Heart failure and ED, this needs to be said.

This will not be easy to write, but it must be done.  I've seen and experienced something that is deeply embarrassing, but may prove vital to someone else. I don't want to talk about this, but I think I must.  

I have congestive heart failure.  In the form I have, the heart muscle is too thick to do the stretchy thing it needs to do.  As the cardiologist gestured with his hands, the heart must expand to pull in blood before it can contract to send it on it's way.  My heart is no longer so good at that expand thing, so naturally it is less then efficient at providing blood flow.  My heart is 'strong', but not good at it's job.

What did this?  It didn't just pop into existence.  I did this to myself.  Long work days, heavy stress, never ending exhaustion, a really bad diet, drinking  too much... and all of it went off the scale at the end of Covid.  At that point I was working 15 hour days, eating fast food for every meal, and living in a hotel room because my teaching schedule didn't allow me to drive home.  I was drinking a lot of booze. A couple bottles a week, give or take. It's what numbed my mind enough that I could catch a little sleep before doing it all again.

My blood pressure went kablooie, and I should have stroked out right there in the hotel room.  Instead, I made it home and to the doctor.  She got the BP under control and I went back to work, but the damage was done.  My heart had the last words in this discussion.  A couple months later I was fully retired, and mostly just sat around for six months waiting to die. At that point I decided 'Screw this' and began working on myself.  The doctors said there was no help, but I did it anyway.  No, I could not even do a fraction of what I used to be capable of, but to my doctors constant surprise I am still alive. 

I'm fairly stable now, but my heart is what it is.  That's not going to get better. I've simply adapted to the situation and I'm taking a long view on improving it.

What does that mean?  Well, think about what blood does in the human body, and understand that my blood 'flow' is inadequate.  Therefor, whatever blood does in operating the body, there lay my challenges.

Primary to my life, blood takes away fatigue poisons and carries O2 to where it's needed.  In my case, there is not enough of either to make my 300 pound self function correctly.  I get tired.  Exhausted even, and not after a days work but after maybe 20 minutes work.  If I pace myself well I can get a few hours a day of on/off function at useful levels.  After that, I crash.  I know it, I can predict it, and I work with it.

Now to the embarrassing part. You may understand why this is hard to write. Blood 'flow' also does something else in a mans body. To be blunt, it is what makes an erection happen.  The old joke is a man does not have enough blood to work both a brain and a penis at the same time.  This, I now understand, hits pretty close to home.

Do I have erectile dysfunction, as well as heart failure?  Yes. I have (almost) come to peace with that and just like the heart failure I WILL do what I can to make it better.  Till then, the situation is roughly the same as the fatigue.  I simply can't do what I used to. Not even close.

Why am I writing these ever-so-hard to write words and opening myself to the deep embarrassment?  Because I must, and because it may be vital to someone else headed down the path I went. Because if I don't speak up, I won't be able to sleep at night.

You see, the ED did not come after the high BP episode and the heart damage and the forced retirement.  It began a year or two before that.  The erectile dysfunction began before the obvious heart failure issue.  It predates it... or does it?

I went the usual road at that time.  I saw the doc.  I got the expensive blue pill.  I started doing a testosterone injection (OUCH) that requires a sewer pipe of a needle.  You know what?  If all that had any effect I was too exhausted to notice, or that is what I thought.  Too tired, too stressed, wondering if I had psych problems at the heart of all that.

Fast forward to about a week ago. Just like the heart failure and the doctors lack of ability to do anything for it, I went off on a research binge regarding erectile dysfunction.  I figured I WILL do what I can to make this work.

All that digging related to an embarrassing and totally hyper-marketed physical issue gave me very little progress.  To be blunt, I was already doing all the stuff and it wasn't helping. I was almost resigned to the heart failure causing the issue and it simply is what it is.  Shut up fat boy and deal with it. No, the doctors did not link the two issues but it seemed obvious to me.

Then, I asked a different question.   "What percentage of men with heart failure experience erectile dysfunction?"   The answer startled me.  81%.  It wasn't a hard number to find, no pun intended.  This started my mind down a different path, and another question. "What percentage of men with ED develop heart failure?"  That number is much harder to pin down, but multiple studies suggest a man with diagnosed ED is roughly three times more likely to develop heart failure.  3x is not insignificant.  In fact, it's almost stunning.  Frankly, it appears that ED is almost as good as obesity and stress as indicators of impending heart issues.

Here's what shook me up about this.  Not a single one of my doctors mentioned this, or ever linked the erectile dysfunction to a possible heart problem.  

I believe if my earlier asking for help with ED had been taken as a possible indicator of heart problems, I could have caught it early and avoided the life changing damage.  That is exactly why I am writing about this, even though I'd rather just shut up and deal with it on my own. No man likes to talk about this problem, ever.

Maybe other doctors might have investigated, but the fact not one of all the doctors I have seen for the last ten years even mentioned this leads me to believe maybe none do. Maybe even doctors don't want to breach that wall of embarrassment.   If that is the case, this is dangerous.  No subject should be taboo when it comes to avoiding.. well.. death.

There it is.  There is exactly zero chance I'm ever going to ask some guy if his winky has gone weak.  That said, if bringing light to this subject might cause even one struggling guy to avoid sitting in a chair waiting to die, then it's worth it.  If any of this is ringing a bell, make something happen about it.  Please.

That's it.  I'm going to go hide in the basement now.  Ya'll take care.