DEALING WITH MALE IMPOTENCE--ANOTHER OPTION

by Allan D. Nichols

Imagine you are a man in your mid-forties. You have been a diabetic for over 30 years. You have fought, and still fight, nearly every conceivable complication of that insidious disease. You are blind, and you have had a kidney transplant following the loss of your own kidneys. You have long suffered from diabetic neuropathy, which has taken both your feet and a couple of fingertips. You know what it's like to go through a painful divorce, due in part to the fact of your impotence. You travel about in a wheelchair. A chronic sore on one of your leg stumps does not allow you to use your prosthetic legs for walking. Sounds like a good recipe for a ticket straight to the nearest nursing home, doesn't it? Not necessarily!

Reading the latest information about diabetes, talking with my personal medical support team, networking with other diabetics in the National Federation of the Blind--these have immeasurably helped me to retain my independence. Recently, I met and married a wonderful lady who desires many of the pleasurable experiences I do, including a satisfying love life. Encouraged by new treatments for male impotence, I am enjoying a satisfying physical relationship with my new wife. Only a few short years ago, I would not have believed this to be possible.

In the spring 1992 edition of the VOICE, Ed Bryant published two articles about male impotence, one of which he authored. Ed's article mentioned several options for dealing with this often depressing and heartbreaking condition. These included hormone treatments, penile implants, and vacuum erection devices (VEDs), which I seriously considered using.

In the fall of 1992, I suffered an unwelcome separation and subsequent divorce from my first wife. Following that devastating experience, I was very reluctant to risk entering into a physical relationship with another woman.

But life has a funny way of working itself out. Debbie, who became my second wife, is very understanding about this particular diabetic complication. When I decided to pursue my options for having a satisfying love life with her, I considered the costs, possible side-effects, and reliability of each available option. Then I discovered penile injections.

I conferred with my diabetologist, Dr. Eric Wedell, who first tested my testosterone level (and found it normal) before recommending I see a urologist. I went on to see Dr. Stacy Childs, here in Cheyenne, who provided me with the details of how to use the medication he calls "triple mixture."

The process works like this: Using an ultra-thin syringe, a 291/2- or 30-gauge needle, between .2 cc's and .6 cc's are drawn. The tiny needle keeps the discomfort level to a minimum. Rarely does it feel much more uncomfortable than injecting my insulin. After cleaning the site with an alcohol swab, quickly insert the needle into the side of the penis. (To avoid hematoma, infiltration of blood under the skin, it is important not to inject into a blood vessel.) Slowly inject the liquid, then withdraw the needle. Apply pressure directly onto the injection site for a minute or two, to help reduce likelihood of blood infiltration. It usually takes between five and ten minutes for the injection to take effect.

Penile injection therapy offers a number of advantages for dealing with male impotence. With this method, there is no need for expensive surgery. Its effects are temporary, and include only a minimum of discomfort for the user. The erections give the user a sense of confidence, to me an important psychological advantage.

Disadvantages may include the need to use needles, the cost per treatment, and an erection that does not subside in a convenient and timely manner (though this may not bother some men). I have found that the prick of the needle is outweighed by the pleasure of the enhanced physical experience. The idea of injecting myself there only bothered me until I did it the first time. By the way, I usually go four to five days between injections, to avoid any cumulative effects.

The medication is not inexpensive. A 10 cc vial, good for 20 to 50 injections, costs about $70, plus cost of syringes and alcohol preps. Not every pharmacy stocks the "triple mixture." For best effect, the ingredients are combined at a local pharmacy. Shelf life is three to four months, though I have not detected any weakening of its effects at its outer time limit.

Sometimes it is not convenient to wait for an injection-induced erection to diminish. To quicken the process, you can use a nasal decongestant, such as "Neo-Synephrine". As it does in the nasal passages, the decongestant spray shrinks the mucous membranes, relaxing the valves at the base of the penis, and allowing the erection to shrink.

Normally, the brain receives nervous stimulation and responds by causing an erection. However, diabetic neuropathy can impair nerve function, and often a satisfying erection cannot be obtained or maintained. The use of "triple mixture" helps the valves at the base of the penis do their job, and for me has produced physical experiences similar to those I enjoyed in my early 20s.

Talking or writing about this very personal subject isn't easy. I am thankful I live in an era when it can be discussed openly. If men are going to enjoy physical relationships with women, we must be willing to share this type of information with each other. Within the National Federation of the Blind there are hundreds of diabetic men. Thousands, perhaps millions of diabetic men in this country also suffer from impotence. Until a cure is found for diabetes and the other medical conditions which cause impotence, we must seek out ways to cope with it.

Don't give up on yourself! Of course it's vital to have a partner who understands your frustrations with the condition as well. I have been blessed in both categories. Successful resolution of this problem will go a long way toward improving a marriage. I speak from experience!

Armed with information about the problem, sharing ideas with a trusted physician and others in your counseling and support team, you should be able to greatly improve your quality of life. The effort is worth the result.

I would be glad to share my experiences with any VOICE reader who suffers from male impotence. If you have questions, contact me. My address is: Allan D. Nichols, 1215 Monroe, Apt. 1, Cheyenne, WY 82001; telephone: (307) 638-8073