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There are nonsurgical options for prostate cancer. Hormonal therapy is just as popular as surgery, but maybe dismissed by many urologists as unproven. Many patients whose cancer has spread throughout the body find relief through reducing the amount of male hormone in the bloodstream which is what the cancer “feeds on". Without testosterone, impotency is almost inevitable. One such drug is the DES (diethistibestrol), a chemical that is similar to estrogen (a female hormone). Although DES brings with it a longer life and lessens the symptoms, it does have side effects. It kills a man’s sex drive, and many men report the nearly female effects: breast enlargement, thinning beards and even scrotal shrinkage. LH-RH Agonists (Leuprolide and Goserelin) can be used in later stages of prostate cancer. This is a synthetic pituitary hormone that regulates the release of testosterone into the bloodstream. After triggering an initial rush of testosterone, it causes a drastic decrease in testosterone which then starves the tumor. The side effects are occasional hot flashes, headaches, or impotence. It is usually administered through injections or implant pellets. Antiandrogens are hormones that inhibits the action of testosterone on cancer cells. It is also marketed to the brand name Flutamide, and it is frequently used in conjunction with other hormone treatments to lessen the pain of advanced prostate cancer Immunotherapy is a method used to build up the body's natural defense against diseases, including cancer. Some doctors combine immunotherapy with chemotherapy to help patients through the later stages of prostate cancer. Other sufferers use natural cures and herbs to help their bodies fight the cancer. Radiation and Hyperthermia Scientists do know that temperatures of 105°F or higher are deadly to cell division and weak cells. Scientists are attempting to put this information to work on prostate cancer by combining it with radiation to kill cancer cells. When applying heat to the whole body or to the localized area prior to radiation, it seem s to be more effective than either treatment alone There are Enzyme-inhibiting drugs such as Proscar by blocking production of an enzyme that triggers production of testosterone. Chemotherapy is usually considered a last resort for many cancer patients. The chemicals directly attack the cancer cells but usually end up killing many healthy cells as well. These are only a few of the treatments available for prostate cancer patients. Please discuss with your doctor as to what treatment may be the best option for you. vimax penis enlargement best enlargment exercise penis manual pnis enlargement exercise free penis enargement pills pennis enlargement excersizes penis girth enhancement vimax permanent penis enlargement natural penile enlargement pills

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The Prostate: Part I – BNP What is situated below a body of water, has four zones and is commonly associated with venial pleasures. No it is not some romantic European city, but rather a walnut sized male organ that serves important procreative functions. It also happens to be an organ that plagues men as we age. This organ or gland is the prostate. This is the first of two articles on the male prostate. This article will focus on a disease process that affects older men, something we refer to as benign prostatic hyperplasia (BPH). BPH is a non-cancerous growth in the size of the prostate gland that impairs the flow of urine out of the bladder. The second article will focus of prostate cancer. But first a little about the small yet important male organ. The gland is located just below the bladder. It usually measures one inch by one-and-a-half inches (approximately the size of a walnut). It surrounds the urethra (the tube that takes urine out of the bladder). It is responsible for producing a fluid important in male sexual function. In the past the prostate was described as having “lobes”, but today we refer to it as having concentric zones. These zones are important both on an anatomical as well as histological level. We can separate pathology along these zones as well. For instance most all cancers occur in the peripheral zone while the benign process of enlargement occurs almost exclusively in the transitional zone (which only occupies about 5% of the total prostate volume). The prostate gland is also made up of different cell types. Cancer cells develop from the epithelial cells, but it is the interaction with stromal cells that is important in the behavior of the cancer. BPH develops from an interaction between these cells as well, but it is complex and poorly understood. Testosterone and other hormones and their interactions with this gland are hot topics of research in understanding prostate disease. The prostate gland produces most of what is found in the male ejaculate. The average volume is about 3 mL. This is less than a teaspoon and only 1% of it is sperm. The majority of the semen volume is made of products of the seminal vesicles and the prostate. The male ejaculate is very rich in potassium, zinc, citric acid and fructose. Along with these substances it also contains prostaglandins. There are many other unusual substances found in the semen. Not all is know about their function or purpose. This important male organ is a complex mix of anatomical structures and cell types that make it possible for human reproduction. However beyond the reproductive years of men, this organ becomes one of burden rather than usefulness. We will discuss the finer points of BPH and how to best avoid it and if plagued with it, treatment options. BPH typically affects men from their fourth to fifth decade of life and beyond. Several hormones come into play that have a drastic effect on the transitional zone (the zone that is most central and surrounding the urethra). Namely a metabolite of the male androgen Testosterone called Dihydrotestosterone (DHT) plays a big part on the enlargement of cells of the prostate and the encroachment on the urethra. There are several signs and symptoms that correlate with BPH and they are: slow urinary flow, the urge to urinate all the time, nighttime urination, enlargement and distension of the bladder with continuous urine leakage (incontinence) and urinary obstruction. Autopsies suggest that more than 90% of men older than 70 years have BPH. The average age for symptomatic development is about 65 years for white Americans and about 60 years for African-American men. Ways to prevent the effects of DHT on the prostate gland and the ensuing enlargement are via medications that block the enzyme 5-alpha-reductase, which converts Testosterone to DHT. Proscar is such a drug commercially available through a pharmaceutical company. Proscar works on blocking the effects of androgens on the epithelial cells and can actually shrink the size of the prostate making some of the symptoms of BPH resolve. Alternatively two FDA approved drugs that aid in symptoms of BPH (but act differently than Proscar) are Hytrin and Cardura. Both Hytrin and Cardura are drugs in the alpha1-blocker class. Originally researched as a centrally acting blood pressure reducer for patient with hypertension, it was discovered that this drug would actually relax the prostate tissue surrounding the urethra making symptoms of BPH resolve. Side effects generally include low blood pressure, dizziness, and nasal stuffiness. While neither of these two drugs will “cure” or reverse the process, they certainly do provide symptom relief for the patient plagued with BPH. Another way to treat this disease and a more natural approach is the use of herbs know for their anti-androgenic effects on the prostate. These include the well-studied Saw Palmetto herbal extract that blocks 5-alpha-reductase in the same manner as the prescription drug. Saw Palmetto taken in a standardized dose of 160mg twice daily has shown increased urine flow, with minimal side effects. Saw Palmetto is an herb indigenous to the Lowcountry of Georgia and South Carolina. Pygeum Africanum is shown to do the same yet it is not as effective and there is a fair degree of stomach symptoms. Pygeum is derived from an African evergreen tree. Stinging Nettles (Radix urticae) is another herb used widely in Europe for prostate health that has been shown to lower the residual urine volume in men with enlarged prostates. These phytotherapeutics (plant derived medicines), used and described by the Egyptians as far back as the 15 Century B.C., have a common compounds called phytosterols. The most effective phytosterol is beta sito sterol for BPH. None of the medications or herbs has been shown to prevent prostate cancer. These prescription medications and herbs are for the treatment, reduction in size or prevention of the benign process of enlargement of the prostate. Prostate cancer prevention and treatment is by other means and the subject of the next article. Besides the herbal and drug therapies there are a few surgical therapies worth mentioning. These include the most common transurethral resection of the prostate or TURP. This is where under the care of an urologist the constricted urethra within the prostate gland is “reamed out” thus mechanically or surgically widened the opening. A variant of this is the transurethral incision of the prostate (TUIP) where an incision rather than resection of the tissue is performed. A suitable procedure for patients with prostates 100 mL in volume. This involves an abdominal operation and removal of the whole prostate. Of course symptoms mentioned above for TURP are of greater frequency with this more radical procedure. There is also thermotherapy (a type of microwave treatment) that alleviates irritative symptoms, but not much is available in long-term results in the medical literature. And finally stent placement is an option. This can be used in selected cases of patients with a poor general condition and in the non-operative candidate. Symptoms of BPH include: Obstructive symptoms: Hesitancy in initiating voiding (trouble getting started) Weak urinary stream, prolonged voiding Post-voiding dribbling (mild incontinence) Sensation of incomplete emptying Nocturia (night time urination) Overflow incontinence Acute urinary retention (very painful condition) Irritative symptoms: Dysuria (discomfort in urination) Frequency Urgency Scoring BPH: The American Urological Association Symptom Index (AUASI) and International Prostate Symptom Score (IPSS) are now considered the gold standard measurement tools for the assessment of BPH symptoms and response to treatment. Both questionnaires can be used by a physician in a clinical practice to quantify the subjective symptoms of BPH and monitor therapies. Part II in this series will cover annual examination of the prostate, blood testing, prostate cancer. It will also cover prevention and treatment of prostate cancer. Reference: http://www.prostatehealth.com Lowe, FC. Et al, Phytotherapy in treatment of benign prostatic hyperplasia: a critical review. Urology 48:12-19, 1996 Dreikorn, K. et al, Stellenwert von Phytotherapeutica dei der Behandulng der benighnen Prostatahyperplasia. Urologe (A)34:119-129, 1995 Fitzpatrick, J.M. et al, Phytotherapeutic Agents in Management of Symptomatic Benign Prostatic Hyperplasia. Urological Clinics of North America. 22:407-412, 1995 Wilt T, Ishani A, Mac Donald R.. Serenoa repens for benign prostatic hyperplasia. The Cochrane Database of Systematic Reviews 2002, Issue 3. Art. No.: CD001423. DOI: 10.1002/14651858.CD001423. [Research by Sagalowski and Wilson, 1998] © 2005 vimax penis enlargement surgery photo penile enlargement surgery cost penis enlargment technique penis enlagement excersizes penis enhancement surgery pnis enlargement testimonials free penis enhancement pills buy penile enlargement pills penis elargement exercise

The Forest As we drove farther into the outskirts of Augsburg, looking out placidly across the top of cars, houses, and at the dogs running about, I got thinking, thinking how I felt being with Chris, about Chris. It was like I was cast into a spell, an enchantment, or perhaps a curse; very seldom did I ever feel like this. Normally I would feel like this only if I was in the presence of a great person, like my karate instructor in San Francisco, Gosei Yamauchi, or his father ‘The Cat’ Gogan, who was one of the few 10th degree black belts in the world. Normally I’d be high the whole next day. With Chris I felt the same way I knew tomorrow I’d be high all day, it was a natural high. Once—I can’t remember when—I had read something about the poet Emily Dickinson, she was something like a recluse, but she made a poem indicating nature was her high, and I always remember that. How true this can be, grabbing the moment and cherishing it, absorbing it as if there was no tomorrow, and at the same time absorbing nature: the sounds and the heart beat mother earth, and sky; others humans, and the dogs and birds, all such things that at that moment surround you; they are all somewhat magical. I was learning, how to be a listener if anything and it entailed all things within your presence. Chris was fully alive now, as I turned my head towards her delectation her steering wheel facing me, at which made the moment a little more interesting, as she felt good about me checking her out; a weary kind of sense, not defeat, just a good profile look; I thought dimly in my mind as she drove mile after mile: how could she afford to look so prim and proper all the time. Do her hair in a unique style, not a hair out of place, so it seemed. I guess in our own way we are all unique, I heard that someone say that someplace, not sure where. An hour and a half had passed on by and she was still driving, and it was getting dark. She pulled into a wooded area; she said it was the outer rim of the Black Forest (otherwise known as the Eyebrow of the Woods), I think I heard of that forest in a fairytale book or at least that is where my mind said I got it from. An enchanting name, I must had said it my second self, that little person inside of all of us that we talk to: Black Forest, Black Forest…! “So you see,” said Chris “…here we are!” She added her conclusive little smile to her face as she said that; as we entered the dark huge green forest, parking the car a little off to the side of a dirt road that lead into the deeper and more distant part of the forest, partly covered by trees and bushes now. There was a chill in the air so I rolled up the window, as she turned on the radio for some music. Very quickly and carefully she moved her thin reserved neck and shoulders into my area, she just starred at me, as if she was going to eat me up; as her left arm was lowered, it pulled out a bottle of Mosel-Saar-Ruwer wine, 1965 wine, -- I looked the bottle over 9.5% volume; I knew they had been making wine around this intriguing river and hilly area for close to 1700-years. It was good wine I had tasted it before, not sweat or dry, flowerily white wine to be exact. “Now,” said Chris indignantly, but with the air of a certain point, “…let’s see what we can do with this battle. We started to drink and laugh. “Ah, yes,” I said to her, “you have a lovely profile.” She smiled and threw her head back. “Well,” I thought out loud “… this is a good way to pass the night away, and begin romantic indecencies”-- she leaned over the center-divider of the bucket seats to kiss me. She opened her mouth, sunk her lips on mine, as she pulled her long legs to the under-part of the dash, she then started to unzip her zipper to her boots. “This,” commented Chris “passes everything…I never did it in a car before.” She had drunk down 1/5 of the wine like a person drinking water. “Chick,” said Chris, ”…come over here.” I moved my body closer to hers. Everything seemed to be in the way. I could not back out of whatever was going to happen; and I knew what was in the makings. She was starting to stretch her hands out: --her blouse went over her head, I just kept looking as she started to strip, I was growing, getting as hard as a pencil. “Oh, damn Chick,” said Chris heartily as she touched my item. Just her saying that aroused me; then pulling off her bra, and her skirt up I seemed to become tranquilized somehow, my mind slipped to King Solomon, of all things, as he once defined the beauty of a woman’s body and how it was to measured for one’s pleasure by enjoying it fully, and this was all I wanted to do now—enjoy it, and I think Chris was feeling the same way for even though we were both a bit on the tipsy side we were fully aware of our responses, I had lost complete focus of the uncomfortable situation, as she did… ◊…now that she was almost completely stripped only her panties on, she curled up in a fetus position holding her legs and leaning back, then opened up her legs slowly… I thought what every on earth possessed her, yet who can predict women I told myself, and started to take off my cloths, quickly…getting out of this spill of sorts. I guess it is true, men like to observe, and women like to touch. I liked both. This was not dirty sex, this was pure sex, at its height, one might even say, it was like a painting; she painted the picture, she taught me how to enjoy what she had to offer. “I’m going to get it all off in a minute,” I said, it was difficult working in this cramped space… she chuckled, “Slowly please, I can wait…”she softly said as she rested her head back and I caught my breath, that is what she wanted, that is, for me to calm down, yet remain hard and possessed with her offering: I think we both had multiorgasms “I feel fine now –“ I said, adding, “cramped but fine…☺” Chris opened up her arms I couldn’t back away after that, could I? I told myself: I have a private room at the barracks…. Then said it out loud to her: “Of course, -- next time…” said she, and we continued to make love for the third orgasm for me, for her, perhaps five or six. We seemed to flop around the front seat finding the right position…’she‘s looking at me eeeeeeeee’, I told myself, I’m cramped, nothing to grab a hold of, her head leaning against the glass of the window. Without a word we continued: --my body heavy onto hers, my heart beating two-hundred ticks a minute, we both were hot, enmeshed in the moment, a lustful, and burning moment; I wanted to open the door, but feared the light going on and someone would see us, plus the air was cool, too cool. I had no escape we met each other’s eyes as I penetrated her. She looked again deep into my eyes as she tried to catch her breath, to make sure I was still alive I think. It was seemingly unfair for me to put her through this I thought, but the thought only lasted a half second, I found myself exploding … as my heart dropped to my feet, and again, and again, I exploded and burned as if I had opened myself up to a volcano; I had learned at that moment, the difference between happiness and pressure: happiness was listening to her talk before, and then came her smile, now the pleasure, sex; I hurt, this had never happened before. “Nice evening, isn’t it?” I said as I started pulling her body closer to me. “I hope you are not offended I am taking the lead?” said Chris. “Not at all,” I said, adding, “I’ll catch up.” “There are times,” said Chris, “when rules are made to be broken like now, them...mmm damn silly rules…” she pulled herself up a bit, “I stopped believing in those rules… this is one of those moments I want to remember…remember for a long time, even after I am dead.” As we tried to untwist our bodies, we caught ourselves laughing at our odd situation. We had made love, and became a little more sensitive with each other…a little more possessive of each other, I guess that is the nature of things in a relationship, they are made to progress, or stop, one or the other, and it was never to take place again in the front seat of a Mustang I knew…. She laid her cheek against my hand. “Chick.” “Yes?” “You realize don’t you, this can’t end here?” “There’s no reason for it to end, is there?” “No.” She spoke some German words I didn’t understand, German mingled with English I should say: then somehow, she went silent…maybe she was taking time to remember the moment, digesting it; I didn’t know, nor did I want to try to guess, I just looked at her, her smile it seemed to promise something, grace; instinct was in it also, around her small enclosed eyes, as they opened and shut slowly they were weaving a web I do believe, “It won’t end here, I promise.” Pleasant and agreeable-like a well-cultured woman she was, maybe too much for me, she opened the door, and dressed quickly, then got back in. “Want a cigarette?” I asked, sitting up straight. “No and neither do you. We are both restless it seems. Come over to me,” she started kissing me. As she released her lips from mine, she sat upright now, pulled out a cigarette, lit it and started blowing smoke rings into the air. “You know perfectly well, I’m very much attracted to you…yoouuuu… right?” “I hope so, I feel the some way.” “Luckily the wine deadens the bruises (discoloration).” I commented, she laughed and kind of stretched her back to put it back in place…”Me to,” she replied. “I wish all relationships could start like ours, it is like saying let’s drop all the game playing and pretend we are on the fifth date, and cut the crap; I like you Chick, I like you very much…” “The bruises will show up tomorrow,” I told Chris. Kind of saying maybe we should go, but neither one of us seemed to be all that bothered with that so we simply started kissing again after her cigarette brake…it was a long and needed pause for me, for a second breathe, a refractory period I needed [from uninterrupted sex]; that is, having multiple orgasms drains a man. I’ve learned also, women don’t need this rest period; so in time I’d learn how to last longer, and perhaps stretch the orgasms thinner but again, longer (three hours at the most; and I did). I thought in my head, she was having sex with me, and then that rich boyfriend she had; she was getting her multiorgasmic pleasures indeed, perhaps a secret to some women, for once they discover this, it is hard for any man to keep up with them, lest he be a superman of sorts. I did not even at that young age have the capacity to pass six organisms; five was my limit I learned. I was limp now; my penis had been as pointed as a scorpions tail a while ago. As scary as it started out for me I thought my reactions afterwards was cool, I seemed to be letting things take their natural course. It was a dark and colorless evening. Grossly romanticized in such an unimpressive way (so I thought in the back of my mind), yet Miss Chris was perfect. I thought to myself: maybe she might be annoyed with my lovemaking… I guess every man wants to please the woman, wife, girlfriend, the one he is making love to, or should want to please her, but most don’t; how can they, they pop too quickly. This is a fact, I’ve talked to men, and when they say they go so quick, no woman could get it on in that time period. A woman taught me how to hold myself from climaxing too early, thus allowing the woman to catch up—and therefore, allowing my female mate to get it on and enjoy. I know this evening went a little fast, but Chris was modest about it, like that other woman who had taught me, helped me, to help her, so we both could enjoy each other more; as my slowing down kept my penis hard longer, allowing her pleasure zone to become wider. This was something of the case in hand, but not completely. Most men think they make love better drinking, but it’s far from the truth. Most men do not know how to make love, no one taught them, so all they do is f*ck, and that is not love, that is, if anything, a quick climax, like eating a big fat burger, and wiping your mouth in its enjoyment and then leaving the café only to find out: you got indigestion, and had you went to a nicer restaurant, ate slower, you’d never forget the meal. I have experimented with that theory, and it is nine-minutes verse four-hours, I say four hours, but I knew in my head it was only one time I lasted four hours, two and a half was the norm. I was thinking now—as Chris kissed me—how I owe some women a bit of gratitude for allowing me to have my pleasure and not returning it to them; that’s the caretaker in a woman I think. But women just don’t know men can learn. And men are too bull-headed to let women teach them what pleases them. I had learned a good lover was worth his weight in gold and even maybe a little more: sometimes they can be irresistible. One could hardly tell her it wasn’t hastily done, our sex (to me it was) for it was, but she seemed to understand the circumstances, and we need not prove anything today, only allow our bodies to be sanctioned to the other. So I think we both felt. Lovemaking would improve as time went on. “I’m afraid my lover, we will have to find better accommodations next time,” Chris said, smiling at me. “Yes,” I hesitated, “absently,” I hesitated-- “I feel the same way.” “It’s a little hard in such a cramped car luckily we are both a little tipsy….” “I’m afraid I’m not, somehow I sobered up when you took your blouse off.” She smiled, with a grin. “Yes. I sense you have, do you really like me Chick?” “You are growing on me. And what is there not to like?” She was like a schoolgirl at times, needing to be encouraged, to grow up, and needed to be admired. But she didn’t need permission to live, she was taking that—but I’m learning to appreciate women more, I told myself, and it seems the more I show appreciation, the more they respect me, and to be quite frank with myself, I need respect. And why not … the world will give it, if you demand it, and if not, let that part of the world go; so my second self, my mind’s eye, told me. But then as I looked at her, if she really felt she was on death row, with cancer, maybe I was just a remedy for a while, and if so, so what, maybe I needed a remedy to make it through my time here in Germany; so seemed just to me. 8 The Spider and The Web A warm-wind had picked up it seemed, and April and May in Germany was a paradise of light-cool sunrays, it was a spring never to forget, Chris and I were growing on one another, like white on rice. More community drinking fairs were picking up and Chris and I tried to make a few, drink it up and eat and just go with the flow; it was a good time for living. Chris and I were known throughout the guardhouse-barracks as lovers and a heat wave at that. She seemed to have a charm with my soldier friends, and often drove her German boyfriend’s Mercedes car to the gate, and about, showing off kind of, not only to me, but it seemed at times going out of her way to show it to the other guards. Most of my friends thought she had two cars, I simply did not up date them, if they were not in my way of thinking or inner circle—why squander my time; and in most cases they didn’t have a need to know; but Ski and a few other of my friends knew the truth. I felt: plus, I felt: why not let Chris make an impression at the guard shacks, if it helps her ego so be it. I do not think I was envious, rather amused. I’m sure somewhere along the line I’d have to deal with envy, but who at my age is envious, for what, I have a lifetime to catch up. She flirted with the guards, and they all thought it cool. At night, if I had to work, she would bring me by a sandwich while on duty; in one way she got the guys a little jealous, or in lack of a better word, annoyed. And sometimes she would simply walk into barracks, which had about fifteen-guards some running around half naked from the shower room to their room, while others went visiting. She’d come knocking on my door. She’d spend the night with me, it was an improvement from the car, and for some reason we only went over to her house once in the following two months. I knew we were not fooling anyone at the guard-barracks, but we pretended to be secret about it anyway. best pennis enlargement pills do penis enlarement pills work cheap vig rx penile enlargment secret penis enlarement surgeon penile enlargment stretcher penile enlargement drug penis enlargment surgery penis elargement exercise

The resent passing of another HIV (Human immunodeficiency virus) testing awareness day this summer made me think about some of my old clients. I was a state certified HIV test counselor for the state of Michigan at the agency where I worked. This meant that I administered HIV tests for those people who believed that they may have been put at risk for contracting HIV, the virus that causes AIDS. This was a stressful job, and some days, down right awful. The awful days, as you can imagine, were the ones when I had to tell a client that they had tested positive for the HIV antibodies. Thankfully, I only had to tell a few people, but those few individuals are forever carved into my mind. I will never forget them or the day that I had to tell them that they most likely were infected with a life altering infection. These people were young, old, and middle aged. They were people not unlike me. Hard working, dedicated to family, goal oriented, future driven. They were beautiful people that are going through life with an ugly, incurable illness. Unfortunately for me, since these individuals tested anonymously, I will never know their true identities and will probably never know how they are and if they are living healthy productive lives, or suffering and alone. Guess what? You could be infected. You could be at risk. You should be one of those clients that walks into an office and asks to be tested. HIV doesn’t discriminate. It doesn’t care if you are rich or poor. If you are male or female. Gay or straight. It doesn’t care how old you are. We have babies in this country still being born with the virus because moms don’t know they are infected. Parents and grandparents are increasingly being diagnosed with HIV. Yes, you need to know that your mom and dad or grandmom and grandpa still have sex. They still can potentially be infected if they are involved with someone sexually that has the virus. HIV is still out there. It is still killing people. We do not know yet how to stop it. Doctors and researchers are developing new ways all the time to slow it down, limit its effects on people’s lives, but we are no where near eliminating it from our world. I have been working with educating about HIV for around 20 years. I am sad and horrified to look at the statistics and see that we are no better off now than we were 20 years ago. The numbers keep rising. There is much in the news about HIV/AIDS rates in Africa and other countries, but I want to remind people that in your own backyard, HIV is still raging. We need to remind people that there are safer ways to behave, to reduce the risk of the infection spreading. The best way to reduce the risk of spreading HIV is to know your own status. There are testing sites available in your state. Get a test. They only take a short time to administer, and usually you can do it without giving blood. You can, in many cases, do it anonymously. Testing is the only way that you will know if you are infected. The earlier the diagnosis, the better the prognosis. Don’t assume you only associate with non-risky people. You can’t possibly know. Ask anyone who has HIV. As a society, we need to become more comfortable with talking about uncomfortable topics. We need to talk to potential partners. We need to talk to our doctors. We need to talk to our friends. I remember thinking when I was a teenager that I wanted to be just like Dr. Ruth Westheimer when I grew up. She was so great about telling it like it was. She called a penis a penis and was proud to do so. I admired that in a time when people didn’t talk to teens about sex, she was willing to. Today, we seem to only talk to teens. We stop talking once that teen grows up. They has become very apparent due to the increasing number of adults over the age of 50 who are becoming infected. So now I am talking. The lessons are fairly simple. Know your HIV status. Know the infectious disease status of your sex partner, or don’t have sex. Use a condom. Don’t share needles if you are using drugs. If it isn’t possible to refuse every time, do it some of the time. Every time you think about your health and act positively for it, you reduce your risk and add another day to the fight against this illness. Find support. There are many wonderful agencies in communities across this country that offer education, help, and the things you need to live a safer life. Everyone has their own story and their own reason not to live safely. These agencies have been trained to help each individual create their own specific plan of action. There are some people who feel that the drugs are available, so it is worth the risk. Certainly we risk getting the flu or infections by going out into the general public with the understanding that there are medications available to make us better if we get sick. So why is HIV different? One reason is that the drugs are expensive. Many people don’t have the insurance coverage to help pay for them, and even if they do, some drugs are hard to come by in certain areas. Secondly, the side effects for many of these drugs are brutal. I know people living with the virus who have chosen to deal with the disease rather than be restricted by the drugs. Another reason is that when you get Strep throat, you take an antibiotic for 10 days and you are done with that medication and that infection. If you get infected with HIV, you take medication for the rest of your life, with the added stress that if you forget to take it to often, it may become ineffective for you, all the while knowing that you never are going to be free of HIV. It is as simple and straightforward as all that. Dr. Ruth couldn’t say it plainer. HIV can’t just be thought about on testing days or awareness days. It needs to be thought about, talked about, and dealt with daily. It needs to have people like you and me to continue to fight the fight for comprehensive sexuality education. To continue to educate everyone about what HIV is about and who it affects. We need to talk equally to young and old alike about the risks that they take with their lives. And mostly we need to not forget those that have died and continue to be infected and affected by a disease that is so easy to prevent. I know that I will always think about my clients and will pray that they are living happy healthy lives. prosolutionpills pnis enlargement supplement surgical penis enlargment penis enargement result cheapest penis enhancement pills does magna rx work free magna rx safe pennis enlargement penis elargement exercise

The Prostate: Part I – BNP What is situated below a body of water, has four zones and is commonly associated with venial pleasures. No it is not some romantic European city, but rather a walnut sized male organ that serves important procreative functions. It also happens to be an organ that plagues men as we age. This organ or gland is the prostate. This is the first of two articles on the male prostate. This article will focus on a disease process that affects older men, something we refer to as benign prostatic hyperplasia (BPH). BPH is a non-cancerous growth in the size of the prostate gland that impairs the flow of urine out of the bladder. The second article will focus of prostate cancer. But first a little about the small yet important male organ. The gland is located just below the bladder. It usually measures one inch by one-and-a-half inches (approximately the size of a walnut). It surrounds the urethra (the tube that takes urine out of the bladder). It is responsible for producing a fluid important in male sexual function. In the past the prostate was described as having “lobes”, but today we refer to it as having concentric zones. These zones are important both on an anatomical as well as histological level. We can separate pathology along these zones as well. For instance most all cancers occur in the peripheral zone while the benign process of enlargement occurs almost exclusively in the transitional zone (which only occupies about 5% of the total prostate volume). The prostate gland is also made up of different cell types. Cancer cells develop from the epithelial cells, but it is the interaction with stromal cells that is important in the behavior of the cancer. BPH develops from an interaction between these cells as well, but it is complex and poorly understood. Testosterone and other hormones and their interactions with this gland are hot topics of research in understanding prostate disease. The prostate gland produces most of what is found in the male ejaculate. The average volume is about 3 mL. This is less than a teaspoon and only 1% of it is sperm. The majority of the semen volume is made of products of the seminal vesicles and the prostate. The male ejaculate is very rich in potassium, zinc, citric acid and fructose. Along with these substances it also contains prostaglandins. There are many other unusual substances found in the semen. Not all is know about their function or purpose. This important male organ is a complex mix of anatomical structures and cell types that make it possible for human reproduction. However beyond the reproductive years of men, this organ becomes one of burden rather than usefulness. We will discuss the finer points of BPH and how to best avoid it and if plagued with it, treatment options. BPH typically affects men from their fourth to fifth decade of life and beyond. Several hormones come into play that have a drastic effect on the transitional zone (the zone that is most central and surrounding the urethra). Namely a metabolite of the male androgen Testosterone called Dihydrotestosterone (DHT) plays a big part on the enlargement of cells of the prostate and the encroachment on the urethra. There are several signs and symptoms that correlate with BPH and they are: slow urinary flow, the urge to urinate all the time, nighttime urination, enlargement and distension of the bladder with continuous urine leakage (incontinence) and urinary obstruction. Autopsies suggest that more than 90% of men older than 70 years have BPH. The average age for symptomatic development is about 65 years for white Americans and about 60 years for African-American men. Ways to prevent the effects of DHT on the prostate gland and the ensuing enlargement are via medications that block the enzyme 5-alpha-reductase, which converts Testosterone to DHT. Proscar is such a drug commercially available through a pharmaceutical company. Proscar works on blocking the effects of androgens on the epithelial cells and can actually shrink the size of the prostate making some of the symptoms of BPH resolve. Alternatively two FDA approved drugs that aid in symptoms of BPH (but act differently than Proscar) are Hytrin and Cardura. Both Hytrin and Cardura are drugs in the alpha1-blocker class. Originally researched as a centrally acting blood pressure reducer for patient with hypertension, it was discovered that this drug would actually relax the prostate tissue surrounding the urethra making symptoms of BPH resolve. Side effects generally include low blood pressure, dizziness, and nasal stuffiness. While neither of these two drugs will “cure” or reverse the process, they certainly do provide symptom relief for the patient plagued with BPH. Another way to treat this disease and a more natural approach is the use of herbs know for their anti-androgenic effects on the prostate. These include the well-studied Saw Palmetto herbal extract that blocks 5-alpha-reductase in the same manner as the prescription drug. Saw Palmetto taken in a standardized dose of 160mg twice daily has shown increased urine flow, with minimal side effects. Saw Palmetto is an herb indigenous to the Lowcountry of Georgia and South Carolina. Pygeum Africanum is shown to do the same yet it is not as effective and there is a fair degree of stomach symptoms. Pygeum is derived from an African evergreen tree. Stinging Nettles (Radix urticae) is another herb used widely in Europe for prostate health that has been shown to lower the residual urine volume in men with enlarged prostates. These phytotherapeutics (plant derived medicines), used and described by the Egyptians as far back as the 15 Century B.C., have a common compounds called phytosterols. The most effective phytosterol is beta sito sterol for BPH. None of the medications or herbs has been shown to prevent prostate cancer. These prescription medications and herbs are for the treatment, reduction in size or prevention of the benign process of enlargement of the prostate. Prostate cancer prevention and treatment is by other means and the subject of the next article. Besides the herbal and drug therapies there are a few surgical therapies worth mentioning. These include the most common transurethral resection of the prostate or TURP. This is where under the care of an urologist the constricted urethra within the prostate gland is “reamed out” thus mechanically or surgically widened the opening. A variant of this is the transurethral incision of the prostate (TUIP) where an incision rather than resection of the tissue is performed. A suitable procedure for patients with prostates 100 mL in volume. This involves an abdominal operation and removal of the whole prostate. Of course symptoms mentioned above for TURP are of greater frequency with this more radical procedure. There is also thermotherapy (a type of microwave treatment) that alleviates irritative symptoms, but not much is available in long-term results in the medical literature. And finally stent placement is an option. This can be used in selected cases of patients with a poor general condition and in the non-operative candidate. Symptoms of BPH include: Obstructive symptoms: Hesitancy in initiating voiding (trouble getting started) Weak urinary stream, prolonged voiding Post-voiding dribbling (mild incontinence) Sensation of incomplete emptying Nocturia (night time urination) Overflow incontinence Acute urinary retention (very painful condition) Irritative symptoms: Dysuria (discomfort in urination) Frequency Urgency Scoring BPH: The American Urological Association Symptom Index (AUASI) and International Prostate Symptom Score (IPSS) are now considered the gold standard measurement tools for the assessment of BPH symptoms and response to treatment. Both questionnaires can be used by a physician in a clinical practice to quantify the subjective symptoms of BPH and monitor therapies. Part II in this series will cover annual examination of the prostate, blood testing, prostate cancer. It will also cover prevention and treatment of prostate cancer. Reference: http://www.prostatehealth.com Lowe, FC. Et al, Phytotherapy in treatment of benign prostatic hyperplasia: a critical review. Urology 48:12-19, 1996 Dreikorn, K. et al, Stellenwert von Phytotherapeutica dei der Behandulng der benighnen Prostatahyperplasia. Urologe (A)34:119-129, 1995 Fitzpatrick, J.M. et al, Phytotherapeutic Agents in Management of Symptomatic Benign Prostatic Hyperplasia. Urological Clinics of North America. 22:407-412, 1995 Wilt T, Ishani A, Mac Donald R.. Serenoa repens for benign prostatic hyperplasia. The Cochrane Database of Systematic Reviews 2002, Issue 3. Art. No.: CD001423. DOI: 10.1002/14651858.CD001423. [Research by Sagalowski and Wilson, 1998] © 2005