When the source of pain is not where you think it is

Dear Dr. Roach: Iama 79-year-old woman in good health. I am very active. Whenever I feel a cold coming, I have pain on the left side of my throat when I swallow and get a stabbing pain in my head. I worry about stroke, and my husband thinks I may have a brain aneurysm. My doctor says he never heard of a correlation like that. What do you think? — H.B.

Dear H.B.: I agree with your doctor that it is very unlikely to be warning signs of stroke or an aneurysm. Stroke warning signs usually involve loss of function. Most unruptured aneurysms have no symptoms.

What I think you have is referred pain. The pain in the throat feels like it is coming from a different area.

Dear Dr. Roach: You had an article about how the blood vessels going to the penis can be blocked, causing problems with erections. Can you go into it a little more about how to solve that problem and what kind of doctor to see? — J.

Dear J.:Problems in sexual function can be a clue to problems that might affect other body systems.

That is particularly the case with circulatory problems. A blockage in one artery means that blockages in other arteries are highly likely. Occasionally, the first sign of atherosclerosis is erectile dysfunction. Proper treatment can reduce the risk of stroke and heart attack.

Blockages in arteries may be treated with medicines to reduce cholesterol or with medicines to help blood flow, or potentially with surgery. Surgical treatment is often done by a vascular surgeon. A urologist remains the expert in surgical treatment of erectile dysfunction and is usually your best consultant if treatments have been ineffective.