Intimacy after stroke

“Sex could kill you. Do you know what the human body goes through when you have sex? Pupils dilate, arteries constrict, core temperature raises, heart races, blood pressure skyrockets, respiration becomes rapid and shallow, the brain fires bursts of electrical impulses from nowhere to nowhere, and secretions spit out of every gland, and the muscles tense and spasm like you’re lifting three times your body weight. It’s violent. It’s ugly. And it’s messy. And if God hadn’t made it so unbelievably fun, the human race would have died out eons ago.”

-House MD, created by David Shore (Season 1, Episode 3 ‘Occam’s Razor’)

Let’s talk about a taboo subject here. Sex and intimacy. It technically caused my stroke 10 years ago and came to be a stroke survivor at the ripe old age of 32. But first I’ll tell you a little more about me and what I was going through before that.

My name is Doyle Fitz, now 41. At an age when most people are either starting or adding onto their family, something amazing happened to me and my family. I had a stroke. There were signs leading up to it, but the most prevalent was pain. Terrible pain on the left side of my neck. I’d had it for months and no matter what my PCP thought of, we couldn’t figure out where it was coming from. The long and the short of it is there was a dissection on my left vertebral artery that caused a deep brain thrombosis and ultimately led to a brain stem stroke…which occurred right after my wife and I finished being intimate together. So, in short she tried to kill me while making me extremely happy.

But in all seriousness, intimacy after my stroke was something that scared the crap out of me. I’m writing this in hopes that my story can alleviate some anxiety and maybe answer some questions you may not have even thought of. Let’s dive in!

Intimacy can be many different things to different people; different strokes for different folks after all (pun fully intended). Regardless of what it looks like to you and your partner there is one thing that we all have in common with each other…it gets the blood pumping. Whether it’s being close with someone that it feels like there’s an invisible bond between the two of you or someone you’ve just begun seeing (no judgements here. You do you boo.), it’s exhilarating. But one thing is all but certain immediately post stroke. YOU. ARE. EXHAUSTED.

Post stroke fatigue is reported in an estimated 30% to 70% of survivors. I still battle mine to this day and I’m 10 years out. I honestly had no inclination to be intimate with my wife, I was too busy focusing on finding my new normal. Healing is hard work. And your brain has to heal like never before. New neural pathways are being established as your brain is literally rewiring itself. Not to mention many of us are in some form of therapy at that time. Mine was food/speech therapy (lost the ability to swallow) and physical (had to learn to walk again). I’d come home exhausted and it may not have even been lunch time yet, but that was ok; my wife was happy just to have me home and not laid out in a hospital. But let’s back pedal a little to an even broader part of intimacy, dating and relationships.

On one of the sub reddits I follow about strokes, someone once asked what to say on a date about being a survivor, which to me sounded odd. Disclaimer here: I haven’t dated anyone in more than 20 years and even then I married my high school sweetheart. My input on dating may leave much to be desired. Ever heard the saying “Don’t make an issue out of a nonissue”? Why would you even bring it up? Granted, as survivors we all healed differently and we all had our own roadblocks to overcome. I was lucky in that regard, I look normal, my neurologist still tells me ‘you’d never know you had a stroke’. But let’s say you use some form of walking aide, or your speech is kinda wonky, or anything else. If you’re self conscious about it I’d address it before the date and let them take it from there. There’s only two things that can happen; they can say all right and maybe ask some questions about it or they can ghost you. If they ask questions then they’re good people and they want to know more about you. If they ghost you then they weren’t worth it anyways.

All right down to fun times! Let’s go over a few things and address the most important thing of all.

The first thing you should do is make sure you’re actually clear to do the deed. After my incident, you can bet I triple checked with my neurologist before I even considered it. It sounds strange and somewhat foolish, but you really should make sure you’re physically capable of performing. If you’re worried about sex causing another stroke, be at ease, research shows that it doesn’t increase the possibility at all.

Also be aware that the desire may be decreased as well, even after you’re fully “recovered”. There’s the post-stroke fatigue mentioned earlier, possible body image issues, lack of muscle control, and a myriad of other things that could be bothering you. If you’re worried about any of this, talk to your partner, doctor, and consider seeking counseling. Sex starts in the brain before it ever reaches the body.

Then there’s possible medication interactions, especially if on antidepressants. Depression is quite common after a stroke and completely understandable as well and unfortunately a common side effect of antidepressants is a decreased libido. There’s the blood pressure control…which is super important of course. However, blood flow is quite important in intimacy. Once again, if you’re having any of the aforementioned issues or believe any medications may be the problem please address it with your care team.

The last thing I’ll say is take it slow. Much like your everyday life don’t expect to jump back into what you used to be able to do. Loss of balance and muscle control issues, which are both relatively common post stroke, could cause some issuers in the bedroom. Yoga will most likely help with balance, flexibility, and muscle control. That’ll take time of course, but it’ll undoubtedly help.

Down to brass tacks, the most important thing of all. Communication. It’s truly the most important part of any relationship. Your partner is…well…your partner. They stick with you because they enjoy your company and think you're pretty spiffy. Talking and listening are key parts in any healthy relationship. In regards to intimacy through anxiety, it’s imperative to communicate with each other. Bear in mind that you may not be the only person worried about it, hence the communication being key here. Be open to addressing any changes from your routine to accommodate the new you and communicate with your partner when and as needed, both in and out of the bedroom.

In short, sex and intimacy post stroke can be scary but is still a healthy part of any recovery. There are so many noted health benefits associated with intimacy after all. Just remember to:

• Check with your care team prior

• Communicate with your care team about any concerns

• Be aware of any medication or emotional interactions and the ramifications they can have

• Take is SLOW

• And communicate any concerns or needs to your partner

Remember this is just a new path in your journey of recovery, and just like any path there’ll be roadblocks and beautiful moments. Always focus on the latter

I'm a 10 year stroke survivor and still have good and bad days post stroke, luckily more good now. My bad days tend to be more associated with neuropathy than anything else. I spend my days with my wife, daughter, 2 dogs, 4 cats, 2 porch racoons and countless relatively fearless deer that frequent my property.

--

Doyle Fitz