Greeting all PDI Warriors,

Welcome to the dog days of summer as we open this August 2011 PD Institute newsletter.

The changes to the DCI website were so well received that we have begun making the same changes to the PDI website. You will notice that we now have a new feature on the PDI website at the top menu bar titled, “Ask Dr. Herazy.” Please go to www.peyronies-disease-help.com to check it out. We have a fair number of Q&As there already, that I know you will find interesting and informative as you learn about PD treatment.

Again this month we use the familiar and popular format of presenting a series of emails between one of our PD brothers and me. This long series of emails is important because it stresses the importance of knowing everything you can about the size, shape, density and surface features of your PD scar. (For those of you who are part of our DCI readership, please simply apply this same idea to knowing everything you can about the size, shape, density, thickness, and degree of lateral movement of the palm nodules and cords, as well as the exact degree of finger extension when you try to open your hand.)

As you read this series of emails between XXXX and me, please notice several things I see frequently with men who successfully change their PD scar and distortions:

1. They follow an aggressive and balanced treatment plan

2. They are organized and keep good records of changes they make in their plans

3. They do not use their plan “sometimes” – they are faithful to their plan

4. They communicate with me about questions and situations they do not understand

5. When we communicate they tell me exactly what they are taking and how they are taking it so I know how to make my suggestions

6. They do not get their feelings hurt – and understand that I am just trying to make a point – when I am direct and blunt with them; they know I sometimes receive dozens of emails daily, and I need to get to the point quickly. They also know I am on their side working toward the same goal. For example, notice how XXXX does not answer an easy and important question, and how I have to make sure he gets the point I am trying to make.

 

For those of you who have written to me with questions you will recognize the familiar format in which I simply copy your email and reply with my comments inserted into your email. I have permission to use these emails from this dedicated PD Warrior.

You will notice that I did not answer one of XXX’s emails he sent to me because I was away. When I finally returned I had to find his old email that did not get answered right away. For this reason the dates are out of order, but the sequence of the communication is correct.  

You will also notice a few times I interrupt what he is telling me in mid-sentence. Read it like two people talking and one interrupts the other to make an important point. To understand the flow of the conversation just keep in mind that the text in black is XXXXX and the text in red is from me.

Here we go:

 

 

Dr. Herazy,

Since I last wrote to you I have continued my treatment plan as follows including your suggestions from our April correspondence. Currently my plan looks like this:

Vitamin E 400/400                             2 pills/day with food
Maxi-Gamma E                                  1 pill/day with food
Vitamin C                                            3 pills/day with food
PABA                                                  9 pills/day with food
MSM                                                   15 pills/day between and with meals
Acetyl-L-carnitine                                3 pills/day between meals
Neprinol                                              12 pills/day between meals
Quercetin/Bromelain                           6 pills/day between meals
Honso herbs                                        twice daily (after Nei gong)
DMSO                                                  once a day
Manual stretching                              one to two times daily
Kegels (6 sets)/groin massage         alternate days
Nei gong                                              twice daily
Hot pack application                            once daily 

I have been on this regimen since I last wrote in April with some tweaking of dosages (up or down).  I’ve been varying individual nutrients for two weeks at a time to see if I can detect any change in my scars. Recently I can sense a subtle change to the surface texture of the large scar at the base of the shaft. I feel more unevenness in what used to be smooth.  For most men it seems that surface feature changes, like you report the smooth surface now having an unevenness to it, is the usual way that early scar changes are noticed.  I caution you that “uneven” is not a full or accurate description for you to use.  You must know the answer to the question, “Uneven like what?”  Be specific and creative so you will have an objective reference point.  Uneven like a tightly woven carpet?   Uneven like a shag carpet?  Uneven and bumpy like an avocado? Uneven like a white potato or a red potato (there is a difference if you look at them in the grocery store)?  Uneven but regular like corduroy pants?   Uneven and irregular like a broken piece of concrete?   Uneven like what?  You need to know this.   By the way, are you sure there is no change in the density at this time; this usually happens when there is apparent breaking up of the scar material.    I also notice that the ‘dents’ on either side of the shaft have tapered out so as to be not as noticeable. Congratulations on your distortion changing. Good work. It is always an exciting thing to le arn about one of the men on the program starting to see change in the appearance of his distortion. However I can feel new small nodules at these former locations which I can feel tapering around to the underside of the shaft.   You probably notice these nodules because of reduction of density of the tissue around them.  This is common to discover things that were already there, like finding things below the snow as it melts. These nodules have a variable firmness similar to kernel of cooked corn on some days and uncooked corn on other days.  Sounds like it could be changing in response to what you are eating.  Tighten up on the diet and avoid cold food for a few days to determine if this is not so.  If you see a nice switch to the scar having a more favorable softer and fragmented presentation then you will know you will have to be stricter with your diet until your PD is gone.   Since you did not comment (complain) about diet restrictions this tells me you might not be doing a lot in this area; true?  I cannot correlate the different feel with any of the changes I’ve made to my treatment plan.  It is there; you are just not seeing it.  Look closer and evaluate your diet better.

With the stretching I have altered the angles and am feeling more of the dull ache mostly on the localized stretch.   Angles are critical.  Play with small changes in the angles and see if you cannot find some that will cause even stronger dull sensations.  So long as you are generating a dull ache there is more tissue response your tissue is capable of allowing.  Keep at it.  Over time, as the tissue has responded as much as it needs to, you will find a time when you cannot generate a dull ache.    With the groin massage I have expanded the area to include the crease at the top of the leg where I’ve discovered a string of nodules which are sensitive to the touch. So far (about five weeks) I haven’t noticed a change but will cont inue to concentrate on these.  Good.

In your experience do other men take higher dosages than what I show above?  Sure.      I read a caveat about serrapetase on the PDI website which cautions taking this enzyme for too long a time. Serrapeptase is in the Neprinol I have been taking for the past six months. Do other men take this enzyme for this length of time?  When a person is using a higher dose such as you are, I suggest taking a Neprinol break or vacation every 3-4 weeks for a few days; just stop it cold and give your liver a rest.  Thanks for the complete report.  TRH    

Xxxxx Xxxxxx

 

From:Xxxxx Xxxxxx
Sent: Monday, July 18, 2011 10:21 AM
To: Dr. T. Herazy
Subject: Fw: treatment plan questions

Dr. Herazy,

I originally sent this email perhaps when you were on vacation. I imagine you had a large backlog of email to work through when you returned. I’m hoping you can respond to my earlier questions below when you have a chance. I have not paid much attention to scar density but will do so going forward.

Thanks,

Xxxxx Xxxxxx

Greetings Xxxxx Xxxxxx ,

It was a good time away. A large backlog of email is an understatement.  See below for comments.

Regards,

Theodore Herazy, DC, LAc

Peyronie’s Disease Institute

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> 

 

From:Xxxxx Xxxxxx
Sent: Thursday, July 21, 2011 8:17 PM
To: Dr. T. Herazy
Subject: Re: treatment plan questions

Dr. Herazy, thanks for your reply. I’ll answer your questions in order.

In response to uneven like what? – the uneveness is due to Please, I understand what the unevenness is due to. I want to know from you a clear and accurate description of the unevenness. I am not asking you the question so I know, but only to find out if you know the answer. Again, I ask “uneven LIKE WHAT?”   If you do not understand the intent of this question then perhaps you should reread chapter 4 of the Peyronie’s Disease Handbook as well as reread the detailed email I most recently sent to you.  Remember from the last email I sent to you I clearly said: “Be specific and creative so you will have an objective reference point.  Uneven like a tightly woven carpet?   Uneven like a shag carpet?  Uneven and bumpy like an avoca do? Uneven like a white potato or a red potato (there is a difference if you look at them in the grocery store)?  Uneven but regular like corduroy pants?   Uneven and irregular like a broken piece of concrete?   Uneven like what?  You need to know this.”  All I want to know is, are you fully and completely aware of the physical nature of your scar so that you are competent to identify a change in the scar when it occurs?  You must be an expert in the condition of the scars you are trying to eliminate. If you do not know, you are not an expert; it means that later when you are in the weary 5^th or 6^th month of your treatment you will not be able to say for certain what the condition of your sca r was when you started to treat yourself. Saying your scar is uneven says very little – almost noting; it only means to me it is not smooth; I understand nothing from the statement that it is “uneven.” My concern is that YOU understand nothing from your statement also, and it will be useless to help you later remember anything about the actual state of unevenness of your scar.  But if you said to me your scar is “uneven like the edge of the small basket I use to hold my paperclips” that would not only tell me a lot about it, but it would tell me you have a clear and accurate reference point for later when that same edge changes because of the great therapy work you are doing.    a  ridge I can feel along the left side of the shaft along the hard edge of the scar (maybe  If you must say “maybe” then you are not doing your homework.  “Maybe” means you are gues sing and you need to know. The answer is right there below your belt, so why do you say “maybe”? Why do you not know if this tissue has decreased in density?  You are hurting your effort when you do not have answers about the condition of your scar. When you say, “maybe the scar tissue next to it has decreased in density,” it upsets me because I know I have must have failed you by not helping you to understand how important this information is as you treat yourself. Please reread chapter 4.    the scar tissue next to it has decreased in density). Also two transverse ridges on the right side of the scar one of which continues out into the corn kernel like nodule I mentioned.

With regard to my diet, I have pretty well avoided the ‘bad’ foods you mention in your Peyronies Disease Handbook. I have kept a journal of what I eat for the past 9 months and lately I have relaxed somewhat and allowed myself more cheese (2-3 times a week) and eggs once every other week). With the warmer weather I am indulging in two or three beers and a cigar on weekends. The one constant is a cold 6 oz glass of orange juice every morning. I’ll try the experiment and switch to a bottled juice   Bottled juice?   Within this dietary restriction or preference concept is no emphasis between fresh and bottled.  That is an entirely different discussion and does not pertain to what we are doing with you.  Cold is the issue, whether fresh or bottled; you need to avoid cold.   for a week or two to see if this shows any effect.

With the stretching I find that I just do not get the dull ache with the in line stretch even when using the compound stretch. I have tried changing the angle the last few days but without effect. I don’t want to overstretch. If I cannot feel the ache should I just abandon this particular technique and focus more on the techniques which give the ache?  Exactly.  The presence of a dull ache will tell you when you are accomplishing something.  Having said that, you must be very careful that the reason for your lack of a dull ache response while using a particular technique is not that you stretching too hard.  If you are stretching too hard you will not achieve a dull ache with any technique in any direction.  Go easy, please.  

Concerning my question about dosages – more specifically do men take more than 9 PABA or 15 MSM or 15 Neprinol daily?  What difference does it make?  You need to determine what YOU need to do and what YOU need to take.  Yes, some men go up into these higher dosages, some for a short while and others back and forth.  You only confuse and frustrate yourself by looking at what other men are doing when it does not match what you are doing. Just pay attention to the size, shape, density and surface features of your scar, and to your treatment plan, and you will do just fine.   Do many (any) men say that acetyl-L-carnitine and/or quercetin/bromelain is an essential part of their therapy?  Isolating o ne or two therapies out of ten different things you are doing, and saying this one is more important than that one is an academic exercise.  They are all important.  Who is the most important player on a baseball team?  The pitcher?  Well, what would happen if he had no catcher to throw to, or no 1^st baseman to make all those easy outs?  What if he had no shortstop to backup the 2^nd baseman?  It is always a team effort and you would not have the same results if you broke up the team.    TRH

 

Xxxxx Xxxxxx 

From:Xxxxx Xxxxxx
Sent: Friday, July 22, 2011 3:48 PM
To: Dr. T. Herazy
Subject: Re: treatment plan questions

Dr. Herazy,

Thanks for taking the time for this detailed response. You make me realize that even though I have read (and reread) your handbook, some of the axioms have not sunk in (e.g.  detailed and creative descriptions as reference points for future comparisons). Your last paragraph also reinforces a realization that I’ve come to recently that I have been overly focused on the pills and not placing enough importance on the other therapies. I plan to stop the pills altogether for a bit (while continuing the external therapies) and focus on food effects then reintroduce the pills one at a time with careful attention to cause and effect. Thanks again for your feedback. Will keep you posted in the future.

Xxxxx Xxxxxx

Good. Then we have accomplished something with all this writing, eh?

Regards,

Theodore Herazy, DC, LAc

Peyronie’s Disease Institute

 

OK, that is all for the August PD Institute newsletter.

Please communicate with me and I will do my best to help you in any way I can. See you next when the leaves are starting to change color.

Regards,

Theodore R. Herazy, DC, LAc