Ask Dr. Paul: Fall 2006 Lupus Now Magazine
Dear Dr. Paul:
Should a man with lupus take a medication like Viagra® or Cialis® for the loss of sexual desire for his partner?
According to our medical expert, Robert G. Lahita, M.D., Ph.D., chairman of medicine and vice president of the Jersey City Medical Center in Jersey City, NJ, any man with lupus can use Cialis or Viagra. But men with significant heart disease or problems with circulation should be cautious.
Dr. Lahita says Cialis and Viagra are drugs that increase blood flow to the penis and cause an erection. Unfortunately, these drugs do not increase sexual desire. But for some men, having an erection where there was none before is enough to enhance sexual activity. However, many men with lupus have low levels of male hormone, which could be at the core of the problem. This male hormone level is easily measured by your doctor and if it is low, can be treated by an endocrinologist or urologist.
Lack of sexual desire is frustrating. You want to feel passion and desire and you feel helpless to generate the feelings. You are probably concerned that your partner could be feeling hurt or angry, or might mistake your lack of desire for lack of attraction. So communication is crucial.
Talking openly with your partner can establish a deeper intimacy than sex can produce. You can learn to understand one another as you learn to express physical affection that does not have to lead to intercourse. Share and face the challenge together.
Dear Dr. Paul:
How do I make myself exercise when I hurt so badly I can hardly get out of bed some days?
It's possible that some days you'll have to put off exercising. On those days you are simply not able to exert the energy that exercising demands. On other days, however, even when in pain, exercise may be exactly what you need. Exercise is necessary for your mental well-being as well as for your physical health. You might not be as vigorous in your exercise every time, but on these days even a five-minute walk or a few push-ups can be satisfying. Also, try doing some muscle stretches to keep flexible. Have a routine of exercise for the days that you feel OK and a more limited one for times when you have little energy. Discuss your discomfort with your doctor. Some pain medication can be helpful.
In order to motivate yourself to exercise, think of how energized and satisfied you usually feel after exercise. Then as much as you can, get "up and at 'em!"
Dear Dr. Paul:
I want to tell my boss that I have lupus but I don't know how he will react. How can I tell him and not lose my job?
Your main focus in talking to your boss about lupus is to make sure that he or she understands the illness and its potential effects on your ability to perform any of your job duties. You might meet with your boss and start by saying, "I want you to know that I was diagnosed with lupus and sometimes I have days when I feel fatigued and (fill in the blank), and I would like to talk to you about some important things that may arise because of my condition." This gives you the opportunity to talk about what lupus is and to discuss whether you need time off for medical appointments or occasional rest periods. You can also inform your boss how you plan to complete required job tasks in the event that you are sick for a few days. You can finish by saying, "I want to assure you that I am totally committed to doing my job."
My experience is that bosses respect the trust shown by an employee who is open about a serious matter that is meaningful to the worker, the boss, and the company.
But most important, if you disclose your illness, your rights as an employee are protected under the Americans with Disabilities Act (www.ada.gov), which prohibits discrimination against qualified people with disabilities.
"Ask Dr. Paul" is Paul J. Donoghue, Ph.D., a psychologist in private practice in Stamford, CT. He is the co-author, with Mary E. Siegel, Ph.D., of Sick and Tired of Feeling Sick and Tired: Living With Invisible Chronic Illness and Are You Really Listening? Keys to Successful Communication.