Most of the recent developments in sexuality and fertility after spinal cord injury focus on male sexual function. Several medical and surgical techniques have been developed for treating erectile dysfunction resulting from spinal cord injury.

On the medical front, medications to treat impotence – especially Viagra, which has received a great deal of attention in the press – may be very effective for some men with spinal cord injury, making genital intercourse possible. Another recent development is the use of a suction pump that can be applied to the penis to help create an erection. Surgical techniques include two types of penile implant, one that keeps the penis in a semi-erect condition and another that uses a miniature internal pump to create a full artificial erection. Unfortunately, the pumps have not been very successful, because they are susceptible to mechanical failure.

Treatment of infertility in men with spinal cord injury has improved greatly. There are various methods of inducing ejaculation in men with spinal cord injury, to obtain sperm for artificial insemination or in vitro fertilization. A testicular biopsy, in which a small piece of testicular tissue is removed, can also be used to collect sperm cells directly from the testes.

Perhaps the most disturbing aspect of sexual dysfunction after spinal cord injury, for both men and women, is the loss of genital sensation. This sensory loss is a direct result of damage to nerve fibers carrying sensory information between the genitals and the brain through the spinal cord. Unfortunately, no way is yet available to repair these nerve fibers. However, research is underway in many laboratories.

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Controlling diabetes is essentially a matter of fine-tuning diet, medication (if any) and exercise. Any disruption in the harmonious balance of these three control mechanisms can bring on problems, some of them potentially life-threatening.

Among them:

Hypoglycemia. This is a condition marked by an abnormally low level of blood sugar. In a diabetic, it can be brought on by:

Accidentally taken too much insulin or an oral anti-diabetic drug.

Undereating, eg. going on a rigorous religious fast.

Exercising too much

The symptoms of hypoglycemia include:

Sweating

Headache

Nausea

Palpitation

Mental fuzziness and disorientation

If untreated, rapid loss of consciousness and, sometimes, convulsive seizures.

Prolonged, repeated bouts of hypoglycemia may have serious consequences, including permanent brain damage.

What to do

If the person is conscious and able to swallow, sugar should be immediately given by mouth. If this is done during the brief period of warning symptoms, it can prevent the loss of consciousness.

If the person is unconscious, he needs to be given an injection of glucagon, a hormone that counteracts’ the effect of insulin. But hypoglycemic coma often signifies a serious emergency requiring immediate admission to a hospital.

Ketoacidosis. If Type I diabetics do not get the required amount of insulin, high levels of glucose remain trapped in the blood. With the cells being starved of their primary energy source (i.e. glucose), the body begins to burn large amounts of fats instead of sugar. This causes certain products of fat breakdown (known as ketones”) to accumulate in the blood and spill over into the urine. The blood becomes excessively acidic, a condition which can cause dehydration, bringing on diabetic coma (ketoacidosis). Insulin-dependent diabetics are asked to carry out frequent urine testing as a means of checking for acetone (an early sign of ketosis). Type II diabetics rarely get out of control with this complication.

Ketoacidosis may occur as a result of:

Inadequate insulin therapy

Stress Infection

The symptoms include:

Increased urination, leading to excessive thirst and possibly dehydration.

Fast, panting breathing

A characteristic sweet odor (caused by the excretion of acetone, one of the ketones, by the lungs). What to do:

Ketoacidosis is a serious complication which usually requires hospitalization. Get to urgent medical help if you have any reason to suspect it. The injection of insulin is essential to tackle this diabetic emergency.

Hyperglycemia. In neglected diabetes, or even in a diabetic who has omitted to take his insulin, glucose levels in the blood can shoot up too high, a condition known as hyperglycemia. Certain drugs taken in large quantities — such as epinephrine (used to treat respiratory illnesses), phenylephrine (in nasal sprays and cold medications), and caffeine (in headache and cold drugs, and in OTC appetite suppressants) — can also raise blood sugar levels. This can lead to a very dangerous condition marked by coma.

Blood sugar can accumulate to very high levels before the sugar spills over into the urine. Therefore, it is blood testing (not urine testing) that can tell you when you have hyperglycaemia without symptoms.

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Headaches can accompany some brain tumors, and people suffering from recurring or severe headaches are often quite concerned that they have a tumor. But it is rare for headaches that recur for several years to be due to a tumor, no matter how severe the head pain is. Headaches usually do not occur until late in the course of most brain tumors, after many other symptoms have developed. Some patients with brain tumors do not experience headache at all.

The headache of a brain tumor does not have any particular characteristic to identify it. The pain may be over the entire head or localized in a special area. It is frequently a dull pain and may be very mild, and it may last for only moments at a time or be continuous.

The headache due to a brain tumor rarely awakens people during sleep, as migraine or cluster headaches do. Movement of the head and changes in posture may increase the discomfort, but this characteristic is shared by many other headaches, like migraine and the headache associated with fever. The brain tumor headache may be eased temporarily by simple analgesics, such as aspirin. For this reason alone, the prolonged use of analgesics for undiagnosed headache is clearly unwise.

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