spelloing
Walt> I know Ron, but I was hoping ..... Yes, let's do this again soon.
JstJeff> thanks walt, i think it was a very productive chat
TRANSAM> Was enlightening Walt, thanks for your time
Walt> Hey, thanks to all of you. This was much better than I was expecting. I may do that research yet!
InsightHostRon> I really appreciate everyone opening up and discussing what can sometimes be a difficult subject
If you didn't get to ask Walt a question you can always send it to him
via experts@arthritisinsight.com
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