Question: I am struggling with ED - I am 68 - My wife and I have been together for over 25 years and our understanding of the issue has been good - I hadn't tried viagra (generic) for a long time - it worked fairly well - but our sexual activity ceased for the past few years because I had 2 consectutive cancers to address - the first was resolved successfully with sugery and radiation therapy

But exactly as I was cleared of that threat I was diagnosed with CML - I have been on Tasigna (nilotinib) for a year - finally we agreed we needed to restore our intimacy - I took a high dose of generic sildenifil - it worked to a point - then failed

I felt more severe side effects than ever before - so I realized I had not checked drug interactions before hand (the last thing on my mind at that moment) - they are contraindicated - I understood why I was feeling so knocked out - scared the crap out of me

Do you have an opinion of which if any ED meds would be safe and effective on the Tasigna regimine?

I also take Irsbisarten for BP, Allupurinolo to reduce Uric Acid that results from the oral chemo - and now Wlebutrin and Lamectal to help combat the energy defecit caused by the chemo

I know I need to address it with my Leukemia doctor - but frankly his nurse - dedicated, wonderful bright woman - is so judgemental on first blush, I can't imagine addressing this with her

Help -

Feeling Desperate
XXXXXXX XXXX

This reminds me of a joke I heard in college many years ago about the man who goes to a brothel because he isn't satisfied with his wife - and out she comes to service him

So all of my medical care is XXXXXXX Doctors - my prescribing psychiatrist is Dr XXXXXXX XXXXXXX and my hematology oncologist is XXXXXXX Jurcic in the garden level of the XXXXXXX Pavillion

I see Jurcic tomorrow at 2 and XXXXXXX Thursday at 10:30 AM

I have a first appointment with Dr Stahl an ED specialist in Urology in the same building as Jurcic (also my rheumatologist, my dermatologist, etc etc)

I am getting the best medical care available in the world

I am just panicking - I've had so many medical issues and so much history I feel like this may be trivialized - and it really has become a VERY significant source of fear and devestation

My primary care guy (Martin Frankel - now XXXXXXX Doctors Morningside) has been seeing me for probably 20 years - he is the only doc to prescribe ed meds over the years - he sent me to XXXXXXX Urology - I am obviously (seems to me) overreacting to reading about medical and surgical solutions I might be looking at and....

My wife and I made love for the first time in several years Friday night - wonderufl to a point (so to speak) but absolutely enraging when the effect of the sildenifil ceased to allow for continued intimacy

Why am I going on to you? I somehow am experiencing that shame and embarrassment because of performance failure so fresh in my mind

I expect you will agree I should just follow the path I am on

But really your research and explanation of the true nature of the interaction between Tasigna and Sildenifil will help me move forward

I mentioned Jurcic's nurse is not warm and fuzzy (a drill sargeant of first blush) and has several times lectured me in what I thought was an inappropriately scolding way for other drug interaction issues (been on Tasigna exactly a year)

Now I think I can walk in tomorrow with some realistic sense of what I'm up against - that is really empowering

Thanks Dr Sheppe - perhaps we will meet on the 12th floor some day!
XXXXXXX

YYYY@YYYY

Yes I know they will

I sent our exchange to Dr XXXXXXX - he found this coincidence as amusing as I do!

I want to reiterate that while I was looking on impulse for an anonymous shot into the internet, I am very grateful for your consideration of my situation and your sane, well researched and explained advice

It really did shift my mental state about getting on with the right treatment with the right doctors

That's good medical practice - my opinion of the notion of online medical advice was tenuous before, but now I realize that really bright, well trained, experienced practicioners are making themselves available for useful helpful advice and opinions

Thanks

Do you actually see patients on 12 at 168th? I know you're more deeply affiliated with Cornell - if so I'd get a kick out meeting you!! Do you know Devlin?