sons of viagra

Sons of Viagra

It won’t “get up” or “stay up,” confessed the shifty eyed man refusing to look his doctor in the eye.  His wife was equally uncomfortable, though it was a toss up as to who was more embarrassed, the doctor or the patient! 

 Men seldom discuss personal problems. It requires a great deal of courage for a man to sit face to face with a medical practitioner confess that his “manhood” is malfunctioning, and he has impotence. Fortunately, more couples are now coming out of the closet, and seeking treatment

A single failure is not erectile dysfunction or impotence. It is a medical problem when there is a persistent failure 75% of the time over a period of 3 months.

About 90% of the urban Indian males develop impotence at some time in their lives.

Rather than have this embarrassing problem evaluated, many men visit the friendly neighbourhood pharmacist, who supplies them with OTC (over the counter ) sidenafil citrate  (common trade name—Viagra) at black market rates. Others prefer alternative medicine laced with dangerous high doses of heavy metals with supposed aphrodisiac properties. Some form long lines in front of the paanwala for his overpriced mysterious “break- the- cot” paan.

Sexual dysfunction is a disease like any other. It needs to be scientifically evaluated and diagnosed before embarking on treatment. The cause may be organic or psychological. 

 The organic dysfunction is better, as, once the cause is treated the impotence resolves. It can be caused by uncontrolled diabetes, hypertension, a high cholesterol, low male hormone levels, abnormal genitalia, chronic liver or kidney disease, spinal cord abnormalities disease or degeneration, and as an aftermath of prostate surgery. Sometimes it is an unexplained side effect of certain medications.

Inadequately and improperly controlled diabetes causes a dysfunction of the autonomic nerves. This affects vascular channels all over the body, particularly and obviously in the penis. Attention to the prescribed diet, regular exercise and adherence to the medication prescribed will usually cure the problem. Uncontrolled diabetes also alters the sex hormone ratios, particularly testosterone, affecting both desire and performance.

Smoking is rightly blamed for a host of diseases. Not only is the quality of the semen in the ejaculate poor, leading to sub fertility, the compromised penile blood supply leads to impotence.

High triglycerides block blood vessels reduces blood supply just when it is needed the most.

Removal of the prostrate may damage the nerves, leading to erectile dysfunction. If men take female hormones for cancer, impotence may occur.

Diseases tumours and degeneration of the spinal cord can lead to impotence.

Sex is not a mechanical action. It is a higher function involving the release of chemicals and neurotransmitters from the brain. A loving cooperative partner and expert counselling can produce vast improvement even if there is a disease process affecting function.

Many medications are touted as miracle cures for impotence. Sidenafil releases neurochemical transmitters with cause expand blood vessels. It takes at least 30 minutes to act and the effect lasts only for 4 hours. The environment also has to be conducive ( not while watching comedy shows) otherwise it will not work. Viagra has side effects. It can produce visual disturbances so driving after taking the tablet is not advised. All blood vessels may be uniformly dilated  and this may produce low blood pressure. It interacts with commonly used medications.

 “Sons of Viagra” or superior versions like varderafil and tadalafil are now available. The onset of action is faster, more specific and long lasting (up to 12 hours). This produces spontaneity, and reduces anxiety. That alone may improve performance.

Hormone replacement is indicated for low testosterone levels.

There are other safer lesser known centrally acting apomophine derivatives that can be placed under the tongue, and do not react with other medications or food. Unfortunately they take around 10 minutes to act (during this time speech may be difficult). Also sometimes up to 6 doses are needed before any effect is seen.

For the brave hearted, there are injections into the penis. These are self administered (may turn off the partner) and the technique has to be carefully learnt to prevent infections and local side effects.

Medicated gels can be directly applied inside the urethra but then again the person cannot lie down or sit for 20 minutes.

A specially designed suction apparatus can be used to  produce an erection.

Penile implants made of silicone can be used but are not very popular as the erection is permanent.

Sex involves two people and impotence is a problem involving a couple. It has to be tackled together. Andrologists (urologists with an interest and training) and psychiatrists can often achieve miracles. Amateur treatment or that of a single partner alone is often unsuccessful despite herbal medicines, alternative therapy and “the sons of Viagra.”

help

Sons of Viagra

It won’t “get up” or “stay up,” confessed the shifty eyed man refusing to look his doctor in the eye.  His wife was equally uncomfortable, though it was a toss up as to who was more embarrassed, the doctor or the patient! 

 Men seldom discuss personal problems. It requires a great deal of courage for a man to sit face to face with a medical practitioner confess that his “manhood” is malfunctioning, and he has impotence. Fortunately, more couples are now coming out of the closet, and seeking treatment

A single failure is not erectile dysfunction or impotence. It is a medical problem when there is a persistent failure 75% of the time over a period of 3 months.

About 90% of the urban Indian males develop impotence at some time in their lives.

Rather than have this embarrassing problem evaluated, many men visit the friendly neighbourhood pharmacist, who supplies them with OTC (over the counter ) sidenafil citrate  (common trade name—Viagra) at black market rates. Others prefer alternative medicine laced with dangerous high doses of heavy metals with supposed aphrodisiac properties. Some form long lines in front of the paanwala for his overpriced mysterious “break- the- cot” paan.

Sexual dysfunction is a disease like any other. It needs to be scientifically evaluated and diagnosed before embarking on treatment. The cause may be organic or psychological. 

 The organic dysfunction is better, as, once the cause is treated the impotence resolves. It can be caused by uncontrolled diabetes, hypertension, a high cholesterol, low male hormone levels, abnormal genitalia, chronic liver or kidney disease, spinal cord abnormalities disease or degeneration, and as an aftermath of prostate surgery. Sometimes it is an unexplained side effect of certain medications.

Inadequately and improperly controlled diabetes causes a dysfunction of the autonomic nerves. This affects vascular channels all over the body, particularly and obviously in the penis. Attention to the prescribed diet, regular exercise and adherence to the medication prescribed will usually cure the problem. Uncontrolled diabetes also alters the sex hormone ratios, particularly testosterone, affecting both desire and performance.

Smoking is rightly blamed for a host of diseases. Not only is the quality of the semen in the ejaculate poor, leading to sub fertility, the compromised penile blood supply leads to impotence.

High triglycerides block blood vessels reduces blood supply just when it is needed the most.

Removal of the prostrate may damage the nerves, leading to erectile dysfunction. If men take female hormones for cancer, impotence may occur.

Diseases tumours and degeneration of the spinal cord can lead to impotence.

Sex is not a mechanical action. It is a higher function involving the release of chemicals and neurotransmitters from the brain. A loving cooperative partner and expert counselling can produce vast improvement even if there is a disease process affecting function.

Many medications are touted as miracle cures for impotence. Sidenafil releases neurochemical transmitters with cause expand blood vessels. It takes at least 30 minutes to act and the effect lasts only for 4 hours. The environment also has to be conducive ( not while watching comedy shows) otherwise it will not work. Viagra has side effects. It can produce visual disturbances so driving after taking the tablet is not advised. All blood vessels may be uniformly dilated  and this may produce low blood pressure. It interacts with commonly used medications.

 “Sons of Viagra” or superior versions like varderafil and tadalafil are now available. The onset of action is faster, more specific and long lasting (up to 12 hours). This produces spontaneity, and reduces anxiety. That alone may improve performance.

Hormone replacement is indicated for low testosterone levels.

There are other safer lesser known centrally acting apomophine derivatives that can be placed under the tongue, and do not react with other medications or food. Unfortunately they take around 10 minutes to act (during this time speech may be difficult). Also sometimes up to 6 doses are needed before any effect is seen.

For the brave hearted, there are injections into the penis. These are self administered (may turn off the partner) and the technique has to be carefully learnt to prevent infections and local side effects.

Medicated gels can be directly applied inside the urethra but then again the person cannot lie down or sit for 20 minutes.

A specially designed suction apparatus can be used to  produce an erection.

Penile implants made of silicone can be used but are not very popular as the erection is permanent.

Sex involves two people and impotence is a problem involving a couple. It has to be tackled together. Andrologists (urologists with an interest and training) and psychiatrists can often achieve miracles. Amateur treatment or that of a single partner alone is often unsuccessful despite herbal medicines, alternative therapy and “the sons of Viagra.”

feeding baby

Feeding your baby

Your Health DR GITA MATHAI

I receive a number of letters from anxious parents (usually for their first child) with queries: How do I breast feed? When do I wean? How do I wean? And, the most common of all, why does my child refuse to eat? In the traditional Indian set up, the joint family had many “experienced elders” available 24X7 for advice, support and help. So these queries did not arise. It was not the parents who raised the child, it was the entire village! Fortunately, healthy children are hardy and resilient. They find ways to communicate their needs to the parents even before they can speak. Instinctively, most parents manage to do the right thing. Breast milk is the best for baby and should be continued exclusively as far as possible till the age of four months (120 days). Initially, milk may seem insufficient but with frequent demand feeding, milk production increases and keeps pace with demand. Remember, women successfully breast fed their children from the time they lived in caves! Anxiety, depression and pressure tend to interfere with this natural process. The new mother should get plenty of rest, eat a nutritious diet and take the prescribed iron and calcium supplements. Although four months is the recommended age for starting solids, all children are not ready to start eating at that time. They need to be able to hold their head upright and steady. Feeding solids in the lying down position can lead to choking. Also, babies are born with an extrusion reflex. This is protective, and helps them to push anything that is not liquid out of their mouths. For successful weaning, the nervous system has to mature and this primitive reflex has to disappear. Cereals like rice and wheat cooked fresh at home are preferable to milk biscuits or ready-to-serve commercial infant foods. Cereals can be cooked in milk with some sugar (but no salt) added. The food should be placed on the tongue and not at the lips. It may be discouraging initially as the child may totally reject the feed. Since most of the nutrition at that age comes from breast milk, this is not really cause for concern. The same food should be retried after 3-4 days. At first only one or two spoonfuls may be taken. Every two weeks a new food can be introduced, like boiled carrots or potatoes, mashed bananas. After the child is 6-7 months old, cooked mashed rice and dal can be added to the diet. By the age of one year, the child should be eating everything the family eats. The food, however, should be well mashed and less spicy. After the age of one, tension may gradually build up between the parent and child at feeding time. The child may refuse food, the parent may try to force feed or substitute milk and snacks for food. Anxiety may set in as other children of the same age may appear bigger, stronger and healthier. The rate of growth is dependent on the birth weight. A child growing normally doubles the birth weight at the end of the fifth month and triples it at the end of the first year. This means that the expected weight of a child that is 2kg at birth is 6kg on their first birthday. In sharp contrast is a child who was 3.5kg at birth. The weight on the first birthday should be 10-11kg, almost double the weight of the other baby, who is also growing normally. After the age of two, online calculators can be used to read off ideal body weight. Alternatively, the formula (age+3)x5 gives the weight in pounds. This divided by 2.2 gives the weight in kilos. Children have inbuilt instincts which enable them to regulate their food intake. They may refuse food if they are unwell. They tend to eat when hungry and stop when full. These self regulating instincts can be overridden with repeated force feeding. A pattern of overeating sets in, leading to recalcitrant adult obesity. If a child refuses a certain food, offer it again a few days later. Do not try to bribe the child to eat it or substitute it with unhealthy snacks. A child that has had enough to eat may try to: • Hit the spoon away. • Spit out the food • Turn away its face • Start crying. If this is the case, stop the feeding. Good food habits need to be inculcated from early childhood. Have fixed timings for food and snacks and serve them in the same place. If the child refuses to eat don’t immediately cook something else. That only leads to frustration, exhaustion and more tension. A little starvation never did any harm, and, by the time the next meal or snack time comes around, your child may be ready to eat again! Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in

gambling addiction

An addiction called ludomania Your Health DR GITA MATHAI Everyone likes to get something for nothing. Winning a bet or money at lotto or on a lottery ticket definitely gives a “high”. Most people gamble at least once or twice in a lifetime. For others, gambling becomes their life. They place bets on anything and everything, hoping for a big payout. Betting and gambling are not new. Gambling been around for centuries and seems to have evolved with civilisation. There is, in fact, a poem called Gambler’s lament which was composed in pre-Vedic times. Few people, however, realise that compulsive gambling is an addiction (medically called ludomania), on a par with alcoholism or substance abuse. It is a disease that affects about three per cent of the Indian population, mostly males. Since our population is huge, the numbers of ludomaniacs are unbelievably large — and they come from every strata of society. Ludomania is difficult to diagnose. The affected individual rarely complains as he does not even recognise that there is a problem. There are no external signs or symptoms. It is usually a concerned relative who mentions the compulsion, that too in passing. An addict is preoccupied with thoughts of gambling all the time. If cards or bets cannot be placed, such people gamble on trivia, for example, the number of red cars that will pass in a five-minute interval. The one symptom of a gambling addict is that financial losses cannot stop the person from gambling. A compulsive gambler’s brain has less nor-epinephrine and serotonin than normal. This means they feel lethargic and depressed. These chemicals are secreted under conditions of stress or thrill. When he places bets, there is a rush of these chemicals to the brain. A feeling of invincibility and euphoria set in, similar to the high gained from snorting cocaine. As the chemicals get metabolised and depleted, he gets the urge to gamble again. Once the bio-chemical pathways become well established, the speed at which the metabolism occurs keeps increasing. The person begins to gamble for higher stakes at shorter intervals to experience the same high. Gambling disorders start in the late teenage years. The social environment also contributes to its development. No one wins all the time. As the losses mount up, the addict borrows from loan sharks, steals, lies and pawns jewellery. This may lead to the loss of a job, family or even arrest. Social relationships break down. There may be spouse or child abuse. The depression may drive the person to alcohol and drugs. Eventually, financial stresses and social pressures may drive the person to suicide. About 15 per cent of suicides have a link to gambling. Treatment of compulsive gambling is difficult. First, the addict and his family may not perceive it as a disease. The addict may also be resistant to advice or therapy. Or he may have tried to quit on his own several times. Psychiatrists, psychologists and counsellors are needed to tackle the problem. Frequent sessions are needed to reinforce the skills required to stop gambling. Financial help from family members may be needed to recover from debt. The problem is that once they are financially stable, the gambling may start again. Medication can be used to treat the addiction. Different groups of medication may be needed, depending on the underlying problem. Antidepressants and mood stabilisers may have to be combined with narcotic antagonists. The treatment is similar to that of drug addiction. Gambler’s Anonymous has branches in major cities. This and similar self-help groups help keep the person on the right track. The desire to stop gambling has to come from within. The person has to realise that the odds are so highly stacked against him that it is unlikely he will win “the next time”. It is best to avoid situations, surroundings and friends who may lead to temptation. Avoid Internet gambling sites even to just “look once.” Yoga and meditation provide the mental strength required to overcome temptation. Regular aerobic activity for 40 minutes a day will also release endorphins which elevate mood and provide a natural healthy “high” which can act as an antidote to the desire to gamble. Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in Share on emailShare on printShare on facebookShare on twitterMore Sharing Services

skin care

Skin deep

Your Health DR GITA MATHAI

You will seldom come across a person who is happy in their skin — they don’t like its colour or its texture or its appearance or its tendency to crack in winter and itch in summer. Problem-free skin is a rarity and naturally so. The skin is our largest organ, accounts for 16 per cent of our weight and has a surface area of around two square metres. It’s thickness varies from 0.5mm on the eyelids to 4mm or more on the palms and soles. It also has a rich supply of blood vessels, sweat glands and hair. The entire skin is replaced every 30 days. New cells grow from below while the cells on the surface flake off. This action needs to be a perfectly coordinated. Otherwise unsightly cracks and fissures can appear. If the dysfunction is confined to certain areas, white or reddish scaly lesions may appear in those areas. If skin is damaged, it does not necessarily mean that there is a medical problem. As a person ages, the number of collagen and elastic fibres in the skin decreases and it begins to sag and develop wrinkles. Smoking destroys elastic fibres under the skin, aging it prematurely, as does stress. Many skin problems can be tackled by nourishing, polishing and maintaining it, much like a well-loved pair of shoes. You can apply coconut oil, a combination of equal quantities of coconut and sesame (gingili) oil, or equal quantities of coconut, gingili and olive oil. Japanese women have traditionally applied rice bran oil on their face. This is believed to be one of the reasons that Japanese women have unlined faces, even in old age. It is best to massage babies with coconut oil. Leave it on for at least 10 minutes and then wash off with a mild moisturising soap. Remember, antibacterial soaps are harsh and tend to dry the skin. After the bath, apply baby oil. Adults who are too busy to apply oil before a bath can also use baby oil at night. Commercial moisturising creams are expensive, but they provide the same benefits. The quality of our skin is also influenced by the food we eat. A diet overloaded with processed foods and trans fats makes skin appear oily and unhealthy. Fruits rich in vitamin C — such as guava, orange, papaya and lime — are good for the skin. To enable the skin to produce its own oil, it needs the essential fatty acids — omega-3 and omega-6 — found in fish and sunflower oil. Garlic and onions contain sulphur which helps produce a smooth skin. Nuts contain vitamin E and zinc, essential to maintain and repair the skin. Ideally, an adult who exercises an hour a day should eat at least two portions of fruits and three portions of vegetables (cooked or raw) every day. One portion is equal to two small fruits — such as chikkus or 15 grapes or six lychees — or one medium-sized fruit, such as an apple, a banana or an orange or two slices (about two inches thick) of a mango. It is also important to drink at least two litres of fluid — including tea, coffee or juice — to keep the skin hydrated. Exposure to sunlight can make the skin dry and itchy and it can even develop discoloured patches. It also increases the pigmentation (unacceptable in India) and is one of the risk factors for skin cancer. To protect the skin, try not to go outdoors between 10am and 4pm. If you must, wear loose, light-coloured and long sleeved clothes made of natural fibres and carry an umbrella. Apply sunscreen at least 30 minutes before going out and reapply it if there is sweating as perspiration can wash it off. In most cases your skin will improve within a few weeks of oiling it and eating the correct food. Consult a doctor if there is no improvement, the skin becomes red and scaly, areas are itchy, or raw or there is a discharge. If the skin is persistently dry, a thyroid function test should be done. Shiny stretched skin may be due to underlying fluid retention and swelling. All these need tests and treatment. Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in