Dear George and all who are interested,
You have a serious complaint. One needs more bravery to make a complaint like
this than to deny it or to only joke about it. Your neuro just laughed, when
you told him about your sexual problem. May be you did communicate non-verbally
not to take it too serious and he was easily tempted to do so, because he can
not handle it.
If a physician takes a complaint about sex serious he has to ask more facts.
Your neuro evidently did not look forward to that and it is not exceptional
among physicians not to be able to talk on a factual and detailed way about sex.
The different causes of not being able to function sexually can be of three
kinds: the desire or libido is absent, the physical impossibility to the act
due to lack of erection and psychological problems. Psychological problems may
be felt as lack of desire, but can be differentiated. If the problem is a pure
psychic one, desire can exist in dreams and fantasies, but disappears in
situations in which having sex would be possible. It is often too uncritically
said that sexual problems of PWP's are psychic, because that seems evident. One
can find so many reasons. If one concludes from that it is psychic one makes
the same mistake as people who say every PWP has so many reasons to be
depressed that it is evident depression is not a symptom of Parkinson, but a
reaction on it.
Parkinson itself may cause not only depression but lack of libido too. Dopamine
has an important role in the feeling of desire and enjoyment when it is
fulfilled. Story's about leva-dopa being an aphrodisiac are in concordance with
this. Some PWP's tell they can only be turned on sexually when they are
allready "on" on leva dopa. Also Permax seems to be able to do this job. If
this is an important factor the time for having sex has to be in line with the
med's intake.
If it is not the libido, there can be a disturbance in the reflexes which are
concerned with having sex. I guess here the meds are the culprit. This aspect
of sexual fuctioning is less dependent on dopamine but more on its antagonist
acetylcholine. Theoretically it can be expected that anti-cholinergics are an
enemy of erectile reflexes, but I don't know whether this is confirmed in
research.
I don't know what possibilies you have in changing meds or med schedules and I
have no idea about the helpfullness of this mail.
When your sexual problem is truly important, dare to complain about it, when
you visit your neuro again. If he can not help, look for somebody else who can.
You need somebody who doesn't only knows about sex but he has to know about
Parkinson end PW meds also.
You wrote something beautifull about time. I have the same feeling. The hours
creep when you don't feel well and you have to wait untill some action is
posible again. Days and weeks fly while you always manage to do less then
intended because mr. Parkinson is in the way.
The worst present P. gave me, is the impossibility to be truly relaxed
without being sleepy.
Ida Kamphuis, 53/12+ Holland
[log in to unmask]
George Andes <[log in to unmask]> schreef:
>
> The recent few complaints have concerned sleep or the lack thereof.
> I personally wake up every two hours or less to take my personal sanitary
> plumbing to the bathroom. If my bladder were better, however, my sleep
> would be less restful than it is. I don't move or turn over in my sleep
> and more than two hours in the same position (left side, right side, or
> back) would cramp my muscles so that I might have difficulty getting my
> plumbing to the bathroom in time. All things work together for good !?!
>
> As for the other uses of personal plumbing: when my neurologist asked
> me if I had any problems with my genitals, I said "no," except that they
> don't work anymore. He smiled at my answer. By the way to pursue this to
> its bitter end; my prostate is very small for a man my age, so the cause of
> my problem can be laid entirely at Dr. Parkinson's door. I guess its nice
> to know. End of personal confession.
>
> My final words, for now, concern time. If there is any single symptom I
> would call characteristic of my PD it is my altered perception of time.
> Time just doesn't pass more slowly or more rapidly; it is just out of
> control. "Hours creep. Days fly." My body is enslaved to a rigid pill
> schedule which is not capable of comfortably regulating my symptoms. Does
> anybody have any wisdom for me?
>
> George Andes 63/15 and counting
>
