Sunday, May 24, 2009

my first viagra prescriptions (PG-13)

So a group of colgueges were discusing the fact that viagra (sildenafil) is used to treat not only erectile dysfuction, but also pulmonary hypertension. In order to avoid the stigma of taking viagra, the same medicine has a different name when it is prescribed for pulmonary hypertension. Someone wondered outloud if the latter is cheaper. He said that he had a lot of diabetic patients with ED that have trouble affording ED meds. I thought to myself - wow, I've never even written a prescription for viagra... and I have plenty of middle age and older diabetic males that I see in clinic. I never ask about it, perhaps I should ask more often, or perhaps my being a female makes my patients less likely to bring up the topic themselves.

Well... within one week of that conversation I wrote my first 3 prescriptions for viagra (without changing any of my history taking habits).

On gentelman, ironically was sitting on an exam table that had 'viagra' paper roll covering the table. This is very uncommon in my clinic, in fact that was the first and last time I've seen that. Usually it's the generic white exam paper roll, and on very rare occasions a pediatric print with animals or something. Now whether or not the advertisement prompted the request or whether it was already on his agenda is anyone's guess.

Another gentelman was preparing to marry a woman he described as 20 years his junior and "frisky", he actually asked me if he could have and unlimited supply of viagra. I also had the pleasure of teaching him proper sexual terms. When I asked if his problem was getting an erection, he asked 'is that when that stuff come out?' .. no sir, that's called ejaculation. 'oh so you talking about when the dick get hard' .. yes, that's called an erection. He thanked me for teaching him the right words.

My third encounter was in Spanish, and while I know a lot of words in Spanish and pride myself on being fairly fluent, erection is not in my Spanish vocab. So the ED discussion consisted of me talking about the pene duro or the hard penis. I was hoping the patient could enlighten me on how to say erection in Spanish, but he either didn't understand what I was asking him or did not know the word himself (errecion - should have guessed!)
. So perhaps pene duro was better understood anyway as had been the case with the 2nd man!

I haven't seen any of these gentelmen back since ... I guess they got what they wanted ;)