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Of all the embarrassing conditions that a man can have, it is likely that erectile dysfunction (ED) tops the cake.  Most men who have this condition will prefer not talking about it or disclosing their sexual problem even with their closest friends and family.  In fact, there are even men who do not even consult the erectile issue they are having with medical professionals and simply keep their little limp secret to themselves.  It is actually not recommended to have such penile problem undiagnosed because there may actually be a chance of treating the underlying condition that causes the erectile issue in the first place.  However, for men who totally prefer not to have their ED condition undiagnosed, they are somewhat lucky because they can get reliable information from the internet, considering of course that the website they are getting their information from is trustworthy.

In the past, if you suffer from erectile dysfunction, you can consider your manhood as disabled because there is clearly nothing you can do about it to temporarily alleviate yourself of your problem.  The only option left was either to treat the condition that causes you to have ED, or use some contraptions in order to assimilate an erection and thereby be able to pleasure your partner, even if you yourself are left unsatisfied.  This is because if the penis is not naturally erect, the sensation felt from sexual intercourse is highly lessened.

Men who have recently acquired erectile dysfunction problems are quite fortunate because these days there are now ED medications that they can use momentarily alleviate themselves of their penile impotence.  The best thing about these ED treatment meds is that the erection is very natural and thus the sensation is also very pleasurable.  There are actually a lot of ED drugs available in the market today.  This includes Viagra, the pioneer ED medication, vardenafil, avanafil, and tadalafil.  Of the four, it is actually tadalafil that is highly notable due to its long effective duration.

Most ED treatment drugs only have an effective duration of 4-10 hours.  Tadalafil on the other has a 36 hour effective duration time, significantly more than its competition.  Those that use tadalafil feel like they do not have any erectile issues at because as long as they have taken a dose within the day, they will be able to achieve an erection, no problem.

If you are interested in buying tadalafil, you will be happy to know that you can buy tadalafil online, from the comforts of your own home.  Read more…

Spinning the facts on Brian Day

A bizarre fact-checking war is heating up around new CMA president Dr Brian Day.

Dr Day's accession to the CMA presidency begat a (PDF) on his reform ideas by the Canadian Health Coalition, which in turn begat a (PDF) by the Brian Day-founded Canadian Independent Medical Clinics Association, which in turn begat a (PDF) by the Canadian Health Coalition.

Does anybody else think "fact"-checking should be slightly less partisan?

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NRM's exclusive on Dr Kevin Patterson gets national coverage

Our new article about attracted some and other CanWest newspapers, including , and .

In our August 30 issue, Dr Patterson (left) made his first -- and, so far, only -- public statement about the case. The Department of National Defence announced in August it would investigate him for disclosing the name and treatment details of a soldier he treated for a gunshot wound during a recent stint as a civilian physician in Afghanistan. The soldier, Cpl Kevin Megeney (right), was killed by "friendly fire" and complaints from his hometown sparked the DND's two separate investigations into .

Reprinted here is the full text of Dr Patterson's statement made to NRM, August 10 by email:

"Talk to Me Like My Father," which appeared in the July/August issue of Mother Jones, is an emotional, accurate and admiring description of the ISAF troops in Afghanistan and their sacrifices. The essay describes the horror of war in strong language, but to understand the extent of the ongoing sacrifice of the troops, I believe that strong language is necessary. If the public is to get a sense of the price being paid on our behalf by these young men and women, it is necessary to face with open eyes the grotesque nature of war trauma. The recent disengagement and fatigue of the public with these matters is itself grotesque. Reasonable people may disagree on the prospects for a durable solution in Afghanistan, but no one could dispute that these young men and women are there for us, and that it is our duty to understand what it is they endure in order to truly honour them for their courage -- and in order to make appropriate decisions about what is to be done in the future.

Kevin Megeney's immediate family was approached by Mother Jones magazine prior to the publication of this piece, and his mother's response was strikingly gracious. Nevertheless, it must have been painful for anyone who loved him to have read this. My intention was to honour their son and brother.
The investigation into Cpl Megeney's death is ongoing, as are the Military Police and the Health Services branch investigations into Dr Patterson's disclosure.

In the meantime, Dr Patterson , according to a Nanaimo Daily News article.

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Photo of Cpl Megeny:

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Montreal couldn't handle a disaster: doctor

Dr Tarek Razek, the trauma chief at the McGill University Health Centre, says Montreal's public-health and emergency systems are , reports the Montreal Gazette.

Tarek Razek said hospital staff would be stretched too thin to cope if Montreal suffered from an event like the 2004 bombing of the train network in Madrid or Hurricane Katrina along the Gulf of Mexico in 2005, in which thousands of people were injured.

"In Montreal, we have very, very severe deficiencies in our overall response capacity," Razek said yesterday afternoon at the conclusion of the 42nd World Congress of Surgery, held at the Palais de congrès this week.
Is Dr Razek's warning a helpful push towards improved emergency medical coverage, or is it alarmist? Tell us what you think in the comments.

Photo: MUHC

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Don Cherry, COLD-fx cleared in federal investigation

The makers of the OTC drug COLD-fx and company spokesperson/hockey commentator Don Cherry have been in an NDP-initiated lobby ethics investigation in Ottawa, reports the Montreal Gazette.

NDP ethics critic Pat Martin called for the inquiry after the pugnacious former Boston Bruins coach and other COLD-fx employees met with Prime Minister Stephen Harper privately in 2006 and gave him a signed hockey jersey and a case of COLD-fx pill bottles.

Soon after, COLD-fx received regulatory approval from Health Canada to market COLD-fX as reducing "the frequency, severity and duration of cold and flu symptoms by boosting the immune system," reports the Gazette. "Company shares jumped nearly 60 per cent in the wake of the news," notes the article.

But the federal registrar of lobbyists ruled the meeting "did not constitute a sufficient amount of time to be considered a significant part of their duties."

UBC pharmacology professor James McCormack last year .

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Therapeutic orgies endorsed by Canadian government-funded institute

A rather unfortunate phrasing in :

Group sex therapy can help beat erectile blues
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Email saves - not wastes - doctors' time

Patients whose physicians use email tend to come in for fewer office visits, CanadianEMR about recent. In other words, all those concerns that email would eat up doctors' time were unfounded - in fact, email use appears to save time.

Dr Alan Brookstone, who runs the physician-discussion website CanadianEMR, admits that most Canadian doctors are also concerned about other email-related issues, including privacy and security problems and the absence of a public-insurance remuneration model.

I wrote in the June 30 issue of NRM.

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Grand Rounds: Volume 3, Number 49

Check out the blog to read this week's edition of Grand Rounds, a weekly collection of the best writing from medical blogs.

Included in this week's edition is a mention of Canadian Medicine's recent continued coverage of the controversial US malpractice-insurance firm Medical Justice and its war on

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Toronto MD ponders internet addiction

That's what The Globe and Mail today asked Dr Bruce Ballon (right), a youth addictions and gambling specialist from the , in Toronto.

His response? "It isn't a problem unless it's a problem."

Thankfully, he explains himself:

In my experience, problem behaviours centred on the Internet, gaming and online gambling often arise out of a failure to find a coping strategy for underlying mental-health issues.

These issues include Asperger's syndrome (the problem Internet behaviour would be trying to find out everything about a topic by constantly researching it); pathological gambling (getting stuck on the casino sites); social anxiety disorder (chats, role-play gaming worlds); obsessive-compulsive disorder (obsessed with something that keeps them tied to the Internet); substance use disorders (ordering and researching ways to use drugs), and sexual "addiction" (seeking and downloading pornography).

Tumultuous events in a teen's life - loneliness, being bullied or parental divorce - can also be at the root of a problem.

In short, technology is not the sole issue - it's really how Internet use and online habits interact with a person's unique makeup that determine whether there are the seeds of a problem.
But here's something that not everyone knows: Dr Ballon himself is a gaming enthusiast (albeit a more old-fashioned kind of game, without electronics). In 2004, NRM profiled Dr , "Unseen Masters."

In June, the American Medical Association , insisting more research is needed. (Read .)

Despite the decision not to include internet addiction in the ICD-10 or DSM-IV, there's advice available to , published in Advances in Psychiatric Treatment earlier this year (subscription required).

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Photo of internet café:

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Queen's U plans new School of Public Health

The Ontario government today announced a $200,000 grant to Queen's University to help plan a new School of Public Health.

The program, leading to a master's degree in public health (MPH), could open as soon as September 2008, according to the initial announcement from Queen's. Dr John Hoey, the former editor-in-chief of the CMAJ who was unceremoniously canned by CMA boss Graham Morris last year, is advising the principal on the matter:

“The plan is to enroll 45 students in the first year, and, by increments, increase to 120,” Hoey said. Hoey added that the University recognizes the need for a school of public health because many other universities already have such schools in place, and because of a growing workforce demand for experts in public health. The master’s of public health program is described as “a non-thesis, professional development degree” on the website.

It will be either 16 months or an accelerated 12 months in length, and will include six core courses: environmental health, global health, health policy, introduction to biostatistics, introduction to epidemiology, and social and behavioural sciences in public health.

Students will also be able to take elective courses and will participate in a three-month practicum. “Creating a school of public health with a more global outlook would encourage opportunities for students and faculties to ‘engage the world,’” Hoey said.

The program is aimed at professionals but also to students who have extensive experience working in the community. Hoey also sees the possibility of there being collaborative programs with the law school and applied science in the future

The proposed Queen's School of Public Health already has , where you can . For now, the school is waiting on approval from the , which must accredit the program before it can open.

Ever-controversial Ontario health minister George Smitherman managed to in his short visit to Queen's to announce the new funding. He didn't show his face at the struggling Kingston General Hospital, which was interpreted as a snub by hospital officials and the Kingston Whig-Standard.

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