Question: Hi, My name is XXXXXXX I am 69 y.o.a. 2 years ago while fighting a bush-fire I fell down a 600ml hole and injured my big toe on my left foot. The swelling was severe. After x- rays, operation, and cortisone injections, the swelling spread to ankle, left knee, left shoulder, and last week attacked my left hand, wrist, and left fore-arm. I have consulted eleven different Medicos. It has been suggested I have RSDS. My local GP has prescribed Prednisone and Tramadol SR 100mg and Tramadol 50 mg. The swelling has reduced but the pain has NOT.

Thank you Dr.Alokkalyani, for your reply. Since I have been receiving treatment for this problem, RSDS, I was put on Lyrica (pregabalin) and Naltrexone, but after six weeks, (less actually), I realised I could not ejaculate. The problem is still now worrying me as my PSA has risen from 4.4 27-07-12 to 12 08-08-13 and at my last blood-test my PSA is at 13. I have had two appointments at Mater Hospital in Brisbane, QLD. Urology Outreach Service. I am reluctant to undergo rectal Prostate Biopsy, as this allows serum to enter the blood-stream, and contaminate other glands, and there is a grave risk of introducing faeces into the Prostate. A very close acquaintance suffered this condition and was 4 days on life-support before the infection was removed. Please help. XXXXXXX

Hi, I do think this is related. Dr.Pieter Le Roux (Toowoomba Pain Medicine Physicians) prescribed Lyrica in October 2013, and by December, ejaculation had ceased. I went off Lyrica, on advice from Dr. Le Roux. Dr. XXXXXXX Reedy prescribed Naltrexone late December 2013. A few weeks later the same, no orgasms would occur. Off Nalterxone XXXXXXX 2014, Normal Ej. returned early March. Now prescribed Prednisone and Tramadol by Dr, Coughlan following severe swelling (photos available) and extreme pain from fingers to left elbow. There have been no Ej since 15-03-14. My wife of 47 years is very upset about this problem. She was diagnosed with Parkinson's Disease 12 years ago and feels the need for a regular outlet of Oxytocin is beneficial, (orgasms). Her condition, (PD), although not improving certainly has stopped deteriorating. XXXXXXX had lost 12 kg in 12 months prior to Dec.2013. Her weight and posture is now improving. Regards, XXXXXXX and XXXXXXX As far as exercise is advised, I am a beef-cattle producer with 3,500 acres and no paid staff, so lack of exercise is not the problem. I have never smoked or taken alcohol. Our property has been in the grip of severe drought since XXXXXXX 2013. Help me pray for rain. Regards, XXXXXXX

Hi Doctor, Thank you for your opinion and advice. I have an appointment scheduled for 12-04-2014, with Dr. XXXXXXX Vecchio, from the XXXXXXX XXXXXXX Hospital in Brisbane, Rheumatologist. I am of the opinion that there has been damage to part of my brain causing problems on my left side. Any injuries to the right side of my body heal with very little pain and in a short period of time. All of treatments (drugs) I have been prescribed are nerve suppressers or blockers. There appear to be few or no nerve endings in my Glans. I am able to attain and maintain an erection for about 15 minutes, but there is no orgasm or ejaculation. A nuclear image scan taken on 05-10-13 shows no significant swelling if the prostate. Regards, XXXXXXX