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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Even with all my training, the women in my life have taught me much I needed to know about health and health care. A few years ago, my older daughter wrote her senior research project on women’s medical issues, focusing on how the entire medical system is not geared toward humans of the female persuasion. Of course, I was pleased and proud she was showing an interest in medicine, but I teased her at first about being up on her soapbox. It’s not like I took a course on how not to treat women, I told her, and except for whatever handful of male chauvinist doctors were out there (unfortunate, but unavoidable), I felt sure women received medical care on a par with men. But as she researched, and I thought about the stories my patients brought to me, and we talked, she showed me she was right.Around this same time, as my wife was going into perimenopause, she had her first bone density measurement. She came home to report that the radiologist just said that everything was fine. But when a copy of the report arrived in the mail, I saw that it actually showed significant bone loss. At her routine visit to the gynecologist, the doctor didn’t comment on the bone scan (which she had received a copy of), but did suggest calcium, exercise, and hormone replacement therapy (HRT), which, aside from the calcium, my wife declined. And so, with just one approach mentioned—and major components rejected—with no “Plan B,” no plan for follow-up, no discussion of protective eating strategies or types of exercise or alternatives to standard HRT my wife might find more appealing, these doctors were satisfied to let the whole matter go, without even explaining the potential for serious trouble ahead! Once it hit this close to home, I finally realized the extent of the problem my daughter had pointed out to me. And nowhere was it more extreme than when it came to osteoporosis.Until recently, bone fragility has been more or less shrugged off as an inevitable part of aging—and basically a woman’s lot. Though this is a totally preventable disease, the incidence of osteoporosis has been increasing because it hasn’t been properly addressed. As some new drugs were approved that provided a real treatment for low bone density for the first time, and I began to get visits from sales reps bearing information on the extent of osteoporosis among women, it became clear just how ignored this health issue had been. Most insurance companies wouldn’t even pay for screening tests, and I saw too many of my patients do without the scans that could have given them crucial information for preserving their health and lifestyle, simply because they couldn’t afford them. My practice was aging right along with Boomer me, and the topic was coming up more and more often. In talking with my patients with a sharper focus on bone health, I also realized how little information on the topic was available for women. Most patients, even those who could rattle off fat grams and recommended heart rates for aerobic exercise, knew precious little about how to correctly protect their bones—or even of the necessity of doing so. So began my crusade. If the ideal doctor-patient relationship is a true partnership, I saw I was going to have to educate myself and my patients if we were going to be able to promote the strongest possible bones.*10\228\2*