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when can i get back original senses level?


- i was operated tongue cancer before 5 years , all since than . ( they've remove some lymph nodes from throat section )

- since last few weeks , it seems that my Brain have lost senses and there at times is headache in right part of brain, feeling numbness in stomach(feels light weight always ). plus tongue food taste is lost (i.e. tongue is unable to detect food taste properly)
also has a erectile dysfunction (i.e. erection problem )

- went to consult ENT physician , they took Throad and Ear city scan and detected Sinus
they medicated since 30 days now, but original issue of brain senses keeps on continuing

- so my question is whether above problem is due to Sinus or something else
and when can i get back original senses level

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replied July 17th, 2014
Thank you for asking
Sinus infections can cause migraine headaches and that explain the headaches. And need migraine management. Now the taste issue needs assessment as you had tongue malignancy and that might have compromised the
sensation permanently. Until one examine it will be difficult to comment on.
Now the ED issue. To assess better what is causing the ED in your case we need a thorough history regarding
Sexual history
Medical history
Psychosocial history
followed by physical examination focussing on
Blood pressure
Peripheral pulses
Status of the genitalia and prostate
Size and texture of the testes
Presence of the epididymis and vas deferens
Abnormalities of the penis (eg, hypospadias, Peyronie plaques)
Then some labs to be run for sorting out underlying cause .following labs will be needed
Evaluation of hormonal status (testosterone, serum hormone-binding globulin, luteinizing hormone [LH], prolactin, thyroid-stimulating hormone [TSH]) - Note that the American College of Physicians (ACP) does not recommend for or against routine use of hormonal blood tests or hormonal treatment in ED patients
Screening blood studies (hemoglobin A1c, serum chemistry panel, lipid profile)
Prostate-specific antigen levels, if the patient is a candidate for prostate cancer screening (controversial)
SOme functional tests like
Direct injection of prostaglandin E1 (PGE1; alprostadil) into the corpora cavernosa
Biothesiometry - Infrequently indicated
Nocturnal penile tumescence testing - Once frequently performed, this is rarely used in current practice, though it can be helpful when the diagnosis is in doubt
Formal neurologic testing - Not needed in the vast majority of ED patients, though it may offer some benefit to patients with a history of central nervous system problems, peripheral neuropathy, diabetes, or penile sensory deficit
Some imaging studies like
Ultrasonography of the penis (to assess vascular function within the penis)
Ultrasonography of the testes (to help disclose abnormalities in the testes and epididymides; rarely indicated)
Transrectal ultrasonography (to disclose abnormalities in the prostate and pelvis that may interfere with erectile function)
Angiography (in patients who are potential candidates for vascular surgery)
Once we do all these labs we will know for sure what is causing your performance issues. The management is easy and will focus on
Sexual counseling, if no organic causes can be found for the dysfunction
Oral medications
Injected, implanted, or topically applied medications
External vacuum and constriction devices
following agents are used
Alprostadil (most common)
External devices that may be used include the following:

Vacuum devices to draw blood into the penis
Constriction devices placed at the base of the penis to maintain erection

some surgical options for ED are
Revascularization (rarely indicated)
Surgical elimination of venous outflow (rarely indicated)
Placement of penile implant (semirigid or malleable rod implant, fully inflatable implant, or self-contained inflatable unitary implant) - Once the only effective therapy for men with organic ED, this is the last option considered in current practice

Last but not the least is management of diet and lifestyle modifications and
Optimal management of diabetes, heart disease, and hypertension
Lifestyle modifications to improve vascular function (eg, not smoking, maintaining ideal body weight, and engaging in regular exercise).
Visit our health centre for further guidance.
Take care
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