Even Viagra won’t help me get an erection, help! Dr Zoe Williams answers your health questions
THE Euros, Wimbledon and the Olympics offer a great chance to have fun with mates.
It’s brilliant to see the energy sporting events bring to the country. But there are some hazards I’d like to warn you of.
If you’re having a BBQ, make sure you cook minced meat (such as burgers) all the way through to avoid tummy bugs.
Suncream is easy to forget when it’s cloudy, but the harmful sun’s rays pass through, so SPF is important every day in summer.
When drinking, consider alternating alcohol with soft drinks. Having single spirits with a diet mixer keeps calories down, compared to lager or cider. Four pints can be 1,000 calories. That won’t help your waistline or risk of health conditions such as heart disease, if you make a habit of it.
And, with football particularly, it’s a sad truth that wins and losses can make existing domestic abuse more frequent and severe.
Call the National Domestic Helpline for free and in confidence any time on 0808 200 0247.
Here’s a selection of what readers have asked this week.
Cancer op has ruined sex life
Q) I HAD surgery for colorectal (bowel) cancer in 2015 and I haven’t been able to achieve an erection since.
Viagra doesn’t work and my penis seems to have shrunk. Is there any other treatment I can access? I’m 64. I’ve also been a type 2 diabetic for around five years.
A) This is a really important question that a lot of people struggle with so thank you for being honest enough to write in about it.
Sexual problems are really quite common in people after treatment for colorectal cancer.
Surgery to the bowel or rectum can affect the nerves to the sex organs merely because they’re so close in proximity, so any procedure can cause sexual problems in both men and women.
Men can have problems with getting an erection and being able to ejaculate after surgery and radiotherapy for rectal cancer. You might not be able to get or keep an erection and may have dry orgasms.
Your cancer specialist should be able to talk through treatment options with you, which may include a penile rehabilitation programme that can help maintain blood flow to the penis and reduce damage to the muscle and tissue in the penis. You say Viagra doesn’t work but there are different drugs, such as Cialis, Levitra and Spedra, which can sometimes be prescribed by specialists for problems caused by surgery, like yours.
There’s also a prescription cream called Vitaros which you apply to the opening of the urethra and if it works you can get an erection anywhere from five to 30 minutes after using it.
A gel called Erexon is available to buy without prescription. It can also be applied to the head of the penis and, by stimulating the nerves, could lead to an erection within ten minutes.
There are also prostaglandin injections and vacuum pumps which draw blood into the penis.
There are a lot of options available to help so please don’t suffer in silence – and don’t think you’re alone.
Q) MY 75-year-old husband had a cataract removed from his right eye in January this year and his left eye was done two months later.
At his post-operation appointment he was told he had fluid at the back of both eyes, and his vision, which was crystal clear after the first surgery, had deteriorated.
He’s been referred to hospital for injections as the drops did not work but will this cure the condition and will his vision improve?
A) While cataract surgery has a success rate of around 95 to 98 per cent, as with any procedure there are things that can change after the operation that can have an effect on the outcome.
The central part of the retina at the back of the eye is called the macula.
It’s responsible for lots of fine vision functions like reading, watching TV and recognising faces.
When blood vessels leak into the retina it can cause fluid to gather and accumulate in the macula, which results in a condition called macular oedema.
It can occur on its own completely out of the blue, but it can also occur as a result of cataract surgery.
We know from the statistics taken from successful cataract surgery that macular oedema is rare but it can happen.
The result is blurring of vision and a distortion of vision, which are both classed as deteriorations by consultants, which is what leads me to suspect this may be what your husband is experiencing.
It can be confirmed with an examination using eyedrops to dilate the pupils, and then a slit lamp is used to help look at the very back of the eye where we can see the fluid accumulation if it exists.
Eyedrops are commonly used as a first treatment and, if no improvement is seen, steroid injections may be introduced – either around the eye or into the eye.
Fortunately, a person’s vision usually improves within a small number of months.
Unfortunately, in rare cases, full recovery isn’t achieved even with treatment, but hopefully your husband will be in the majority that do recover.
Coughing up blood as I wait for surgery
Q) I’M a 64-year-old man waiting for a new hip. I’ve been coughing up blood every morning for four months.
I’ve had a chest X-ray, MRI scan and blood tests, and all were clear.
Doctors don’t know why it’s happening. They told me to take two omeprazole tablets instead of one.
Could it be because I’m taking too many tablets?
I’ve been in pain waiting for my hip op and I take two amitriptyline, four tramadol, one atorvastatin and two omeprazole every day.
A) The first thing is to help identify exactly where the blood is coming from.
You say “coughing up”, which suggests it’s coming from your airways, but some people use that term when they’re actually spitting it without a cough. In which case it could be coming from your stomach, food pipe, oral cavity or the back of your nose or throat.
If it’s from your lungs it could be a chest infection, pneumonia, bronchitis, a lung tumour or a blood clot – but you’ve had investigations to fairly confidently rule these diagnoses out.
If it’s coming up from the gastrointestinal tract as reflux or vomit then potential causes include inflammation or ulcers of the stomach or oesophagus. Blood from the nose can travel backwards to the throat during sleep and appear in the spit in the morning and bleeding lesions in the mouth should be identifiable with a thorough oral examination.
In terms of the medication you take, tramadol can very rarely cause someone to bleed from a gastric ulcer, but omeprazole is used to prevent upper gastrointestinal tract bleeding, so is protective.
As a GP, it’s reassuring to me that tests have been done and nothing found.
While I do get the fact that if you don’t have a conclusive answer it can be frustrating as a patient, if we can rule serious things out as medics we’re often quite happy to watch and wait.
It’s worth keeping an eye on and checking in with your GP regularly if anything changes at all, especially if you notice any changes to energy levels, any weight change and any new pains or aches, no matter how trivial they may seem.