Spinal cord injury no bar to intimacy
Medicine: Viagra, Levitra revive sexual joys despite paralysis.

By Tracy Manzer
Staff writer

LONG BEACH -- Described as one of the most devastating events in a person's life, spinal cord injuries are sudden and catastrophic and can transform a strong, healthy person into someone completely helpless.

The lifetime of physical, emotional and economic effects of such trauma has a tremendous impact on the person, his or her career, self-image and personal relationships.

Recent developments in treatment and rehabilitation of spinal cord injuries have made huge progress in lifespans of patients and their ability to function independently. Until the last few decades, most people suffering such injuries did not survive, and if they did, their conditions were considered untreatable.

And until the late 1990s, the inability to enjoy intimate relationships was a fate many paraplegics and quadriplegics were destined to suffer with, often in silence.

Then came Viagra.

Taken every eight seconds in the United States, the erectile dysfunction drug has been used to help the clinically depressed, those with heart disease and diabetes, and prostate cancer patients, to name a few.

It and a new drug on the market Levitra have also seen astounding success in the population with spinal cord injuries. Paraplegic and quadriplegic patients are the fourth-most-likely group to be prescribed either drug.

"It seems to work better with my spinal cord patients than any other population,' said Dr. Barton Wachs, a Long Beach urologist who specializes in erectile dysfunction and who says the medications work with 90 percent of his spinal cord injury patients.

Both drugs work on the same principle. Viagra was first on scene, and because of this, will likely remain the popular favorite, Wachs said.

But Levitra, which last month was cleared by the Federal Drug Administration for widespread use in the United States, still has a large market on which to capitalize.

Wachs had more than 30 spinal cord patients enrolled in the final phase of the clinical study of Levitra, and was the only Southern Californian physician to participate in the extensive study.

Like Viagra, the drug lasts about four hours. Viagra takes about an hour to take effect, Wachs said. Levitra starts working 15 to 20 minutes faster than Viagra and it provides a stronger dose.

For Levitra and Viagra to work, the patient has to have sexual stimulation.

"For some, it's visual, for others it's in the brain,' he said. "Some need physical contact' for the drug to work.

There are a few, rare side effects. Fewer than 30 percent of patients reported getting headaches. An even smaller number complained of facial flushing, Wachs said.

Because there has been no direct study comparing the two drugs, at least not yet, it isn't known if the stronger dose will see better results.

But, "there is virtually no downside,' the physician said from his office on Atlantic Avenue. "Oral treatments are great for all men, but it's especially nice for the spinal cord population.'

That is because 82 percent of spinal cord injuries in the United States occur in men ages 16 to 30. For young men, the issue of intimacy is one that can have a profound and debilitating impact on their quality of life.

It certainly is not an easy problem for 27-year-old Long Beach resident Kevin Conrad to discuss.

Conrad was 23 when he became paralyzed in a hit-and-run accident while riding his motorcycle on the freeway.

More active now than before the crash, Conrad competes in basketball and tennis and surfs. He recently filmed an episode of Fox-TV's "Malcolm in the Middle,' which will air Nov. 16.

But no matter how fit or active he was, enjoying regular intercourse was difficult.

Both drugs work best for patients paralyzed at the 12th thoracic vertebra down, or the lower back. Although Conrad suffered his injuries higher up the spine in his first, second and third thoracic vertebrae he has still had great results with the new medication.

The drug cannot restore sensation to the penis, but Conrad can enjoy physical intimacy and can experience orgasm. While sex does not feel exactly as it did prior to his accident in 1999, Conrad said it is great to just know he can engage in intimacy again.

And although he was somewhat reticent when talking about his personal experience with Levitra, Conrad came alive when asked if any of his friends had expressed interest in the drug since his participation in the trial.

"Oh yeah,' he grinned. "All my friends were coming up to me asking me 'What's that doctor's name? Do you have his phone number?''

He agreed to the interview because he said he felt it was more important to help other spinal cord injury patients realize there is hope.

"Anything I can do to help someone else, I will,' he said. "It's hard to talk about, no one likes to talk about it. But it's important.'

Wachs agreed.

"Most of these guys are young guys. One day they are completely healthy, the next day they find themselves unable to move,' Wachs said. "It has a devastating impact, to feel like you're no longer an independent man. And when you're young, sex is still a very important part of that feeling.'