Health professionals often use guides to help them discuss issues. This discussion shows how a couple were helped to talk about sex by their stroke nurse. Sue had a stroke and Steve is her husband. Ben their stroke nurse helped them to talk openly about their feelings on how stroke had affected their relationship. This included the physical aspects and sex.

• Steve – well, it took us a while to get round to even thinking about this. Sue had her stroke in February and was in the hospital for 6 weeks. You don’t think to ask about these things, I was just so relieved that she hadn’t died. We’d been home for a few months and the stroke nurse had been visiting. He was really coming to see Sue but he would always ask how I was doing and sometimes he would see us together. He always asked “do you have any questions” and it was only after I could see Sue managing better that I began to wonder if it would be okay for us to have sex – but I didn’t like to ask – felt that might be selfish. When Sue first came home she wasn’t sleeping well and I had started sleeping in the spare room. Then one visit Ben asked Sue if it was okay to ask her some questions on how her stroke had affected our relationship, Sue asked me to come in and sit with them both. Ben explained that after stroke many couples found it difficult to be the same with each other including talking to each other about how they are feeling and about sex. Well at first I didn’t know where to look, I sneaked a peek at Sue and she was blushing. Then I felt relieved, maybe I could talk about this and somehow it seemed easier with Ben being there too. I had been frightened to ask Sue about how she would feel about sex, we had had the odd cuddle and kiss but I was always aware her arm and leg were weak and I knew she had a catheter in – I didn’t know if we could have sex if she had a catheter.
• Sue “I was worried too, I thought you probably wouldn’t fancy me anymore, my arm and leg don’t work properly, I’ve this tube sticking out, I can’t feel you touching me the same way, sometimes its tingly and painful, . Even when you kiss me it’s duller somehow and sometimes I feel as though my face is droopy . I always felt tired and we weren’t sharing the same bed – I didn’t know how to ask you to come back into our bed. Ben had said sometimes medications or the affect of the stroke and how we feel can cause problems. He encouraged us to talk more about it.
• Steve – I didn’t want to hurt you, you know physically, and I was worried about causing another stroke. Our relationship had changed and I had had to help with so many things that I was feeling like your carer rather than your husband. Ben chatted to us and gave us some advice on thinking about getting back to having a sexual relationship. To take it easy, first step was to start being in the same bed, This naturally led to a bit more closeness and cuddling.
• Sue – yeah – he gave us some more specific information about sex when you have a catheter – it made me realise I wasn’t the only person that had this. He said I could just tape the catheter to my stomach or leg out of the way, he even said that men could have sex when they have a catheter just to tape it to themselves and put a condom on – I was really surprised.Ben also said some medications, especially blood pressure medications can affect men but these could be changed for some different ones. Most other things we’ve managed to ask other people their opinions or advice but its not the kind of thing you speak to your children about.
• Steve – Ben suggested setting some time aside together, making sure we were rested and not going to have any interruptions. Think about what worked for us before. Set the scene with lighting the candles that Sue likes and dim the lights. We took lots of cushions up to bed for extra support and at first we just concentrated on touching and speaking to each other.
• Sue – We’d not done that for years and I found it helped to go back to basics but I wasn’t getting aroused like I used to. We spent longer in finding what was good for me and used some lubricant and that did help when we eventually “went for it”
• Steve – we’re still taking it slowly and gaining confidence, its like courting all over again, its been good for us
• Sue – yes it has.