Five Signs of Empty Nose Syndrome

Persons with empty nose syndrome have a difficult time in getting a proper diagnosis. Yet, correct diagnosis and management make a huge difference in symptom relief.

In a typical scenario, a patient presents to the doctor and explains she can’t breathe through her nose. Then, the doctor looks in the nose and sees it is wide open. He doesn’t see any blockage to breathing. He may measure the blood oxygen and sees that it is normal. If he orders a blood count, that is normal too. He may decide to “humor” the patient and give her a sample of a nasal spray. Then this patient leaves the office unhappy that she was essentially ignored.

The main sign of empty nose syndrome is the complaint of not getting enough air from the nose.

In ENS the turbinates have been removed or severely reduced. Instead of a blockage, the nose is actually excessively wide open. But, like a garden hose, when the hose opening is wide open, the water has very little pressure and comes out only inches. In the hose, when the opening is made smaller, the water will project several feet.

Because the nose is now wide open, the sensors for air pressure don’t get notified that there is air coming in. That much lowered air pressure “feels wrong” and so the patient feels like he isn’t getting any air. Unless your doctor understands this, he will be confused.

The second sign of ENS is a history of nasal turbinate surgery. There are various procedures that doctors do to open a narrowed airway. These include Laser Turbinectomy, Somnoplasty, Coblation, Microdebridement, and Turbinectomy. Despite care, sometimes too much nasal turbinate tissue is removed or destroyed.

A third sign of ENS is unusual pain. Because the airflow is severely changed, certain nerve endings may be stimulated. Because the pain is very difficult to pinpoint, the accompanying anxiety is made much worse.

A fourth positive sign of ENS is frequent or constant nasal/sinus infection. There may be thick postnasal drainage and a constant sore throat. This is due to the absence of nasal cilia that are no longer there to move bacteria out of the nose, and to help moisten the air to the throat and lungs.

A fifth indicator that this is ENS is a reduced sense of smell and taste. The sense of smell is critical to life’s pleasures. Sometimes the poor smell is the primary complaint of the ENS patient. When smell sense is reduced, that also affects the sense of taste. You enjoy a steak because you can smell the cooked meat. The altered air currents don’t bring the odor particles to the organ of smell in the roof of the nose, plus the excessive dryness are both factors in causing the hyposmia.

Which comes first, the lack of sleep causing fatigue, or the fatigue from constant infection that causes poor sleep? Fatigue and overall reduction of quality of life can be significant.

For many ENS patients, a CT Scan of the sinuses taken before turnbinate surgery may not even show sinus disease, yet for many ENS patients the CT Scan taken a year later does show sinus disease!

Differential Diagnosis:

The doctor needs to make a differential diagnosis here. Chronic sinus infection can also cause fatigue, poor sleep, and reduced sense of smell. The difference is that in chronic sinusitis, the airway is seen by the doctor to be swollen and partially obstructed.

Atrophic rhinitis is also called Ozena. Here there is severe nasal crusting, a bad smell from the nose, and the internal nose is wider. This condition runs in families. There is a blockage of the blood supply to the nasal tissue, causing the underlying bones, particularly the turbinates, to shrink. Present mostly in females. The main difference between Ozena and ENS is that with Ozena, you don’t have a history of nasal surgery. Ozena shows much more foul smelling crusts.

Sjogren’s Syndrome is characterized by dryness of the nose, mouth and eyes. It is an autoimmune disease that involves the glands that moisten the mouth and eyes, as well as the mucus secretions of the nose and throat. In Sjogren’s, the primary complaint is the dry mouth and eye, there is no history of nasal surgery and the nose shows ordinary turbinate tissue.


For ENS the primary problem is lack of nasal cilia and decreased mucus. It is this absence that allows bacteria to grow and penetrate the nasal tissue and cause sinus disease. Therefore the best therapy is pulsatile irrigation because the pulsing saline going through the nose and sinuses, pulsaing at a rate analogous to the normal pulse rate of the cilia, performs like regular cilia action. This pulsing action with enhanced saline used early will prevent the significant sinus infections that often accompany ENS. Pulsatile irrigation for ENS also helps to massage the nasal tissue and bring more circulation to nasal tissue. If biofilm forms in ENS, pulsatile irrigation is an effective means of removing these organized bacterial colonies. Later, if sinus disease has developed as a result of ENS, pulsatile irrigation is effective in clearing the sinus disease. Of particular value is the fact that you can add your prescribed antibiotic to the pulsatile irrigation solution and avoid the systemic antibiotic effects.

For Atrophic Rhinitis pulsatile nasal/sinus irrigation has the advantage of being the best means of removing the thick heavy crusts. In orthopedics they reported that pulsatile irrigation is 100x more effective for removing bacteria and crusts than simple wash.

In ENS, measures to improve immune factors are important. Take iron if your hemoglobin is low, take Probiotic or yogurt to aid the production of immune factors. CQ 10 can be a help. Depending on what the doctor finds, he may ask you to use Premarin vaginal cream in the nose to build up membrane thickness.

Avoid cortisone nasal sprays as these will thin the nasal tissue. ENS patients are especially sensitive to saline spays that contain preservatives such as benzalkonium, so these should be avoided. Products like Atrovent or Afrin don’t improve ENS symptoms.

Anxiety is often seen in ENS, especially when the diagnosis is not well established. I hope this presentation will clarify many of the concerns of ENS patients and serve to reduce that anxiety.

How to Treat Angina

Angina attack is an acute chest pain or discomfort felt around the chest area on account of reduced blood flow to heart due to narrowing of the arteries of the heart. Angina could also be caused due to increased demand of blood supply for the heart, blockage of artery, or thickening of heart muscles. Supplying more blood through narrow arteries causes discomfort, sudden pressure, tightness, heaviness or squeezing pain in the chest area which leads to Angina.

True angina can be very serious, but if it is just the pain, not an actual heart problem it may be caused by muscle tension known as Trigger Points which you can locate on your back in the iliocostalis muscles which run along each side of your spine. They can also cause pain mimicking pleurisy, appendicitis, kidney stones, tumors, rib inflamation, ligament tear or disc problems. If you put a tennis ball inside of a long sock (to hang onto it), you can massage the muscles on your back by pressing into a wall.

Boost your vitamins–A, C and E. Here’s another benefit of a low-fat vegetarian diet: It’s rich in the antioxidant vitamins A, C and E–three nutrients that have been found to help prevent or control angina.

Sit down. Medication or no, your first response to angina should be to sit down and relax, says Dr. Ouyang. If you’re having an arterial spasm, it will subside in a minute or two and release its grip on your artery. If clogged arteries are to blame, relief upon resting may suggest that whatever you were doing when the pain hit required more oxygen than your clogged arteries could deliver. Sitting down reduces the workload on your heart and should relieve the pain.

Goals of Treatment — All of the medical and interventional treatments for people with coronary heart disease have the same goals: to decrease improve quality of life and to alleviate symptoms such as angina. In some people, these interventions may also delay or stop the progression of the disease and thereby prolong life.

Aspirin makes platelets less “sticky,” decreasing the chances of blood clot formation. One 75 to 325 mg coated tablet daily is the typical dosage for chronic stable angina and unstable angina.

Studies have shown that some patients are resistant to the effects of aspirin therapy. Regular blood tests may be performed to monitor the patient’s response; the results of these tests can be used to adjust the aspirin dosage or change the medication.

When physical exertion, strong emotions, extreme temperatures, or eating increase the demand on the heart, a person with angina feels temporary pain, pressure, fullness, or squeezing in the center of the chest or in the neck, shoulder, jaw, upper arm, or upper back. This is angina, especially if the discomfort is relieved by removing the stressor and/or taking sublingual (under the tongue) nitroglycerin.

Typically, angina is described as a “pressure” or “squeezing” pain that starts in the center of the chest and may spread to the shoulders or arms (most often on the left side, although either or both sides may be involved), the neck, jaw or back. It is usually triggered by extra demand on the heart: exercise, an emotional upset, exposure to cold, digesting a heavy meal is common examples.

Calcium antagonists are extremely effective in preventing the coronary spasm of variant or Prinzmetal’s angina. These drugs, along with nitrates, are the mainstays of treatment. Prinzmetal’s angina tends to be cyclic, appearing for a time, then going away.

How To Get Rid Of Gout Quickly – Discover The Best Method To Get Rid Of Gout Forever!

Gout is a metabolic disorder which affects mainly middle aged men (especially the obese ones) and is characterized by the deposition of urinary salts in the joints (it usually affects the feet and hands). This disease is mainly caused by the increase of uric acid in the blood, either due to genetically predetermined purine overproduction or decreased excretion of uric acid or both.

Uric acid is the final product of the decomposition of purines, found in all body tissues and some foods. It is naturally transferred from the blood and excreted in the urine. However, in some people the production of this substance from the body increases and the ability of the kidneys to eliminate it decreases, which leads to the higher concentration of uric acid in the blood and induces the formation of crystals. Patients with type 2 diabetes, obesity, anaemia, and kidney disease have an increased risk of developing gout. Also drugs such as diuretics can affect the excretion of uric acid. In rare cases someone can inherit a reduced ability to metabolize purines and thus may have an increased tendency to develop gout.

Other factors that affect uric acid:

  • The abuse of alcohol increases it.
  • Pregnancy and the administration of estrogen reduces the level of uric acid in the blood of women.
  • Very low calorie diets also cause an increase in the production of this substance, but a gradual weight reduction lowers it.
  • Diets containing a very small amount of protein and diets high in fat also lead to increased levels of the substance.
  • The intake of fructose has a negative effect.

How to treat gout:

People suffering from gout should consume foods low in purines and should be encouraged to limit or avoid foods high in purines. Purines are mainly contained in protein foods, and consuming them in large quantities ultimately leads to uric acid, when they get metabolized by the human body. So while a typical diet contains 600 to 1000 mg of purines per day, in cases of severe or progressive gout the purine content of the diet should be limited to about 100-150 mg / day.

Foods with high purine content:

  • Soy Milk.
  • Seafood (octopus, sardines, herring, mackerel, mussels, scallops, trout, anchovies, tuna).
  • Goose and duck.
  • Beef broth, poultry and most fish.
  • Yeast.

Foods with moderate level of purine:

  • Meat, lean fish, shellfish.
  • Beans, lentils, peas, spinach, mushrooms and asparagus.

Foods with low purine content (that can be eaten daily):

  • White bread and cereals.
  • Macaroni and rice.
  • Milk, yogurt and cheese.
  • Coffee, soft drinks, tea and cocoa.
  • Eggs
  • All kinds of fruit.
  • Vegetables
  • Oils, butter, margarine and olives.
  • Chocolate, sugar, sweets and honey.
  • Salt, vinegar and pickles.
  • Peanuts

Respiratory Problems in the Elderly

Respiratory problems mean that we have difficulty catching our breath and in the elderly this can cause serious issues and even death. Our lungs function by inhaling air into our systems that we breathe in and then exhaling air back out of our system. When we inhale air, we are acquiring oxygen and when we exhale air we are letting out carbon dioxide. Sometimes if we get a cold, we can have problems breathing and this is because of the buildup of mucous in our lungs. Our sinuses can become clogged as well and this makes it very difficult for us to breathe.

Asthma isn’t just a problem with the elderly. It can be a problem for children as well. There has been a rise in the number of cases of asthma in the elderly though over the last few years. Asthma is one of the diseases that is very frequently under-diagnosed. Asthma symptoms in the elderly include tightness in the chest, coughing, shortness of breath and wheezing.

For elderly people with respiratory problems, they may be susceptible to contracting pneumonia. Pneumonia in an elderly person can be deadly. Elderly people that get pneumonia may or may not get a fever with it. If they have a fever than it would be easier for someone to tell that they have something wrong but without a fever that is much harder to diagnose. Sometimes the elderly do not cough or have difficulty in breathing with pneumonia. If an elderly person suddenly becomes confused or has a rapid heart rate or they are breathing rapidly that could signal that they have pneumonia. It is very difficult in some cases with the elderly to actually tell that they have pneumonia or not until it is too late. A lot of elderly do end up dying because of pneumonia.

Some elderly people get emphysema. Emphysema decreases that exchange of air in the lungs. Emphysema is found in a lot of people who smoke and the longer they have smoked the more damage emphysema is going to do. People with emphysema usually have a very bad cough. Sometimes people with emphysema are first thought to have bronchitis. After we reach the age of 50 the symptoms of emphysema become very severe and just continue as we age. Some people have been known to crack their ribs open with coughing from it.

Respiratory problems in the elderly can be very deadly and if they are experiencing any symptoms they should be checked by their doctor right away. Breathing problems in the elderly are a very serious concern.

Type 2 Diabetes – Which Exercise Method Is Best for Weight Loss?

Managing or reversing the effects of Type 2 diabetes means more than getting your blood sugar under control. It also means regaining your health as much as you possibly can, and safeguarding it.

You may be wondering which particular method of exercise is best for you as you look to regain your health: cardio or resistance training. When it comes to weight loss, it is worth considering their differences. While cardio and resistance training are both forms of physical activity, they accomplish different things. With that said, favoring one method over the other would cause you to miss out on benefits that could be essential in your particular case. It is in your best interest to consider all of the benefits when structuring your exercise routine.

Before we go over their differences, know any form of physical activity is better than no exercise. If you are currently sedentary and you have chosen to change, we congratulate you on your decision. There is little worse for your health and well-being than choosing to remain physically inactive.

When you think of cardio, you likely imagine jogging on a treadmill or cycling on a stationary bike for a reasonable amount of time. Plenty of sweat, no lack of effort, and hundreds of burned calories. In fact, cardio is a great way to burn fat, as it is an efficient method of expending calories. If your cardio routine is intense, you are almost guaranteed to put your body in a fat-burning state. And the longer your session lasts, the more calories you can expect to burn. As long as you don’t allow your increased appetite to take over, you are guaranteed to lose fat with regular cardio.

Resistance training adopts a different approach. Like cardio, it still burns calories, but not with the same efficiency. The difference, however, is resistance training stimulates your muscles in ways cardio cannot. Resistance training places incredible stress on your muscle fibers, resulting in muscle breakdown. When they inevitably repair themselves, they are stronger, more able, and sometimes noticeably larger in size.

The benefits go beyond performance and physical changes. Your body benefits tremendously from the muscular and structural adaptions resulting from resistance training…

  • improved posture,
  • better moods,
  • increased energy,
  • increased bone density (crucial for women), and
  • neuromuscular enhancements help individuals maintain their movement independence as they age.

If we are talking strictly about weight loss, cardio is superior for its ability to burn calories efficiently. But if we focus on the bigger picture, which is overall health and well-being, resistance training is not to be overlooked, particularly for those looking to strengthen multiple areas of their life

Ideally, you will structure an exercise routine featuring both forms of activity. Ultimately one is not better than the other since there is more to your health than just your weight. Evidently, cardio along with weight training is a balance you should strive to achieve.

Can Being Overweight Cause Premature Ejaculation?

Can being overweight cause premature ejaculation? In this article, I’ll explain how the complications of being overweight can lead to premature ejaculation and also advise how you can fix this problem for yourself.

Being overweight will not directly cause premature ejaculation but can contribute to it in other ways.

An overweight person can have many health problems that are directly related to having to carry around excess stores of fat and due to the pressure of this fat on internal organs, as well as other complications. Actually carrying excess weight does not cause premature ejaculation but being overweight does bring with it other problems which can then lead to premature ejaculation.

Vascular System

Your body carries mile after mile of a huge network of blood vessels. If you are overweight then it is likely that your blood vessels are not in optimum shape. In many men, this leads to erectile dysfunction.

In some men, there may be a connection between erectile dysfunction and PE. If you improve your health and lose weight in the long term then you can make sure that you never get erectile dysfunction.

Body Image

Being overweight often leads to unhappiness about one’s own body image. The appearance of a smaller penis due to abdominal fat can affect a guy’s confidence when he is naked with a sexual partner. When surveying the entire body, it is easy for a guy to feel unattractive to his partner.

Progression To Bedroom Anxiety

This leads to anxiety which is the root cause of premature ejaculation. If you are not 100% confident about yourself and your performance and have even just a tiny seed of doubt then this is enough for it to spiral out of control and into PE.

This happens because of something called the sympathetic nervous system. Anxiety releases stress hormones and a feedback loop is established: basically, the more you worry then the more likely that PE will happen.

How To Cure Your Anxiety

The key to overcoming your anxiety is to try to get rid of it. You can use short term tools like delay condoms to help build your confidence. You can try going for a second or third round if you have the energy – again, this will help build confidence.

Bronchitis and its management

When you breathe in (inhale), small, bristly hairs near the openings of your nostrils filter out dust, pollen, and other airborne particles. Bits that slip through become attached to the mucus membrane, which has tiny, hair-like structures called cilia on its surface. But sometimes germs get through the cilia and other defense systems in the respiratory tract and can cause illness.

Bronchitis can be acute or chronic. An acute medical condition comes on quickly and can cause severe symptoms, but it lasts only a short time (no longer than a few weeks). Acute bronchitis is most often caused by one of a number of viruses that can infect the respiratory tract and attack the bronchial tubes. Infection by certain bacteria can also cause acute bronchitis. Most people have acute bronchitis at some point in their lives.

Chronic bronchitis, on the other hand, can be mild to severe and is longer lasting — from several months to years. With chronic bronchitis, the bronchial tubes continue to be inflamed (red and swollen), irritated, and produce excessive mucus over time. The most common cause of chronic bronchitis is smoking.

Bronchitis (pronounced: brahn-kite-uss) is an inflammation of the lining of the bronchial tubes, the airways that connect the trachea (windpipe) to the lungs. This delicate, mucus-producing lining covers and protects the respiratory system, the organs and tissues involved in breathing. When a person has bronchitis, it may be harder for air to pass in and out of the lungs than it normally would, the tissues become irritated and more mucus is produced. The most common symptom of bronchitis is a cough.

People who have chronic bronchitis are more susceptible to bacterial infections of the airway and lungs, like pneumonia. (In some people with chronic bronchitis, the airway becomes permanently infected with bacteria.) Pneumonia is more common among smokers and people who are exposed to secondhand smoke.

Signs and Symptoms

Acute bronchitis often starts with a dry, annoying cough that is triggered by the inflammation of the lining of the bronchial tubes. Other symptoms may include:

  • cough that may bring up thick white, yellow, or greenish mucus
  • headache
  • generally feeling ill
  • chills
  • fever (usually mild)
  • shortness of breath
  • soreness or a feeling of tightness in the chest
  • wheezing (a whistling or hissing sound with breathing)

Chronic bronchitis is most common in smokers, although people who have repeated episodes of acute bronchitis sometimes develop the chronic condition. Except for chills and fever, a person with chronic bronchitis has a chronic productive cough and most of the symptoms of acute bronchitis, such as shortness of breath and chest tightness, on most days of the month, for months or years.

A person with chronic bronchitis often takes longer than usual to recover from colds and other common respiratory illnesses. Wheezing, shortness of breath, and cough may become a part of daily life. Breathing can become increasingly difficult.

In people with asthma, bouts of bronchitis may come on suddenly and trigger episodes in which they have chest tightness, shortness of breath, wheezing, and difficulty exhaling (breathing out). In a severe episode of asthmatic bronchitis, the airways can become so narrowed and clogged that breathing is very difficult.

Causes of Bronchitis-

Acute bronchitis is usually caused by viruses, and it may occur together with or following a cold or other respiratory infection. Germs such as viruses can be spread from person to person by coughing. They can also be spread if you touch your mouth, nose, or eyes after coming into contact with respiratory fluids from an infected person.

Smoking (even for a brief time) and being around tobacco smoke, chemical fumes, and other air pollutants for long periods of time puts a person at risk for developing chronic bronchitis.

What Do Doctors Do?

If a doctor thinks you may have bronchitis, he or she will examine you and listen to your chest with a stethoscope for signs of wheezing and congestion.

In addition to this physical examination, the doctor will ask you about any concerns and symptoms you have, your past health, your family’s health, any medications you’re taking, any allergies you may have, and other issues (including whether you smoke). This is called the medical history. Your doctor may order a chest X-ray to rule out a condition like pneumonia, and may sometimes order a breathing test (called spirometry) to rule out asthma.

Because acute bronchitis is most often caused by a virus, the doctor may not prescribe an antibiotic (antibiotics only work against bacteria, not viruses).

The doctor will recommend that you drink lots of fluids, get plenty of rest, and may suggest using an over-the-counter or prescription cough medicine to relieve your symptoms as you recover.

In some cases, the doctor may prescribe a bronchodilator (pronounced: bron-ko-dy-lay-ter) or other medication typically used to treat asthma. These medications are often given through inhalers or nebulizer machines and help to relax and open the bronchial tubes and clear mucus so it’s easier to breathe.

If you have chronic bronchitis, the goal is to reduce your exposure to whatever is irritating your bronchial tubes. For people who smoke, that means quitting!

If you have bronchitis and don’t smoke, try to avoid exposure to secondhand smoke.

Smoking causes lung damage in many ways. For example, it can cause temporary paralysis of the cilia and over time kills the ciliate airway lining ciliated cells completely. Eventually, the airway lining stops clearing smoking-related debris, irritants, and excess mucus from the lungs altogether. When this happens, a smoker’s lungs become even more vulnerable to infection. Over time, harmful substances in tobacco smoke permanently damage the airways, increasing the risk for emphysema, cancer, and other serious lung diseases. Smoking also causes the mucus-producing glands to enlarge and make more mucus. Along with the toxic particles and chemicals in smoke, this causes a smoker to have a chronic cough.


What’s the best way to avoid getting bronchitis? Washing your hands often helps to prevent the spread of many of the germs that cause the condition — especially during cold and flu season.

If you don’t smoke, don’t ever start smoking — and if you do smoke, try to quit or cut down. Try to avoid being around smokers because even secondhand smoke can make you more susceptible to viral infections and increase congestion in your airway. Also, be sure to get plenty of rest and eat right so that your body can fight off any illnesses that you come in contact with.

Symptoms of a Yeast Infection in Men



Well a penis/penile yeast infection (or whatever they call that) comes from a yeast-like fungus called Candida and is also referred to as candidiasis. A sign of male yeast infection usually appears ON THE PENIS. One symptom is that the tip of the penis may become SORE, RED, or ITCHY PENIS.Some may also experience slight discharge or dry, flaky skin on the penis.Irritation may also occur in the form of anal burning or anal itching or itching at the head of the penis.A red rash or spots with white patches on the foreskin and also the shaft of the penis may be another indication. Redness can also appear on the scrotum or the upper thighs.


These includes:


Men with diabetes can get a number of yeast related infections. Most men with diabetes have high levels of sugar in their urine, saliva and general system. Yeast tends to feed off this sugar and exacerbate systemic yeast. This can set off an entire host of other yeast related infections in different areas of the body, both internal and external.

Penile Yeast Infections

Men with diabetes can also get penile yeast infections. These can occur on the penis or scrotum. This condition can cause both itching and burning. There is often a starchy odor that accompanies the other symptoms. People with this condition often have reddish bumps or blisters on the shaft or head of their penis; and sometimes on the scrotum. They can also get a clumpy white discharge. Again, diabetic men tend to have high levels of sugar in their urine, which can foster this type of infection. Candidiasis in the colon can also set it off. Men with diabetes must see a doctor if suspect a penile yeast infection. Nystatin creams can sometimes bring relief. However, this yeast infection can often recur.

*Low immunity,

Which can result from other conditions, such as an under-active thyroid gland,

chronic stress, Lyme disease, and HIV.

*Sexual transmission

Candida can be transmitted between people by direct contact, and so can be considered a sexually-transmitted disease. A yeast-infected woman who has unprotected sex with a man can infect her lover, treat her own infection, and then get reinfected next time she has sex with him. If you or your lover has an active infection you should be extra-careful to follow safer sex guidelines until you are sure both of you are infection-free. During an infection or while being treated, refrain from vaginal intercourse, wash your hands or change your gloves in between touching your own crotch and your partner’s, and keep those sex toys really really clean.


Although far less common than sexual transmission, the other main cause of penile yeast infection is prolonged antibiotic use. The male body has a standard contingent of creatures that inhabit the crotch, and antibiotics can rid the body of the good ones, allowing the normally-occurring yeast to take over.

*Condoms with nonoxynol-9

Although it’s not at all the same problem, this seems like as good a place as any to warn you that i’ve seen occasional rumors in gay magazines saying that condoms with nonoxynol-9 added to the lubricant may contribute to anal infections. This is very plausible given that we know it can cause vaginal yeast infections. If this is a problem for you, try using a condom that doesn’t have a spermicidal lubricant.

*Continual masturbation.

If your hands and toys are clean then this is not your problem.

*Poor personal hygiene.

Cleanliness I’m sure i don’t have to elaborate this one.

Penis Pain and Masturbation: Tips for Relief

For most men, masturbation is a regular part of their sex lives. Although rates of masturbation vary greatly from one man to the next, it’s the rare man who does not at least occasionally indulge in self-gratification. While masturbation is an inherently pleasurable experience, there are occasions when the practice may lead to some degree of penis pain. Practicing good penis care can aid a man in handling this issue when it arises and interferes with self-pleasuring.

Penis pain causes

In some cases, penis pain during masturbation may come from some outside cause and may not actually be related to the act of self-stimulating. For example, a sexually transmitted infection (such as gonorrhea) may cause a degree of penis pain (significant in some cases). A kidney stone or diabetes are other pain-causing conditions that can create discomfort during masturbation.

Most of the time, however, penis pain during masturbation is related to the physical process of self-stimulation. The typical reasons why such a pain occurs include:

– Masturbating too roughly. This is a common cause of penis pain – masturbating the penis when it is not properly lubricated. Although the penis does produce some self-lubrication, often this is not enough to ensure that the organ will not fall prey to the effects of intense friction. Although many men use saliva as an additional form of lubrication, this may not be sufficient. Investing in an appropriate lubricant – whether body lotion, petroleum jelly or a form of lubricant specially designed for sexual use – can make a big difference in preserving the penis.

– Masturbating too tightly. “Getting a grip” is a good idea when masturbating – but in some cases, a guy’s grip on his member is too tight. It’s understandable – after all, the tightness feels good and may create a new level of sensation. But consistently using a too-tight grip for a prolonged period of time can cause the same kind of damage (and resulting pain) as pounding without lubrication.

– Masturbating for too long a time. Sometimes a guy has so much fun masturbating that he doesn’t want it to stop and delays the ejaculation for as long as possible. “Edging” like this can result in a tremendously long session; it may also result in a very sore piece of manhood.

– Masturbating too frequently. All those tales about going blind or getting hairy palms from masturbating too much are false, but it certainly is possible to masturbate at a frequency that causes soreness and discomfort.

What to do

There are several things to do to deal with masturbation-related penis pain. In some cases, it may be advisable to take a short masturbation hiatus, especially if the cause is related to frequency of masturbation. Relaxing the grip can help, as can keeping on hand (and on one’s hand) a decent supply of a good lubricant.

But treating penis pain from masturbation may require a more direct approach, especially if the penis is raw and sore from its exertions. For restoration of penile health in these cases, regular application of a quality penis health creme (health professionals recommend Man1 Man Oil) is strongly advised. Penis pain is often an indication that the penis skin has become worn and/or torn and that there may be some capillary damage. These issues can be addressed by the proper crème. For example, a crème with a combination of a high-end emollient (such as Shea butter) and a superior hydrator (such as vitamin E) provides the nutrients that can repair and soothe damaged penis skin, making it supple and elastic again. If the crème also contains L-arginine, so much the better. L-arginine is a necessary component of penile health, helping to keep blood vessels open and protecting capillaries from damage. Man1 Man Oil can alleviate penis pain and make a guy ready for another round of solo-based fun.

Hip replacement

What is a hip replacement?

Hip replacement, is an operation to replace a hip joint with an artificial (‘ prosthetic’) hip joint. It is a common procedure and effectively relieves pain and restores mobility.

Why might a hip joint need to be replaced?

The hip is the joint that connects the thigh bone (the femur) to the pelvis. The hip joint is what is known as a ‘ball and socket’ type of joint. The upper end (head) of the femur is rounded and smooth so that it fits into a hollow cup in the pelvis. This arrangement gives the upper leg the very wide range of movement needed to walk, run, climb and jump.

The hip is a ‘synovial’ joint, meaning that it is enclosed by a ‘capsule’. The space within the capsule is filled with fluid, which allows the two bone surfaces to move smoothly over each other. The bone surfaces are also covered by a smooth substance called ‘cartilage’ to aid this movement.

There are many reasons why a hip joint may need to be replaced. However, by far the most common reason for hip replacement is joint damage due to arthritis. There are two major forms of arthritis, which are fully described in another factsheet. Rheumatoid arthritis is an inflammation of the joints that tends to affect women in early to middle age. Osteoarthritis is ‘wear and tear’ of the joint and most commonly affects the joints of elderly people. Both of these conditions can lead to destruction of the hip joint which results in pain and loss of mobility of the joint.

The hip joint may also need to be replaced after injury. In older people particularly, the head of the femur can be fractured in an accident and it may not be possible to repair surgically.

A less common reason is death of the head of the femur. This may be from a number of causes, including sickle cell disease, trauma, excessive use of steroids and rare genetic conditions.

What happens during a hip joint replacement?

The replacement joint is an artificial version of the natural ball and socket joint. It has two separate components. The lower part is usually made of metal and is a shaft with the ball part of the joint at the top. The other part of the artificial joint is the socket which fits into the pelvis and this can be made of either metal or a special type of plastic.

There are many different types of prosthetic hip joint, made of different materials and in different shapes. Improvements are being made all the time to strengthen and to perfect these artificial joints. The surgeon performing the operation will choose the type of replacement joint he or she feels is most appropriate for your condition and build.

During a hip replacement operation, the surgeon first cuts through the skin and parts the muscle to get to the hip joint. The femur is then separated from its cup in the pelvis.

The rounded head of the femur is then removed and replaced with the artificial substitute. The natural socket in the pelvis is opened out and the artificial socket inserted. Both parts of the artificial hip joint are strongly bonded to the normal bone using a special glue rather like cement.

The ball and socket are then re- united and the muscles and ligaments repaired. Any final repairs to tissues are then made and the incisions closed.

What are the preparations for a hip replacement?

The hip replacement operation is carried out under general anaesthetic. This means you may be asked to visit the hospital one to two weeks before the date of your surgery, to have a preoperative interview with a nurse and / or the anaesthetist. They will ask you questions about your current and past health, and will need to know about any allergies you may have, medications you are taking (including over the counter products or vitamin supplements), previous surgery, whether you smoke or take street drugs, and how much alcohol you use. You may also be given a physical examination, during which your heart and lungs will be checked to make sure it is safe for you to have an anaesthetic. You may be given routine laboratory tests, such as urinalysis (tests of your urine), chest x- rays, or complete blood cell counts, as well as a hip x- ray. These should reveal potential problems that might complicate the surgery if not detected and treated early. No testing may be necessary if you are in good health and younger than age 65, but each clinic may have different requirements.

Please answer all questions completely and honestly as they are asked only for your own wellbeing, so that your surgery can be planned as carefully as possible. If you are unsure of the names of any medications, bring them with you. You will be told whether or not to stop any medications at this preoperative clinic visit. For example, if you are taking aspirin-containing medicines or anticoagulants, they may need to be temporarily withdrawn or reduced in dose for two weeks before the procedure. If you can, try to stop smoking at least six to eight weeks prior to surgery.

What are the possible complications?

Hip replacement is usually very successful and can lead to an enormous improvement in quality of life. The operation can relieve constant severe pain and make it possible for people who had become virtually immobile to get about comparatively easily.

One potentially serious complication is for the new joint to become infected. For this reason you will be given antibiotics when you have the operation and for a short time afterwards. If an artificial joint does become infected, it may have to be replaced.

Surgery on the leg combined with immobility after the operation increases your chances of getting a blood clot in one of the veins in the leg (venous thrombosis). For this reason you will be given injections of heparin, a substance that helps prevent clots.

Eventually, the artificial joint may need to be replaced, usually after about 10 years. The weakest point is the glue used to bond the artificial parts to the bone. Sometimes the bond can gradually loosen with time. If the joint becomes loose, surgery to repair it is necessary. However, constant research and development is leading to rapid advances in the design of artificial joints and methods of uniting them to the pelvis and femur.

How long will I stay in hospital?

The joint remains unstable for 1 or 2 weeks after the operation. The length of time you will stay in hospital will therefore depend very much on your progress and mobilisation in hospital, as well as your age and general health and how you are set up to manage at home. Mobilisation as early as is safely possible after the operation is generally recommended. Your progress should be discussed with your doctors, nurses and physiotherapists.

What happens after a hip replacement?

The joint and the muscles need time to settle down after the operation as at first the joint can easily become dislocated. You will be advised on how to go about mobilising yourself by your physiotherapist and on how best to sleep so as not to put undue strain on the newly replaced joint. The main point is to take things gently and enjoy your new- found freedom of movement.

Dermatologist Information

Dermatologists, or skin care doctors, have expertise in the care and treatment of human skin as well as the prevention and treatment of a wide variety of skin conditions, including skin cancers. They can also diagnose and treat disorders of the scalp, hair and nails as well. After earning a medical degree and completing a hospital internship, a dermatologist receives three more years of special medical training to becoming an expert dedicated solely to the conditions of the skin, hair and nails. Some dermatologists get even more specialized training and expertise in a specific areas of dermatology, such as pediatrics, surgery, or cosmetics. Dermatologists treat many types of skin conditions, here are the most common.

Acne: Dermatology experts can help eliminate acne and acne scars with the use of different topical, oral medications and laser treatment options. These laser treatments control breakouts and significantly reduce acne difficulties. When diagnosing acne, Portland Dermatologists classify it into four grades. They evaluate the types of comedones present, amount of inflammation present, breakout severity, how widespread the acne is and what areas of the body are affected. Since acne has many different forms, your dermatologist will design an individual approach to care for the successful control of your acne.

Wrinkle Treatment: older folks can use wrinkle removal/reduction to make their skin appear years younger. Botox, Restylane, Juvederm and Perlane injections can all help smooth out wrinkles and prolong a persons beauty. The effects of aging on our body and especially on the dermal layer are significant. Not only does the dermal layer thin, but it also starts to produce less collagen, and the elastin fibers that provide elasticity begin to wear out. These changes in the building blocks of the skin cause the skin to wrinkle and sag over time. Exposure to ultraviolet light, UVA or UVB, from sunlight accounts for 90% of the symptoms of premature skin aging.

Scars, Birthmarks, Stretch Marks and Tattoo Removal: Although complete scar and stretch mark removal is not possible, most scars can be significantly improved in appearance through one or more cosmetic techniques, including microdermabrasion, chemical peels, collagen injections, and fat transfer procedures. Your Portland dermatologist may also recommend a cream, gel, or bandage that contains silicon to help reduce scar visibility and pain. During a laser tattoo removal treatment, the laser’s high energy light breaks up the tattoo ink into tiny particles, which are gradually absorbed by the skin. Laser tattoo removal may cause slight discomfort, though a local anesthetic can be used to eliminate the pain.

Rosacea: This is a chronic and potentially life-disruptive disorder primarily of the facial skin. It causes redness similar to blushing, but can be extremely uncomfortable with itching an burning. There are a few different options available to your Dermatologist to treat this disorder. Your dermatologists will usually recommend a combination of treatments tailored to the individual patient. Many rosacea treatments are applied directly to the affected skin. Creams, lotions, foams, washes, gels, and pads that contain a topical antibiotic, azelaic acid, metronidazole, sulfacetamide, benzoyl peroxide or retinoids may be prescribed by your dermatologist.

Psoriasis: This is a common skin condition that causes rapid skin cell production which results in large red, dry, flaky, and extremely itchy patches of skin. It is said to affect more than 2.2% of Americans and 1% to 3% of the worlds population. Psoriasis is characterized by period flare-ups of red patches covered by silvery, flaky skin. The exact cause of psoriasis is unknown and there is no cure as of yet, but most researchers believe that a combination of several factors contributes to the development of this disease.

Your Portland Dermatologist is trained to help you identify your condition and then help you design a treatment plan that will aid you to gain control over your outbreaks.

Allergies in Children – Inherited Or Acquired?

Allergies in children are more common today than they were 50 years ago, leaving one to question whether allergies are acquired or inherited. Although most doctors believe that heredity is the primary factor for a child’s allergies, new studies show that there are steps that parents can take to reduce the risk of allergies in children.

One possible reason for the increase in children with allergies is the vast reduction in the amount of breastfed babies. Breastfeeding builds immunity to allergens, something that no formula can provide. Although children who were breastfed can still develop allergies, the chance is much lower when compared to formula fed infants. Studies also show that the longer a child is breastfed, the lower their risk. This is why the American Academy of Pediatrics has revised its policy to recommend breastfeeding for at least one year, and longer if desired. It also suggests that exclusive breastfeeding for at least six months is optimal. This means that breastfeeding is not supplemented with food or formula or any other form of nutrition.

Another contributing factor to the rise of allergies in children is the premature introduction of solid foods into their diet. When solids are fed to an infant before their digestive system is fully developed, it weakens the immune system because the body has to work so hard to digest the food. This has been shown to cause allergies, especially to food.

So while it is possible that grandma’s allergies may be passed down through the blood line, the good news is that there are still steps you can take to reduce or prevent allergies in your bundle of joy.

Shoulder Pain, Injury and Treatment

The Centers for Disease Control and Prevention reports shoulder pain afflicts nearly 1 in 10 people. Shoulders have a range of motion greater than any other human joint. It is no wonder they are frequently injured!

Shoulder Injuries: As a personal injury attorney, I represent clients who have suffered serious shoulder injuries and broken bones as the result of being in an accident. Injury to the shoulder may occur when a bicyclist is hit by a car in a crosswalk, in a grocery store fall when someone slips and falls on a spill on the floor or falls in a pothole or other tripping hazard as well as in pedestrian/car collisions.

Shoulder Anatomy: Shoulders are the most commonly dislocated joint. The shoulder is not put together as snugly as our body’s other ball and socket joints. Shoulder sockets are shallower, flatter, and the balls (the upper end of the top arm bones) have to be held in position by a lot of soft tissue.

Shoulder Problems: Aside from wear and tear,shoulders are susceptible to many other injuries.Problems more often occur in the ligaments and tendons of the shoulder rather than in the bones. Doctors may diagnose the precise location of shoulder pain by performing an examination, or through x-rays or an MRI.

Types of Shoulder Injuries: Dislocation: When the ball-shape top of the upper arm (humerus) becomes pulled out of its socket (glenoid) the surrounding soft tissue is stretched and often torn, causing a lot of swelling and pain in the shoulder. As a result, the supporting ligaments in the front of the shoulder may become damaged. Dislocation of the shoulder can cause excruciating pain. A doctor can usually maneuver the arm back into place, although sometimes shoulder surgery is indicated.

A dislocated shoulder injury is frequently the result of a slip and fall accident or pedestrian or bicycle accident.The nature of the injury makes it more vulnerable to future dislocation. When this occurs in an older adult, the damage may be more severe, due to soft tissue becoming weaker with age.

Treatment for a Dislocated Shoulder: Treatment generally includes rest, cold packs, pain medicine, muscle relaxants, and physical therapy. Separation: A separated shoulder happens not in the ball-and-socket joint but closer to the neck, at the point where the top of the shoulder blade (scapula) meets the collarbone called the clavicle. The ligaments holding the two bones together are stretched or torn.

Treatment for Separated Shoulder: Treatment for a separated shoulder joint injury usually involves rest, ice, pain relievers, and physical therapy.

Rotator Cuff Injury: The rotator cuff is the structure that holds the ball of the shoulder in its socket and comprises four muscles and several tendons that are attached to the ball, beneath the deltoid and pectoralis muscles. A rotator cuff injury can progress from inflammation to partial tears, small tears, and larger tears. One of the tendons in an injured rotator cuff may begin to detach from the arm bone. Symptoms include pain in the shoulder and upper arm which becomes worse with time and when the arm is lifted overhead or lowered.

Treatment for rotator cuff tears: If caught early, they may be treated with rest, ice and an anti-inflammatory, and physical therapy. Ultrasound, along with a steroid cream, can reduce inflammation and increase blood flow, which speeds up healing. Tendons may be reattached using arthroscopic surgery, in more serious shoulder rotator cuff tears.

Frozen Shoulder: Some people, who have an injured shoulder requiring immobilization as part of their treatment plan, suffer what is called, frozen shoulder. This is caused when the shoulder is immobile and scar tissue forms locking the shoulder joint into place.

Treatment for Frozen Shoulder: Frozen shoulder can be quite painful and is sometimes treated with an anti-inflammatory, heat and stretching. More serious cases require the injection of steroids into the shoulder joint or electrical stimulation. When frozen shoulder does not respond to conservative care, doctors perform a forced manipulation under anesthesia to actually free the joint from the scar tissue.

Irritable Bowel Syndrome (IBS) and the Americans With Disabilities Act (ADA)

Assuming all of the appropriate criteria are met, an employee suffering from Irritable Bowel Syndrome (IBS) can request a reasonable accommodation under the Americans with Disabilities Act (ADA) from his or her employer. This is a modification to some aspect of the job that will allow the employee to perform the essential job functions more effectively, despite the impairments caused by IBS. A reasonable accommodation is a powerful protection, because it is pro-active, meaning you don’t have to wait for relief in court or through some other administrative process to remedy discrimination that’s already occurred.

The Employer

The Employer must be covered by the ADA. Employers covered are:

  1. All private (e.g. non-government) employers with 15 or more employees
  2. All State and local government agencies with 15 or more employees
  3. All Federal government agencies regardless of the number of employees.

The Employee

The employee seeking protection under the ADA must (1) be qualified to perform the essential functions of the job, with or without reasonable accommodation; and (2) have a disability, meaning a have a physical or mental impairment that substantially limits a major life activities.

In regard to qualifications, if the position requires a certain level of education, experience, skill set, certification or licensure, the employee must meet those requirements. Assuming the employee is otherwise qualified, the question is: would the employee be able to perform the essential functions of the job in spite of the IBS without modification to the position being sought as a reasonable accommodation? Please note, the focus here are the essential job functions, meaning the ones that are fundamental to the performance of the job. This will be determined on a case by case basis. A written job description by the employer would be helpful in defining essential job function, but it is not determinative.

A disability under the ADA is a physical or mental impairment that substantially limits a major life activity. The term “major life activity” is meant to be broad and inclusive. Fortunately for sufferers of IBS, a 2008 amendment to the ADA specifically defined major life activities as including digestive and bowel function. Whether the condition causes a “substantial limitation” will be applied on a case-by-case basis, though Congress has directed that the standard be applied liberally. An impairment that is episodic or intermittent will still qualify for protection if it would substantially limit a major life activity when active. The assessment of the degree of impairment is also made as if no palliative measures were being taken (e.g. no medication or other treatment).

What is a Reasonable Accommodation

There is no absolute definition of what is a reasonable accommodation, but one recognized example is modification of and flexibility in work scheduling. If unexcused and/or excessive absenteeism and lateness caused by the IBS is having an adverse impact on the employee’s job, the situation could be remedied (or at least remediated) through greater flexibility in scheduling. Examples would be time shifting or taking time away from lunches or other break-time to make up for tardiness. Similarly, modification of the position to one that is not hourly, e.g., based on work output or some type of quota should be an option. In other words, the employee can work around flare-ups as best as possible and, as long as the work is completed to a pre-determined standard, there is no penalty for “non-conformance” to the standard work day schedule. These are not the only examples of reasonable accommodations at work that could apply, though they will probably be the frequently requested by a sufferer of IBS. There are circumstances where an employer can deny a request for a reasonable accommodation, but that is outside the scope of this article.

A more detailed treatment of the protections available under the ADA to employees suffering with Irritable Bowel Syndrome and other digestive diseases can be found at the link.

Cognitive Behavioral Therapy (CBT) And Depression (Thinking Errors)

The basic tenet of Cognitive Behavioural Therapy, or CBT, is that what you think affects the way you feel. That is to say, if you think depressive thoughts then you will feel depressed. Conversely, if you manage to stop yourself thinking these thoughts, then your depression will lift.

As a Psychiatrist in Edinburgh I use CBT techniques extensively. My first step is to look for unhelpful patterns of thinking with my clients. Depressed people often think in particular ways that are very different from non-depressed people. These ways of thinking are called – in CBT language – “thinking errors”. Thinking errors help to cause and then maintain depression.

Numerous different thinking errors have been identified by CBT therapists over the years, and particular kinds of errors seem to predispose to particular psychological problems. In my experience as a Psychiatrist, the most common errors found in depression are “All-or-Nothing” thinking, “Mental Filtering”, “Disqualifying the Positive”, and “Personalising”.

“All-or-Nothing” thinking (also known in CBT circles as “Black-or-White” thinking) emphasises extremes and ignores the fact that most things in life are shades of grey rather than absolutes. For example, a person thinking in this way may play one poor game of tennis and then decide that he’s totally useless and give up forever. Or she may miss one yoga class and tell herself that as she’s fallen behind, there’s no point in going back. “All-or-Nothing” thinking sets very rigid rules for a person to live by – rules that, if broken (as they almost inevitably are!) can lead to the abandonment of enjoyable and worthwhile activities, and predispose the person to depression.

“Mental Filtering” is the term applied to the thinking patterns of people who “see” the world in a depressive way. People with this thinking error are biased in what they take notice of, and what they later remember. They will tend to notice (or, in CBT parlance, “attend”) to objects, people, or events that “fit-in” or confirm their previously held beliefs. For example, a depressed person who thinks that the world is an unpleasant place to live is more likely to remember the sad news stories as compared to a non-depressed person. A depressed person who thinks that they’re unlikeable will take extra notice of possible sleights from others. CBT theory posits that such mental filtering reinforces a person’s depression.

A closely related thinking error is termed “Disqualifying the Positive”. As well as focusing on the negative features of the world (and themselves), depressed people will often actively ignore (or “disqualify”) evidence to the contrary. A depressed person may well recall the person at the party who ignored them, but he will forget or downplay the others who chatted to him for hours. If a CBT therapist asked them about this, he will often say things like “oh, they just felt sorry for me”, thereby turning a positive interaction into something very different.

“Personalising” is the term given to a type of thinking that places the person at the centre of events. Such a view of the universe places a huge burden on the persons shoulders – they can feel responsible for all the bad things that happen. You may be “Personalising” when you feel guilty about not being able to help an unemployed friend keep his house, or when reading about climate change due to our Western way of living. There are factors beyond your control and for which you should not take responsibility. If you do, then CBT hypothesises that you will experience feelings of guilt, shame, and ultimately depression.

The above is a brief review of the common thinking errors that I have come across during the course of my work as a Psychiatrist in Edinburgh. Identifying such errors with the client is a first step on the way to identifying other, healthier, ways of thinking.