I used to hate travelling long distance. The laborious and restless journey to the “other side of earth” is just so unappealing, when one is stranded in a confined space, and need to ask permission from a fellow traveller for permission to go to the restroom. This is simply atrocious!

I still dislike the journey to London, but I don’t loathe it that much these days. I guess with advancing age, falling asleep anywhere at will, is not such a difficult thing anymore. Besides, what better way to pass time than to indulge in old movies?

I watched my best friend’s favourite 1990s classic, Pretty Women, on my way to London recently. Originally intended to be a dark cautionary tale about social class and prostitution in Los Angeles, the film was received as a romantic comedy. It truly depicts how love could overcome barriers of society.

Julia Roberts once said: “I believe that two people are connected at the heart, and it doesn’t matter what you do, or who you are or where you live; there are no boundaries or barriers if two people are destined to be together.”

This is inline with what Ronald Reagan who once stated in his speech: “There is no constraints on the human mind, no walls around the human spirit, no barriers to our progress except those we ourselves erect”.

On the note of “erect”, let’s handle a predicament from a wife with quandary.

Dear Dr G,

I’m writing with a few questions from a concerned wife, whose husband suffers from ED (Erectile Dysfunction) in the last two years.

Both my husband and I have had HCV for 25+ years. We encounter serious gastrointestinal issues and other health ailments as a result of the infection and its treatment.

My husband’s ED issues began during a clinical trial (for hepatitis C medications) that we took part in. It was my second round of treatment & his first cycle.

Unfortunately, due to serious adversity, we did not continue the treatment and were dropped from the trial.

Sadly, from the end of the trial, our once healthy and frequent sex life had come to an abrupt end. This has declined to the point where we haven’t had sexual intimacy for over 2 years.

Although I am near menopause, I still would like to have a healthy sexual life and cannot imagine not being intimate with my husband again.

I’ve tried talking to him about it, but this has been disastrous. How do I approach him with this sensitive subject? Is there a right way?

The fact he doesn’t seem to even miss our sex life makes it much more confusing and difficult for me. I know he’s going through issues so I don’t want to make the situation worse.

My husband also doesn’t have a regular doctor and hasn’t for years. I know he would not feel comfortable talking about it with a doctor he saw only once and has not built a good rapport.

Although my husband is only 50 and I will turn 46 years old soon, we are hardly too old for sexual relations. This is hard on both of us. Thanks for any advice!

Mrs RK

Hepatitis C is an infection caused by a virus that attacks the liver, and can lead to inflammation. The infection is generally chronic in nature and most people with such infection experience no symptoms.

Although the long-term effect of the infection can be mild, many sufferers do experience fatigue, nausea and poor appetite.

The specific correlation of erectile dysfunction is not particularly documented by patients, unless in advanced disease.

The new treatments for hepatitis C are generally antivirals and medications to manipulate the immunity such as interferon.

Although there are associations of sexual dysfunction published in medical journals with hepatitis therapy, it has also been highlighted that the subjects in the 50s and 60s already experienced erection problems prior to the medical interventions.

The open discussion of the subject of sexual dysfunction is never easy, especially in a more conservative society.

Men usually go through a cycle of psychological turmoil before recognising the problem and accepting treatment.

Initially, men would experience denial. During this process, the sufferers shrug off the “inadequacy” as a temporary set back and blame it on other matters, such as stress at work and partner issues.

After multiple failed attempts of sexual encounters, many men would experience fear.

The worry of the unknown and over what is happening to the bodily function is fuelling the distress and trepidation. This tends to worsen the ED and results in avoidance of intimacy with a partner.

The next cycle of progression tends to be anger. The unease, anxiety and apprehension of sexual dysfunction may occasionally lead to irritation and antagonism in a relationship.

Clearly, this situation can easily lead to the breaking up of a relationship that is already in a fragile state.

The final stage of the road to recovery for men facing ED is acceptance, which can lead to unearthing the etiology and solutions of the problems. The whole process of acceptance may take years.

The role of the partner is vital in dealing with ED problems. Physicians usually help to open doors and focus on open communications to ease the barriers.

Tim Cook once said: “You can focus on things that are barriers or can focus on scaling the wall or redefining the problem.”

I empathise with Mrs RK’s dilemma and at the same time admire her courage – for standing by her man who has been facing a chronic hepatitis C infection for 20 years, and willing to share that love for many decades to come.

Maya Angelou once said: “Love recognises no barriers. It jumps hurdles, leap fences, penetrates walls to arrive at the destination full of hope.

With love, I hope you can guide your husband to overcome the denial, “penetrate” the wall of fear and succumb to the acceptance of love.

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