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THE SECRET OF INTIMACY: SUMMARY

Couples who know the secret of keeping intimacy alive are able to remain in Good Enough Territory and have a reasonably happy and healthy marriage. Such a marriage—what I call "a healing marriage"—is a great aid to coping with the stresses of illness and rehabilitation. In a healing marriage,

  1. You accept the challenge of making your relationship a place of nurturing for each other, both in reacting to your partner's childhood wounds and in reacting to your partner's daily stresses.
  2. You accept that marriages—like individuals—grow and change, and you never stagnate in your willingness to discover new aspects of each other.
  3. You take responsibility for being honest with your partner about what you think, feel, need and want—both on a daily basis and on broad levels regarding what is important to you in your life.
  4. You train yourself to behave constructively when relating to your spouse. Rather than getting stuck in destructive ways of communicating, you listen, empathize, and compromise.
  5. You privately and publicly convey respect for your partner's thoughts, feelings, needs, and wishes, and you openly let the world know that you value and are proud of your mate.
  6. You acknowledge your own negative personality traits, weaknesses, and insecurities, and you work honestly in your efforts to control your defensiveness about them and your tendency to blame your partner for your own struggles.
  7. You learn to avoid power-struggle tactics for getting your own needs met, and you replace them with more direct, honest, and fair methods of getting your basic needs and desires satisfied by your mate.
  8. You learn to develop within yourself the abilities and traits that you need to feel like a more complete person, rather than relying on your partner to make up your personality deficits for you.
  9. You learn to be less driven by stress and frustration, more gentle and forgiving in your dealings with the people in your life, and more balanced in attending to the work and fun aspects of your life.
  10. You accept the fact that keeping the spirit of healing alive in your marriage won't happen naturally; it will involve consciously working together to maintain a loving teamwork.
Our discussion of healthy marriages has thus far omitted a crucial ingredient: sex. Many people believe that sexual compatibility is the most important aspect of marital intimacy. This notion is certainly open to debate, but professionals in the field of marital therapy have repeatedly noted that sexual issues are among the concerns most frequently mentioned by couples at all stages of marriage. As will be seen in the following chapter, attending to this very important aspect of marriage is a crucial part of cardiac rehabilitation.
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EPILEPSY AND PREGNANCY

Women with epilepsy are quite often concerned about getting pregnant. There appear to be five reasons for this concern. They wish to know:
if they are likely to hand their epilepsy on to their children;
whether their fits will get worse during pregnancy;
whether it is safe for the baby that the mother should take anticonvulsants drugs during pregnancy;
if there will be any problems in the newborn baby from these drugs;
if they can safely breast feed the baby.
With regard to handing on epilepsy to one’s children – as mentioned earlier, if one parent has epilepsy, the chances of one of the children having epilepsy are no greater than in the population at large. If both parents have epilepsy, it would appear that the risk of a child having epilepsy is about 10 per cent. So in fact the chance of a child inheriting epilepsy, particularly idiopathic epilepsy, is negligible.
As far as seizures during pregnancy are concerned, the situation is not as clear as it might be. There is evidence that for some women, seizure control may deteriorate, while for others there may in fact be no change or even an improvement. A patient told me recently that “she would like to remain pregnant forever” as she had not had a single fit during her pregnancy, compared with six fits in the preceding nine months!
As a general working rule, it is suggested that people who have more than one grand mal fit a month are those who are most likely to have a deterioration in seizure control during pregnancy. The deterioration, if it occurs, is most likely during the first three months of pregnancy. There are a number of theories why this may happen, but none has been proved. It may be of value to check the blood anticonvulsant levels during pregnancy, especially if there is a deterioration in seizure control. The blood levels may fall, necessitating an increase in dosage during the pregnancy.
The main concern for parents is whether the anticonvulsants can harm the unborn baby (foetus). It is known by most people with epilepsy that this is a potential hazard. The effects include physical abnormalities in the baby, a process known as teratogenesis. Abnormalities have been reported in the offspring of mothers on all the commonly used anticonvulsants with the exception of carbamazepine. This is particularly applicable to phenytoin, barbiturates and sodium valproate. Babies born to mothers who have been on carbamazepine have not been shown to have any physical abnormalities, but have a smaller head size than other babies. This has not been shown to be any handicap to the babies who have been followed up for five years.
The risk of abnormalities in the baby is difficult to assess, but it seems to be most common in mothers on polytherapy (receiving numerous drugs), especially if they are on three or more anticonvulsants. The risk in mothers on phenytoin, with or without other medications, appears to be about a 10% chance of the baby showing features of the ‘foetal hydantoin’ syndrome. This syndrome consists of cleft palate, abnormalities of the fingers, possible heart abnormalities and mild mental retardation. Thus, at present, if it is possible, it would seem wise to try to change patients over to carbamazepine before conception. This may not be possible in all patients and, of course, many women will first visit their doctor when already pregnant, at which time there is no purpose in making the change.
Anticonvulsants taken by the mother during pregnancy may have some effects on the baby immediately after birth, as they are transmitted to the baby across the placenta. These include the possibility of a mild bleeding tendency and some drowsiness. In mothers who have been taking barbiturates, the infant may occasionally show features of a withdrawal reaction with irritability, jitteriness and poor sucking. None of these features is [...]

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ERECTILE DYSFUNCTION SYMPTOMS

Most patients have a combination of two or more of these problems. They are usually first given a thorough medical history and examination to determine the extent of the prob­lem and to hopefully pinpoint a cause. I want to briefly outline the nature of these four symptoms so that your problem will make more sense to you as a patient if you are experiencing any of them.

PRESCRIBED DRUGS

Taking prescribed medications with most vitamins is safe as is taking herbal complexes that are available through health food stores. However, you should always check with your doctor, your pharmacist or your naturopath. They are all trained to know what can go with what.

Weight loss

Overweight is most commonly a result of overeating and lack of exercise. Overweight and fluid retention often go together with people who have glandular problems or under-active thyroids. In such cases an iodine and phosporous deficiency may be the cause.