Comprehensive men's sexual health information, tips and news about men's sexual health.

Some people’s idea of really “doing” a jigsaw puzzle is to cover up the picture of the completed puzzle on the front of the box. This adds to the challenge of figuring out which notch fits into which groove, by matching colors, patterns, and shapes. The trial and error needed to arrange the pieces without knowing what the completed picture looks like can be frustrating, but the final feeling is one of triumph.

Much the same process has been going on as you “reemerge” after spinal cord injury. So many pieces to reconnect – and the final picture an unknown. First there was the pre-disability you, then the trauma and its aftermath – hospitalization and (in most cases) rehabilitation – then your return home, perhaps to school or to work, or a new home somewhere else. You resumed the daily rhythm of your life. You began to go out with friends again. Life, with its disability blip, continued.

You are beginning to feel like yourself again. It may have taken one, two, or even five years to arrive at this point. But at last you can say, “I’m back. I’m my old self.” Or, “I’m my new self” – a surprising arrangement of your jigsaw puzzle.

As you begin to feel in control of yourself and your life again, you may be ready to chart where you are and what you’d like to do to make life more complete. Remembering the variety of experiences you have endured, survived, and mastered will give you the sense that “you can do it.” Indeed, as your ability to deal with life and its adversities deepens, you may find a wellspring of strength and confidence for the years ahead. In short, you’ve discovered that life is a journey of “uncovery” and “discovery” – of the world and its possibilities, and of yourself, your talents, and your deepest resources.

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To enable you to obtain a better understanding of the number of calories in many foods and the appropriate portion size, I want you to begin to do the following:

Read Labels

Before purchasing a food or beverage item, it’s very important to read the container label. Start with the number of calories per serving and the total number of servings per container. Multiply these numbers. That represents the total number of calories in the entire container.

Calories per serving x Servings per container = total calories for the entire container

You then need to determine your average portion size. It probably is much, much more than you realize and greater than the serving size described on the label. That “small” bowl of fat-free frozen yogurt you’ve been downing may be more like 450 calories than the 150 calories you thought you were having. To better gauge portion/serving size, purchase a measuring cup, a food scale, and other items that establish portion size. If you go to my web site, www.jimkaras.com, you will find a complete listing of the items I am recommending and can purchase them directly. Here are a few visuals that should help you to begin to gauge portion size:

3 ounces of protein = the size and thickness of the palm of an average hand or the size of a deck of cards

1 ounce of cheese = the size of four dice

1 average-size piece of fruit = the size of a baseball or the size of an average fist

You will also find a complete listing of calorie counts for popular foods on the site as well. Like the food diary, you don’t need to use these for the rest of your life, just long enough to create or improve caloric awareness. Pretty soon determining portion size will become second nature. You’ll quickly get a feel for what four ounces looks like.

As you begin this process, be aware that many of the foods Americans frequently consume are extremely caloric:

Food item Calories

1 ounce of granola 130

1/2 cup of premium ice cream 150-300

1 ounce of mixed nuts 160-180

1 medium-size fig 50

1 medium-size avocado 300

1 cup of guacamole 400

1 ounce of mozzarella cheese 90

1 ounce of Brie cheese 100

1 ounce of American cheese 110

2 tablespoons of peanut butter 190-210

1 tablespoon of mayonnaise 100

1 tablespoon of real salad dressing 45-85

1/2 ounce of croutons (about the size of two dice) 65

Diet Busters

I also want to mention what I refer to as “diet busters”: traditional favorite foods that we may think of as being “healthy,” when in reality they are loaded with calories and fat and can quickly sidetrack a weight-loss program. The list includes:

Food item Calories

Typical restaurant Caesar salad 660

Taco Salad from Taco Bell 850

Deli tuna fish sandwich 750

1 cup of hummus 440

1 ounce of pesto sauce (only 1 ounce) 150

Three-egg omelet with 2 ounces of cheese 600-700

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There are twelve cranial nerves, the nerves that arise from the brain itself, but all the pain impulses in the head are carried by only two of these, the fifth and ninth cranial nerves, which also serve most of the other sensations felt in the head and face. Pain can also be produced by stimulating the tenth and eleventh cranial nerves, as well as nerves coming from the spinal cord in the upper part of the neck; this pain is felt at the back and top of the head.

The fifth or trigeminal nerve arises from an area in the upper part of the hind-brain and its control centre (nucleus) lies deep in the spinal cord in the neck. In this part of the nucleus the areas of the face are represented in a concentric way, so that damage to the upper part can cause tingling or loss of sensation round the lips. The main trunk of the nerve splits into three branches in an area of the skull near to the front of the upper part of the jaw bone. The upper branch goes to the area of face above the eye and forehead, the middle branch to the cheek, whilst the lower one goes to the lower jaw. There is, of course, an identical nerve on the other side of the face. When a dentist anaesthetizes half the jaw, it is a branch of this nerve that he is blocking.

Much of the knowledge regarding these pain pathways was ascertained by experiments on volunteers undergoing operations, since such a detailed analysis could not be obtained by work on animals; this speaks volumes for the co-operation and interest of the volunteers. Many of those who suffer from headaches are keenly interested in co-operating in research. The methods employed in these experiments varied, e.g. mild electric shocks and traction, but they were not the sort of stimuli that cause headaches in everyday life.

The sites within the head which give rise to pain are related to blood vessels, and the relationship between these and the structures they supply are of paramount importance.

Blood vessels, especially arteries, have a muscular coat which enables them to change their diameter. These changes both alter the amount of, as well as the resistance to, blood flow. The smallest blood vessels (capillaries) form a network to supply organs with oxygen and nutrients, without which body tissues die. Blood flow to the tissues can also be regulated by opening or closing parts of the capillary system.

Pain due to stretching of blood vessels is the explanation of all vascular headaches, including migraine. The pulsation felt over the temple during an attack is due to dilatation of blood vessels and pressure on an artery, because it prevents or limits pulsations, lessens the pain. This is the way that an ice pack, by producing constriction of blood vessels, relieves an attack.

Before the headache phase of migraine, which is due to widening of blood vessels (vasodilatation) outside the skull, there is a narrowing of blood vessels (vasoconstriction) inside the head. Why this first phase occurs is not known but, during a migrainous attack, there may be a very low cerebral blood flow (similar to that following a stroke caused by blockage of a blood vessel).

The decrease in blood flow to the brain accounts for the visual symptoms and other odd sensations before an attack. During or soon after the decrease of flow in the brain, there is a dilatation of the branches from the extra-cranial carotid artery and this marks the start of the headache. The throbbing pain is made worse by the release of chemical substances (kinins and histamine). Nausea supervenes and this also occurs when the vessels are dilated passively. This simplistic explanation of the sequence of events in a severe attack of migraine gives a picture of the complex changes involved.

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