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Whelehans Health News

Erectile Dysfunction (Part 2) Causes

Posted by Eamonn Brady on

Erectile Dysfunction (ED) is the inability to get and maintain an erection that is sufficient for satisfactory sexual intercourse.

Causes

Causes of ED can be either physical or psychological, or a combination of both. Certain medications, prescribed to treat other conditions can, in some cases, cause ED.

Physical causes

Physical problems leading to ED can be categorised in four ways: -

    • Vasculogenic (vascular caused by reduced blood flow))
    • Neurogenic (nerve related)
    • Hormonal (eg) lack of tesosterone
    • Anatomical (eg) due to shape of penis

 

  1. Vasculogenic (ie) reduced blood flow

Conditions of this type affect the blood flow to the penis (70% of physical related causes). Causes include:

Cardiovascular Disease (CVD) –As the blood vessels in the penis are a lot smaller than the blood vessels elsewhere in the body, they are often affected first. Having ED is often considered an early warning sign for cardiovascular disease.

Diabetes – Over 50% of men with diabetes will suffer from erection problems. This is due to circulation problems caused by diabetes thus reducing blood flow in the penis and nerve damage from prolonged incontrolled high blood glucose which disrupts nerve signals between the brain and penis.

 

High blood pressure – both treated and untreated high blood pressure can be a cause of ED

 

  1. Neurogenic (nerve related)

Conditions of this type relate to the brain and nervous system.

 

Examples include:

Multiple Sclerosis (MS) – a condition of the central nervous system that affects movement. ED is an often an overlooked common complication for MS sufferers.

 

Parkinson’s disease –like MS, sexual and erectile dysfunction is common in men with Parkinson’s. It is a symptom which may appear long before more recognised symptoms of the disease appear (eg.) Tremor, slowdown in movement.

 

Stroke – Whilst stroke in itself is rarely a cause of ED, stress and worry about resuming an active sex life post stroke is more likely to be the cause.

 

  1. Hormonal

The primary hormone related to ED is Testosterone. As men get older, typically, testosterone levels drop. Reduced levels can reduce libido (sex drive), which in turn can have a direct effect on a man’s ability to achieve an erection.

 

Additionally, too much Cortisol produced by stress will also have a diminishing affect of Testosterone levels. Other related examples include thyroid hormone where either too much (hyperthyroidism) or too little (hypothyroidism) is produced. Other ED related hormone imbalances can come from Liver or Kidney disease. Simple blood tests by your GP can diagnose any of these hormone deficientcies and excesses and once diagnosed are easily treated.

 

  1. Anatomical

Referring to the structure and function of the penis itself there are several conditions which can result in ED, two of which include Hypospadias (relates to the abnormal development of the male urethra which is duct where urine and semen is transferred) and Peyronie’s disease (a hard lump develops within the penile tissue due to injury leading to scarring. For more information on these two conditions check out my full ED article at www.whelehans.ie

 

To be continued....next week I discuss diagnosis and treatment

Disclaimer: Please ensure you consult with your healthcare professional before making any changes recommended

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Erectile Dysfunction (Part 1)

Posted by Eamonn Brady on

Erectile Dysfunction (ED) is a common condition which mostly affects older men. ED is age related, with estimates showing that up to 50% of men in the 40 – 70 age range will experience ED to some degree.  Erectile dysfunction (ED) is the inability to get and maintain an erection that is sufficient for satisfactory sexual intercourse. The inability to achieve and maintain an erection caused by an insufficient blood flow to the penis due to narrowing or restriction of blood vessels or damage to nerves that help stimulate blood flow.

If it persists for more than a couple of weeks, a visit to the GP for assessment is essential as the condition can be an indicator of perhaps a more serious underlying health problem (eg. heart disease, diabetes).

Causes

Causes of ED can be either physical or psychological, or a combination of both (as is the case with Diabetes). Certain medications, prescribed to treat other conditions can, in some cases, cause ED.

Psychological Causes

Even men that are “physically healthy” can suffer from ED. When this is the case it is most likely related to a range of negative feelings and emotional issues that are preventing the “trigger” message being sent from the brain when needed. At a higher emotional level, those suffering with depression or anxiety are increasingly likely to experience ED.

 

An erection starts with a message from the brain, however with psychological disorders and general emotional issues, the chemicals in the brain are unbalanced, so, if the right levels of chemicals are not there when the message comes, the result is erectile failure.

 

The causes could include:

  • Self esteem issues
  • Sexual Performance issues
  • Relationship problems or perhaps a new relationship
  • Condition related stress (eg. Diabetes)
  • Past sexual history or relationships,
  • Negative feelings of guilt.

 

Medication related ED

Certain medicines prescribed for a variety of conditions, may cause ED. If concerned or have experienced ED since starting a new medication, check with your GP or pharmacist whether it is a possible cause. In most cases there will be suitable alternatives. Do not stop taking prescribed medication unless your GP or other doctor advises to do so.

 

Medicines types that can cause ED include: -

  • Diuretics (to reduce fluid in heart conditions and reduce high blood pressure)
  • Anti- Hypertensives (to reduce blood pressure)
  • Fibrates (for cholesterol; statins are more commonly used nowadays)
  • Anti-psychotics (used to treat mental health conditions, such as schizophrenia and bi-polar disorder (eg. Risperidone)
  • Anti-depressants (more common with the older types less commonly used nowadays)
  • Corticosteroids (used to control inflammatory conditions such as rheumatoid arthritis, bronchitis)
  • H2 – Antagonists (reduces stomach acid for likes of heartburn; newer PPIs types are used more nowadays)
  • Anti- Convulsants (for epilepsy)
  • Anti – Histamines (for allergies)
  • Anti-Androgens (for hormone disorders)
  • Cytotoxics (chemotherapy medication used to kill cancer cells)

 

It is important to note the ED is a rare side effect with most of these medicines.

To be continued.. causes and diagnosis next week

 

Disclaimer: Please ensure you consult with your healthcare professional before making any changes recommended

For comprehensive and free health advice and information call in to Whelehans, log on to www.whelehans.ie or dial 04493 34591.

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Some light at the end of the tunnel at Midlands Rheumatoid Arthritis Event

Posted by Eamonn Brady on

 More than 70 people took the positive step of attending the “Rheumatoid Arthritis” (RA) talk, hosted by Whelehans Pharmacy, Mullingar in conjunction with the Westmeath Branch of the Arthritis Ireland on Wednesday 12th Oct at the Greville Arms Mullingar. There was an impressive line-up of 4 speakers.

The main speaker was Dr Killian O’Rourke, Consultant Rheumatologist at Midlands Regional Hospital, Tullamore. Dr O’Rourke delivered an excellent presentation which focused on two main areas:-

  • Update on Midlands Rheumatology Services to Oct 2016
  • Advances in RA treatment

Dr O’Rourke gave an overview of the extensive range of facilities now available at the service in Tullamore. One other really positive development within the unit was the extensive training programme for Midlands GP’s, hosted by Dr O’Rourke. On completion, each GP will have had around 400 hours of Rheumatology related training, which is then immediately relevant at point of first contact for most people (ie) the GP Surgery. This greatly assists with early diagnosis and subsequent quick referral.

New National Electronic Referral Form

To support the many recognised benefits of very early diagnosis, Dr O’Rourke outlined a new referral system of suspected IJD (Inflammatory Joint Disease) for GP’s using the new extremely detailed National Early Inflammatory Arthritis Referral form, developed in association with the charity Irish Society of Rheumatology and the HSE, full patient details along with supporting information (x-rays, pictures, history etc) can be sent electronically to rheumatology departments like Tullamore with a commitment to see referrals within six weeks.

Waiting list for Tullamore Rheumatology Department

Dr O’Rourke gave an update on the current waiting list position for new RA patients with recent improvements now sits at 15 months (down from 30 months), with those awaiting DEXA / MRI now at 12 months. In addition, whilst there has been recent positive progress in staffing levels, he outlined those shortfall areas that still exist to reduce the “waiting list” issue. The rheumatology department have a triage system which allows them to see more urgent cases quickly (eg) newly diagnosed early RA which needs early and aggressive treatment to prevent joint damage.

Risk factors for RA

Dr O’Rourke went on to discuss RA Risk factors. At the top of the group are two primary genetic factors followed by a list of over 12 “Higher Risk” factors….. of note here were:- Female Gender also Pregnancy and 12 months after giving birth; Occupational risks related to dust (mining, oil, woodwork, electrical, asbestos); Lifestyle factors (Smoking, High BMI, Coffee Consumption). Some developing evidence show that there may be a link between gum disease and development of RA.

Dr O’Rourke then gave an insight as to how RA is classified and the various systems that are used to evaluate severity. Two main organisations ACR (American College Rheumatology) and EULAR (European League against Rheumatism) have combined resources to produce a harmonised scoring system that provides some common classification criteria against which presenting symptoms can be measured, scored and which treatment pathway to take based on the outcome. The newly simplified scoring system aims: - Initially to REDUCE Disease activity, which through time PREVENTS structural damage, which then through remission, DECREASES disability. These factors are then translated into the recognised DAS28 scoring system which when used to indicate exactly where an individual lies within the goals above which dictate / prioritise immediacy and type of treatment.

Future of RA treatment

Looking to the future of RA treatment, the audience learned of a variety of current scientific initiatives and advancements that aim to help and assist with the earliest diagnosis of RA, perhaps even long before physical symptoms have appeared.

Gene screening to maximise treatment

Gene screening, currently in use in America, could help predict which drugs would be most effective for a given patient, which then enables the most effective treatment to be used right from the start.  Leading on from this, Dr O’Rourke suggested that at some time in the future, everyone could have their complete genome screened with the result showing what diseases or ailments they may be predisposed to. This is more likely to be reality in the coming years, something that would have been the realms of science fiction 25 years ago.

An RA vaccine?

Again, currently in progress is the possibility of a vaccine to prevent RA. Research in Australia is developing a vaccine to re-educate the immune system and the T-Cells (which currently attack in RA) to act in support of the immune system and prevent attack. Whilst an outcome may be a long way off and hugely expensive currently, it may be reality in within most of our lifetimes.

Cannabis based painkillers

To conclude, another therapy currently under evaluation (and common practice in many countries) is the use of Cannabis based Medicine (CBM) to treat and alleviate the symptoms of RA. Dr O’Rourke gave examples from USA and Israel of how CBM treatment has been proven to reduce and eliminate pain in RA. Medicine is administered primarily through tablets or sprays so that the purity and dosage can be guaranteed, CBM has been shown in clinical trials to reduce symptoms across a range of “traditional” RA measures. Cannabis based painkillers have been shown to have significantly less side effects than many traditional painkillers. Dr O’Rourke pointed out the CBM is not currently available in Ireland in any form.

Other health professionals

Next up was a presentation from Dr Siafullah Khan from Mullingar Dental Centre. Dr Khan is qualified in Special Care Dentistry. Dr Khan gave an overview of how Special Care dentistry can be of benefit to those with Mental or Physical challenges. He mentioned that something as simple as scheduling the “right” appointment time can be helpful for those that may, for instance, experience stiffness in the morning, making an afternoon appointment a better option.

Kevin Conneely, Chartered Physiotherapist from Health Step Physio based at Whelehans Pharmacy suggested that physiotherapy treatment can help maintain or increase range of movement for those with mobility issues. Physiotherapy can also help people understand the limitations that RA presents, which in itself can be a benefit in helping people help themselves.

To conclude, the final speaker of the evening was Eamonn Brady, MPSI, Pharmacist at Whelehans Pharmacy who gave an initial overview of medications used to manage RA. So, initially, looking at medication to reduce pain and then drugs aimed at slowing down the progression of the disease, pointing out that whilst there is no cure for RA, the correct and appropriate use of medication can have a significant positive effect on living with the condition. Supporting Dr O’Rourke earlier position that the earliest possible diagnosis is ideal and then the initial introduction of DMARD’s (Disease Modifying Anti-Rheumatic Drugs) to slow disease progression.

Eamonn highlighted that paracetamol is rarely effective against the pain of RA but may be used to augment other pain killers while waiting for longer term solutions like DMARDs to work. He cautioned however against the long term use of codeine based medications such as tramadol and Solpadeine® and potential addiction risks.

Moving on to discuss NSAID’s (Non-Steroidal Anti-Inflammatory drugs), Eamonn indicated that whilst these offered relief, they would not affect the progression of RA and should not be used longer term. Giving examples such as diclofenac and etoricoxib, Eamonn stated that these should not be given to patients with heart problems or who had a high stroke risk.

Eamonn went on to discuss DMARD’s in more detail, giving an overview of how they work and, as they slow down the progress of the disease, the benefit of early referral. DMARD’s treatment can only be initiated by consultant, so, some of the initiatives mentioned earlier by Dr O’Rourke to speed the process of GP – Consultant referral will help massively.

Commonly used DMARDs include methotrexate, hydroxychloroquine and sulfasalazine. They can be slow to work, however Eamonn stressed the need to maintain the treatment as it can take some time to find the right one and for the benefit to materialise. A key point regarding Methotrexate was that it should only be taken weekly.

To conclude Eamonn discussed the various Biological treatment injections available. Traditionally, these would be a “last resort” for those with severe RA, however, with medical advances, these are now being promoted earlier to improve response to treatment overall. Mostly given by sub-cutaneous injection, can biologics can be used in conjunction with DMARD’s if needs be. In Ireland, Enbrel® and Humira® would be the most commonly used biological brands. More than 650 RA patients now take biological treatment at the Midlands RA Service.

Local Support

Westmeath Branch of Arthritis Ireland supports a vibrant community of 17,000 people living with Arthritis in the County.  The committee is made up of people living with arthritis so they understand the challenges that a chronic condition brings.  Your local committee are here to support you and offers a wide range of activities, information and training that will help you to live well with arthritis. If you have any further queries, Westmeath Branch contacts are: Margaret Egerton, Chairperson 0857587171 or Secretary 0871413225 (Branch Phone). You can follow the Westmeath Branch of Arthritis Ireland on Facebook.

Check www.arthritisireland.ie or Locall 1890 252 846 for more information

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Arthritis: Techniques to help manage pain

Posted by Eamonn Brady on

 

You may have to accept that sometimes medicines, physical therapies and other treatments cannot relieve all of your pain. Pain may limit some of the things you do, but it doesn’t have to control your life. There are many techniques you can use to cope with pain so you can go on living your life the way you want to. Your mind plays an important role in how you feel pain. Thinking of pain as a signal to take positive action can help turn it to your advantage. Also you can learn ways to manage your pain. What works for one person may not work for another, so you may have to try different techniques until you find what works best for you.

 

Ways to manage your arthritis pain:

  • Make sure you are making the most of your medicines and physical therapies
  • Visit your doctor regularly to make sure you are getting the best treatment for your arthritis symptoms.
  • Take care of your body. Exercise to improve your fitness and strength, eat a healthy diet, and get a good night’s sleep every night.
  • Use heat and cold treatments for extra pain relief. A warm bath or shower, or a heat pack placed over a painful joint for 15 minutes, can provide effective pain relief.
  • An ice pack may reduce swelling and relieve pain in the same way. Ask your doctor or physiotherapist which type of treatment (hot or cold) is best for you
  • Find some distraction techniques that work for you. These may include exercising, reading, listening to music, or seeing a movie. Anything that focuses your attention on something enjoyable, instead of your pain, will help you.
  • Learn some relaxation techniques. When you are stressed, your muscles become tense, making pain feel more severe. Relaxation techniques such as meditation or deep breathing help decrease muscle tension.
  • Ask your physiotherapist about transcutaneous electrical nerve stimulation (TENS). A TENS machine applies very mild electric pulses via small electrodes (pads) to block pain messages going from the painful area to your brain. TENS can be very useful for longer-term pain but does not work for all people. You should see a physiotherapist to trial a TENS machine, and to learn how to use it correctly.
  • You may find massage and acupuncture useful to help control pain and improve relaxation.

 

Educate yourself about your condition

Whelehans Pharmacy, in conjunction with Arthritis Ireland (Westmeath Branch) are hosting a Rheumatoid Arthritis Information event this week (Wednesday Oct 12th at 6:45pm) in the Greville Arms Hotel in Mullingar. Admission is free.

The guest speaker for the evening will be an expert in this field, Consultant Rheumatologist from Midland Hospital Tullamore, Killian O’Rourke MD MSc FRCP FRCPI. Dr O’Rourke will give first hand information on the condition along with tips on what you can do to help you help yourself including information about surgery and aftercare for those thinking of going down this line. He will take questions from attendees.

Chartered physiotherapist Kevin Conneely MISCP of HealthStep Physiotherapy Mullingar will discuss the role of physiotherapy in Rheumatoid Arthritis (RA), such as the benefits of manual therapy, the importance of a tailored and comprehensive exercise program.  The final speaker is pharmacist Eamonn Brady MPSI who will discuss medication.

This article is shortened to fit within Newspaper space limits. More detailed information and leaflets is available in Whelehans

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Healthy Hair Starts From Within

Posted by Trish Wallace on

 

For those of you that are Pinterest obsessed, I’m sure you have a tonne of “hairspiration” pics pinned to your boards! Getting long, lustrous locks isn’t an easy task to accomplish, but nourishing your body from the inside is the first step you need to consider!

 

There are lots of factors which can impact the health of your hair including stress, medication, over styling, extensions and bleaching and while using appropriate products will help, they usually just mask the problems. Nourishing your hair from the inside out will encourage healthy hair growth right from the start.

 

Viviscal® have one of the best hair care supplements on the Irish market and is the No.1 recommended supplement with top hairdressers. It is scientifically formulated with biotin, zinc and marine protein complex AminoMarC which combined will help to promote healthy hair growth.

Viviscal® also offer a fantastic range of complimentary products including a newly formulated gentle shampoo to gently cleanse and exfoliate the scalp and hair, a moisturising conditioner to nourish and condition the hair and scalp, a hair and scalp serum to support healthy hair growth and add volume to the hair.

 

Viviscal® also have extra strength supplements especially for men worried about fine or thinning hair, while they won’t replace hair that has already been lost, they will strengthen the remaining hair and help add volume.

 

The Viviscal range is available in Whelehans Pharmacy

Written by Trish Wallace, Beauty Consultant at Whelehans Pharmacy Mullingar. For skincare and makeup tips and advice including free consultations, call in to Whelehans or call us at 04493 34591 or check www.whelehans.ie

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