SUPER MARITAL SEX: SEX AND THE HEART
Would you risk it? I’m not going to die having sex. I’d sooner live without sex than die trying to have it.
HUSBAND
Fewer than one person in four returns to “pre-heart attack” sexuality. Almost none of these persons have any physical or medical reason not to return to sexual activity, but fear, lack of knowledge, diminished self-concept, general depression, or physician neglect of this important area of their rehabilitation got in the way. There were seldom significant organic reasons to avoid sexual interaction, but poor education from their doctor and reluctance to communicate about sex with their doctor or spouse robbed them of the opportunity to return to intimacy.
My interviews suggest that depression, whether from lack of information, lack of self-esteem, or fear, is at the core of the problem. “Will I ever be able to work again, work like I used to?” asked one man. “I just can’t imagine being like I was before.” I have never talked with a patient who reported such concerns who did not also have sexual concerns, for sex cannot be separated from our concept of self, our work, and our sexual “workability.”
The lack of specific discussion of heart disease and its relationship to sex implies a negative message to the patient. “I thought because he didn’t say a word about it that he thought I’d be crazy to even think it, so I stopped thinking it. At least, I tried. Every time I had sex it was like I decided I would die for it if I had to.” This patient expresses the concern of most of the heart patients with whom I have counseled: forget the whole thing or risk your life.
When some information was given about sex and heart disease, it was usually wrong. Wait about six months for the heart muscle to heal, was a rule of thumb, followed by the now infamous “two flights of stairs” advice. If patients could walk up two flights of stairs without heart symptoms, they could have sex. Medicine apparently assumed that climbing stairs is the closest analogy to having sex. It makes one wonder how doctors have sex. The effect of such advice was to raise anxiety, as the patient waited for the weeks to pass to attempt the stair-climbing. Few health-care workers thought to study the effects of the anxiety caused by such delay and anticipation> the effects that such an emotional state could have on me healing heart.
Research data indicate that maximal heart rate during a typical workday is actually higher than that achieved during orgasmic contractions. Blood-pressure changes with sexual activity also are not at a risk level in the absence of other illness factors. Of course, each case is different, but unless the doctor can tell you why you should not have sex, then you would probably benefit from sex, not just survive it. I have never found that waiting for healing was helpful in any illness. Getting better is an active, not passive state, and diseases of the heart may be healed more easily by loving than waiting.
*270\97\8*
