I am 75 years old and since having a prostate tumor removed in 2021 I have suffered from erectile dysfunction and incontinence. Nothing has helped. Now I have heard about a treatment called electromagnetic wave therapy. What do you think about it?
Dr. Ellie answers: Unfortunately, incontinence and erectile dysfunction are common risks associated with radical prostate surgery.
While this can often be a life-saving surgery, it is still distressing to suffer these side effects. Typically, the NHS will offer tablets like Viagra for erectile dysfunction. Sometimes patients are offered a vacuum pump, a device that helps maintain an erection.
Unfortunately, incontinence and erectile dysfunction are common risks associated with radical prostate surgery, writes Dr. Ellie.
Low-intensity electromagnetic shock wave therapy is a relatively new form of treatment. It involves directing energy waves to the penis over several sessions.
The treatment has long been used for kidney stones, but there is growing evidence that it helps increase blood flow to the penis and may even improve some nerve functions.
This is encouraging because, unlike Viagra or a vacuum pump, it actually treats the underlying problems rather than creating a temporary erection. There is also some evidence that it also helps with incontinence.
However, it is still considered an experimental treatment and is therefore not yet offered on the NHS for erectile dysfunction.
Patients may be able to take part in an NHS research trial; It would be worth talking to a urologist about this possibility. Some private clinics also offer it, but at high prices and with no guarantee of success.
My daughter is in terrible pain due to folliculitis, a skin disease on the neck and scalp. He has been given antibiotics, steroids and painkillers, but nothing has worked for a long time. What should she do?
When normally effective treatments do nothing to combat a disease, then the diagnosis may be incorrect, writes Dr. Ellie.
Dr. Ellie answers: When normally effective treatments do nothing to combat a condition, then the diagnosis may be incorrect.
Folliculitis is an infection of the hair follicles which then become inflamed and can form hard spots that are extremely painful. In some cases, these spots can clump together, creating a large, painful mass called a carbuncle. However, even the most severe cases of folliculitis usually respond to antibiotics.
If the infection does not respond to medications, a sample should be taken from the area and tested to ensure that the correct antibiotic is being used.
This swab would also detect another possible trigger for these symptoms: a bacterial infection called staphylococcus PVL. It tends to not respond to normal antibiotics and would require specialized care from a microbiologist.
Another cause may be that the skin has too many bacteria in general, known as staph colonization, which means that infections keep coming back.
If suspected, a doctor may prescribe a long-term treatment called decolonization, which involves regularly applying an antiseptic body wash and shampoo to remove bacteria from the skin.
Another possible cause of the rash is the inflammatory condition psoriasis, which causes red, raised, itchy patches on the skin; The scalp is one of the most common areas where it occurs. Treatment includes steroid cream and immune-suppressing injections.
My 94-year-old mother has excess phlegm that makes it difficult for her to eat. He was prescribed carbocisteine but it hasn’t had much effect. Now he seems to be losing weight. The problem began after she was hospitalized with pneumonia earlier this year. What do you think could be the cause?
Dr. Ellie answers: Weight loss in an older person should always be investigated by a doctor, as it may be caused by cancer. A small weight loss is expected in the future, due to a reduction in muscle mass, but if it is noticeable or continuous, it is necessary to inform a doctor.
Overproduction of phlegm can be caused by chronic bronchitis, an inflammation of the airways. This can be caused by smoking, as well as inhaling fumes or pollution. A bout of pneumonia can also make it worse.
Carbocisteine is an effective treatment for reducing phlegm, but if the underlying cause is bronchitis, it is usually given in combination with inhalers to combat inflammation in the lungs.
A less common cause of excess phlegm is a condition called bronchiectasis, which occurs when the airways in the lungs widen, making them more vulnerable to infections. This can occur after an attack of pneumonia, but bronchiectasis would only be detected by a CT scan in hospital.
Excess phlegm can also be caused by heartburn, also known as acid reflux. This occurs when acid regurgitates from the stomach, inflaming the throat.
One way to find out if this is the trigger would be to try purchasing a simple over-the-counter heartburn medication, such as Gaviscon.
In my practice we seem to face an almost endless shortage of medications, writes Dr. Ellie, particularly eye drops, diabetes medications, antifungal medications and ADHD tablets.
Ignored drug shortages
Are you having trouble getting vitally needed prescription medications? You wouldn’t be alone.
In my practice we seem to be facing an almost endless shortage of medications. More recently we have noticed a lack of eye drops, diabetes medications, antifungal medications and ADHD tablets.
It is incredibly frustrating for patients and takes up valuable time for GP appointments as we have to find alternative options for patients.
That is why I am surprised that the Government has not yet announced any solution to solve this problem at the national level. It’s as if ministers don’t believe it’s really a problem.
Have you had difficulty getting your medications? Has this affected your health? Please write to me and let me know using the email address below.
When the weight loss jab doesn’t help
It seems like every week we hear about a new and surprising way that weight loss jabs will improve the health of the country.
Last week the Government’s ambitious plan was to use the jabs (Ozempic and Wegovy) to help obese people get back to work.
However, I am struck by the fact that there is a group of patients who do not seem to derive any benefit from these medications: those with lipoedema, a weight-related disease. It causes an abnormal accumulation of fat in the legs and arms, it can be painful and makes daily activities difficult. It is also more common in women.
However, to date there are no drugs that can effectively treat lipedema. And we’re still not sure what causes it.
I recently saw a patient who was really struggling and she was shocked to discover that these weight loss medications, despite all their benefits, couldn’t help her.
Has the lack of treatments for lipedema affected you? Please let me know.
