Veterans Administration (VA) Benefits
The VA offers both health care and disability help to veterans who qualify. Although all service-connected disabilities are covered by the VA, RA generally does not qualify as a service-connected disability, and so eligibility for treatment of RA would depend on other criteria such as your income and ability to pay. The benefit specialist at the local VA center can assist you by outlining the options available to you. If you are a veteran, find out what benefits you are eligible to receive.

Income Taxes
Having RA can be quite expensive. For tax purposes, the question is whether your expenses in any one year are high enough to be tax deductible. Generally, health care costs are only deductible when they reach extremely high levels – currently, more than 7.5 percent of your gross income. If you spend a large amount of money for health care, however, you may be able to get some assistance in the form of a tax break.
If your health care expenses are high but not high enough to be deductible on your income taxes, there may be other options. Many corporations offer a cafeteria I flexible benefits program which allows you to use pretax dollars to pay for your health costs. In this way, you do not pay income taxes on income that you spend on health care. Find out whether this program is available where you or your spouse works. If not, you may be able to promote some interest in the program in the personnel or human resources department. Meanwhile, save all of your receipts for any expenses that relate to your RA, including home modifications or special expenses that are a result of your arthritic condition. Ask your tax advisor for more information.
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Long before Pat had the hysterectomy that she believes ruined her sex life, and long before Ed lost all sexual desire for her because she no longer turned heads, their marriage had plenty of conflict in it. From the outset, Ed, whose narcissistic personality traits included needing to have his self-worth constantly confirmed by other people’s respect, admiration, and praise, was capable only of taking from Pat, who periodically got tired of doing all the giving when she was getting very little in return. “Oh, we had a great house,” she said, “nice cars. He would buy me clothes and jewelry and he did take me out a lot, to dinner, to social functions for his company, things like that. He treated me well in that way, but I always felt like a ‘Stepford wife,’ you know, a little robot replica of a wife who did everything her husband wanted but wasn’t supposed to have needs or a mind of her own.”
For instance, Ed was very “particular” and demanding about everything from Pat’s housekeeping to her hairstyle. “I don’t think he means to be cruel or unreasonable,” she commented. “He’s just very appearance-conscious. He has certain ideas about how his children and his wife are supposed to look and act, especially in public. He wants everything to appear perfect, including me. We all try to please him, but sometimes he just goes too far.”
According to Pat, asking Ed to change his behavior or lower his expectations was pointless. Consequently, from the start, whenever Ed became overly demanding, cruel, or insensitive, Pat, who knew that having sex with her “boosted Ed’s ego,” started withholding sex. “I just said no,” she recalled. “And-1 kept on saying no until he started showing me a litde more respect and affection.”
In this way, Pat not only punished Ed for behavior she found unacceptable, but also made an attempt to balance the give/get tally sheet in a relationship where she did most of the giving. Since Ed was basically incapable of giving, the only way Pat could achieve a balance was to not give Ed something that he wanted—sex.
Withholding sex is one way less “powerful” partners, like Pat, can exercise some power in their relationships. Through actions rather than words, they say, “Well, maybe you do make decisions without consulting me. Maybe you do constantly put me down and pay more attention to your career than you do to me and expect me to drop everything to meet your needs, but you do not have all of the power in this relationship. When you want to have sex, it’s my turn to call the shots. In the bedroom, I have something you want, but you can’t have it until I’m ready to give it to you.”
What’s more, even if you do periodically give in to your higher-desire partner’s pressure and have sex, if you haVe ISD, you still have an ace up your sleeve. As Pat put it, “Sometimes, Ed can get me to have sex, but he can’t make me want it or like it.”
Higher-drive partners can also use sex as a weapon or means of expressing anger, such as when they initiate sex even though they know their partners aren’t interested. In doing so they may be disappointed, but also feel somewhat self-righteous. Meanwhile, because the higher-drive partner is using sexual advances as a weapon of humiliation, the other partner may feel sexually inadequate.
Unfortunately, while sexual withdrawal and sexual humiliation are powerful weapons and a way of evening the score, using them does not resolve the underlying problem. In fact, it usually only makes the problem worse.
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Acupuncture is a traditional treatment that has been used in Asia for more than 2,000 years. Researchers have conducted a few double-blind placebo-controlled trials on the use of acupuncture to treat osteoarthritis, and two of these were reviewed in an article in the Annals of Internal Medicine. Neither study, however, is evidence that acupuncture is effective.
One double-blind trial observed 40 participants with osteoarthritis. The active treatment group received acupuncture at traditional points. The placebo treatment consisted of inserting needles at random points. Treatment was done once a week for 8 weeks. Two physicians who did not know which participants had received which treatments evaluated the results.
Both groups improved to some extent, as would be expected due to the placebo effect. However, the results did not show any difference in outcome between the real acupuncture and the fake acupuncture groups.
Another study compared acupuncture with no treatment. Two groups of 16 participants each received either 20 minutes of acupuncture twice a week for 3 weeks, or no treatment at all. Everyone was evaluated after 9 weeks. Those receiving treatment reported a 23% decrease in pain, compared to a 12% worsening of pain in the untreated group. While this is a very significant result, it is impossible to tell if acupuncture was really beneficial on its own, or if the improvement was a placebo effect from having needles inserted, or simply from receiving attention.
One problem with acupuncture studies is that most of them tend to use a predetermined set of points for the treatment of all participants. True acupuncture, however, is much more sophisticated and individualized to the symptoms of each individual. For this reason, such limited studies cannot fully assess the power of this traditional art.
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Quite early on, children work out that people come in two different varieties: boys and girls.

Ask a small child what makes boys different from girls, and most of them will tell you, ‘Boys have a penis and girls have a vagina.’ Not a bad start. The problem is that the anatomy lesson usually stops there. ‘Penis’ becomes a useful expression to mean ‘the thing that makes a bump in a boy’s swimsuit’ … no mention of scrotum, testes or epididymis.

‘Vagina’ ends up meaning anything covered by a girl’s underpants, or just ‘not a penis’. How many parents, at any time, have sat down and told their daughters exactly what a vagina or a vulva is; that they also have a clitoris, labia, a uterus and so on? This explains why so many boys and girls grow up without even having words to describe their body parts, because no one has ever talked about them. If that is the case, they certainly have not been encouraged to investigate for themselves either. It is not uncommon for a girl in her teens to find out for the first time that the vagina actually goes somewhere, when she tries to work out what to do with a tampon.

There was a great uproar after I presented a segment on television showing on a live model (in close up) exactly where the clitoris is, and explaining how it works. A few days later I was interviewed by a popular talk-show host in front of a live audience of predominantly middle-aged women. He questioned the need for the live model. I explained that for many people, diagrams were like reading a road map. It doesn’t give you a great idea of the landscape. I spent years learning anatomy from atlases in books and from cadaver specimens. It wasn’t until I got into an operating theatre and saw the real thing that it all made sense. Traditional sex education has relied too heavily on the imagination of its target audience. Too much gets lost in the translation. The host also questioned whether the segment we had shown was valid at all, saying that at least half of the viewing audience out there would know all about the clitoris anyway. He was genuinely astonished by the reaction from the studio audience. That reaction was spontaneous and almost unanimous. A murmur of ‘No we don’t!’ rippled through the group.

This whole incident just goes to show how easy it is to assume that, where sex is concerned, just because someone doesn’t ask doesn’t mean they aren’t interested.

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Our first awareness of the pleasure of touch comes moments after we are pushed from the womb and placed at our mother’s breast. Tiny fumbling fingers explore its fullness and softness and our first experience of sensual pleasure is linked to our very survival. We can see the primitive power of physical contact in the way a crying baby settles when held and gently rocked. And so we are set on our journey of life, and the many landmarks we pass from that moment on will lead us to happiness and fulfillment or guilt and confusion.

In infancy and childhood, we’re busy little bodies, climbing trees, riding bikes, rollerskating, learning to swim and children’s minds are as adventurous as their bodies. They are naturally curious about everything in their world. From the time they start to talk they start asking questions. By the time they get to four or five, the questions can start to get a bit curly, and the way we respond to those questions will have a big impact on the way they see the world. If we have never talked openly with our own parents or peers, a child’s questions about sex can really rattle us.

Where small children are concerned, what we mean when we say ‘sex education’ is really ‘preparation for sharing your life with people you care about’. The early observations a child makes about sexual closeness are the ones that some people lose sight of, or take for granted later on, and others never attain. Qualities like intimacy, playfulness, a sense of humor, respecting your partner’s opinions and autonomy, not stifling their independence … these form the true framework of mature and complete relationships.

Learning about sex is a lifelong process rather than a single event, and it is so vital to our emotional development. We say that in today’s world, because of AIDS, knowledge about sex is more important than ever. No more important I would have thought than when syphilis was rife before the days of antibiotics. As a diagnosis, it was just as devastating. The STD clinics were just as busy in the 1930s as they are today, and history is littered with the early deaths of some of the human race’s most talented people, victims of sexual ignorance or disregard of its risks. Yet still we have generations of people whose knowledge of sexuality is sketchy at best, and others who actively seek to keep our future generations in the dark.

I was astonished to hear the spokesperson of one religious group announcing on national television that the only thing young people needed to be told was to say ‘No’ until they are married, as if that were the solution. Reminds me of an ostrich sticking its head in the sand. The reality is that children need a lot of information before they get to the age of experimentation, but it needs to be given in bite-sized chunks; a comment here, a comment there … not one big ‘talk’ at the first sign of underarm hair.

But the earliest messages children get about their sexuality don’t need words at all. The way we handle sexual situations tells a child a lot about a parent’s attitudes.

What do you do when a four year old bounces into the bedroom when you and your partner are in the middle of a Sunday morning quickie? Do you utter some expletive and tell them to go out of the room? Do you stop and smile and say you are having a nice cuddle, and did they have a good sleep? How do you reply to a child who asks you in the middle of a crowded pharmacy why you bought colored condoms? It’s not so easy to plan your reactions to situations like this.

Many people tell me they never saw their parents show any signs of physical affection towards each other. No kisses goodbye, no hugs in front of the television. Seeing the way parents interact with each other is the most powerful influence. Do they listen to each other, do they really communicate? Do they show affection and mutual respect, or is there a power play with one parent constantly bullying the other? Some people tell me they remember, as children, how their fathers would criticize their mothers, denigrating their opinions or mocking their part-time jobs. Others tell me that they remember their mother calling their father a drunk, or a wimp, or a loser because his job wasn’t as good as she would have liked.

Introducing children to sexuality is quite involuntary. They watch and listen and react, and they learn from all they see. Sex education is as much about living as it is about loving.

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If you suspect that something like a piece of dirt or an insect has entered your child’s eye, try washing out the eye first by rinsing it thoroughly with water. With your child lying down, hold a cup filled with water just above the eye and pour it into the eye. Repeat this for several minutes, and encourage your child to blink a lot while you are doing it. Examine the eye carefully to see if the object has been dislodged, checking inside both upper and lower lids. If you can still see the object try to remove it very carefully with a moistened cotton swab. If unsuccessful after a couple of tries, cover the eye with a gauze pad and see your doctor immediately. If you cannot see anything in the eye, but your child still complains that there is something in it, see your doctor.

Splinters of glass or metal in the eye require first aid and immediate medical attention.

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In school they taught us to always have contraception available. They said you could end up pregnant if you start kissing and stuff and don’t have protection.

FIFTEEN-YEAR-OLD BOY

Being old enough to have sex means being old enough to be totally! responsible for yourself and your behaviors. That includes not having children if you don’t want or can’t handle them. If you are not ready for children, you are not ready for intercourse. But don’t think that just because you kiss and are feeling romantic that you should! automatically think of intercourse and contraception. I tell all of the young people I talk to that they should not have intercourse until they are married. Plain and simple, just don’t do it. Touch, hold kiss, and love, but no intercourse. If you have learned a lot about contraception, you are really far ahead because that’s very important knowledge. If you have learned that you must or almost automatically will have intercourse because you are a sexual person,! you have learned the wrong lesson. Such sex should not mean intercourse. No matter what you hear, self-control is just as important as birth control, and contraception never replaces self- and partner responsibility. Saying no is an excellent contraceptive.

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I used to be so stiff, like a stick. Now I’m sort of stiff and sort of limp, too. I’m not hard like I used to be.

HUSBAND

If there is one Mr. Myth that has caused more trouble for men and women than any other, it may be the myth that an immediate, long-lasting erection is the key to sexual fulfillment. Men have lied about their erections, worried about them, exaggerated about them, made jokes about them, mocked other men about them, celebrated and magnified them in all forms of art, and given them all types of names.

The medical establishment has accepted this orientation. New implants are now available. There is now an injection that causes temporary erection. Firm penises are becoming a major industry. Urologists who once ignored or dismissed the sexual concerns of their male patients now find it financially wise to keep up to date on keeping men up.

The penis is more sensitive when it is flaccid. Erections were designed in our evolution to allow for quick and easy insertion of the penis for conception, not for pleasure. The blood that engorges the penis to firm it also renders it somewhat less generally sensitive except in certain specific areas. Erections are actually only neurological reflexes that have little to do with complete sexual fulfillment. They have little to do with fertility, with psychasm, or even with all types of orgasm. Our attitudes about erection have become more rigid than the organ itself can ever be.

Erections do not signal arousal or interest and can be present when there is no sexual interest at all. Erections are reflexes, not only to our thoughts and feelings, but also to aggression and even bladder pressure

Men who fail to have “erections” are sometimes called “impotent.” A diabetic man came to me, stating, “I have absolutely no erection. Well, maybe just a little, but nothing to write home about. My doctor wants me to have special tubes put in or maybe a harness-type thing to hold it up.” Following several weeks of counseling with his wife present (the wife had never been consulted by the physician), he stated, “Now I don’t know why I was so fixated on that. I’m having more fun than ever.” The wife added, “Me, too. And you know what? You are more erect now.”

“Really?” questioned the husband. “I never really noticed.”

Physicians have believed for years that diabetes, blood pressure medications, and other situations can “destroy sexual response.” This is not true. Many things affect circulation to the penis, but firmness is only one and a relatively insignificant dimension of sexual interaction.

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