They have Feelings too...

This has never happened to me, before. But, are my cats getting more perceptive, can they read our minds as they get older? Do they have empathy for those that feed them, house them, and befriend them? Or, are they just cats? Aloof, detached, just wanting to be left alone until they need something like food or your lap heat?

This morning I woke up to a tummy ache, more like painful gas. I went shopping last week and forgot to get some veggies of any kind. I did manage to get a ton of beans. Veggie baked beans, white bean, kidney beans, 16 bean soups and some pasta. But no vegetables. So, I have had beans just about every day this week. And today it has backed me up.

I have been on a vegetarian diet for the last 19 months (considering that I haven’t had any red meat for 33 years) and at times it gets boring, to say the least. I just have to stay away from sweets and beer…but of course I digress…

I was feeling very  bad this morning and as I was going to go out and do my morning walk/run I decided that I was going to just lie down for at least an hour, hoping that I might feel better then.

Five minutes after I laid down my cat Tom came up the stairs and hopped onto the bed with me. Normally he usually he very vocal but for some different reason he just sat next to me and pawed my shirt right about where the pain was in my tummy. He pulled my shirt up and just looked under, looking for what I can’t say. This went on for maybe two or three minutes more. 

He then climbed on to my stomach and proceeded to go to sleep, as cats seem to most of the time. Now, unlike his brother, Jerry, who weighs 22 pounds, Tom is only 12 pounds. But, his heavy butt is still heavy on my belly. I gave him a long back rub and he then climbed down curled up next to me, I then fell asleep. I woke 90 minutes later feeling a little better, Tom still by my side.

But, when I woke up he decided to leave me and I decided to get up and do something else, since it was past my usual running time, like rake up the last, I hoped, of those leaves.

Anyway, that was kind of a first, but Tom, I feel is kind of empathic, to a small degree. He still won’t come to me when I call but as of late (I think because it getting colder) he has been spending a lot of time sitting in my lap as has Jerry, to which they avoided during the summer. I would guess it is too hot to sit in my lap.

I’m getting a lot of feeling with Tom though, they both turned eight years old this past October, middle age for cats. And Tom and I chat a lot, like I said, Tom is very vocal. Sometimes he yells at me and other times I have figured out that, as usual, what all cats want, he just wants to be fed. Well that works for me.

I do want to know, though, as they age, do they, my cats, really know my feelings, whether good or bad, in pain or not? I think they care, a little or at least Tom does. I know for a fact that Jerry is selfish, and arrogant, he thinks he is the Alpha cat in this house. Thank goodness I have a vacuum cleaner!

G.A.M.E

Who was the best James Bond

Hey guys, guess who's in another episode of G.A.M.E. this week! The latest episode asks who is the best 007? He's one of the most recognizable characters in cinema with 23 films under his belt. His introduction is legendary but now the panel tries to figure out who is the best James Bond. Make sure you subscribe so you'll know when new episodes are made available. Follow us on Twitter @gameshowchat Email us: gameshowchat@gmail.com Share this with your friends and make sure to leave your comments, suggestions and requests for topics below!

Check it out!http://www.youtube.com/watch?v=mbgj2hym03U

The G.A.M.E

GAME

The newest episode is up now! Join in on the discussion here: http://youtu.be/r7veeqeoWq8?a

G.A.M.E., for the anime and game fans

G.A.M.E.

Ok all of you anime fans out there, here's one for you. The panel takes a good look at anime and asks, "Why is anime these days so weak?" Be sure to subscribe so you won't miss new episodes when they are released. Follow us on Twitter @gameshowchat Email us: gameshowchat@gmail.com And make sure to leave your comments, suggestions and requests for topics below!

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                                                            check out the latest video at:  https://www.youtube.com/watch?v=pwryjtycruU&feature=youtube_gdata_player

Assassination attempt #256

Assassination attempt #256: At 4:03 am, this cold morning -- I forgot to close my window again, thank goodness for my down blanket -- my nose was stopped up so I figured I'd turn over onto my left side, I knew it would clear that up. My cat Tom was sleeping at my feet so I could not turn over. So I pulled my leg up and immediately  I got a cramp in my hamstring, so I sat up to rub it out. But, my back had been hurting, for the last couple of days and I was forced to lay back down, darn near passed out from the twin pains! Three minutes later the pain subsided and I finally turned over. In the meantime Tom yawned and went back to sleep, he knew his plan failed...

 

Preventing Hormone Therapy Side Effects

Posted: 21 May 2013 01:45 PM PDT

BY MARK SCHOLZ, MD

Side effects vary from patient to patient and are influenced by types of testosterone inactivation pharmaceuticals (TIP) used, and by the duration of treatment. However, a number of interventions are available that can substantially reduce these adverse side effects.

Loss of Libido

Libido is an emotional attraction to the opposite sex (in most cases). Libido is not the same thing as potency, which is defined as the ability to get an erection. TIP causes loss of libido about 90% of the time.  Libido returns when TIP is stopped though some men say libido after TIP is chronically diminished. Loss of libido and the cessation of sexual activity has wide ranging ramifications far beyond the intended scope of this blog. Specialists in sexual counseling are available and can be of great assistance.

Erectile Atrophy

Whether or not couples continue to have sexual intercourse after treatment, we counsel men to induce daily erections to counteract the risk of penis shrinkage. Cialis or Viagra should be taken daily.  If this fails to restore the normal pattern of nighttime erections then either a vacuum pump or injection therapy should be considered. 

Muscle Atrophy

Muscle mass can be maintained with a strength training program. Walking, aerobics, and stretching are healthy but accomplish little toward building muscle mass. Strength training that is effective requires a program similar to that undertaken by body builders.  Ideally, strength training requires a minimum of two, one-hour sessions weekly during which all the major muscle groups are exercised: Pectorals, Deltoids, Biceps, Triceps, Latissimus dorsi, Upper and lower back muscles, Abdominals, Gluteus, Quadriceps, Hamstrings, and Calf muscles. Three sets of 10-12 repetitions should be undertaken with weight selected to result in muscle failure toward the end of the third set.

Fatigue and Lassitude

Tiredness and weakness from TIP are a direct result of muscle loss and reversible with strength training. Strength training is very effective for counteracting fatigue. Men who begin strength training when they initiate TIP will not only forestall tiredness, they can actually increase their strength.

Osteoporosis

TIP causes accelerated calcium loss from the bones, termed osteoporosis. Untreated bone loss can result in hip and spine fractures. Osteoporosis can be prevented with medications such as Prolia, Xgeva, Zometa, Boniva, Actonel and Fosamax which should be initiated when TIP is started.  See the booklet titled Osteoporosis available** soon at www.prostateoncology.comfor further details. 

Hot Flashes

Hot flashes occur in about two-thirds of men on TIP. When severe, a progesterone injection (depo provera) can dramatically reduce hot flashes. Other prescription medications, which are effective about half the time, are low dose Effexor, a medication approved for the treatment of depression, and Neurontin, a medication approved to prevent seizures. Transdermal estrogen patches are very effective but sometimes cause breast enlargement or nipple tenderness.

Weight Gain

TIP slows metabolism causing weight gain. Keeping a stable weight is easier than trying to lose weight. It is wise to evaluate your diet at the time of starting TIP to see if fat and sugar intake can be reduced. See the brochure about diet from the PCRI for more details.

Breast Growth

Breast growth (even without estrogen patches) occurs frequently in men treated with Casodex monotherapy and less frequently, about one-third of the time, in men treated with other forms of TIP. If there is any evidence for breast growth or nipple tenderness, therapy with an estrogen blocking pill called Femara should be started immediately.  Alternatively, a short course of radiation to the nipples can be administered prior to starting TIP. 

Anemia

Blood is a mixture of red cells and "serum" (water). When the proportion of red cell is diminished it is termed anemia. Severe anemia can cause shortness of breath. Milder degrees cause fatigue. Anemia reverses when TIP is stopped. If anemia is severe, it can be corrected with a medication called Aranesp. Iron is not beneficial.

Arthritis

Joint pains particularly in the hands but sometimes in other joints are common and often improve with glucosamine, Motrin or Celebrex.

Liver Changes

Casodex and Flutamide occasionally cause serious liver problems. This is detected by blood tests that need to be done routinely after starting TIP. The problem is easily reversible if detected early and the medication is stopped. 

Mood Swings

Men on TIP occasionally mention increased intensity in their emotions. Some find this effect unpleasant whereas others enjoy it. For men with the former attitude, low doses of medications such as Zoloft or Paxil can reverse the unpleasant feelings.

Final Thoughts

My general impression after many years treating men with TIP is that treatment is quite tolerable if side effects are expertly managed. Preventative measures such as weight lifting and diet are critically important. Checking blood tests for anemia and liver function is essential. Side effects like joint pains, hot flashes, depression, emotional swings, breast enlargement and impotence can be greatly reduced with judicious medical care.

 

**email us to receive Osteoporsis booklet -- mail@prostateoncology.com

Helping our Youth Find Their Voice

Created by Stephanie Bryan on May 16, 2013

WALDORF, MDVolunteer & Service

 0

I Am Who I Am is the name of the company. I am starting a non-profit for youth in the DC, MD, and VA area. I Am Who I Am provides mentoring programs for middle and high school youth in the DMV area. The program will form partnerships with local school districts and the juvenile court system. I Am Who I Am's goal is to foster a commitment to young teens that will promote self-esteem, build strong interpersonal skills, finding their inner voice, and reassert a sense of hope in the future. Only through personal relationships can a sense of individual responsibility be reestablished that will give youth the commitment to follow through on a path to adulthood with a sense of pride and accomplishment. But first they need to find that inner voice that has been lost. Through repeated failures in the classroom or home and the development of destructive habits, at-risk young teens have lost faith in the possibilities that await them if they are successful in putting their lives together. To accomplish this goal, young teens must be in a caring, loving, and inclusive learning environment that promotes their best effort and reinforces personal respect on how they view themselves and life. They need to know they are valued, respected, believed, and know that someone is in their corner. WE are teachers, speakers, mentors, and most of all FRIENDS. I do this out of my own pocket, it is getting expensive, and our youth are dying. I am a doctorate student and hopefully will graduate this year. Any donation you can do will help reach our youth. I thank you in advance, and God bless.

 

 

http://www.gofundme.com/iamwhoiammd

 

Men’s Health, The Big Picture

Tuesday, April 23, 2013

Men’s Health, The Big Picture

BY MARK SCHOLZ, MD

As a specialist in prostate cancer, I am in constant contact with men who are exerting prodigious efforts to get appropriate treatment for their disease. However, as many people are learning, low-risk forms of prostate cancer rarely lead to death.  Therefore, I am concerned that many men are missing the big picture regarding their overall health.  They have a greater risk of dying from other causes than from prostate cancer (Table 1).  Many of these common diseases are preventable by early detection.
The obvious place to start is with an annual physical with standard blood tests. Testing should include evaluation of liver and kidney function, mineral levels in the blood, evaluation of vitamin and hormone levels and testing for anemia and serum glucose. The specific blood tests are explained in more detail athttp://prostateoncology.com/files/pdf/Standard_Laboratory_Tests.pdf

Heart Disease, the #1 Killer
The root cause of heart disease is cholesterol plaque, otherwise known as “hardening of the arteries” or atherosclerosis. Cholesterol infiltrating the arterial wall causes inflammation and scaring. Over time, scar tissue becomes calcified.  When plaque progresses to arterial blockage, a heart attack occurs. Similarly, a stroke occurs if an artery supplying blood to the brain is blocked.

Only Scans Can Measure Plaque
Cholesterol blood tests answer the question, “How much cholesterol is floating in the blood? ”The real question that needs to be answered is, “How much cholesterol is sticking to the wall of the artery?”  Modern CT scans accurately measure coronary plaque with a dose of radiation similar to a set of dental X-rays. Color Doppler ultrasound measures plaque in the carotid arteries leading to the brain without any radiation exposure at all.

What if Plaque is Detected?
1. Obtain an exercise stress treadmill
2. Lower cholesterol and blood pressure
3. Inhibit blood coagulation with aspirin and fish oil
4. Follow a sensible diet and exercise regularly 

Osteoporosis
With age, bones weaken from calcium loss. Osteoporosis is mistakenly thought to occur only in women.  However, one-third of hip fractures occur in men of advanced age.  Bone fractures have dire consequences associated with shortened survival, chronic pain and loss of height. Causes of osteoporosis include over-actively of the thyroid or parathyroid glands, excessive alcohol, caffeine or tobacco. Cortisone use, excess vitamin A, lack of exercise and vitamin D deficiency are additional potential causes. Hormone therapy used to treat prostate cancer can also cause osteoporosis.

Only Scans Can Detect Osteoporosis
Osteoporosis needs to be identified and treated before a fracture occurs. There are two types of scanning technology used to detect osteoporosis, DEXA and QCT. While both types of scan are accurate in women, only QCT is accurate in men.  In men, DEXA seriously underestimates the degree of osteoporosis. 

Osteoporosis Treatment Protocol 1. Calcium 500 mg with dinner or at bedtime
2. Vitamin D 1,000 units daily.  Adjust dosage according to measured blood levels
3. Weight bearing exercise 4. Consider prescription medication with Fosamax, Boniva or Prolia
  
Colon Cancer 
Colon cancer is easily curable when detected early. Screening can be accomplished with colonoscopy (a scope performed by a physician called a gastroenterologist), or with a CT scan, which is termed a virtual colonoscopy. 

Beware of Sarcopenia Muscle mass and strength automatically decline with age. Studies in otherwise healthy individuals indicate that poor fitness is more dangerous than smoking! Table 2 shows the dramatic difference in predicted 10-year survival of men age 65 depending on their fitness level. Muscle loss can be prevented with regular exercise consisting of weight training for an hour twice a week.

Lung Cancer Smokers who forgo lung scans are taking a huge risk. Lung cancer is almost universally fatal if diagnosed after symptoms such as cough, chest pain, or weight loss appear. CT scans can detect small lung cancers at an early stage when it can still be surgically removed and cured.  Smokers (and any ex-smokers who quit in the last 10-15 years) are crazy not to spring for $300 each year to have a lung scan done. 

Flu and Pneumonia Flu is easily recognized by the sudden onset of fever, sore throat and body aches. Most people know about vaccines but forget that Tamiflu, an antibiotic, is effective if started within 24 hours of initial symptoms. The risk of pneumonia can be reduced by Pneumovax given every ten years. It is recommended for men who are over age 65 or who have a chronic illness. 

Conclusion The screening and early prevention program outlined in this article relies more heavily on scans, vaccines and prescription pharmaceuticals than many men would prefer. However, the serious health conditions listed above have a propensity to incubate silently until the day they suddenly explode on the scene as a full-blown disaster. The old aphorism, “An ounce of prevention is better than a pound of cure” certainly applies when there is an opportunity to detect and prevent life-threatening illness at the earliest possible stage. 

I Love Popcorn!

            I like popcorn, no, I love popcorn. I have the feeling that I am addicted to popcorn. Sometimes I feel that I can’t get enough. I noticed that at a local CVS they sell popcorn for a dollar a box. Well, I purchased a couple of boxes and took them home for a feast. When I opened the box, put it in the microwave, fired it up, I noticed, after it finished popping, the bag was half the size of a regular bag of microwaved popcorn. I was horrified.

            Of course I got over it quite quickly, though I never had more than one bag a day. I am guessing more than that constitutes an addiction, which I don’t, have contrary to anything I might had said prior. Anyway, last year I use to go to Costco and buy those boxes of Orville Redenbacher popcorn, the 48 count kind.       

            The only problem I had with Redenbacher popcorn, it never fully popped all the kernels. So, there’d always be bunch of un-popped kernels in the bag, and I hated that. Could’ve broken a tooth or something. Then I remembered Act II popcorn. That was the popcorn that I ate at work, most of the time because it’s what they sold in the vending machines.

            I knew they sold it at Kroger and I really had to change my mind because it was cheaper than Redenbacher’s popcorn. So, I stuck with Act II for a while but it too seemed to have many of those un-popped kernels in the bag.

            Last year or so I thought I’d try Kroger’s popcorn, only because it was way cheaper than both of the other popcorns they sold. I was truly amazed when I popped it because out of every bag, 99.9 percent of the kernels were popped! I would like to say there are usually one or two kernels in the bag when I finished… but not really, I have a really bad memory most of the time, ok, I never count. In fact, I just counted the kernels in the bag I just finished a few moments ago and there were seven un-popped kernels in it. Really, that is a better count than the expensive popcorns.

            I just noticed today that I still have some old-style popcorn, the kind that you put in a pan, with a touch of oil, and shake it over a flame. I have the feeling that I better use it or it won’t pop. I’ve tried a few times in the past and one time it worked and another time it didn’t pop at all, considering that both of those jars of popcorn are over, well, quite a few years old. But with that type of popcorn you can use all the ingredients you have at hand.

            And I always like to put grated Parmesan cheese and or garlic and or onion salt on my popcorn. But, those were the days. I wonder do they still make Jiffy-pop? Well, I guess they do. I just Googled it and there still is a product called Jiffy-pop, go figure. When I got out on my own, that was my main staple, that and anything Mickey D’s, and beer.

            And, don’t get me started on Movie Popcorn. I go to the movies just to get the popcorn, but to be honest not with a lot of movie butter. I hate the messy, greasy mess. So, I usually get it without the butter. Some movie houses usually have some sort of spice or cheese that you can add to your popcorn. I love those places, but there are none close by my house. With or without, movie popcorn is great!

            Chances are tonight, during the baseball game I am going to have a bag of Kroger popcorn, Kettle corn, heck it was only a dollar a box so I got a couple and I am going to enjoy the baseball with a smile as I snack on my popcorn.

Prostate Snatchers: Third Dispatch from the Front--

Prostate Snatchers: Third Dispatch from the Front--IMRT: BY RALPH BLUM

BLOGGERS: MARK SCHOLZ, MD & RALPH H. BLUM

The co-authors of Invasion of the Prostate Snatchers, blog alternate posts weekly. We invite you to post your comments.

TUESDAY, MARCH 19, 2013

Third Dispatch from the Front--IMRT

BY RALPH BLUM

In my last blog, I said that after all this time living with prostate cancer the uncertainty was beginning to wear on my nerves.  At this point, and having thoroughly researched all my options, the idea of having my prostate fried by electrons doesn’t seem quite so alarming, and as four-letter words go, “cure” has a sweet ring to it.

I’m talking about IMRT, which is short for Intensity Modulated Radiation Therapy. IMRT is a precisely targeted procedure that allows the physician to control the intensity of the radiation beam within a given field. This means that a much higher dose may be given to a tumor within the prostate without an increase in radiation to the surrounding tissue or organs. And if the cancer has spread through the wall of the prostate gland into the seminal vesicles (as in my case) the target field and dosage can be adjusted as necessary.

The big advantage of IMRT over regular external beam radiation is that the beam can be shaped to the exact dimensions of the area to be radiated. And instead of a solid beam of uniform intensity, it utilizes a variety of small independent beams known as “multileaf collimators” that can be turned on or blocked during treatment, varying the radiation beam intensity across the targeted field.

Because of the complexity of the treatment plan, radiation oncologists employ special high-speed computers, treatment-planning software, diagnostic imaging, and positioning devices molded to fit the precise contours of the individual patient. Typically a patient will be required to have several scans, and a team consisting of a radiation oncologist, a medical physicist, a dosimetrist (who sets the radiation dosage), a technician (who does the set-up session), a therapist and a radiation oncology nurse will oversee the treatment.

As with conventional radiation therapy, multiple treatments are required, but with IMRT, the eight-to-nine weeks of treatments (lasting about twenty minutes each) significantly lower the risk of adverse side effects, and the chance of a cure is substantially higher. When I first saw the twelve-foot tall linear accelerator in the treatment room I have to admit I found the idea of having a mountain of energy shot at my pelvis from this giant ray gun--the muzzle of which would be situated barely two inches from my pecker--extremely daunting. And the matter of “rectal burn” cannot be ignored.  However I have been assured that with IMRT rectal irritation is generally temporary, and can be relieved with medication.

So it’s decision time again. I still wish I could safely stay on Active Surveillance, but with IMRT the odds are favorable for a cure, Dr. Bahn has advised me to go for it, as has Dr. Scholz. Even I, the ultimate “Refusenik,” suspect it is time to act.

I’ll keep you posted!

Are K-cups a bad idea?

I am a coffee lover. I love the taste and smell of coffee. I wasn’t a big coffee drinker until I retired in 2006. Before that time, when our department moved into a new building, I would have one, maybe 2 eight ounce cups a day. And that was only because I was the first one in the building and I made the coffee, and we had one of those large two pot coffee makers. Of course the coffee was fresh and always I got the first cup.

When I retired I found out about Gevalia coffee, so I subscribed and was delighted with the flavors they offered. On one hand, I really don’t care about the flavors, per se, because I really, really love the taste of black, dark roast coffee. On the other hand having different flavors spiced up my day. But, to be honest, I really craved the Breakfast blend, and the French roast.

At that time my only problem was, I didn’t know how to make a smaller pot of coffee. I would make one pot and I would finish it in an hour or so. This went on for quite a while and what made it worse, my son who was living with me, after work he would bring home those little donut balls. In the morning I would feast on coffee and donut balls.

The donut balls continued until my son joined the navy and my sugar level got high enough to cause alarm. The pot of coffee continued until 2012 when my coffee pot burnt out and was virtually useless. I then had to go out to the local coffee shop and get a large cup of their breakfast blend. My other son gave me a one cup coffee maker and I kind of liked the idea, one cup. But that device died within a couple of weeks, considering it had been sitting on the top of my kitchen shelf for quite a while.

In the meantime I couldn’t keep my thoughts off of the Keurig coffee maker. The one I wanted was expensive, to me, but I had to have it. For some reason, I don’t remember what, I got a check from my old company, so that day I went and purchased a Keurig Special Edition Brewing System, it was a decent price. Of course there were cheaper coffeemakers out there, but I just liked the way this machine looked.

All in all I thought this was a great coffeemaker and it came with a box of 12 of those K-cup packs. They were great for, 12 cups of coffee. And those pack piled up, in the trash, as luck would have it I believe in recycling. The one thing that troubled me was; those K-cups packs were expensive.

Expensive, yes, running anywhere from 60 cents apiece to, depending on the company that provided the K-cup pack, up $1.20 apiece. What made it so bad was the Keurig Brewing system I purchased only had three cup settings with the largest being only an 8oz cup. All my cups are 16 ounces. Adding an additional insult to me, those K-cup packs can only be used once! So, I would have to use two packs for one cup of coffee.

To me, this was expensive, wasteful and a stupid idea. I did find out, a couple of months later that there was a device, Keurig My K-Cup Reusable Coffee Filter that would fit into the coffeemaker and you could use your own coffee. And, even if coffee was, the cheapest being around $7.00 for one of those large one pound cans of coffee, to which you can get up to 90 cups of coffee per container.

I purchased the device from Amazon.com for only $5! The shipping and handling was $6, though. I later figured out that I could have a great cup of coffee even if I used the same coffee twice, in the filter, to fill my 16 ounce coffee cup. I felt that was much better. I was really on the verge of getting rid of my Keurig coffeemaker and getting a good old fashioned coffee maker that makes one whole pot at a time.

Now that I think about it, though, I am still drinking about a pot a day anyway. But, I love coffee, I love the taste of coffee, and I love waking up in the morning to the smell of coffee brewing. I also love my Keurig coffeemaker. In the past nine months I have had no problems with it, well except the coffee cup selection, but I have gotten over that, now. Coffee, coffee, coffee, you gotta love it! I do!

Prostate Snatchers: Sexuality and Intimacy after Prostate Cancer Treat...

Prostate Snatchers: Sexuality and Intimacy after Prostate Cancer Treat...: BY MARK SCHOLZ, MD

After having my prostate cancer removed in 2006 I have been doing a ton of research on the problems after surgery. This is one of the things I wish I know before surgery. I guess it is the best to get the information out first that others don't have to find out what happens after the fact. As I find the information I will post it.

Sexuality and Intimacy after Prostate Cancer Treatment

Posted: 26 Feb 2013 06:03 PM PST

BY MARK SCHOLZ, MD

My life is turning into an evangelistic crusade to raise awareness about the risks of prostate cancer treatment.  Tens of thousands of men are undergoing unnecessary radical prostate cancer therapy with dire sexual consequences. These inappropriate and often fatefully wrong treatment choices are made because men are often completely unaware of the irreversible effects of the treatment itself.

Thankfully, I am not alone in this battle to inform men about the harm associated with prostate surgery. Another prostate oncologist, Dr. Celestia Higano from the University of Washington, recently published a scientific review on this very topic in the Journal of Clinical Oncology (JCO). For those of you who haven’t heard of the JCO, I consider it to be the most prestigious scientific cancer journal in the world.

Today’s blog will offer quote seven selected sections from Dr. Higano’s important article. To add some gravitas to the eye opening statements you are about to read, please realize that every one of her comments was referenced to a specific scientific report.  In other words, these statements have nothing to do with opinions. They are genuine outcomes from published scientific studies.

So without further ado let’s start with the first quote from the article:

Quote #1: “Unfortunately, many couples believe that even if they have problems with erectile dysfunction (ED) … they will be able to resume their normal sexual practices through the advances of modern technology.4 They are not informed that sexual function will never be the same after any form of therapy and they are often unprepared for the changes in their sexual and intimate relationship.” (Italics mine)

Quote #2: “PDE5 inhibitors (Viagra, Cialis) and other erectile aids are not successful for all patients with ED and, even when effective, half the patients stop using them within one year.11 Why couples stop using ED therapies has not been adequately investigated , but disappointment that sex life is not the same … likely contributes to this outcome.”

Quote #3: “In a Memorial Sloan-Kettering series of 475 men … 20% of men who had radical prostatectomy (RP) had climacturia at one year, and climactauria as associated with both painful orgasm and penile shortening.13” (Climacturia means that orgasm results in the ejaculation of urine instead of semen).

Quote #4: “At the Karolinska Institute, 1,288 patients had either open or robotic-assisted laparoscopic RP, and of the 691 men who were sexually active, 38% reported climacturia at least sometime during sexual activity. Of the men who reported climacturia, 72% had climacturia less than half the time, 17% more than half the time, and 11% all the time.14”

Quote #5: “In a review of 1,459 men who had RP at New York University, climacturia was found to decrease from 44% at 3 months to 22% at 24 months after surgery. Climacturia is a common complication of RP but is often overshadowed by concerns about ED and overt urinary incontinence.14-16”

Quote #6: “In a study of VED (vacuum erectile device) use after RP, the length and circumference of the penis decreased in 63% of patients who did not use a VED after RP compared with only 23% who did.18-20”

Quote #7: “Surgery can also result in Peyronie’s disease (also called, “crooked penis”) in up to 16% of patients.23"

When patient are informed of the dire consequences of surgery they are often mystified as to why urologists, who must be aware of the damage surgery causes, continue vigorously to recommend it. I have heard many patients voice the opinion that urologists are driven by a selfish desire for financial gain.   

The financial motive, however, fails to ring true. As medical procedures go, prostate surgery is poorly reimbursed. Also, when urologists are diagnosed with prostate cancer they themselves often proceed with a radical prostatectomy. So money is not the primary issue. Rather, consider that performing surgery is part of the very fabric of a surgeons’ persona. From a surgeon’s point of view, if you are not operating, you are not a surgeon.

Men considering surgery for prostate cancer need to be aware of its substantial risks. And when getting advice about which treatment to select, patients also need to realize that surgeons usually can’t provide balanced advice. They are too close to the trees to see the forest.   

Will the fighting end?

            Today is Saturday, a gray and cold, but beautiful day. It’s mid-afternoon and I figure that I should get out of the house and go and play in the snow. Not really, just kidding.

            I thought I would write something about my cats, Tom and Jerry. I really don’t know what has gotten into them the last few years, but it’s driving me nuts. A couple of years ago my cats got wind of some female pheromones. I found out later there are a few female cats or just the one, living under my porch.

            I know that this had been going on for quite a while but, at that time, all of a sudden my cats started to fight and I mean bloodletting and blood-curdling screaming at each other. I’m talking about scars across their faces, legs and their ears. These fights would go on about every couple of times a month or so. It seemed like in the winter, the fights would stop, but only because I closed the windows and doors to keep those smells out.

            Last year, 2012, it seemed like the fighting would end and it did for the most part. Then there was a new lady in town and she too decided to spend her time in my yard and under my porch. This lady calico cat not only caused a dysfunction with my cats, but she stopped the birds from gathering in my back yard and now that I think about it, the squirrels have disappeared, too. The only things that come into my backyard now are deer and a few dogs that feel they have to take a dump in my yard.

            Now, this past winter Tom and Jerry had, kind of, been cordial with each other. Not really fighting; Jerry just hisses at Tom when Tom wants to play. Tom loves to play. He loves to bat his foam balls around the house and I do love watching him chase those balls. Sometimes I open the basement door, just wide enough that he fits through and I toss the ball through the door and watch him chase it down the stairs.

            Every now and then he would bring the ball back up the stairs then drop it and go about his business. I usually get the hint at that point. But I pick it up (I think they are training me) and throw it back down the stairs. Or I throw it anywhere and he go nuts over that ball. Of course Jerry just watched.

            The only problem is that he doesn’t bring the ball back to me. He brings it up the stairs bats it a few times then moves off to do something else, like rest.

Jerry on the other hand is the “A” alpha cat or so he thinks. He has gotten big, maybe fat, I have caught him eating Tom’s food and I just yell at him to, “Eat out of your bowl!” and he goes and eats out his bowl, until I leave. Jerry is the, “I’ll wait until Tom does something before I will do it” kind of cat.

If Tom doesn’t do it first Jerry won’t try it. Jerry will go to the basement door, stand on his hind legs and tap the doorknob. I get up and open the door. He will back off and sit across the room. Then Tom will come out of nowhere and go down into the basement. Jerry goes to the door and just looks on for a few minutes before will go downstairs.

            Anyway, as of the last few weeks, Jerry will play; wrestle, with Tom and then run up the stairs and all over the house. When he doesn’t want to be bothered he will hiss at Tom. Tom kind of looks at Jerry, like, “What did I do now” kind of look, and then goes and looks out the window.

            Last Saturday was my birthday (60^th) and the cats were with cool with each other, Jerry still hissed at Tom but nothing came about it. This past Tuesday I noticed that darn Calico cat (Now that I think about it, it was that male cat that has been hanging around as of late) at my window but this time it sprayed my window, twice and Tom went off. He was so loud and angry it scared me. I was afraid to touch him. Tom was so hyped that he broke the plastic slat in the blinds trying to get at that outdoor cat.

            So, Tom and Jerry, for the past few days have been at each other’s throats. Tom chases Jerry into the kitchen where Jerry jumps into the chair; he thinks that chair protects him. In the meantime Tom has destroyed my suede chair with his swiping at Jerry perched in said chair.

            I woke up this morning and Tom was curled up on my left side and Jerry was curled up on my right side. So far so good. Usually Jerry had been spending his time sleeping on the sofa downstairs or in the hallway outside my bedroom door. But he has calmed down for today.

            Tom, when the alarm goes off in the morning jumps off the bed but comes back a few minutes later. This time he goes to where Jerry is laying and they touch noses.  Another good sign. So, Tom decided that things were fine and he then decides to mess with me until I get up and feed him. I get up and feed them but Jerry doesn’t eat, at first. He just watches from the top of the sofa on the other side of the kitchen.

            Later they were running and playing (wrestling) but not hurting each other. Another, somewhat, good sign.

            As I sit here typing, I hear the hissing so, I am guessing that the truce is over. It is quiet now. And Tom is sitting behind me playing with a stuffed (with catnip) mouse. I guess he is tired of Jerry, but in a few minutes he will go and mess with Jerry and the Hissing from high places with start again.

            My cats are seven years old going on eight. That’s about 49 years old in human years. I am guessing that Jerry is getting to be that old guy who yells at the kids to keep off his grass. And as of late he has been spending the most time sitting on my lap. I had to kick him off so I could write this piece. I am guess that is probably why Jerry is mad at Tom right now.

I now see that Tom has gotten into a bag that I have sitting on the floor. But, of course that’s going to end in a few minutes when Tom wants to play with his brother, Jerry.

Nope, it’s been 20 minutes, Tom is gone, out of sight and it’s still quiet. All is well…

           

The big 60!

Today is February 15, 2013 and tomorrow is my 60^th birthday. I have been trying to find things to write about but I didn’t know my life was this boring, as far as finding something to write about. Well, actually it isn’t that boring, but I have my dry spells every now and then and I am hoping that 2013 isn’t one of those boring (for writing) years.

            I did have a boring, I mean uneventful Valentine’s Day, but it is an over priced commercially created day. And since I have been divorced for the 22 years, 2 month, 5 days, 4 hours, 53 minutes and a few odd seconds ago, I really haven’t participated. Anyway, I need to write something.

            That brings me to today. I am going to start here, on this blog, and then take it from there. The more I look at my life and life in general; I have come to the conclusion that every day is a holiday, or my birthday, or Saturday, or Sunday, for that matter.

 So, tomorrow is just another day for me, considering I celebrated all of the above today. I will enjoy tomorrow, I purchased a 6 pack to help me celebrate, though, and it will be a first for me, being that I will be 60 Fracking years old! Yea!

I do know that I have to get ready for this coming spring and summer, because I plan to be as active as I possibly can. One of the things I am going to get, no matter what…some new running shoes!!! The last time I ran was in October.

I did walk this past December and January and I ran a couple hundred feet or so, but couldn’t continue running because I lost my wind, not doing anything in those past few months. I hate not working out, I miss it badly.

Those of a few of the things I need to do this year. I also figure working out  keeps me “young” (looking). But, since I grew another beard, this past October, I look like and old goat.

 It’s funny; I retired in June of 2006 and hadn’t had a beard in 15 years, this is the second time in the last two years, though. I really haven’t gone anywhere or done anything, so I figured, why shave. I am going to have to shave it off, soon, well at least when it starts getting warm again.

I guess I’d better start on my Short story. But, first I gotta get up off my butt, because it’s starting to hurt from sitting here in front of this computer for so long! Aches and pains, you can’t live with em and you can’t live with out em! Ouch! Yea, 60!!

             

For the love of coffee...

There has to be something magical about the smell of freshly brewed coffee. Waking up early in the morning, your coffee maker on auto; that brewed coffee aroma smoothly makes its way to your nose. You rise, dress and head downstairs to have that first cup of coffee.

You then wonder to yourself, do you add cream and sugar or is it going to be black, today?  Black and strong, it is. After that first sip you can feel the edge slipping, your eyes open and you are now, ready to take on your day.

Out the door and on to the highway you just realized that you left your coffee mug on the kitchen table. Your edge comes back with a vengeance. But you are safe, up ahead is a McDonald’s and you're feeling better. You roll into the parking lot but decided to go inside instead. You open the door and are greeted with the big, bold aroma of coffee, your day is made.

On the menu you notice that McDonald’s McCafé has nine selections. When it comes to coffee, your preference is black and rich, but today you decide to try something different. No iced coffee for you, though, that’s what you do on your way home to help you unwind.

Your choice now is between the McCafé Mocha, an Espresso drink, strong, hot, with milk, chocolate syrup, of course, whipped cream. But your second choice is the McCafé Cappuccino, made with nonfat, or your favorite, whole milk, steamed and topped with frothy milk. You don’t hesitate and pick the extra-large McCafé Mocha.

Your day is now set and you feel you do a full day’s work, that is until lunch…McDonald’s or…?

No time to fail...

I got this note today from a site I applied for. I used a few of my articles that were published on another site:

Regarding the clarity of your writing: I see what the writer was trying to express, but I'm still a little confused.

Regarding the flow of your prose: The thoughts linked together, with one or two notable exceptions.

Regarding the extent to which you kept the reader engaged: The subject was interesting and informative, but my focus still wandered.

Unfortunately, we're not able to reverse this decision. However, you are welcome to apply to other specialties...

That was disheartening, and I guess, a fail on my part. I know I am kind of rusty. Writing was a passion, many years ago. Now a must, I do have to figure out how to get back that passion. I would love to say I don't know what I am going to do, but that's not my way. But, I must figure out something and implement it as soon as possible.

I just read a book on how to make my prose more colorful (my word). And I guess I'd better re-read it, because I am missing something. In fact I have downloaded quite a few books, on the subject of writing, the last few months. Sometimes I feel that reading that much takes away from my writing. But, I have to get this done.
This shouldn't be hard, it wasn't, once upon a time, a long time ago. But, times have changed. I guess I'd better get off my butt, from in front of the TV and get back on my butt, in front of this computer and start writing and reading.

A bad case of Writer's Block...

Today is February 9, 2013 and I have finally come to the conclusion, on a great many things this day. All of them, in regard, to my writing life. I had a little talk with my daughter-in-law and it would seem that she has more faith in me than I do with myself, which is odd for me to lack one of the only things I have going for me when it comes to writing.

I am one of those people that have a positive attitude about life, love and the pursuit of happiness, since I retired in 2006. This includes my writing life. I was ecstatic when I self-published my book and of course I went through the roof when I self-published my second book, like a kid in an all you can eat candy store.

But, I digress…things are, I feel, different this year.  It has been difficult for me to put words on paper (on screen). I wouldn’t go as far as to say I have been procrastinating, or being lazy, (the latter is because of my retirement *smile*), but what has happened is that I looked back at the last few years and have seen something in me that kind of just punched me in the gut causing me to put a halt to writing and I have to find some way to get back on track.

I have finished two novels so far, one a book of science fiction and my fictional autobiography. Now that I think about it I have finished, in the last two years, two short stories to which I would to turn into e-books and two screenplays. And I have finished 29,107 words for part two of my fictional autobiography, out a series of five stories.

What I've realized is; I have been asking friends and family to help with my works until I can succeed an get them published, and make something (money) from my works. This approach isn’t working, though. Also, my cats have the tendency to fight as to see who gets to sit in my lap as I am writing and that’s not helping one bit.

Nevertheless, this world is based on “money”. In order to get things done you have to pay for what you get. I know this, but being a starving writer, it doesn’t hurt to ask. On that point, everyone wants to read my stories. That I really don’t mind, because I could use the feedback, bad or good. There are many problems with that, though. One is that most folks are busy, and I don’t have a problem with that, to the point that it has taken a year to get any answers. And as of right now I have gotten nothing back.

I even offered a family member some compensation; that apparently hasn’t produced anything. So, I can either save up more cash, (do make a few bucks selling books and odds and ends on eBay and Half.com.) and again offer it so I can get things done. Which is what I am going to have to do? Only because my novel is sitting here collecting dust.

Another thing that keeps coming up, I could learn to use and create cover art on my own. I looked at that for quite a long time and came to the conclusion, if I was 20 something I could learn how to really utilize Adobe Photoshop, but I’m not 20 something and I am trying to commit myself to finishing my novels and have them published. I am getting hungrier by the day.

I guess, the more I look at it and I can’t say I’m being let down by asking friends and family for help but it isn’t helping. Money makes the world go around, but seems like the buck passed my house by. All this means is that I am going to have to get up on my pony and do the giddy up.

I do know one thing; I am going to have to continue writing every day, again. I was doing well last year and I have to start writing every day again, starting today, now. And since the beginning of this year I have opened Word and sat and looked at the screen for hours. Can’t do that anymore. My stomach is growling right now, and I really miss my steak and Lobster, in a creamy butter sauce.

It took me ten days to write 29,000 words last year. Now I have to see if I can replicate those numbers. No, I don’t have to take ten day, I just have to finish, and continue to write! For whatever reason I just happened across a web site that offers jobs for freelance writers and I now and have taken advantage of that site. That should keep the blood flowing.

As I sit here, looking at the words flow across the screen, I have also realized that; am I being hard on myself and other by asking for their help? And not bugging them to finish? But, as I see it I can only blame myself for my failure or success. And hunger?