In the September/October issue of Arthritis Self Management, Victoria Ruffing R.N. writes an excellent piece titled "Intimacy." She begins with the premise that "feelings and attitudes toward sex are quite complicated."

Well, yeah. But she goes forward in a clear and thoughtful way to discuss communication, setting the stage, the power of touch, medicines and more, and comfort.

I found her suggestions to be useful and hopefully easy to do.

For instance, in the communication section she advises getting clear about your own needs and desires. She asks readers to examine their own attitudes before addressing their partner.

Questions like:

• "Do I react negatively when my partner wants to have sex?"
• "What are my preferred sexual activities?"
• "Am I willing to try new positions that will put less stress on injured or painful joints?"

She offers advice that may seem simple -- "take advantage of your good days" -- but we often haven't thought of it.

Make sure you are warm and that your environment is warm -- take a bath or shower, warm the bed with an electric blanket or flannel sheets.

Check the side effects of your medication -- and if that is contributing to your problems, speak with your doctor or rheumatology nurse.

Ruffing's top item is to "make yourself comfortable" and she gives many specific positions and suggestions so that you can "enjoy the journey!"

I encourage you to seek out this article.  (Available in the Sept./Oct. Arthritis Self Management magazine at your local library or bookseller, or by ordering online at www.arthritisselfmanagement.com.)

Another article had a slightly different perspective to offer. It was less about the practicalities, and more about research into chronic inflammatory disease and sexuality.

Most of the research in this area is conducted by assuming there are problems. Checklists are constructed and answers are limited to questions that deal with problems.

A different kind of research was done, asking women to describe the sexual effects of their illness in their own words.

A surprising finding was that some women found improved sexuality and relationships, even as they dealt with physical and emotional issues. The researchers posit that these positive sexual outcomes are important to note and explore further. [The study was done by Arno Karlen and published in Sexuality and Disability, Vol 20 (3), Fall 2002, 191-208.]

This stimulated my imagination because it helps focus on what some of the upside of these painful chronic diseases may be. Perhaps increased tenderness and a willingness to take time is part of the improvement.

Someone who is ill may find their partner really is caring and attentive, which improves communication and trust. Other benefits may be a deeper closeness that comes with fighting a battle together.

I am interested and wonder if any of you can expand on these findings with your own story?

I'd love to hear -- and I'm sure other readers would, too!

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