Never Say Never
The case of the month is an actual patient of The Turek Clinic. This month, we present the 2012 Case of the Year.
Life on Wheels
Mark is 45 years old and wants to start a family. He is an attorney who works as a public defender and is the absolute nicest guy you will ever meet. He is graced with incisive wit and a fabulously positive attitude toward life. Mia, his wife, is an adorable and caring partner who is 31 years old. Mark has had serious trouble getting erections ever since he was 15 years old, about the time when most teens have them every 20 minutes regardless of what they are doing. This, and the fact that he is unable to ejaculate, is the reason that they are seeing me for infertility.
Not at all a complainer, Mark has a lot be thankful for given that he was involved in a serious car accident as a teenager and survived. To him, the wheelchair is only a minor inconvenience; it is the wide smile on his face that truly symbolic of his outlook on life. But, breaking your neck can have a serious impact on fertility.
Fertility in spinal cord injured patients is a special challenge. The good news is that, like a sneeze, ejaculation is a spinal reflex that can be stimulated in almost all men. However, stimulating this reflex can critically raise the blood pressure of men paralyzed from the neck down, even to the point of having a stroke. Carefully, using some pretty impressive equipment at my disposal, we induced ejaculation in the office in controlled setting with medication to inhibit spikes in blood pressure. It went swimmingly. In Mark’s world in which even the most basic activities of daily living take four times longer than normal, having kids had just become that much simpler.
I called him up the next day and said: “Based on your great response to what we did in the office, I can teach you to collect a semen sample at home. Along with a home insemination kit, you should be able to conceive on your own.”
Nature Knows Best
Just what they wanted to hear. No fancy IVF, no office inseminations, no doctors passing judgment. Just a little well-placed training to be able to conceive in the privacy of their own humble abode. Filled with hope and purpose, they said “Thanks, doctor!” and began planning their family like anyone else.
One year later, without a peep before that, I received a photo of Mark holding his gorgeous three month old son August in his lap. But this photo wasn’t taken at home. He was in the woods, near a riverbank, camping out, with his wheelchair on gravelly rock and tall pine trees all around him. There they were: a cherubic little boy sitting with his proud, beaming father. Perfect Mark. So, congratulations to Mark and Mia, who with unmatched inspiration, grace and quiet elegance, personify the “never say never” attitude in life.