Wednesday, June 24, 2009

It's the End, the End of the 70's

(for those of you who recognize the title, congratulations!)

WARNING: THE FOLLOWING POST IS NOT FOR THE SQUEAMISH. I MEAN, IT'S NOT AS BAD AS THIS STORY FROM MY ESTEEMED COLLEAGUE ERP, BUT IT AIN'T GOOD EITHER. SO STOP READING NOW IF YOU THINK IT'S GOING TO FREAK YOU OUT, OR IF YOU'RE EATING.

Before Viagra and it's cousins, there were some other methods of waking Sheriff Woody. They're still out there, for those who have issues with Viagra.

One of them is Caverject (or Alprostadil for my pharmacy fans). This is fairly effective at getting it up for special occasions. They have to be pretty special, though, because Caverject has to be injected directly into the side of your winkie for it to work. What fun.

Because it came to market before the era of direct-to-consumer celebrity advertising, we were fortunately spared TV ads featuring Eric Clapton singing (to the tune of "Cocaine"):

"If your lady is hot
Just give yourself a shot-
Caverject."

But I digress.

I have a patient who's been using Caverject for years. For whatever reason he can't use one of the newer drugs. He's kind of an aging, swinging, disco guy. In the 70's he was swinging, single, wearing gold chains, and picking up babes at the disco. In 2009 he's still swinging, still single, still wearing chains, and now picking up aging babes at the disco.

A few weeks ago he had a small stroke (he's fine now), and as a result he's now on Coumadin, a potent blood thinner. This gives new meaning to "Stayin' Alive".

So last Saturday he was out getting his boogie on and picked up Ms. Agingdiscoqueen. They went back to his place for some wild times. He shot himself up with Caverject and the fun began.

And abruptly ended. Apparently she got on top, and while she was riding the disco pony, blood began squirting out the side where he injected Caverject (thanks to Coumadin). Seeing blood flying all over those dark areas killed the mood fast. She ran out, and likely went home to douche with bleach.

He's been visiting me and his cardiologist today, to discuss stopping Coumadin.

Thus endeth the 70's.

24 comments:

Soon-to-be-PharmD said...

Gasp! That's very sad, yet hilarious. I will be telling my Cardiology Preceptors this story tomorrow.

kath8562 said...

Hey, he can always try Muse (that's the one where you stick a small suppository up your willie).
And I've been working in a Pharmacy just way too long to remember both of those drugs.
Also, it's amazing how many men who are on C,L,or V (grin) and who have taken/are taking nitro will ARGUE with the pharmacist about us having to call for a Doctor's ok. Would you rather have a woodie, or not have your nitro work when you're having an attack?!?

Lipstick said...

I just have to LOL that he is on the rush to immediately d/c the Coumadin!!!

BTW, you should write other Eric Clapton direct-to-consumer marketing jingles. You are quite fab.

Lovely, CPhT said...

It's the end, the end of the century!

I'm really not surprised that poor Aging, Swinging Disco Guy would rather have another stroke than never get laid again. It reminds me of our patients who pay upwards of $80 for 4 Viagra pills. My female co-workers and I just look at each other and shake our heads.

arogalski said...

There is a prostaglandin urethral 'suppository' called Muse that has a lower risk of bleeding, but an even more disturbing route of admninistration than Caverject if you ask me. When he is defeated by his cardiologist, you might suggest it. However, this is prime opportunity to sit quietly and passively force him toward normal social behavior.

-A friendly pharmacist.

Reality Rounds said...

Hmm. I have never heard of this Cadaver-Erect drug before. Sounds stimulating. Not sure why you thought this post was for the faint of heart. I say, stop the Coumadin and let this old hippie die happy, and with a happy. It would be the ultimate "happy ending."
Peace out.

Uro*MA said...

KATH~ i fight with my pts all the time! They neglect to write down in the history sheet that they are on a nitro and so the dr writes for c,l,v whathaveyou and then the pharmacy calls, i love that phone call and the follow up call to the pt, they are always wondering why and how they can get the dr to take them off the nitro, as if having a "good time" is more important than say, i dont know, living? jeez

One Nurse said...

Too funny. This is the second time this week that I have heard someone talking about Caverject! I just can't imagine injecting that with ANYTHING sharp!!! Unfortunately as soon as I saw he was on coumadin, my first thought was "HOW GROSS, what about the injection site??"
Poor guy! Stoke. . . . no sex. . . .how do you choose?

Fiz said...

Haven't people heard of AIDS? Geez! God, I miss the 70's - I was young, pretty (others said) and having a great time. Then AIDS came along and killed all of my gay friends bar 2 (way before AZT came along) and one of them cried in my arms because he'd been promiscous and knew "it" was coming for him . RIP, Nikhol, and Ziggy, Bob...too many to list. As for your ageing hippy,Dr Grumpy, if sex means that much to him, stop the Coumadin!

Chrysalis Angel said...

On a serious note, albeit your Clampton rendition had me chuckling...what about the pump for this individual? Non-invasive and can be bought through medical supply stores, complete with rings. Some insurance companies will cover it, but the reps that usually come to the urology departments cost the patient and the insurance co. a high fee for theirs, when you can get the same thing at a medical supply place. Just a thought for your patient.

Grumpy, M.D. said...

Just to clarify the above, I am not the doc managing his ED. His uro doc is, uh, handling that. He was seeing me for separate neuro stuff. Like neck pain from wearing heavy gold chains with spoons on them for 40 year.

Anonymous said...

I remember injectable papaverine, but seriously why not suggest cantharides from the shininess of beetle wings or that stuff that used to go like hotcakes...hmm yohimbine? I don't remember the efficacy, nor predictability, but it was used heavily until availability of prostaglandin analogs or nitrites were heavily touted by manufacturers. Can't imagine an interaction of centrally acting yohimbe with Coumadin, though, due to different MOA, however might be cautions with papaverine if recent stroke.

Fiz said...

I was discussing the chains with my husband and he said he bet that the ageing hippy had arthritis from them! Score:1!

Amanda said...

You made me spit Diet Coke on my monitor. Hate to waste Diet Coke like that... (but dang that was funny!!!)

Anonymous said...

Might his coumadin level be a bit high?

ian in hamburg said...

Of course the 70s haven't ended.

After all, he's still stayin' alive, stayin' alive...

amyrph96 said...

I remember my first pharmacy rotation at the mere age of 21. The pharmacist told me to go instruct this 80+ y/o on his new medication....caverject! Never had heard of it and now will never forget it. Thank goodness the guy was very open about his situation. I think I blushed for a week. He spent the whole time trying to make me feel more comfortable. Meanwhile, the pharmacy is laughing their asses off at me. Sigh, the good old days.

pharmacy chick said...

Brilliant, at least he has his priorities straight. cut the coumadin, keep winkie happy!

Anonymous said...

This guy is a fucking idiot. Literally

Dragonfly said...

Haha. Sounds like he has quality of life though...

Pink said...

He just really needs to practice falling a lot (while you turn a blind eye). Then, he can get an IVC filter or some ASA and Plavix.

LAW said...

Rewrite a pamphlet insert and 'hand' it to the Uro who is 'handling' Mr. E.D. Flaccid and tell him to use a coverlet bandage and a condom.... or perhaps a suggestion of direct pressure? ::giggle::

Anonymous said...

He can't just "beat on the brat"?

Anonymous said...

Poetic in a strange sort of way...injecting meat to inject meat.

Heh.

Knowing me, if I ever needed one of those pumps, I'd likely get a tattoo that said "Reebok" just for the comic value alone.

 
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