"I've booted my daughter out of the car for this conversation. She's gone to walk the dog and has no idea why!"
This was my first conversation with Heather. She had been referred to me by her psychologist earlier that month. Her husband, Martin, had gone through prostatectomy and they were now using their resourceful mindset to gather a team together to help them navigate recovery.
(It is worth noting that they did not have a urology nurse helping them round up a healthcare team, so they were Macgyvering the system themselves).
Heather and Martin were similar to most of the couples I see. They worked together as a team, they loved each other, and they knew sex was important to their relationship. But they were struggling to find information about how their sex life would now look.
"I am so sick of hearing 'oh don't worry you'll still have intimacy... what if we want more than that?" (Heather)
Sex does not end after prostatectomy - but it does change. It is an opportunity to re-invent your sex life. In our sessions we re-designed from the foundations up what their new sexual normal could look like.
There was also the challenge of finding a suitable exercise regime, downstairs : 'penile rehab'.
After prostatectomy it can take up to 2 years or more for damaged cavernous nerves to 'repair' (the ones around the prostate, controlling erectile function). These nerves are usually slightly damaged during surgery due to exposure to heat. The process of repair is called neurapraxia.
During these two years it is important to keep oxygenated blood flowing to the penis so that when/if nerve function returns, the penis is fit and ready to allow for an erection.
If you injured a leg playing sports, you would have a similar fitness regime to keep the muscle active.
Every individual or couple I see has a unique set of requirements. But two elements remain the same. The space I offer is one to talk frankly and easily about sex. During the appointment we address how to incorporate daily 'penis fitness' exercises in a way that is enjoyable rather than a chore.
It was a delight to help Heather and Martin get their mojo back.
After our sessions we stayed in touch due to our shared interest in advocacy for patients needs for quality of life education and solutions after surgery.
Together we created this video series that I will be dispersing on this blog over the next few weeks.
If you would like to follow their journey as they manage challenges such as incontinence, self-care, erectile dysfunction and communication, please join the mailing list below :