Hi again Dr. Herazy,
Just one more question. I am beginning to see changes in my scar, like softening and reduction of the scar. . What I want to know is, when and how do I make changes to my plan?
Progress or lack of progress with your Peyronie's plaque is what determines when you change your plan and what changes you make to it. As I have said so many time before, "The scar dictates treatment."
If you are currently making satisfactory changes in your scar, do not change anything. If you are not making satisfactory changes in your scar, you should think about making a positive change to your plan.
Do you have the 1st book I wrote, “Peyronie’s Disease Handbook”? If you do not have it, then you will not know about monitoring your current condition. If you have it, then you can use this information to guide you to increase or decrease your plan as your PD dictates.
For you to know for sure that a recent treatment plan modification is effective you will have to notice some positive change in your scar (softening, fragmentation, smoother edges, etc.) within 10-14 days of the change in your plan, perhaps faster. I would make some logical change (usually an increase of an existing therapy item or a new therapy item if your plan is small) and then wait at least 14 days before looking for a change to occur in the size, shape, density or surface qualities of your scars, before considering another change.
In the beginning of care it might be necessary to only add or increase one therapy if you are at a lower level of therapy (just starting to take the medium plan). In the early stages of therapy modification you will likely keep slowly adding to your plan, one therapy (only PABA or only MSM or only Neprinol only or whatever single item you decide to increase) at a time, by adding 1-2 pills per day. It is not wise to go too quickly from one level to another (like taking Neprinol at 6/day, and then jumping to 14/day; this is too fast and you might not need to take so many for good changes to occur). After a while, when your total number of pills is getting to a point where you might think you simply do not want to take more pills/spend more money, then at that point you might consider this a good strategy: modify your plan by decreasing one therapy slightly as you increase another therapy slightly. This way you are not overwhelming your system with unreasonable loads of pills and you are not spending an extreme amount of money.
Be gradual with your changes. Keeps good notes about your scars. Let me know if this did not answer your question. TRH