Both men and women with spinal cord injury who are sexually active and do not want a pregnancy must use a birth control method, even if you think ejaculation is unlikely. Keep in mind that erection and ejaculation are separate functions. Some men with paraplegia can ejaculate despite the lack of erection or sensation of orgasm. Therefore, if you are having sex and wish to avoid pregnancy, birth control is essential.All birth control options available to able-bodied people are possible for people with spinal cord injury. Birth control pills and intrauterine devices have the advantage of greater effectiveness in preventing pregnancy, but may have higher medical risks for women with spinal cord injury. Barrier methods such as the diaphragm and condoms have the advantage of also protecting against sexually transmitted diseases, but they may be difficult to use because of mobility impairments. Permanent contraceptive methods such as tubal ligation or vasectomy are an option for individuals or couples who are sure they do not want children. The best way to decide on the method that is right for you is to consult your doctor. Together you can explore the options and weigh the risks and benefits of each type of contraception.
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In addition to daytime sleep attacks, the primary symptoms of narcolepsy include sleep paralysis, hallucinations, and cataplexy. Sleep paralysis—sudden inability to move—occurs at the beginning or the end of sleep and renders immobile virtually every voluntary muscle except those around the eyes. When hallucinations are present, they usually come at the beginning of sleep; they may be vivid, realistic, and sometimes violent.Cataplexy—an attack of muscle weakness or dysfunction lasting from a few seconds to a few minutes—is one of the most disconcerting features of narcolepsy, largely because of the suddenness with which it appears. An attack can be triggered by almost any form of emotional arousal, from anger to athletic activity to excitement—even the mere anticipation of excitement. A mother of three told me she had to allow her children to run amok; she was unable to discipline them because doing so would trigger an attack. Another patient reported that his fraternity brothers considered it an evening’s entertainment to regale him with jokes, just to get him to laugh so that they could watch him collapse. Another described his sadness at having to stay away from Yankees baseball games. During any thrilling moment, he said, just as the other fans were rising to their feet, he would crumple to the floor of the stands. In one case reported in the literature a patient became cataplectic every time he had an orgasm. He had naturally come to believe that such paralysis was simply part of the sexual experience. Sometimes the consequences can be disastrous. A narcoleptic butcher fell asleep while wielding a meat cleaver and awakened to find he had lopped off three of his fingers.Cataplexy may involve all of the muscles or just a select few; the severity ranges from a slight loss of tone to complete paralysis. Victims do not lose consciousness. Not all narcoleptics experience cataplexy; in some, however, the attacks are frequent. People with narcolepsy may notice excessive daytime sleepiness as much as a year before the onset of cataplexy.Memory difficulties are also reported by about half of narcoleptics. In addition, some experience symptoms in the eyes: fatigue, difficulty focusing, double vision. Except for cataplexy, however, these symptoms are not unique to narcolepsy but are found in other disorders as well.*151\226\8*

For many people they are only a cosmetic annoyance. Still others have minor symptoms of mild swelling and a feeling of heaviness or aching in the legs at the end of the day. In some cases,  varicose veins are  serious enough to lead to chronic skin thickening or ulceration. For many people, support or elastic stockings to help counteract the increased pressure in the veins are extremely helpful for limiting swelling and other more serious complications.Overtime, varicose veins tend to become more prominent. You can help slow progression of your varicose veins by using elastic support stockings, by not standing for too long, or by not being too sedentary. Move around as much as possible, but periodically lie down and elevate your legs above the level of your heart (“toes above the nose”) at the end of the day to help relieve swelling. Regular exercise will also decrease the pressure in the veins.Surgery to strip or remove the varicose veins can be performed in severe cases. In one study, 85 percent of people who had surgery had no recurrence of the varicose veins during the next 10 years. If you have small and less severe varicose veins, you might be best treated with injection of the veins or with a laser.Laser therapy may be used on very small, superficial blood vessels, but injection therapy (sclerotherapy) is usually best if the blood vessels are large enough for the procedure to be performed. Sclerotherapy may be helpful alone or in combination with surgery. Sclerotherapy is done on an outpatient basis. The physician slowly injects a solution into one or several of the visible veins while you are standing. Then, a small bandage is wrapped snugly over the veins for 24 hours. It may take more than one treatment session to achieve optimal results.Sclerotherapy collapses the veins, and blood is then prevented from flowing into them and the discoloration is eliminated within about a month. The treatment has no significant effect on circulation in the leg. In about one-third of people who have sclerotherapy, a yellow-brown discoloration may appear in the area and c take weeks, months, or even longer fade.*212\252\8*