Chapter 122.

Anna stood at the entrance, she wanted to ask the doctor if she could be intimately involved with her husband, but she didn't know how the question would sound.

She turned around and took a deep breath, doctor Raji wasn't expecting her to still have questions, though he wanted to know what conspired between she and Andrew earlier.

"Is there a problem Mrs Andrew?

He called out and she nodded as to say No, she walked out, but couldn't hold it anymore, there was no point in hiding anything from them, they were medical personnels they know these things, she opened the door to their office again and asked without mincing words.

"Can I have sex with my husband?

The two doctors in the room exchanged glances and the younger doctor left, while doctor Raji invited her in again.

"Like j said before, there is nothing you cannot do, but you need to have the understanding, if what a tually happened to your husband.

Before I go further, why do you ask, is it you who wants it or him?

"He asked me to sleep with him and I refused, telling him we were at the hospital, then he got angry and screamed at me.

"Wow, that is a good one, that means his accident gave him an increased libido" 

"What do you mean doctor?

"A brain injury can change the way a person experiences and expresses their sexuality. Problems might include reduced sex drive, difficulties with sexual functioning (such as impotence) and behaving sexually at inappropriate times.

While at other times, it increases the sex drive and the person might talk and want   sex at inappropriate places.

Talking about sex can be embarrassing, but it is important for the person with brain injury and their loved ones to discuss the various issues.

For Andrew to have been open with you about it, then it means, he wants to give remebering you a chance.

every one is entitled to express their sexuality and since he has expressed it to someone that was supposed to be his wife, the way to go about it even if you didn't want to was make him talk more about his wants while you talk more about yours.

Your husband was involved in a car accident, and so he got a traumatic brain injury.

How traumatic injury affects the brain

Acquired brain injury (ABI) refers to any type of brain damage that occurs after birth. Causes can include damage resulting from infection, disease, lack of oxygen or a blow to the head. Traumatic brain injury (TBI) is one type of ABI. It is usually caused by a direct injury to the head – for example, in a car accident.

Traumatic brain injury can cause changes in thinking, behaviour and body function, depending on which brain areas were affected and to what degree. Generally, the more severe the injury, the more significant the symptoms and loss of function will be.

Changes to sexual behaviour after traumatic brain injury (TBI)

Common changes in sexual behaviour after a traumatic head injury include:

Reduced libido – about half of people with a traumatic head injury experience a drop in sex drive. The remainder experience increased libido or no change at all.

Erectile problems – between 40 and 60 per cent of men have either temporary or permanent impotence following their injury.

Inability to orgasm – up to 40 per cent of men and women report difficulties having an orgasm.

Reduced frequency of sex – possible reasons for this include disability, depression, relationship break-up and sexual problems.

Causes of sexual problems and TBI

Sexual functioning and arousal involve a number of areas of the brain. If those areas are damaged, a person may experience difficulties having sex. They may not feel sexual in the same way, even though their physical functions still work.

Which is why I initially said that this was good, because his case is not the fact that he had lost his potency, he was still very much active;

"Other factors after brain damage may also contribute to, or even cause, the person’s sexual problems. These factors could include:

Emotions – depression, anxiety and stress can reduce sex drive.

Medications – certain medications can dampen libido.

Associated injuries – if, for example, the person’s brain was injured in an accident, they may have other injuries that directly affect their sexual functioning (such as a spinal cord injury).

Relationship breakdown – a couple experiencing problems are less likely to have sex.

Prior sexual difficulties – brain injury can make worse any sexual problems the person was having before the injury occurred.

Reduced confidence – the person may feel less confident or attractive after the brain injury, which makes them less likely to feel sexual. This is why you need to admire him even on a wheel chair.

Other illnesses – such as diabetes or hypertension (high blood pressure) can reduce libido.

If sex must happen, you need to create dirty talk conversation with him, reminding him how good he was the last time, allow him talk about his expectations, fears and feelings.

A couple can solve most relationship problems if they communicate frankly with each other.

Take it easy, and try not to put too much pressure on yourselves.

Focus on pleasure, rather than technique. You may need to change your earlier style of lovemaking for a while. For example, if penis-in-vagina sex isn’t possible, experiment with other sexual activities including oral sex and mutual masturbation.

Concentrate on boosting the romance in your relationship. Suggestions include remembering to appreciate and compliment each other, offering lots of affection (such as kissing and cuddling).

"There are usually different sexually problems after brain injury, but there are solutions.

We are now going to commence our treatment for depression, stress and anxiety, if necessary.

"Like I said earlier, Sometimes, a person   with brain injury may behave sexually at inappropriate times – for example, they may masturbate in front of people. This type of behaviour can be difficult for family members. And that was what your husband exhibited earlier.

Try to be calm. If you appear shocked or distressed, it could make the person feel there is something wrong with their sexuality.

Tell the person that their behaviour is inappropriate and offer alternatives. For example, you could ask them to masturbate in their bedroom instead of in the lounge room.

You may need to remind the person many times to curb their inappropriate sexual behaviour, so be patient.

. Try to develop a consistent way of dealing with inappropriate behaviour.

Talk about sexual issues with him more.

Set firm boundaries on sexual behaviour. Help them to find appropriate and satisfying ways to express their sexuality. And it will turn out good.