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Q: Healthcare professionals often don't have enough knowledge about their own sexuality. Could this be the obstacle in counselling patients with sexual difficulties?
A: Dr Bitzer
This is very true for all clinical situations. Many professionals have sexual difficulties and so do not feel able to effectively counsel the patient. They have a fear of being confronted and have inhibitions towards counselling. It may be that a feeling of solidarity can be given to the patient by explaining to them that these difficulties often occur in healthy people. The aim of sexual counselling is to encourage and empower people, diminishing their inhibition and setting realistic goals.
Q:In many cases healthcare professionals do not have specific instructions or cures in order to help patients with sexual dysfunction, especially women, but often just an open discussion helps the person with MS discover the reasons for the feelings they have been experiencing. Do you agree?
A: Dr Bitzer
Men may seem privileged, as there are more pharmaceutical therapies available to them. However, it is important to realise that for a lot of people with MS it is not a drug solution that is the most important factor but the opportunity to share and discuss their feelings.
Q: It is important to remember the role of the spouses. In Finland, we have courses for both the patients and their spouses and the focus has been on giving information. The results are extremely good. Do you have any such experience?
A: Ms Jønsson
I have no personal experience, as there are no such groups where I work. But I have heard the results are very good and I think it is a very good idea. I know you use a lot of written information. After a consultation the person with MS is provided with a piece of paper stating what has been discussed in the consultation. Information on coping is also provided and I think this combination of written and verbal materials is very good.
Q:Many people like to have saunas, which are very hot. Is it possibly harmful for patients? Could it cause permanent harm?
A: Dr Lienert
Some people affected with MS benefit from saunas. Similarly, if a person with MS asks about going on holiday to the Caribbean or somewhere similar I advise them to go and try and see how they manage with the heat. It varies from person to person.
Q: What are the benefits of a baclofen pump if oral baclofen or temazine is not suitable?
A: Dr Lienert
With the pump you can give higher doses. With oral medication you cannot keep increasing the dose without suffering extensive side effects. By using the pump there is a direct effect at the required site and the dose can be adjusted to suit the person with MS.
