Medical Humor - E-mail Exchange About New Prescription

I recently exchanged the following e-mails with my doctor’s chief nurse about a new prescription I have been given.  Please forgive me; I just could not overlook an opportunity to generate some humor.  I hope the nurse and her associates got a laugh out of it.  They do a great job of boosting their patients’ morale and are always there when we need them.  I imagine that their job gets depressing at times.  I have edited the e-mails to protect the innocent.

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From: Larry Cox [mailto:LarryCox1200@gmail.com]
Sent: Thursday, March 24, 2011 9:40 AM
To: Nurse
Cc: Esther Cox (EstherCox@yahoo.com)
Subject: Several Questions About My New Prescription

Nurse,

Dr. X prescribed Fluvoxamine 50mg Tablets for me….  I just got the prescription filled as Walgreens had to place two special orders for it.

I read the information sheet that Walgreens provided with the tablets and have several questions.  Perhaps you can find the information in my files or ask Dr. X.

1.  The common uses for this drug are listed as treatment for obsessive compulsive disorder (OCD) and depression.  I do not believe I have OCD nor am I depressed.  I remember Dr. X talking about some symptom but for the life of me I cannot remember what it was?  Can you look it up in my files?

2.  I swear that I did not make up the following.  The information sheet has the following special caution:

 “FOR MEN: This medicine may rarely cause a prolonged, painful erection.  This could happen even when you are not having sex.  If this is not treated right away, it could lead to permanent sexual problems such as impotence.  Contact your doctor right away if this happens.”

a.   Are these “painful erections” like the ones I experienced as a teenager when I thought I would explode?  How are they different?

b.   What is the recommended treatment for such an occurrence?  I am not sure that Esther’s health is up to a “prolonged” standard treatment.  (I would try to remember your advice in yesterday’s e-mail about pacing my exercise to 5 minutes of strenuous exercise followed by 5 minutes of rest.)

c.    If I need to go to the Emergency Room for treatment, will it be OK to be driven there by car or should an ambulance be called?  I can see the 911 Operator reacting the same way you are as you read this:  “You’re kidding me----a 70-year old man is having a painful prolonged erection….”

d.  Just to be on the safe side so I don’t accidently cause such a problem, how much of a dosage of this Fluvoxamine would I have to take to experience this side effect?

Thank you in advance for getting back to me on these serious questions.  I am trying to be very careful about the prescriptions I am taking.

Sincerely,

Larry Cox

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From: Nurse

Sent: Thursday, March 24, 2011 3:30 PM
To: 'LarryCox1200@gmail.com'
Cc: Esther Cox
Subject: RE: Several Questions About My New Prescription

Hi Mr. Cox,

The reason that we prescribe the fluvoxamine is for pseudobulbar affect which is a form of emotional liability that is commonly associated with ALS.  Because this is sort of an “off label” treatment, you may not find this info in the medication handout. As far as the potential for a prolonged erection, I would be willing to bet that the odds of this happening are extremely low, and we have never had a patient experience this problem in relation to fluvoxamine.  If it happened to 1 person the drug companies are required to put it in the literature.  I wouldn’t worry about it, but if it does occur you should go to the local ER immediately, either by driving or calling 911.  If you were unlucky enough for this to happen (which again I wouldn’t worry about)  I am not sure exactly what they would do to treat it, but I believe it involves aspirating blood/fluid from the penis to dissipate the erection.  (Italics added by editor.)

Hope this helps put your mind at ease!

Thanks

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From: Larry Cox [mailto:LarryCox1200@gmail.com]
Sent: Thursday, March 24, 2011 3:57 PM
To:  Nurse
Cc: 'Esther Cox'
Subject: RE: Several Questions About My New Prescription

Nurse,

Thank you for relieving my concerns.  The “aspirating blood/fluid from the penis to dissipate the erection” sounds ominous.  (Editor:  Like sticking a sharp needle in and draining the blood.  Ouch!  I will try to talk the doctor into a Rx for Viagra.)

Larry Cox

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