Over 1.5 million Americans use wheelchairs for a variety of causes: a congenital condition, traumatic injury, or disease. People who depend upon wheelchairs for mobility are in varied situations. They might live independently or need attendant care; live alone or with family; be employed full-time or no longer working. Despite differences, people dependent on wheelchairs face some similar medical issues and a need to cope with changed circumstances. "Life on Wheels: For the Active Wheelchair User is for people who want to take charge of their own life experience while using a wheelchair. Author Gary Karp, ergonomics consultant and long-time chair user, describes: Medical issues (paralysis, circulation, rehab experience, choosing the optimal wheelchair, scientific progress toward a cure) Day-to-day living (keeping fit, skin care, bowel and bladder care, sexuality, home access, maintaining a wheelchair, wheeling technique, insurance) Psychological and social issues (grieving loss, self-image, adjustment to life change, friends, family, asking for and being helped, cultural attitudes, history of disability, and activism)