RELATIONSHIPS
Wheelchair
LIFE
Interpersonal relationships are important for normal growth and development of every human being. That does not change just because we are inconvenienced by a wheelchair. Friends, family, and lovers all play different roles, but all are necessary for support and well-being. Whether it is a family relationship, a friendship relationship, or an intimate physical relationship, they all take on different dynamics for someone in a wheelchair (sometimes slightly, sometimes greatly). For all relationships, we wheelchair users need to be cognizant of, and pay continued attention to, those different dynamics. It is our responsibility to stay on top of the game, because we bring the different dynamics to the equation. And, hopefully, we are more practiced, and better at addressing the unique circumstances.

It doesn't make sense to adopt an attitude of, "This is how I am, now you deal with it." Notice people who think like that – in chairs, or able-bodied – find themselves isolated, and unhappy. The danger of a 'take me as I am or leave me as I am' mindset is that most people will say, "Okay, I choose to leave you." We have to help make people feel comfortable with the unusual. To "break the ice," if you will. We are used to our disability ... most other people are not. We also need to do as much as we can from our end to contribute to the relationship in a positive manner. It's not the easiest thing in the world to be friends with or be involved with someone inconvenienced by a wheelchair (sometimes the inconvenience spills over). So we need to remember not to confound our relationships by adding more issues. Dont ever approach your relationships as if you are desperate. Just remember that although no one is perfect, we don't want to let our wheelchair "issues" become unbearable "baggage."

This section will address, rather candidly, the different dynamics in terms of sex-life for people who use wheelchairs. I would venture to guess that a significant number of people who click on this section are looking for the "sex" discussion, first and foremost. It is true that "sex sells." It's common for people to be anxious or eager (by the way, those two words are often misunderstood to be interchangeable -- see guy's website it's really good) about human sexuality. But the personal relationship component should be addressed first, because it is most important for healthy, lasting relationships that happen to be sexual. And, guys, it is much more attractive (and sexy) to women if you focus on their brains before their bodies.

The first thing to realize for all personal relationships, is that they consist of give-and-take. Depending on the level of your disability, it is sometimes easy to become more of a "taker." Wheelchair folks may need more in terms of assistance, patience, or understanding. But we cannot allow it to become a one-way street. It is understandable, but not good, when 'wheelers' adopt a victim mentality, become self-centered, or get caught in believing that they need help with everything, and therefore are not paying attention to the "giving" part. But it is a self-destructive trap. Even the most disabled people need to figure out a way to contribute, a way to “bring something to the table," a way to give back to the relationship. Sure, there are people who feel satisfaction and pleasure in providing for others. But no one can continue to give, long-term, without getting something in return (at least close to the level they give).

For some people a wheelchair is a stigma. Sometimes even people in wheelchairs see their own chairs as a stigma. When other people see the chair as a stigma it basically stems from unfamiliarity, and/or preconceived notions of inadequacy. We can dispel notions of incompetence and remove social awkwardness by taking the lead ourselves. Strength and power come in many forms, physical muscular strength is just one (and, frankly, the least sophisticated). If we know in our own mind that we are a whole person, who just happens to be inconvenienced by a wheelchair, and we go about our life exuding the characteristics of a  "normal" strong individual, people eventually see us as people, not as a "disabledf people."

But if we dwell on the fact that there are some things we cannot do, or we take a "confined to a wheelchair" attitude, people think of us as disabled first, and they define us that way in their minds. We cannot let that happen. The best compliment I can get is when people tell me they sometimes forget that I'm paralyzed. Of course, when people describe us, they will say he/she is in a wheelchair. That's because it is the most distinguishing feature; the most uncommon (just like if someone has pink hair, you wouldn’t say, "You'll recognize her, she has blue eyes."). I don't define myself that way either. But sometimes, when planning to meet someone who has no idea that I use one, I just say, "I use a wheelchair."

The point is, if, in your relationships, you don't dwell on the fact that you're in a wheelchair, it can become a non-issue. If you expect people to treat you the same way they would treat anyone else, and you act accordingly, the stigma goes away. You can't be a 'handicapped whiner' or 'woe is me,' gloom and doom-type person, if you want to be treated "normally." That being said, there are some people who are not as 'evolved,' and may never be able to get past the wheelchair. Chances are, we don't want to waste time in relationship with those Neanderthalish folks anyway. They have their own issues to overcome.

For familial and friendship relationships, there is a certain degree of understanding that is required of the able-bodied people. It is a fact of life that people who use wheelchairs to get around, generally need to do more planning and preparation than able-bodied folks. We have to consider transportation options, accessibility of locations, diet, bowel and bladder issues, and for some, we need to plan for assistance. We also need to be aware of temperature conditions, skin integrity, and backup plans in case of mishaps. Wheelchair veterans are keenly aware of these different conditions. But it's not reasonable to expect most people around us to understand all the considerations we face. The longer they are around, family, friends, and lovers begin to appreciate, to some degree, our unique circumstances. But even they can get caught up in living their own lives, and not pay attention to the additional considerations we face. Most often the factors are not overly burdensome, they are just unique. Good communication skills can go a long way toward avoiding misunderstandings and problems.

If we remember that able-bodied folks sometimes need to be reminded of our slightly different protocol (especially if we are successful in not allowing people to primarily think of us as "disabled"), things will generally go more smoothly. We don't have to be tremendously detailed, and we need to take care not to come across 'whiny.' For instance, if we're making plans to do something with someone, it may help to simply say something like, "I just need to know if you are 'in,' so I can make the appropriate plans."

Generally, most people are happy to provide us with a little assistance, and/or accommodate our particular needs. That is, until we start to expect that they do so, without being polite or appreciative. Even close friends and family who are very familiar with our situation, may want to be asked for something they know we need (I learned this the hard way). It's just normal human relationship dynamics that people want to feel appreciated. A simple, genuine "please" and "thank you" goes a long way.

Support
We all need support systems. Whether it is friends, family, church, a support group, or something else, we need someone we can talk to when we need to be energized or revitalized. Someone to turn to when things aren't going so well (it doesn't even have to be terribly bad). Just someone we can count on. It can be different people to provide different support, for different things. But we do well to identify the people in our lives we can trust, and whose input we value. Be careful not to pick 'enablers' to be part of your support system. We may also be part of their support system. Or we may be someone else's. We shouldn't burden our support with trivial things, or burn them out with too much drama. Our support systems can serve as a bit of a compass, to keep us headed in the right direction. They can be sources of information, moral support, or simply an ear to listen. There are various disability support groups, both online and local. There are online forums that can provide some support as well. See the Wheelchair LIFE section on Resources. Be very careful, however, not to base relationships on a negative. If the basis of a friendship is only commiserating, that friendship won't be very healthy, and it may contribute to feelings of victimhood because you may tend to focus on negativity in order to maintain the relationship.

Intimacy
When looking for a soulmate, life partner, lover, or whatever we want to call it, I would venture to guess that very few people, if any, would honestly say that one of the characteristics they seek is a wheelchair (although, I ran across matchmaking and dating sites especially for the disabled. I don't use them, but apparently they're out there. Click here, and here). I say, tongue-in-cheek, "No one is looking for a good quad" [this realization makes me smile]. But that doesn't mean a quad, a para, someone with MS, polio, or  other disability can't be someone's perfect match. A pretty lady I used to date once told me, "You are everything I'm looking for in a man ... except for the wheelchair." It struck me as a little bit odd, but I still took it as a compliment. And that’s exactly what she was thinking, so she was just being honest. She wanted to get married, but I didn't find her compatible, though I really wanted to ... she was very attractive, and also very ... well, you know (so I could only date her a few months).

The trick is that we have to let (or make) our personalities transcend our wheelchairs. Yes, physical appearance (including one's body) are important attractors. But it's what's inside that is most important, and is the thing with which people fall in love ("lust" is a different story).

As a general rule, women are less hung up on looks than men are. Okay, that's not true for every woman, and everyone is driven by appearance to different degrees. But this is a general rule (well, more like a guideline than a rule). The key is to be comfortable in your own skin. It took me a while to realize that women could be attracted to me even though I don't have my former, rugby-player body. I put too much importance on body image. Of course there are some people who cannot get past the wheelchair issue. But that's okay, there are many who can. It just reduces the number of "potentials."

The last thing you ever want to do is "settle" for someone because you think the wheelchair makes you not a good catch. That's a dangerous trap. A self-fulfilling prophecy that is bound to result in your being miserable because you ended up with the wrong person. Sure, I don't have the macho protector thing, but I more than make up for it in other powerful ways. The worst thing you can do is act out of desperation. Desperate people repel the opposite sex (at least the healthy ones). Be confident and selective. And be patient. It's better to be lonely than miserable.

Sexuality
Now, some might say that a disabled man or woman cannot function sexually in order to sustain an intimate relationship. To the contrary. Your sexual performance and your sexual experience can be as good as, and even better than, that of an able-bodied person (this is the point at which my mother, my niece, and my sisters should stop reading, and go on to another section).

I don't need to get too graphic here, but when I lost feeling below my waist I learned some tricks that result in far more satisfaction for the ladies I've been with, than when I was focused on my own body. Let's just say that there is a whole lot that can be done with other parts of the body. And when you can't use your hands very well, you're basically forced to learn new things. I can honestly say that I'm a far better partner now than before I broke my neck (No, I don’t want to meet your "friend," sorry, I do fine on my own).

When one cannot feel one's own genitals, one's center of focus naturally shifts. Even the most selfless partner is trying to achieve something for themselves during sex. For people with spinal cord injuries, the goal becomes better performance for our partner. It is actually a fortunate enlightenment that is a byproduct of an otherwise unfortunate situation. My greatest sexual satisfaction is truly pleasing my partner. It helps my partner to hear that she is satisfying me by being truly satisfied, even though I can't feel orgasms the same way I used to.

Throughout this website (and my life) I try to stress that people need to dwell on the positives rather than the negatives. The same goes for lovemaking. If you or your partner are unable to achieve firm, sustained erections or vaginal/clitoral sensation, then focus on satisfaction through other means. Far too often, men can become penis-centered. That actually deprives them and their partner of a heightened, more satisfying sexual experience (paralyzed and able-bodied alike).

Exploration of both partners' erogenous zones, and communication (verbal and nonverbal) about what feels good and what is satisfying, can lead to far deeper and more meaningful lovemaking. Take your time. Realize that paralysis will necessitate some different methods, positions, and considerations, which may take some getting used to. But understand that once both partners are comfortable, the sharing and the mutual stimulation (of perhaps new areas, and perhaps in new ways) can be wildly exciting, and profoundly satisfying. People are always looking for some variety to keep their sex lives exciting. What could be more varied than sex with a person inconvenienced by a wheelchair? You see, it is possible to find the positives in just about every situation.

Notwithstanding the above, there are some things that can help erections in spinal cord injured men. Talk to your doctor about Viagra,® Cialis,® and Levitra.® You may also want to look into Ferticare®, an adjustable-amplitude, battery-powered medical vibrator that is approved by the FDA, and has undergone clinical trials for men with spinal cord injuries (the sellers indicate it can also treat women with sexual dysfunction or incontinence). The device (pictured left) costs $795, and requires a prescription. The following findings from clinical trials published in The Journal of Urology appear on the Internet here, and on a web site selling the Ferticare medical vibrator, here.

Significantly more patients ejaculated using high (54.5%) versus low (39.9%) amplitude stimulation. Using either amplitude the ejaculatory success rate was highest in men with injuries at C3 to C7, followed by T1 to T5, T6 to T10 and T11 to L3. While high amplitude stimulation increased the ejaculatory success rate in each group, the highest rate occurred in men with injuries at C3 to C7 (65.6%). Ejaculation was reliable, since most men who ejaculated did so during 100% of the trials and within 2 minutes of stimulation onset. Symptoms of autonomic dysreflexia were safely managed with nifedipine. All patients who ejaculated produced antegrade specimens. With the exception of ejaculate volume, which was significantly higher with high versus low amplitude stimulation, semen parameters were similar using both vibrator amplitudes.

Conclusions
Ejaculatory success is better while semen quality is similar using high versus low amplitude penile vibratory stimulation in men with spinal cord injury. This method may be considered first line treatment for anejaculation in men with spinal cord injury. This method may be relative effectiveness, and relatively low investment of time and money.

So, this is even more good news. If you and/or your partner have learned the benefits of not being penis-centered, but can also achieve firm, sustained erections and ejaculations, you can have the best of both worlds.

Just remember, sex and intimate relations, like life, do not end because you are in a wheelchair ... they just change.
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