instruction: hello doctor I am 54 years old I have been diabetic for long years and under insulin I also suffer from diabetic retinopathy for two years I did more avastin injection and laser sessions eight months ago I had an ischemic stroke just a few months after the injections my blood pressure was very high the left gauges are 20 better thanks to physiotherapy I returned as before except in the legs the pelvis and purse erection problem and the rest constipated for 100 meters of walking I am exhausted and tired at the level of the purse I have burning sensations at the level of the pelvis it hurts if I try to sit on the floor or to turn on the bed the pains are rather nocturnal than at rest same also at the level of the left arms when I press or turn in rotation drugs insulin humalogu mix 25 insulin lispro mix 25 insulin lispro and 75 insulin lispro protamine suspension approvasac 300 my 5mg 0 fludex indapamide 1 alas 20 atorvastatin 20mg 1 ultracet paracetamol 325 my 0 1
output: hello I went through your post you seem to have diabetic neuropathy which is the cause of your erectile dysfunction and easy fatiguability in addition there are features of osteoarthritis instead of paracetamol 325 I would suggest sustained release form like it para og half tablet twice daily and neurotropic medicines like a combination of methylcobalamine with pregabalin which will improve neuropathic symptoms good control of your blood sugar is important to decrease or slow the progression of diabetic complications evaluation of cardiac status is important as it may cause easy exhaustion the ray does not show any gross abnormality