Health News. Lots of resources and information

Some men with spinal cord injury are not able to impregnate their partners because they are unable to produce viable sperm. But there are other options for having a family that you and your partner might want to explore.One possibility is artificial insemination with donor sperm. Sperm banks collect sperm samples from healthy anonymous donors. Use of donated sperm allows a couple to go through the experience of pregnancy together and to begin parenting the child from the moment it is born. For some couples, however, the “imbalance” of having a child genetically related to the mother but not the father is unacceptable and a reason not to pursue this option.A second possibility is adoption. The adoption procedure may involve extensive evaluation of you, your partner, and your home by the adoption agency, long waiting lists for an available child, and a series of evaluations and court proceedings before the adoption is legally finalized. Adoption agencies may have discriminatory attitudes toward parents with a disability, but your application to adopt a child cannot be refused solely on the basis of your disability. A private (non-agency) adoption is an alternative, but this can be extremely expensive and result in much disappointment if the birth mother decides not to relinquish the child.If you wish to adopt a child, consult with other adoptive parents who have disabilities and inquire at several adoption agencies to find one that is best suited to your needs. If you are willing to persevere, adoption can be a rewarding way to become a parent.Elliott looks back on the day his first wife announced her pregnancy as a turning point in his recovery. He recalls the surprise and happiness in finding out he could father a child, his wife’s enthusiasm, and a dawning sense of responsibility. For more than two years Elliott had been dependent on others. Now he would have to take care of someone else. At the age of twenty-two, he wasn’t “real hot” about having a child – until he found out he was going to have one! “The real point at which I knew I was trapped and there was no way out, and I didn’t want any way out, was when I saw her born. I was there in the delivery room. She had me wrapped around her little pinky from the day she was born!”After his divorce, Elliott lived alone for three years, rebuilding his self-confidence and independence, working, dating, getting his power wheelchair and van. Then he met the woman who would become his second wife, and they lived together for a few years before marrying.In this marriage, Elliott feels he is an equal partner. He sometimes asks his wife for assistance with particularly difficult or time-consuming tasks, but he functions independently for the most part. He has been steadily employed during their marriage, recently switching to a better job. His daughter, always a frequent visitor, moved in with them during high school and is now starting college. Elliott’s second wife has never had children. Now in her mid-thirties she and Elliott are thinking about having a child together.Elliott was fortunate in having substantial recovery of his sexual function and being able to father a child without medical intervention, gut his story also illustrates the interaction between physical and psychological factors in dating, developing romantic and sexual relationships, and being a responsible and loving parent. Elliott found that the road to becoming an attractive sexual partner and succeeding in a long-term relationship required self-confidence, some social risk-taking, a sense of humor, a relish for relationships, and responsibility for his own life.
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Once it has been determined that an adolescent needs treatment and the adolescent has agreed to treatment, it is important to proceed in a careful way. Because medical and psychiatric complications frequently accompany adolescent substance abuse, a thorough medical and psychiatric evaluation should precede or be an early part of any treatment plan. Treatment options include outpatient, residential, or hospital-based care and can involve individual, group, and family counseling, plus self-help groups such as AA or NA (Narcotics Anonymous). Halfway houses may also be helpful for adolescents who are not ready to return home from a hospital-based program, but who no longer need the structure of a hospital.There are very good alcohol/drug treatment programs for adolescents. There are those, on the other hand, which might most kindly be described as “nontraditional,” or those less concerned with therapeutics than with turning a profit. Don’t forget the standard questions before referring an adolescent to any program: “Does the program work?” “Is the program drug free?” “Is there a strong family component” “Is there a strong therapeutic component ” “Is there a strong educational component ” “Is the adolescent involved in treatment planning?” “Is there a peer component?” “Are there provisions for aftercare?” “What are the costs and risks of treatment, including both financial cost and time cost?” “What beliefs are instilled” “What are the staff credentials, including training, experience, licensure and certification?” “Is there a full range of services, including pediatric, psychiatric, educational, psychological, and alcohol counselors?” “Is there involvement with AA?” “How does the program feel when you visit it?” “Does the program evaluate itself?” “Is the program accredited?” “If so, by whom?”When referring an adolescent for treatment, it is important to remember that alcoholism is a chronic disease. Treatment does not end with discharge. The conceptual model to use is not that of an acute illness like appendicitis, where the offending tissue can be surgically removed and the problem will never recur. It is rather a chronic illness like asthma, or arthritis, where ongoing monitoring is always essential, and whereas some cases are mild and require only outpatient treatment, others may require hospitalization.*153\331\2*

An uncommon problem with blood vessels is a malformation in which arteries and veins are directly connected, instead of being joined by capillaries. This can take two general forms: arteriovenous malformation, which is a congenital condition, and arteriovenous fistula, which is usually the result of trauma.Arteriovenous malformations are “tangles” of small arterial vessels that are intertwined with small veins. The blood from the arteries flows directly into the veins. These malformations can be present anywhere in the body and in any organ. The consequences of having an arteriovenous malformation depend on their location and size. A small one in the brain may produce more problems than a larger one in the liver, for example.A fistula can be thought of as a window or conduit that directly connects a large artery with a large vein. This might occur if a person receives a puncture wound that penetrates through an artery and vein that lie next to each other. Even after the healing process occurs, a connecting pathway between the two vessels may remain. Some blood from the artery may be diverted (shunted) directly into the vein before it goes to the capillaries. If a fistula (or arteriovenous malformation) is large, the blood flow through it may be very high. If so, the heart works excessively hard to keep up with the needs of the body.Some arteriovenous malformations can be fixed by blocking the artery from which they branch. This can occasionally be done by inserting a special small balloon or other material directly into the artery with a catheter.*215\252\8*