6 Surprising Benefits of Cold Water Therapy for Fat Loss, Detox and Recovery

A lot is being said lately about the benefits of cold-water therapy for fat loss, detox and recovery. “Cryotherapy,” or cold-water immersion, cold showers, cold gel packs and the cold water Detox Bath (based on Louis Kuhne’s friction sitz bath) are popular amongst athletes and health seekers, and can equally benefit practically everyone else.

A long list of benefits is attributed to regular cold-water exposure. They include:

• Reduces Inflammation

• Triggers detoxification

• Decreases excess white body fat

• Boosts immune system

• Enhances sleep quality

• Boosts sexual performance and improves fertility

• Increases pain tolerance threshold

• Enhances hormone production

• Reduces food cravings

• Decreases uric acid levels

• Increases glutathione, the body’s most powerful antioxidant. (Dr J Mercola)

Of course, these benefits vary from one person to the next. This method does NOT provide all the benefits above to everyone equally.

For the purposes of this article, let’s focus exclusively on the fat loss, detox and recovery benefits attributed to the regular application of cold temperatures to the body, in the form of cold showers, dipping in a cold pool after the sauna, practicing Louis Kuhne’s Detox Bath or using cold gel packs.

So, how does cold exposure contribute to fat loss, detox and recovery?

1- Brown fat activation: BAT or brown adipose tissue is brown fat that’s abundant in the body in childhood and decreases in adulthood. It is primarily found around the collarbone, neck, shoulders and upper back. A unique type of fat, it generates heat by burning the regular white fat that deposits in the stomach, hips, and butt and legs areas. Brown fat burns energy instead of storing it. Studies have proven that you can actually activate the brown fat -to burn the white fat- by cooling your body down.

2- Detoxification: Toxins are known to nestle in the dense white fat cells. When, through exposure to cold, you activate the brown fat, it dissolves the white fat and consequently detoxifies the body.

3- Enhancing the Immune System: Cold therapy enhances immunity by increasing the number of immune system cells that fight disease and infection. Due to its ability to stimulate norepinephrine release, cold exposure can induce an increase in natural killer cell count and activity, which can greatly improve the immune system function.

4- Hardening: The exposure to a natural stimulus, like cold, is called “hardening.” It is known to increase the body’s tolerance to stress and disease. “The underlying premise of cold water therapy is that briefly and somewhat regularly exposing the body to certain kinds of natural stresses can enhance health”. (Mark’s Daily Apple)

5- Drinking cold water speeds up the metabolic rate, because the body has to work to warm the water up. However, other types of cold or ice therapy, like cold gel packs applied to the groin area, can also help support your body’s fat-burning and detoxification ability.

6- Exercise and injury recovery By lowering the tissues’ temperature and constricting blood vessels in the targeted area, cold numbs it and prevents swelling. That’s why ice packs are often used after injury, to help minimise bruising and swelling from fluid build-up, and for pain relief.

Cold baths and cold gel packs have proven more effective than resting in the relief of the typical muscle soreness occurring after exercise.

What’s the Easiest Way to Cool the Body Down and Achieve the Benefits of Cold Exposure?

You can either take a cold shower or drink cold water, or even sit -immersed to the waist- in a tub of cold water for 10 minutes, 3 times a week. The water should be cold but not freezing.

However, the easiest, least invasive and most comfortable way to cool the body down and achieve the benefits listed above remains the regular use of cold gel packs, which are particularly effective when applied to the groin area.

Teen Diet Plans – Can Teens Use the Medifast Diet to Lose Weight?

Are you are teen or do you have a teen in your household who needs to lose weight? If you have used Medifast yourself, or you’ve seen the ads for it on television, you might be wondering, “Can teens use the Medifast diet to lose weight?”

I expect you will be happy to learn that teens can use Medifast too. You will want to look over the program for teens though, because it isn’t the same as the adult diet plan.

The adult diet program is called the 5 and 1 plan. On this plan, you eat five Medifast meals each day as well as an additional meal that they’ve dubbed the lean and green meal. This is the only meal that you eat non-Medifast food and your servings are restricted to lean protein and fresh vegetables.

The teen plans, however, have a lot more regular food on them and they cut back on the number of Medifast products that are eaten throughout the day. The teen weight loss plan includes three Medifast meals per day, instead of five.

Because teenagers have different nutritional needs than adults, due to their growing and changing bodies, the Medifast diet for teens includes whole grains, fruits and dairy products. These are things you won’t see on the adult plan, but they are crucial for teens.

Of course, the teen plan also includes lean protein, such as lean meats and meatless proteins (such as beans and tofu), and lots of fresh vegetables. The fruits and vegetables part of the diet follows standard guidelines, five servings per day. Also, there are a few differences between the plans for teenage boys and teenage girls, with the boys’ plan adding some additional quantities of whole grains and fats.

A big aspect of the plan for teens is using the Medifast plan to make a lifestyle change, so there are lots of tips for eating a healthy diet and how to incorporate better meals into a teenager’s day. Plus, exercise and being active outdoors is important as well, so there are suggestions for adding more activity to each day. An hour a day of exercise or some kind of sports activity is the usual recommendation, but for sedentary teens, you may want to start just adding 30 minutes of exercise three to four times a week and add more time each week.

Easy Quick Recipes For Weight Loss – Baby Corn Delight

A healthy diet is one that is high in nutrients and low in fat, sugar, salt and cholesterol.

Fruits and Vegetables have very little calories and hence eating more fruits and vegetables instead of meats will quickly reduce your weight. Moreover, some fruits and vegetables such as lettuce, zucchini are best eaten raw. Other Vegetables also require less cooking time to preserve its original taste and nutrients.

Preparing a quick simple meal of vegetables can be equally nutritious and delicious. Below is a good example of a simple, yet delicious meal that only takes 10 minutes or preparation time and 15 minutes of cooking time.

Baby Corn Delight

Servings : 6

Preparation Time : 10 Minutes

Cooking Time : 15 Minutes


  • Baby corn- 200 gm
  • Green chilly (finely chopped) – 1 no
  • Ginger (finely chopped) – 11/2 tsp
  • Garlic (finely chopped) – 11/2 tsp
  • Soya sauce -1tsp
  • Tomato-chilly sauce – 2 tsp
  • Corn flour -1tsp
  • Capsicum – chopped -2 tbsp
  • Oil – 1 tsp
  • Salt and pepper – to taste


Mix together soy sauce, tomato-chilly sauce and corn flour with 2 tablespoons of water in a bowl and keep it aside. Heat the oil in non-stick pan and add the baby corn and sauté over a high flame for 5 minutes. Add the green chilly, ginger and garlic and sauté for another 3 minutes. Then add corn flour and sauce mixture. Mix well over a high flame till the sauce coats the baby corn. Toss in the capsicum, add salt and pepper and mix well. Serve hot. A great side dish to enjoy!

Note: The ingredients used above are not only low in calories but also have health beneficial values. Ginger is considered to have some cancer fighting properties and garlic may be slightly protective against heart disease. Adding ginger and garlic occasionally in our diet is quite useful for a healthy living. Tomatoes protect the heart and studies suggest that regular use of tomatoes can cause reductions in prostate and other cancers.

Haunted Ghost Tours in St. Augustine, Florida at a Glance

There are several different haunted ghost tours that are offered in St. Augustine, Florida. This particular city is considered to be the oldest city located in the entire nation. If you are interested in old ghost towns, this one is likely to draw your attention. Throughout the day, you will find several sightseeing trolleys and horse and carriage rides roaming the streets teaching the visitors about the colorful history associated with the city. However, as the sun sets, a new side of St. Augustine comes to life. This is the spiritual side where stories of the spirits that wander the streets and haunt the buildings are shared. If you are interested in participating in one of the haunted ghost tours offered at night in this historical city, it is important to know how to make the most of the tour that you elect to take.

There are several types of tours available for those that are interested in ghost hunting. Because of the fact that St. Augustine is a coastal city, you may choose to take a tour on a sailboat. There are also haunted ghost tours that will allow you to board a trolley that looks like a black train and even a traditional trolley that is black in color and looks like those that travel the streets of San Francisco. You may even choose to take a tour that drives you around in a hearse. There are also several tours that allow you to walk from one haunted place to another. In order to make the most of the tour that you take, you must determine which type is most appropriate for you. To enhance the exposure that you have to the paranormal side of St. Augustine, you could take all the tours – the boat, the trolleys, and the walking tour!

When you elect to participate in a haunted ghost tour in the City of St. Augustine, it is important to bring some basic ghost hunting supplies. You should ensure that you have a digital camera, a traditional camera, a video camera, and even a digital voice recorder. These devices will permit you to capture ghost videos, real pictures of ghosts, and even ghost sounds. In order to get the most out of a ghost tour, it is essential that you have items that will assist you in capturing evidence that supports the fact that ghosts are real. There are several different types of oddities that may be captured such as orbs, rods, and even full or partial body apparitions. You cannot expect to get the most from a haunted ghost tour without having equipment that assists in documenting your experiences while on the tour.

It is also important to ensure that you bring along other basic supplies such as a first aid kit, additional batteries, a flashlight, a notebook and a writing utensil, and protective clothing. Since it is hard to carry all of this ghost hunting equipment around in a comfortable manner, you should ensure that you store it in a protective container that will prevent environmental elements from damaging your supplies. A waterproof backpack is likely your best option. By having these items, you will find that you are prepared for unforeseen circumstances such as sickness, injury, and/or unfavorable weather conditions.

Most of the haunted ghost tours offered in St. Augustine, Florida includes several people at once. In order to get the most out of your experience, it is important to choose at least one person to go on the tour with you. When ghost hunting, it is important to never stray alone in locations that are considered to be infested by spiritual entities. Many ghost tours will allow you to investigate certain haunted places a little on your own. By bringing along a friend or relative, you will be able to indulge in this type of activity with little to no complications. By following the steps outlined in this guide, you will find that the haunted ghost tours of St. Augustine will provide you with a favorable and memorable experience.

99495-99496: Two New Codes to Report Transitional Care Management (TCM) Services

Primary care specialties will receive the largest increase in payment by virtue of a new payment for managing a Medicare beneficiary’s care when the beneficiary is discharged from an outpatient hospital observation, inpatient hospital, community mental health center, partial hospitalization services or from an SNF. While announcing its new policy, CMS acknowledged that the extensive non-face-to-face care coordination provided by physicians and nurses was not considered in the existing payment schedule for E/M (Evaluation & Management) services. The new directive will provide payments for physicians as well as other healthcare providers for coordinating care transitions of Medicare beneficiaries after they are discharged from hospitals/skilled nursing facilities to assisted living facilities or their own homes. The new rule is effective from January 1, 2013.

The New Codes: 99495 & 99496

CMS has a clear objective in introducing these new codes for Transitional Care Management (TCM) services. They are intended to prevent emergency department visits and re-hospitalizations during the first 30 days after discharge. Apart from primary care physicians who would be billing for most of these services, specialists who provide necessary services can also bill these new CPT codes.

TCM Code Requirements

  • 99495, TCM: Communication (direct contact, telephone, electronic) with the patient and/or caregiver within two business days of discharge; Medical decision-making of at least moderate complexity during the service period; face-to-face visit within 14 calendar days of discharge.
  • 99496, TCM: Communication (direct contact, telephone, electronic) with patient and/or caregiver within two business days of discharge; Medical decision-making of high complexity during the service period, face-to-face visit within seven calendar days of discharge.

It is to be noted that both these codes necessitate communication with the patient and/or care provider within two business days of discharge, plus a face-to-face visit with the patient within a fixed time period. Decision regarding medication and management must be made at least by the day of the face-to-face visit.

Non face-to-face care coordination services can be carried out by the provider and/or licensed clinical staff under his/her direction. However, the face-to-face visit is to be performed by the providers themselves with staff assistance.

Fee Schedule for the New TCM Codes

The values assigned to the new TCM codes are 4.82 relative value units for Code 99495 and 6.79 relative value units for Code 99496. Provided the Congress prevents the impending 26.5% cut to payments for physicians and maintains the current conversion factor of $34.0066, the payments for these codes will be:

In non-facility (Physician office) settings:

  • Code 99495: $163.91
  • Code 99496: $230.90

In facility (Outpatient hospital) settings:

  • Code 99495: $134.67
  • Code 99496: $197.58

These codes can be billed only after at least 30 days post discharge, when the service period is completed. The primary care incentive payments will not be added to these amounts.

Points to Keep in Mind

  • Make sure that you bill only for post-discharge patients who require moderate or high-complexity medical decision making.
  • The initial face-to-face visit need not necessarily be in the office.
  • The first face-to-face visit with the patient after discharge is part of the TCM service and cannot be reported separately. E/M services provided additionally can be reported separately.
  • Documentation guidelines for E/M are not applicable to these codes. Providers must therefore take into account how they would like to document the non face-to-face services that are required by codes. Complexity of the medical decision making, timing of the first communication after discharge, and date of the face-to-face visit will have to be documented.
  • Providers can use these codes to bill for new as well as established patients.
  • Discharge services and the face-to-face visit required under the TCM code cannot be provided on the same day. However, the same practitioner who bills for discharge services can also bill for TCM services. Importantly, the same practitioner cannot report TCM services provided during a post-surgery period for a service with a global period since it is understood that these services are already included in the payment for the underlying procedure.
  • A very important point to remember is that only one practitioner can bill for TCM services during the 30 days post discharge of a patient. The first practitioner to bill for the service alone will receive reimbursement. Therefore, practitioners should necessarily communicate with the patient and/or caregiver, and the discharging physician to be clear about who will be managing the TCM services.
  • Practitioners can bill for TCM only once in the 30 days after discharge even if the patient happens to be discharged 2 or more times within the 30-day period.
  • Providers cannot bill for other care coordination services (such as care plan oversight codes 99339, 99340, 99374 – 99380) provided during the TCM period.

Prostate Massage And Milking The Prostate – How To Milk The Prostate – Nurse’s Guide

Prostate massage and prostate milking are both commonly used terms to describe the massage or stimulation of the prostate gland either for medical or sexual reasons. Both terms are frequently used when the purpose is the relief of the symptoms of chronic prostatitis by a doctor and prostate milking or milking the prostate is used more often when the purpose is draining prostatic fluid during sexual activity to achieve a specific effect. Both can be performed internally or externally, but I will describe the internal technique here.

The prostate gland is just one part of the complex male reproductive system. It produces seminal fluid and functions in the process of ejaculation and orgasm. The gland is about the size of a walnut and is positioned directly behind the bladder. It’s prone to many conditions and diseases including, acute prostatitis, chronic prostatitis, enlarged prostate or BPH (benign prostatic hypertrophy) and prostate cancer.

The prostate milking technique is as follows (also sometimes prostate massagers or other milking or medical devices are used).

It’s best not to attempt this unless you’re sure you don’t have chronic prostatitis or any other serious condition. It’s always preferable to be cleared by your doctor first.

1. Gather your equipment together. You’ll need sterile non-latex gloves. Do not use latex gloves; serious allergies can develop over time with repeated use. You’ll need gloves that won’t snag or tear easily from sharp fingernails, etc. You can find these cheaply in any store with a pharmacy or over-the-counter drug section. You’ll also need some lubricant that is water-based; you can get this at your pharmacy also if you don’t already have some. Don’t use oils, lotions or perfume-based lotions; these contain irritants.

2. Check out your fingernails and make sure they are clipped and/or filed smoothly and won’t snag the gloves.

3. Take a trip to the bathroom and completely empty your bladder and bowels. This will help you relax more and will lessen the chance of an accident. Wash the area around your anus thoroughly to avoid any transfer of organisms. Wash your hands thoroughly and scrub them with a nail brush.

4. Get into a comfortable position, usually on the back or side. Put on one of the sterile gloves. You can use gloves on both hands if you like. Put a little of the lubricant on the fingers of the gloves you’re going to use.

5. Gently insert one or more fingers – better to start with one until you know what you’re doing. Be very careful if you have hemorrhoids. If that’s the case you may want to have them checked out by your doctor first. Move you finger slowly up the wall of the rectum, until you can feel the prostate gland. Be very gentle. No forcing or pushing. The gland will feel like a small ball.

6. Carefully and gently stroke or massage the gland along the sides only with your finger tips, not fingernails. You don’t want to touch the center or the top where there are many sensitive nerves and where you could do some damage.

7. Note the time. You should do this for only a few minutes. You may experience some odd feelings or sensations. And you may feel like you have to go to the bathroom but that should pass. Once the gland has contracted it will release some seminal fluid. You may or may not experience sexual pleasure, orgasm or ejaculation; this varies from person to person.

8. Carefully take off the gloves to avoid contamination and dispose of the gloves – they are no longer sterile and can’t be cleaned properly. Wash your hands thoroughly using a nail brush.

Prostate milking or prostate massage has been practiced by prostate specialists for many years for specific medical conditions. It’s controversial however. Although many men have been using this technique, there are risks involved. If you have any known or hidden condition or infection or inflammation of the prostate it’s possible to cause a serious systemic infection. The best approach is to get thoroughly checked out by your doctor first before you proceed.

High School Wrestling: John Jesse’s Wisdom on Strength and Conditioning

In 1974, a book entitled Wrestling Physical Conditioning Encyclopedia was published. This book was written by a man named John Jesse.

Conditioning coach Vernon Gambetta writes, "You are probably asking who is John Jesse? John Jesse was an expert on strength training, injury prevention and rehabilitation from Southern California."

I never knew of this book’s existence until recently even though it’s obviously been around a long time. I came across it while surfing the internet and researching wrestling conditioning.

I borrowed a copy from the public library and found it really fascinating. John Jesse’s book doesn’t seem that outdated even though it was published 38 years ago. He really knew a lot about strength and conditioning.

So, what did he know?

Year-Round Training

Jesse emphasizes the importance of continuity in training. Continuous year-round physical training is imperative if a wrestler wishes to be successful. When discussing the importance of continuity he points out that, “Repeated efforts are required for the formation of conditioned-reflexes in the nervous system required for the development of great skill.”

A wrestler needs to train continuously the entire calendar year. However, Jesse recognizes the importance of breaking down the yearly training into cycles. Jesse divides the year-round training into four cycles.

The Four Cycles

  • Transition (Active Rest) Cycle – a period of one month immediately following the competitive season
  • Basic (Foundation) Cycle – a period of five months divided into three stages
  • Principal (Specific Preparation) Cycle – a period of two months
  • Competitive – generally a period of four months

Jesse advises to take one week totally off immediately following the season and then begin the transition cycle. However, you are not to engage in any wrestling or skills work during the transition cycle. During that cycle one should abstain from any wrestling, but you need to begin training for strength, endurance, and flexibly again. If you take too long of a break the physical attributes you’ve gained will begin to dissipate.

I’m sure that most of you have learned about the concept of periodization. Well, as you can see, that’s exactly what John Jesse is writing about.

In this current age, periodization is still used. Periodization is basically just planning your training. Dr. Fred Hatfield (a.k.a. Dr. Squat) is a big advocate of periodization. In an article entitled The Simplicity of Periodicity he writes of the “tremendous value of short-term periodization in your training.”

Moreover, he adds, “As your competition draws nearer and nearer, your training objectives change, and therefore your training methods change commensurably.”

Sports scientist Tudor Bompa has said, “We either have periodization or chaos.”

John Jesse writes something very similar in his book. He states, “Without a long-range training plan the athlete’s training can easily degenerate into chaos.”

Jesse knew what he was talking about.

Do you think champion wrestlers only work out during wrestling season? Do you think they train in some haphazard fashion? No! They train year-round with a well developed plan in mind just like John Jesse advocated and strength and conditioning experts still advocate.

Individuality and Specificity

Regarding individuality Jesses writes, “Training is an individual problem. All individuals react differently to the same training load.

Further, he states, that “No athlete should base his training plan on that used by some champion or outstanding athlete particularly as to the intensity of training loads.”

For instance, a high school wrestler may not be able to tolerate the training load that a college wrestler handles during a training year. You may not be able to train with the same load or intensity that Dan Gable or John Smith used while training.

According to Dr Fred Hatfield, there are seven laws of training that most sports scientists subscribe to. One of those laws is the law of individual differences. According to Hatfield, “We all have different abilities and weaknesses, and we all respond differently (to a degree) to any given system of training. These differences should be taken into consideration when designing your training program.”

Jesse knew the importance of individuality just as coaches do now and you should too.

Regarding specificity Jesse writes, “This principle maintains that training and its effects is specific to the muscle cells, organs and movements of the body in the development of either strength, endurance, flexibility or skill.”

Further, he states, “The specificity principle is of particular importance to the wrestler who requires various types of strength and endurance in order to excel in competition.”

Another of the seven laws of training is the specificity principle. According to Hatfield, “You’ll get stronger at squats by doing squats as opposed to leg presses, and you’ll get greater endurance for the marathon by running long distances than you will by (say) cycling long distances.”

A closely related law is the SAID principle: Specific Adaptation to Imposed Demands.

You are a wrestler. Therefore, you must wrestle to improve at wrestling. You must also train for the demands of wrestling. You are not a marathoner so do not train like one. Wrestling is an anaerobic sport requiring strength, power, endurance, and many other abilities. So, train accordingly.

John Jesse knew the importance of specificity. Now you do too.

Supremacy of Strength

Jesse states, “The importance of strength in wrestling competition as the primary source of human power is frequently underestimated by coaches and wrestler alike. Strength underlies all other factors when one considers the total functioning of the body. Without sufficient strength other factors such as endurance, flexibility, agility, and skill cannot be used effectively.”

Similarly, performance coach Kelly Baggett states, "Maximum strength is the backbone upon which all other strength qualities lie. You’ll hear me talk a lot about being fast and the importance of speed, power, reactive ability etc. All of these qualities of strength are very important, but truthfully, unless you have enough raw horsepower in your engine you won’t be going anywhere or doing anything in a hurry!"

You may be interested in plyometrics, circuit training, and other modes of conditioning. However, one of your first priorities should be building a good strength base.

All-Round Strength

In Wrestling Physical Conditioning Encyclopedia, all-round strength or total body strength is discussed. A wrestler wants his total body to work in a harmonious manner as a well-coordinated whole unit.

Some exercises recommended for the development of all-round strength include the one arm get-up, two arm get-up, dumbbell clean and jerk, barbell clean and jerk, barbell push press, barbell jerk press, deadlift, one hand swing, two hand swing, high pull to chest, and dead hang clean.

It’s interesting to note that the one arm and two arm get-ups and the one hand and two hand swings are illustrated using dumbbells. These exercises are popular choices now for athletes using kettlebells. The get-up is usually called the Turkish get-up. The Turkish get-up is hailed as a fantastic all-round strength and conditioning exercise. In addition, the Turkish get-up is endorsed because it requires all the muscles

of the body to work together in order to accomplish the labor.

Kettlebell swings are considered the foundation kettlebell exercise and are said to burn fat, build strength, and enhance cardiovascular fitness.

His book doesn’t mention kettlebells, but John Jesse knew the importance of all-round strength.

Strength Endurance

John writes, “The type of endurance that is in general overlooked in the conditioning of wrestlers is strength endurance. It is perhaps the most important basic physical quality a wrestler should develop.”

He suggests that one way of building strength endurance is to pick two exercises and do 4 sets of each. You do one set with 30, 50, 70, and 80 percent of your 1RM respectively. You would do this during the Principal (Specific Preparation) Cycle.

Some current strength and conditioning coaches may argue that Jesse’s routine is more suited to building muscular endurance than strength endurance.

The point is that John Jesse knew that after acquiring strength a wrestler needed to convert that strength into strength that he could use repeatedly over the duration of a match.

Trainer and coach Ross Enamait states, "Strength endurance is defined as the ability to effectively maintain muscular functioning under work conditions of long duration. Strength endurance is a vital strength quality for any combat athlete. Power and speed are useless without the stamina necessary to apply these physical attributes throughout the contest."

Similarly, strength and conditioning specialist Matt Wiggins writes about strength often being the most beneficial when you can take advantage of that strength over an extended period of time. He prefers to build strength endurance by using heavy weights and shortened rest periods.

Others prefer to do circuits using dumbbells or kettlebells combined with bodyweight exercises.

The bottom line is that you want to be as strong as possible for as long as possible. Jesse really emphasized strength endurance in the strength and conditioning training plan of a wrestler.

Rotational Strength

John believed that athletes placed too much emphasis on developing the muscles of the arms, shoulders and legs, while overlooking the importance of strength in the muscles of the lower back, sides, and abdomen.

He states, “No athlete engaged in activities that involve rotational and lateral movements against resistance such as wrestling, can truly project the concept of total body strength in movement if he is relatively weak in the muscles surrounding the lower trunk.”

When writing of John Jesse, conditioning coach Vernon Gambetta states, "He was preaching tri-plane work in the late 1940’s. Big emphasis on rotary work, a surprise to the gurus of today who think they invented rotary work." He also adds, "His ideas are very contemporary; he was a man ahead of his time."

Interestingly, certified strength and conditioning specialist Bret Contreres states that many sport movements include either large or subtle rotational elements. For example, imagine a wrestler attempting to take down an opponent. Does a double leg or single leg take down only involve strength in the vertical plane? I don’t believe so. You don’t lift your opponent straight up. One is usually lifting, moving laterally, and rotating.

Throws certainly occur in the transverse plane. What’s the transverse plane? Or, for that matter, what are the sagittal and frontal planes?

According to functional training expert Fraser Quelch, "As the body moves through space, it uses any combination of three planes of motion: sagittal, frontal and transverse." He adds, "Most traditional strengthening programs heavily favor sagittal-plane movement in a training environment that promotes one-dimensional motor patterns. These factors can undermine the body’s ability to move effectively in any given direction, and, in many cases, may lead to joint dysfunction."

Strength and conditioning coach Chad Waterbury states, "Rotational strength is probably the most important strength movement quality for MMA fighters. Sure, deadlifts, cleans, squats, chins, etc. are great strength building exercises, but they only establish a base of strength: that strength base must be further enhanced with rotational movements."

So, you see, John Jesse knew the importance of rotational strength for combative athletes. He mentions various rotational exercises in his book involving barbells, swingbells, and sandbags. You may have no idea what a swingbell is. That’s fine. There are many things an athlete can do with medicine balls or simply his bodyweight to exercise in the frontal and transverse planes.

Grip Strength

Jesse states, “No other athletic activity requires the combined strength and endurance of the grip as that required in the sport of wrestling.”

Similarly, Zach Even-Esh states, "Having strong hands and a powerful grip is misunderstood and undervalued by most wrestlers. Remember, everything passes through your hands in wrestling. The stronger your hands, the stronger your holds will be. The stronger your hands, the less likely your grip is to be a limiting factor in holding an opponent or finishing a move."

Joe Makovec, strength and conditioning coach for the nationally ranked Hofstra wrestling team, discussed some grip exercises with STACK Magazine (2007). He states, "We do a lot of wrist rollers and fat bar exercises, like rows and curls. We do a farmer’s carry, too, with a fat bar and with regular dumbbells. We also do a lot of pulling motions where you have to grip a rope."

Strength coach Charles Poliquin advocates thick bar training for grip. In an article about thick bar training he tells an anecdote about a Russian wrestler who displayed his grip strength at a press conference during the 1970s by producing two pairs of pliers and proceeding to squeeze them so hard that they snapped. After this Russian wrestler defeated an American wrestler, the defeated US wrestler commented that when the Russian grabbed his arms, he felt as if they were locked in a vise grip.

Can you maintain wrist and hand control on your opponents throughout a match? It is essential to have a strong grip. Good grip strength will greatly add to your ability to control or take down an opponent.

Hamstrings and Hips

Every wrestler has heard how important the hips are in wrestling whether it be properly using your own hip strength and power or the need to control your opponent’s hips.

Jesse discusses the fact that most of the holds used by a wrestler employ the hamstring, leg adductor, and hip flexor muscles to a much greater extent than leg extensor muscles. He believed that the strength of the hamstring muscles also played an important role in the prevention of injury to the knee.

According to STACK Magazine (2005), Gary Calcagno, head strength and conditioning coach for Oklahoma State University, says that lower body strength training is as simple as doing squats, glute ham raises, and lunges.

According to Coach Dave Tate, "We have known for years that the Glute Ham Raise (GHR) was regarded as one the best movements for the posterior chain (lower back, glutes, hamstrings and calves)."

And, Testosterone Magazine says of glute ham raises, "In addition to building up those hammies, it can also make an athlete virtually invulnerable to hamstring injuries as the movement lengthens the sarcomeres to an unparalleled degree."

You may not have access to a glute ham machine. Doesn’t matter. You can do them without a machine. I’m simply pointing out that current strength coaches realize the importance of strong hamstrings.

According to Coach John Gaglione, "The strength of a wrestler’s posterior chain is extremely important for optimal performance on the mat. Most athletes only focus on the muscles they can see in the mirror; often times neglecting the muscles they can’t see such as the glutes, hamstrings, and low back. This is a HUGE mistake, especially when these muscles play a paramount role in many movements you see in competition."

According to Patrick Dale, "Hip strength is vital in grappling sports such as wrestling and jiujitsu. Throwing your opponent to the ground and escaping from a pin attempt require power in your hip muscles. There are a variety of muscles that cross your hip joints, including the gluteus maximus or butt muscles, hamstrings, quadriceps and hip flexors."

Hip flexion brings the legs forward. Hip flexors are the muscles that bring the torso and leg closer together Think of how you lower your level before shooting a takedown.

Strength and conditioning coach Kevin O’Neill states, "Through my experience working with athletes in a variety of sports I have come to the belief that athletes and coaches do not train the hip flexors for strength gains nearly enough as they should."

He says the stronger the hip flexors, (along with the hamstrings and glutes), the faster the athlete is going to be.

It’s possible (even common) to have hip flexors that are too tight. It’s possible to overdevelop the strength in your hip flexors as well which is undesirable.

Hip extension is extremely important too. Don’t neglect the importance of hip flexion or extension.

Interestingly, Kelly Baggett claims that one of the main differences between average athletes and good athletes can be attributed to the strength, development, and function of the glute musculature. I had no idea the glutes were so important.

The anatomy and physiology stuff can be confusing. I think the main point I’m trying to make is that John Jesse knew the importance that the hamstrings and hips play in wrestling and so do current strength coaches. He knew the effect proper training of those muscles could have on performance and so do current strength coaches.

Anaerobic Endurance

Jesse discusses the fact that during a match a wrestler will engage in many bouts of oxygen debt activity. Therefore, a wrestler requires a high degree of anaerobic metabolism efficiency and resistance to oxygen debt discomfort.

The author discusses the fact that a wrestler needs the capacity to continue at a high level of work in the interval between the "oxygen debt" periods of maximum exertion and still efficiently clear the waste products of the oxygen debt periods that produce fatigue in the muscles.

Have you ever seen your strength or speed drop in the third period because your muscles were burning with fatigue? It’s difficult to shoot a powerful takedown in the third period if you’re feeling fatigued.

The author discusses how a great capillary structure aids a runner in his efforts to clear waste products from his lower body. However, running cannot help a wrestler to develop endurance in the other muscles of his body such as the muscles of the back, chest, arms, and shoulders. A different form of training is required for that.

Jesse states, “Strength endurance training programs develop the wrestler’s ability to tolerate “oxygen debt” (anaerobic endurance) and vastly improve the all-important psychological quality that is called the “will-to-win.”

It’s interesting to note that strength and conditioning coach Alwyn Cosgrove has a similar view. He states, "Some conditioning coaches use sprint training as their sole method of energy system development (ESD). This is at best a short-sighted approach. It is not uncommon to see well-conditioned fighters who have used sprint based ESD fatigue rapidly in hard matches. This is because although their cardio system is well-conditioned, the effect of lactic acid on their localized muscle groups is devastating. If we do not condition the muscle groups themselves to handle high levels of lactate, the cardio system will feel fine, but that area will lock up and shut down."

Cosgrove recommends using barbell complexes. Barbell complexes involve doing a series of exercises one after the other without putting the bar down. Complexes may help condition your body to handle the high levels of lactate that will be produced during a wrestling match.

In their article The Physiological Basis of Wrestling: Implications for Conditioning Programs, Kraemer et al. (2004) state, "As a combative sport, wrestling imposes unique stresses on the body. From a metabolic perspective, the acid-base balance is severely disrupted. For example, a college or freestyle match lasts between 6 and 8 minutes (including overtime) and can elevate blood lactate concentrations in excess of 15 mmol/L and sometimes reach nearly 20 mmol/L."

In other words, a wrestling match can produce a lot of lactate. This disruption can cause fatigue. So, how can a wrestler train to tolerate this disruption? The authors recommend a circuit training format with brief rest periods. Circuit training is similar to complex training. Interestingly, the authors (much like John Jesse and Alwyn Cosgrove) note, "It is also vital that the upper body is trained in this manner to increase the capability of upper-body musculature to directly adapt to the dramatic acid-base shifts that occur with wrestling."

You may want to research anaerobic threshold training, lactate threshold training, complexes, and circuit training.

Interval Training

You may be aware that interval training, especially high intensity interval training (HIIT) is all the rage right now. The Tabata protocol is especially popular. Interval training involves alternating between bouts of high-intensity work and recovery periods of lower intensity work.

For instance, instead of running at a slow steady pace for 24 minutes a person may run hard for 2 minutes and jog for 4 minutes (6 minutes total) and repeat this protocol 4 times (a total of 24 minutes). Both workouts are 24 minutes in length, but the second workout may elicit a different training response. Or, a person may perform several 30 second sprints with each sprint followed by a recovery period and then run perhaps 10 sprints total.

The high intensity nature of the training is supposed to burn more fat, enhance one’s lactate threshold, and promote greater cardiovascular benefit than traditional slow, steady-state cardiovascular work. An athlete’s work to rest ratio could be 1:3, 1:2, 1:1, 2:1, and other combinations.

Did John Jesse know about interval work? Yes! Regarding interval work training Jesse writes, “This is physical work or activity of a given intensity, interspersed with pauses.” Further, he adds, “The steady work uptake and the repeated slowing down or stoppages of work (jogging, walking, lying down, etc.) stimulates the organism to much higher physiological adaptations, thereby forcing the organism to its optimal development, endurance wise.”

Of course, even in 1974 when Wrestling Physical Conditioning Encyclopedia was published interval training was nothing new. Interval training was first developed by German physiologists Reindell and Gerschler in the 1930s. Roger Bannister, the first man to run the mile in under 4 minutes, used interval training.

The point is that John Jesse knew the benefits that this type of training could offer to athletes including wrestlers. He knew that it had many advantages over continuous steady-state types of training.


John discusses the fact that sandbags are awkward to handle. That is one of the main reasons that strength and conditioning coaches advocate sandbag training.

According to strength coach Brian Jones, "During a sandbag rep or set the load may shift substantially from one side to the other, sag in the middle, or otherwise try to escape your grasp. Such shifting forces your core and stabilizers to work overtime in an attempt to get the weight back under control. You will be forced to work considerably harder to control a given load."

John Jesse also believed that sandbag training mimicked the lifting and pulling movements encountered in wrestling. Also, he believed that sandbag training was good for developing rotational strength and power.

Certified strength and conditioning specialist Mark Roozen states, "Using sandbags in a training program can help develop power, quickness, agility, and conditioning components. This can all be accomplished with a piece of equipment that can simulate contact, throws, and be utilized in ways that solid resistance equipment could not be used."

Sandbags are becoming a very popular training tool. You can find many articles online about sandbag training.

Calisthenics and Running Combined

Jesse writes, “Athletic coaches in all sports use combined programs of running, calisthenics, rope skipping, stadium steps running, etc., for the development of strength, muscular and circulo-respiratory endurance and agility.”

Strength and conditioning coach Mike Mahler likes the benefits that can be derived from "roadwork." He states, "Here is how it works, go out for a jog and every 50 yards or so, drop down and do some bodyweight exercises such as push-ups and sit-ups. Crank out 25 reps and then get up immediately and start jogging again. After another 50 yards or so, drop down again and crank out some more bodyweight drills. This is an efficient way to build up cardio and muscular endurance that will carry over to the ring."

For anaerobic endurance training Mike Fry suggests visiting your local football field. He writes, "Starting at the goal line, sprint to the 10 yd line and walk back to the goal line and do 10 push-ups, continue by increasing your sprint by 10 yds each time and walking back to the goal line. Do pushups after each return to the goal line." Make sure to do a warm up before and a cool down afterwards.

Legendary wrestler and former Iowa Hawkeye coach Dan Gable used to enjoy utilizing the stadium steps of Carver-Hawkeye Arena to condition his wrestlers. Walking up those steps with a buddy on your back could be especially grueling.

Drilling and Technique

Jesse emphasizes the importance of “improving skill (technique, use of leverage, etc.) to eliminate unnecessary movements that waste energy and use up oxygen.”

Personal fitness trainer Brian Copeland writes very similar words. He states, "It is always best to include skill practice before resistance or endurance training. The goal of skill training is not to just practice… it is to get better! It amazes me how often this simple principle is overlooked. It is my experience that people don’t really understand how to practice to make improvements, at least not beyond a basic level of skill. Skill practice is analyzing every single aspect of every movement you make and finding more efficiency, better leverage, etc."

If one desires to use sparring as a method of developing endurance for mixed martial arts, strength coach Charles Poliquin suggests, "The best way would be to pair up with 5 other fighters that each take turns to fight you. Since they are fresh, they will give you a run for your money. Depending on the system you want to develop you would manipulate the work /rest interval. For example 6-10 minutes work on fighter 1, 2 minutes off, 6-10 minutes work on fighter 2, 2 minutes off, etc. The permutations of that type of work are staggering. Twice a week should be plenty. What is good about it is that you will be forced to make decisions in conditions of fatigue, which is a determinant in MMA fighting."

Interestingly, in Wrestling Physical Conditioning Encyclopedia, the author writes of a wrestling drill for building endurance that is a bit similar to the MMA routine above. He writes, "Wrestler remains on mat and wrestles for 9 minutes against a fresh opponent each minute, with 10-second rest intervals."

Cycling Work and Rest

Even though year-round training is encouraged, one is not expected to train with the same volume and intensity year-round. Jesse recognizes the need for varying volume and intensity in the training plan. Some days will be low intensity, some medium, and others high. Some days may involve total rest.

According to Dr. Owen Anderson, "Any periodization scheme must begin with one basic element – rest. This is intuitively and logically obvious: the human body simply needs ‘down’ (restoration) periods to recover from extended periods of stress; you must convalesce from the training you carried out in your just-completed mesocycle or macrocycle."

Proper Weight Reduction

John Jesse warns the reader about the dangers and foolishness of crash starvation diets and dehydration. He recognized that crash starvation diets can have devastating effects on a wrestler’s performance. He suggests that it’s better not to diet unless you actually have weight to lose. Many wrestlers are already lean to begin with and then starve and dehydrate themselves to make weight.

Professor William Kraemer points out that a wrestler will not be functioning optimally physiologically if he engages in dehydration practices for the purpose of weight reduction.

He also notes, "Adopting different weight-loss strategies that stabilize muscle mass and body mass to prepare for a match appears to be the best way to eliminate physiological breakdown and allow the wrestler to perform at a higher level of physiological readiness."

Improper weight loss techniques can be detrimental to a wrestler’s conditioning and to his performance in competition.

Craig Horswill, PhD suggests some possible options regarding weight loss in wrestlers. Describing one of these options, he writes, "Lift weights and grow into the weight class. Be stronger at the end of the season. How many wrestlers start strong but fade in the tournaments because they are burned out after weight cutting has taken its toll? If a wrestler can grow into the weight class to the point that he needs to begin cutting weight only by the end of the season, he spares himself three months of nutritional deprivation and improves his chances of not becoming over trained. He is fresh when it really counts."

Interestingly, John Jesse mentioned that some wrestling coaches had achieved success by letting wrestlers stay at their natural weight or perhaps even gain weight during the season.


Wrestling Physical Conditioning Encyclopedia also covers topics such as flexibility, injury prevention, circuit training, gymnastic apparatus exercises, isometrics, proper nutrition, and more.

In his article Seven Keys to Athletic Success, strength and conditioning coach Alwyn Cosgrove discusses concepts of physical training such as the importance of strength, explosive power, endurance, flexibility, injury prevention, and core training.

John Jesse addressed all of those concepts in his book in 1974. You may want to borrow a copy of this book or buy it online. I think you’d learn a lot and enjoy reading it. If you don’t read the book it’s no big deal. The important thing is that John Jesse knew that proper training for wrestling based on science as well as years of experience had the potential to dramatically improve a wrestler’s performance.

The main reason I wrote this article is because I believe that John Jesse and his book deserve to be recognized and remembered.

But, as I said, you don’t need to read his book. So much incredible information regarding the training for wrestling and other combative sports can be found in books, magazines and journals, and online. Take advantage of the wealth of knowledge that is out there. Take advantage of science and let it help you become the best wrestler that you can be.

Amino Acid Products For a Boxing Training Program

Amino acid products are becoming a very popular component of a boxing training program. Athletes of all shapes and sizes can make use of amino acids because they provide a huge range of benefits. They are of course natural compounds, and your body utilizes them in a near infinite amount of ways. Take a look at how you can benefit from them as a piece of your boxing training program.

When most people think about amino acid products they think about building muscle and strength, and this is true. Aminos are the building blocks of proteins, which are the building blocks of muscles. They are necessary for muscle repair, growth and recovery, and if you want to build new muscle mass you need to be ingesting enough amino acids.

As mentioned, most people realize that but what most people don’t necessary think about is that they make for excellent muscle recovery supplements. They will help your body repair your muscle mass in less time, allowing you to get back in the gym and back to training. You will also be able to prevent injuries from reoccurring, and you’ll notice less pain and nagging strains as well.

In addition to serving as muscle recovery supplements, they can also help to improve the strength of your entire frame. They target the bones, joints, ligaments and cartilage, providing an all-over boost to your strength and fitness. You will immediately notice the difference in your performance and what you’re capable of.

With amino acid products this is still really just the beginning. They can be used for just about anything. Some can actually serve as a natural energy booster, while other products and supplements can help your focus and concentration. You can find both complete amino acid products and those that offer or specialize in just one key amino acid. The most popular of these products are those focusing on L-Glutamine and L-Arginine.

It’s also important to realize that many of these are actually essential for your diet, which means that your body can’t produce them and therefore needs to ingest through through diet and supplementation. Therefore, using some of these products will enable you to meet all of your dietary needs, which can have a wide range of health benefits as well.

For a boxing training program, your body and your performance can reach entirely new levels as you take advantage of amino acid products. As muscle recovery supplements and in many other ways, they will increase the results that you see and keep you in action for more of the time with less pain and aggravation.

Alcohol Treatment

When an individual with an alcohol abuse problem has made a conscious decision to stop abusing alcohol, but has been unsuccessful in all attempts to do so on his own, it may become necessary to solicit help from an alcohol treatment professional. The importance of choosing the appropriate type of treatment for an individual's specific situation should not be underestimated.

The initial step of choosing a treatment program should ensure that the most effective treatment method is selected to fit the individual's specific treatment needs. If an incorrect evaluation is made when selecting a treatment mode, the chances for failure increase significantly. Alcohol treatment should address the specific needs of each individual. There are varying degrees of abuse. Some individuals may have a history of many failed attempts to end their abuse patterns. For those who fall into this category, inpatient residential treatment may prove fruitful. Research studies show that inpatient treatment is the most successful way for individuals with multiple unsuccessful attempts at sobriety to succeed.

An alcohol treatment center is a place where an individual who has a drinking problem can receive help. Treatment means that an individual enters a program that helps them with their alcohol addiction and provides them with the tools necessary for a complete recovery.

Alcohol treatment works for many people who have problems with alcohol abuse and addiction. But just like any other drug problem, the individual has to be committed to make a change for the better. Some people stop drinking and remain sober. Others have long periods of sobriety with bouts of relapse. And still others can not stop drinking for any length of time. With alcohol treatment, one thing is clear: the longer a person abstains from alcohol, the more likely he or she will be able to stay sober.

HIPAA 5010 Implementation for Medical Billing

HIPAA 5010 was adopted to replace the current version of the standard that covered entities must use when conducting electronic transactions. Version 4010 is currently being used under HIPAA standards.

Although HIPAA version 5010 gets much less attention than ICD-10 medical codes,it is just as important and physicians, medical practices and other health providers, should already be working with vendors on the version 5010 implementation.

Testing with external trading partners began in January of 2011. It is very important that you test as early as you can and often.

Here are some important 5010 compliance testing dates to be aware of:

  • January 1, 2011 Level I compliance-ability to process 5010 transactions for testing and transition with able trading partners
  • January 1, 2012 Level II compliance-all covered entities must begin using 5010 transactions

Simply put, transactions are electronics exchanges involving the transfer of health care information between two parties for specific purposes, such as a health care provider submitting medical claims to a health plan for payment. The Health Insurance Portability & Accountability Act of 1996 (HIPAA) named certain types of organizations as covered entities, including health plans, health care clearinghouses and certain health care providers. HIPAA adopted certain standard transactions for Electronic Data Interchange (EDI) for the transmission of health care data, as well. These transactions include, but not limited to:

  • claims and encounter information
  • payment and remittance advice
  • claims status
  • eligibility
  • enrollment and disenrollment
  • referrals and authorizations

Unlike the current 4010 transaction standard, version 5010 is more specific in the type of data it collects and transmits over the course of a transaction. 5010 also has clear situational rules built in which will help enhance the understanding of claim corrections, reversals, recoupment of payments and the processing of refunds.

For example, HIPAA 5010 will increase the diagnostic field size to accommodate the increased size of ICD-10 codes. Some other changes include:

  • a version indicator that distinguishes between ICD-9 and ICD-10 codes
  • format changes that will increase the number of diagnosis codes allowed on a claim

Interestingly, the 5010 format does not require the use of ICD-10 codes. However, it will be able to recognize and distinguish between the ICD-9 and ICD-10 medical code sets, which may help in a future with dilemmas of billing utilizing the dual code sets.

All health providers have to establish steps for preparing for 5010 Implementation and it might include the following:

  • Software must be modified to produce and exchange the new formats (e.g. trading partners must be able to read incoming 277CA transactions).
  • Review business processes to ensure changes are not necessary to capture additional data elements not previously required (e.g. Impact of patient registration, billing, and claim reconciliation).
  • Contact your vendor and/or clearinghouse to ensure products and processes are updated (e.g. license includes regulation updates, and will the upgrade include acknowledgement transactions 277A & 999).
  • Trading Partners should contact their local Medicare-Fee-For-Service contractor (MAC) for specific testing schedules.

Do External Hemorrhoids Go Away?

Generally speaking the answer is yes, but if you are actually asking “Do external hemorrhoids go away on their own?” then the answer is no, a least not in 99% of cases. If you are suffering from this reasonably common ailment then your best solution to curing them is to apply some kind of treatment plan. For the problem to heal itself, it would have to be a very mild form of the disease and perhaps a first time occurrence as normally they get worse with every occasion. A hemorrhoid is in fact a swollen and inflamed vein around the anus area and can form both inside and outside of the rectum resulting in two varieties, internal and external. Severe cases may require surgical intervention.

External hemorrhoids will go away by applying simply treatments such as Witch Hazel or Annusoul which can be bought over the counter in any well stocked pharmacy. If you don’t wish to make your disease publicly known then try buying a treatment online, there are plenty of options available to you.

The symptoms you can expect to experience from external hemorrhoids are itchiness which can become very severe, a burning sensation around the affected area, pain caused from the swollen lump and possibly bleeding. These symptoms can bring a lot of discomfort to the sufferer and if you do start having any of these you should really take the time to visit your local doctor who can properly diagnose the condition.

The other form of hemorrhoids you may need to be aware of are the prolapsed kind. These originally begin life as an internal hemorrhoid and become prolapsed which means they have become so distended they are pushed outside of the anus. During this process you may also get a strangulated hemorrhoid which is when the sphincter goes into spasm and traps the prolapsed hemorrhoid outside. Prolapsed hemorrhoids fall into one of four categories which are labeled as follows;

1. The internal does not become prolapsed and remains as an internal hemorrhoid

2. It occurs during defecation but retracts on its own accord soon afterwards to its original position.

3. The same as grade two but they will not retract on their own and will need manual assistant.

4. The same as a grade 3 case but manual help will not work, they only treatment is surgery.

The recommended method to make external hemorrhoids go away is to first get the condition diagnosed and then apply a treatment plan, of which your doctor should be able to point you in the right direction.

Fibromyalgia – New Treatments

Fibromyalgia (FM or FMS) is a condition that causes chronic musculoskeletal pain. Besides widespread pain it is characterized by tender points, painful areas located in certain parts of the body. There are often other symptoms as well, such as fatigue, headaches, cognitive problems, sleep disturbances, anxiety and depression.

People with fibromyalgia frequently have other comorbid illnesses, such as chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), migraines, restless legs syndrome (RLS) and irritable bowel syndrome (IBS). Fibromyalgia commonly occurs together with autoimmune diseases, especially rheumatoid arthritis and lupus (SLE), but it is not thought to be an autoimmune illness. The exact mechanism that causes the illness is not fully understood yet.

Lyrica And Cymbalta

The FDA has approved two medications for fibromyalgia: pregabalin (Lyrica) in June 2007 and duloxetine (Cymbalta) in June 2008. Pregabalin is an anticonvulsant (epilepsy drug), though it is used more often for pain disorders. Duloxetine is an SNRI antidepressant (serotonin and norepinephrine reuptake inhibitor), also used for diabetic neuropathy and stress incontinence.

Despite being in entirely different classes of drug, both Lyrica and Cymbalta can help pain, sleeping problems, fatigue, cognitive impairment, depression and anxiety caused by fibromyalgia, though they don’t help everyone and even if you do benefit, you might not get improvement in all of the listed symptoms.

Other Similar Drugs

The drug companies behind these drugs would of course like us to believe they are the magic bullets, but luckily there are many other medications that can help fibromyalgia. The manufacturers of most other drugs just haven’t invested in the expensive trials needed to gain FDA approval — often because the patent is going to expire soon and after that their benefits will drastically drop.

For example, gabapentin (Neurontin) is an anticonvulsant very similar to Lyrica, which used to be widely prescribed for fibromyalgia, but now Lyrica has surpassed it. The drugs have almost identical modes of action. There is no clear evidence showing that either one is more effective. Some people can tolerate pregabalin but not gabapentin, and vice versa. Neurontin comes with a bit cheaper price tag.

Duloxetine is not the only SNRI antidepressant either. Venlafaxine (Effexor) is also an SNRI, though in low doses it does not have that much effect on norepinephrine. Milnacipran (Ixel) is a promising SNRI antidepressant which is not yet available in the United States, but is sold in most of Europe. It has shown good results in preliminary fibromyalgia trials. It is also very inexpensive and thought to be one of the best tolerated antidepressants.

Anticonvulsants And Antidepressants

Generally almost all anticonvulsants, including older names like carbamazepine and lamotrigine and newer players like topiramate, zonisamide and levetiracetam can help the symptoms of fibromyalgia. There are big differences in modes of action among drugs in this class, so even if one does not work or produces intolerable side effects, another one might be worth a try. They tend to be especially helpful for pain, mood problems and migraine prevention, often also for sleep.

The same goes for antidepressants, too. The reason they are used in fibromyalgia is not that fibromyalgia is a psychiatric disorder, but they are also used in many other painful conditions like migraines, chronic headaches, neuropathic pain and IBS. It is thought that fibromyalgia may be associated with a deficit of serotonine and norepinephrine.

The SSRI antidepressants like fluoxetine (Prozac) are generally not so effective for pain. Many other antidepressants, however, also affect norepinephrine. These include tricyclic antidepressants such as amitriptyline (Elavil) and imipramine which have been used to treat fibromyalgia since the 1980s. They are used in very small doses, usually much smaller ones than would be used for depression. They are especially effective for sleep, but often cause too many side effects.

NMDA Antagonists

A third promising class of drugs is NMDA receptor antagonists. The NMDA receptor is thought to be overactive in fibromyalgia and downregulating it could relieve all symptoms of the condition. NMDA antagonists include the cough suppressant dextromethorphan, amantadine which is used for influenza and Parkinson’s disease, the Alzheimer’s drug memantine and riluzole, a new drug used for amyotrophic lateral sclerosis (ALS).

Other drugs that also downregulate the NMDA receptor include e.g. calcium channel blockers, many anticonvulsants, some opioids (methadone and dextropropoxyphene) and the muscle relaxants dantrolene and orphenadrine. Magnesium and the amino acid taurine may also have this effect.

Hormonal Treatments

Fibromyalgia has also been associated with endocrinological (hormonal) deficiencies, especially of growth hormone, thyroid hormone and vitamin D, which is nowadays considered a steroid hormone. Others, such as estrogen, testosterone and cortisol have also been suggested as culprits.

Growth hormone has been shown to be deficient in a subset of people with fibromyalgia and supplementation helps many people. Unfortunately the treatment has to be given as an injection and is very expensive. Luckily some oral drugs can also boost growth hormone secretion, such as the anti-anxiety drug buspirone, the blood pressure drug clonidine and the muscle relaxant baclofen. Melatonin may also have this effect.

Some doctors believe that thyroid supplementation can even completely relieve fibromyalgia symptoms in some cases where laboratory results are supposedly normal. On the other hand many patients have reported excellent results, even complete pain relief with large doses of vitamin D.

Promising Drug Candidates

Many drugs are currently in clinical trials for fibromyalgia. Sodium oxybate (Xyrem) is a sleep aid which can also help depression and pain. It is currently approved for narcolepsy, but is used off-label for severe insomnia. Several trials have demonstrated good efficacy in fibromyalgia, but insurance companies are likely to frown at the price.

Flupirtine (Katadolon) is used in many European countries for e.g. low back pain. It has some NMDA blocking properties and has shown good efficacy in preliminary trials. If clinical trials are successful, the company is planning to market it for fibromyalgia with the brand name Effirma.

Lacosamide (Vimpat) is an anticonvulsant with a novel mode of action. It is not yet on the market, but may be approved in the United States and Europe before the end of 2008. A recent phase IIa trial concluded it was effective and well-tolerated in fibromyalgia.

Low dose naltrexone (LDN) is a treatment that increases the secretion of endorphins, our natural painkillers. Fibromyalgia may be associated with an endorphin deficiency, which could also contribute to fatigue, depression and other symptoms. A clinical trial trying LDN for fibromyalgia is currently running in United States.

Use Bad Breath Medicine & Other Tips to Cure Halitosis

I never thought that I would have to take bad breath medicine, but my husband finally sat me down and told me that we should look into what our options were. I was upset and found it hard to talk to people because I was scared that my halitosis would turn them off.

I tried to stay positive and determined that I was not going to let this situation affect my life in a negative way. I jumped online and started doing a lot of reading in order to learn the causes and cures so that I could get rid of bad breath. The studying paid off and soon I was putting what I learned into action. Soon both my husband and I started noticeing a difference and I am no longer living in fear of my halitosis!

If you think that you need to start using bad breath medicine, you need to realize that there is more to beating this than that. Yes, the remedies help a lot. But the most important thing that you should do is to make a few lifestyle changes in order to prevent the halitosis from ever coming back. Here are the steps that I took and that you can test out also:

  1. Have lozenges and gum near you at all times. Chewing on these will bring more saliva into your mouth and saliva is a natural mouthwash.
  2. Please stay away from cigars and cigarettes. You may think that this is common sense, but many people who have halitosis continue to smoke and this will only make things worse.
  3. Watch the food you eat and stay away from spicy and high protein foods. At the same time, do not drink soda or alcohol and substitute it with water instead.
  4. Brush your teeth after every meal and floss at least once a day.
  5. Start using an all-natural bad breath medicine. Look for in the form of a supplement because these work best.

These five steps will clear up your condition and soon you'll forget that you ever had to deal with bad breath!

How Do I Get My Penis Hard Fast?

How long does it you to get an erection?

Do you miss instant, hard and firm erections you got as a teenager?

It is not unusual for men to take more and more time to get an erection as they get older. There can be many underlying reasons behind this. Your brain is equally involved in the process of getting an erection and if there are too many things on your mind, it is quite possible to take longer than usual for getting a hard erection.

Chronic stress, depression, anxiety and other negative feelings can result in delayed arousal. Not just this, state of your overall health can also play a major role. Being overweight and excess body fat can result in clogging of arteries resulting in sluggish blood flow to the penis. This can not only lead to erectile issues and problems with libido.

Ways to Make Your Penis Hard Fast

1. Essential Fats

In order to unclog your arteries it is important to include essential fats in your diet. EFA’s like Omega 3 are great for unclogging your arteries and ensuring better blood flow not just throughout the body but to the penis as well. One of the best sources of EFA’s is olives and olive oil. Nuts are also a great source.

However, it is important to ensure that include them in your diet in moderation. You do not really want to load your system with fats and gain extra weight!

2. Get Your Body Moving

It is extremely important to workout regularly. Exercise is not just great for blood circulation in your body but also helps build your stamina and energy levels. Good sex is all about energy!

Not just this, exercise is also great for beating stress. Just a regular morning walk can also be a great way to boost flow of blood in your body.

3. Vitamins

Most men are not actually aware of this but lack of certain vitamins in your diet can also lead to erectile problems.

Vitamin E is often called the sex vitamin. There is compelling evidence that it can be a great aid in ensuring improved cardiovascular and erectile health. This is because it helps maintain endothelial function which refers to normal blood vessel flexibility which is important for proper erectile function.

Vitamin C also plays a major role in your sexual and reproductive health. It has been observed that its deficiency results in the weakening of sexual organs. Vitamin C also helps reduce cholesterol in your body which is great for boosting blood circulation. Improved blood circulation ensures faster and better arousal leading to quick erections.

4. Erection Oils

Many men try to cure erectile problems with pills, whether natural or herbal. One of the problems that remains with pills is that they can take 30 minutes to an hour to help you get an erection. This can be a passion killer for most couples. Getting instant erections, is however, possible with the help of an erection oil.

As soon as you rub it on your penis, it gets absorbed through the skin pores and reaches the bloodstream, thereby producing real fast erections. In fact, some of the best oils can help you get an erection during application itself.

Such an oil packs in a lot of natural ingredients such as Vitamin C, ginkgo biloba, pomegranate 70% ellagen, horny goat weed, l-arginine etc.,

Another great benefit of such an oil is that it can help you last for up to 2 hours so that no one can ever call you a 3 minute man!

So, if You Want to Make Your Penis Hard Fast, Check out the Best Erection Oil that has Become a Massive Hit Across the World.

Two Recommended Hospitals in Frankfurt, Germany

Frankfurt, officially known as Frankfurt am Main is the second largest metropolitan area in the country of Germany. Frankfurt is a globally renowned center for commerce, transportation, finance, education, culture and tourism. It is regarded as the second most expensive city of Germany and one of the top 10 most livable cities in the world. This city is very multicultural as 30% of its residents are immigrants. It was also the former headquarter of the U.S. Army in Germany. Visitors can find many modern hospitals in Frankfurt that offer high quality health care at global standards. All the leading hospitals accept major health insurances and provide special accommodations for international patients. Here is a note on some of the better hospitals in Frankfurt.

The University Hospital of Frankfurt located at Theodor-Stern-Kai 7 is a major health care facility in Frankfurt. The hospital offers comprehensive medical service to a large number of patients. Founded in 1914, the hospital now has 25 medical clinics and 25 research institutes. It is one of the most well known centers for various types of transplant and the only designated center for liver and pancreas transplants in the area. The central laboratory performs every kind of test for hematology, immunology and coagulation analysis. Its ISO 9001:2000 certified Institute of diagnostic and interventional radiology is remarkable and offers service in many areas. This is a premier institute for medical education and research. Tel: + 49 69 630 10

Hospital of the Holy Spirit GmbH (Hospital zum heiligen Geist) is another popular hospital in Frankfurt that offers modern and effective health care at an affordable cost. This hospital is regarded as the oldest health care facility in the city with its glorious history of about 800 years. The center offers the complete range of medical services including internal medicine, gynecology, obstetrics, surgery, aesthesia, psychosomatic medicine and pain therapy. The surgical clinic employs some well known surgeons and works under and interdisciplinary consensus. The Women’s Hospital features four birth rooms with a birthing pool, a birth stool, and a waterbed. The hospital has the best emergency care unit and ICUs. The emergency section has 20 beds and features many specialized units for heart attack, renal failure, poisoning, acute abdominal problems and shock. Tel: 069/2196-0