The first signs are what seem to be a cold or flu, sometimes with a headache, then developing with fever, vomiting and a rash. But there is no guarantee that these symptoms will appear or in this order. It is often the case that treatment is too late if the rash appears. This is a sign of meningococcemia, a bacterial infection of the blood stream. In some cases, there can be a loss of blood circulation to the hands and feet. At the beginning, they feel cold and, if treatment is delayed, gangrene can set in and there is no choice but to amputate. It is a little like a horror movie. First, surgeons remove the fingers of the affected hand. If that does not stop the spread of the rot, the hand follows, then the arm below the elbow, continuing until there is no arm left. That just leaves the other arm and two legs to go. Amputations occur in between 10 and 20% of cases.

This brings us to Jamie Schanbaum who is a student at the University of Texas in Austin. Early in February, 2009, she felt ill and quickly realised it was something serious. But, instead of going to hospital, she went to bed hoping to sleep it off. This was a crucial loss of time. When she awoke, the bacteria had spread throughout her body. But she has benefited from a new approach to treatment. Patients are placed in an oxygen chamber and given high doses of viagra. Although this drug is most usually associated with the treatment of erectile dysfunction, it works by dilating arteries in certain key areas through out the body. So it has a general effect in improving blood circulation. Changing the air pressure also improves flow. With these two working together, circulation to the affected areas of the arms and legs can be improved and amputations avoided. Years ago, Jamie would have lost all her limbs. Today, comparatively little needs to be removed. Although this is an extreme example of the effectiveness of viagra, it should remind us that it also represents a dramatic way of restoring circulation to the penis and creating hard erections. Different needs are equally well served by this amazing drug.

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