This week we respond to questions about erectile dysfunction and rib fractures.
Dear HOUSE Calls,
I am a 52-year-old man that has trouble getting an erection. Should I take a medicine like Viagra?
Thank you for asking this sometimes difficult question. It may surprise you to know how often our patients ask about this.
Without knowing more about your problems, it is hard to answer you directly. If you have not seen a doctor about this, that is a critical first step. There are a number of conditions which can cause or contribute to difficulty with erections – diabetes, high cholesterol, depression, and cigarette smoking are some of the most common ones. Also, a number of medicines can cause or contribute to this problem. It is therefore critical that your doctor review your medicine list with you.
It is also important to note that problems achieving and maintaining an erection can come from a complex interplay between the mind and the body. Relationship problems can be an important contributor.
So yes, Viagra, and medicines like it (Cialis and Levitra) can help many men achieve and maintain a satisfying erection. There are some side effects you need to understand. The most important issue that you need to be aware of is that you can’t take these medicines in combination with nitrate medicines often taken for heart disease (like nitroglycerin used for chest pain).
These medicines don’t work for about one third of men, but there are some other options. They are also expensive, and insurance coverage is variable. Bottom line, go talk with your doctor.
Dear HOUSE Calls,
I recently fell and broke a rib. At urgent care they said there was not much to do but wait for it to heal and take ibuprofen. It is killing me and the ibuprofen is not helping. Is there anything else I can do?
Usually with broken bones, a cast stops the fragments from moving and alleviates the pain. We can’t do that with rib fractures. Every time you breathe, the broken ends rub on each other.
Some people get relief by splinting their chest with a pillow when taking a deep breath, coughing, or sneezing. If ibuprofen is not providing any relief, you and your doctor could consider opiate or narcotic pain relievers. These have some down sides, such as sedation, constipation, and addiction.
You also might ask your doctor about Lidoderm patches, applied directly to the painful area. Time will heal this, but it may take several weeks. Good luck.
HOUSE Calls is a weekly column by Dr. Adam Goldstein, Dr. Cristy Page, and Dr. Adam Zolotor on behalf of YOUR HEALTH™ and the UNC Department of Family Medicine.
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