Withdrawal
This not very effective method of birth control is most commonly used by people who have not taken the time to consider alternatives. The withdrawal method involves withdrawing the penis from the vagina just prior to ejaculation. Because there can be up to half a million sperm in the drop of fluid at the tip of the penis before ejaculation, this method is unreliable. Timing withdrawal is also difficult; males concentrating on accurate timing may not be able to relax and enjoy intercourse.
Emergency Contraceptive Pills
There are more than 2.7 million unintended pregnancies per year in the United States, and nearly half are due to contraceptive failure. According to the Centers for Disease Control and Prevention, more than 11 million American women report using contraceptive methods associated with high failure rates, including condoms, withdrawal, periodic abstinence, and diaphragms. These facts led the Food and Drug Administration (FDA) to approve the “Preven Emergency Contraceptive Kit.”
Emergency contraception can be used when a condom breaks, after a sexual assault, or any time unprotected sexual intercourse occurs. Emergency contraceptive pills (ECPs) are ordinary birth control pills containing the hormones estrogen and progestin. Although the therapy is commonly known as the “morning-after pill,” the term is misleading; ECPs can be used up to 72 hours beyond. The use of ECPs can reduce the risk of pregnancy by 75 percent.
Emergency contraceptives require a prescription. After a woman determines she is not pregnant, by using the pregnancy test included in the kit, the first dose of two light blue emergency pills is taken as soon as possible, within 72 hours after sex with a known or suspected birth control failure or sex without birth control. The second dose is taken 12 hours later. The most common side effects related to emergency use are nausea, vomiting, menstrual irregularities, breast tenderness, headache, abdominal pain and cramps, and dizziness.
Emergency mini-pills contain progestin only. Like ECPs, mini-pills can be used immediately after unprotected intercourse and up to 72 hours beyond. Emergency mini-pills are equally as effective as ECPs, but nausea and vomiting are far less common. Emergency mini-pills are an excellent alternative for most women who cannot use ECPs that contain estrogen.
Abstinence and “Outercourse”
Strictly defined, abstinence means deliberately shunning intercourse. This strict definition would allow one to engage in such forms of sexual intimacy as massage, kissing, and solitary masturbation. But many people today have broadened the definition of abstinence to include all forms of sexual contact, even those that do not culminate in sexual intercourse.
Couples who go a step farther than massage and kissing and engage in activities such as oral-genital sex and mutual masturbation are sometimes said to be engaging in “outer-course.” Like abstinence, outercourse can be 100 percent effective for birth control as long as the male does not ejaculate near the vaginal opening. Unlike abstinence, however, outer-course is not 100 percent effective against sexually transmitted infections (STIs). Oral-genital contact can result in transmission of an STL, although the practice can be made safer by using a condom on the penis or a dental dam on the vaginal opening.
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Physical therapists, respiratory therapists, and occupational therapists all help the patient intensively during the early days of hospitalization. Every patient with a spinal cord injury will work with a physical therapist. Physical therapy involves the use of physical exercises and techniques such as massage or the application of heat or ice. The physical therapist has the major responsibility for maintaining your strength and flexibility and for teaching you mobility skills. The therapist will test each body part to determine muscle function and strength, before initiating an individualized exercise program.
As you begin physical therapy, you’ll encounter different terms for the various exercises. Ranges of motion exercises are the bedrock of the therapy, and these begin immediately. Range of motion refers to the degree of flexibility of a joint and is quantified by measuring (in degrees) the joint’s limits of motion in each direction. Various exercises are used to maintain or improve range of motion. If you cannot move your own limb and the therapist does it for you, it is called passive range of motion exercise. In active range of motion exercises, you control your own movement. There are also active resistance exercises in which you move against a force with your own energy. In active assisted exercise, the therapist helps you move weakened muscles. Range of motion exercises will become part of your daily routine for the rest of your life. They prevent contracture, a condition in which soft tissues around joints shorten, stiffen, and lose flexibility, leading to a loss of joint motion.
Physical therapists also teach you or your family the proper positioning of your body and proper movement so that pressure sores or decubitus ulcers do not develop (these and other complications of spinal cord injury are discussed below). After a few days in the hospital, you’ll probably begin to sit up, and your physical therapist will be there to help with positioning.
If necessary, respiratory therapy is initiated early in your hospitalization. This therapy involves the use of machinery and the therapist’s hands to help you breathe and cough. If you are using a ventilator, respiratory therapy is essential to monitor proper use of the ventilator equipment and management of the tracheostomy. If you do not need a ventilator but your injury is above T12, you may need respiratory therapy to help keep your lungs clear of fluid, because the muscles for coughing are weakened. This therapy includes inhaling medications to help expand the small airway passages in the lungs, along with breathing exercises and techniques to help keep your lungs clear.
Occupational therapy focuses on use of the upper body, arms, and hands for self-care activities such as feeding, bathing, and dressing, and for functional activities such as writing, balancing a checkbook, and cooking. The occupational therapist may begin work on self-care activities, also called activities of daily living, in the acute phase of your treatment, but you will work more intensively with occupational therapists in the rehabilitation hospital.
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The brain functions normally when there is interaction of many cells. When a sufficient number of cells work together, an “event” occurs. What the event will be is determined by which cells are firing. If the firing cells are in the motor area of the brain, the event may be the movement of a finger, hand, or foot; if it is in the sensory area, it may be a feeling like a tingle or a burning. In other areas it may be a taste, or a smell, or a memory. These normal human experiences occur when specialized parts of the brain are sufficiently excited.
A seizure occurs when the balance between excitation and inhibition is lost. A motor seizure, for example, happens when a sufficient number of cells spontaneously fire together and produce a sudden movement, a jerk. Not all sudden movements are seizures. A seizure is usually the result of repetitive firing of these same cells; when in the motor area repetitive firing leads to the rhythmic, repetitive jerking of a group of muscles.
Other types of seizures occur when cells from other areas of the brain fire simultaneously. The type of seizure depends on how many cells fire and which area of the brain is affected.
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