Practicing family physicians from the UNC Department of Family Medicine have teamed up with The Carrboro Citizen to bring you a weekly feature responding to your questions about health and medicine. Send your questions or comments to yourhealth@unc.edu
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 raising 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 that 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. 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 nitrates (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.
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, which are applied directly to the painful area. Time will heal this, but it may take several weeks.
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.