Good Morning, thanks for the e-mail. I do have a couple of questions in regards to the ultra sound machine treating PD. Are there any past results negative or positive using the ultra sound machine for Peyronie’s disease? Yes, that was discussed in the last newsletter. Several people reported recently that they are seeing improvement with US therapy – and they were using the wrong machine! Also, does it matter if the shaft is soft, semi rigid or fully rigid while receiving the ultra sound treatment. US therapy should be done while flaccid since you will have best contact with a flat surface rather than a rounded contour of the shaft. TRH
Thank you, RXXXXXXXXX
Dr. Herazy:
I have questions on the ultrasound machine usage. Your instructions say to use 3 days per week. Are you concerned that more frequent usage could cause problems? This is yet another area of controversy in medical practice. While there are those who suggest daily US treatment might be appropriate, others limit the frequency of US treatment to three times weekly care. The greatest concern is usually for excessive US treatment over bone tissue in cases of arthritis, causing increased uptake of calcium and resulting in bone weakness with possible fracture. For Dupuytren’s contracture treatment with US being applied over the small metacarpal bones of the hand, daily US treatment is a real concern; for Peyronie’s disease US treatment being applied over the shaft and far removed from bone so this is of less concern. Having said that, there is always room for user error, over-enthusiasm, miscalculation and bad luck. For these reasons you must always be cautious when using US and ask your local MD for his/her opinion since they know your current situation directly. I always advise to use a broad range of therapies (including US) first done at a conservative level for both DC and PD. If after reasonable time the desired tissue changes are not forthcoming when done at a modest level, it is then possible to consider slowly and cautiously increasing the range of treatment of these therapies. In the case of US it might be reasonable to consider increasing the individual treatment time from 10 minutes per application to 11 minutes per application for a few weeks. Later, if the 11 minute application does not have a good impact on the problem to possibly increase to a 12 minute treatment time. These treatment changes are done all the while assessing for changes in the size, shape, density and surface features of the target tissue. Increasing US treatment time by several minutes all at once, or doubling the time of treatment, is dangerous and foolish. Alternately, instead of increasing the time individual treatment, a person could consider increasing the frequency of treatment from 3 days/week to 4 days/week for a few weeks to assess for tissue changes.
Please do not consider that going from 10 minutes to 11 minutes is a small or trivial increase. It is a great increase; it is a 10% increase, and that is a lot. Be cautious and careful with these one minute increments of treatment time.
How many 10 intervals per day of usage? 3, 4, 5,…etc? Sorry, but I am not sure I understand what you mean here… If you are asking about using US treatment for 10 minutes to one area, stopping for 10-15 minutes, and then doing another US treatment for 10 minutes TO THAT SAME AREA – the answer is NO, NONE, DO NOT DO IT THAT WAY. The 10 minute wait after a 10 minute treatment is to allow the quartz crystal in the sound head of the US machine to cool down. It is not for the purpose of letting one BODY AREA rest briefly before you treat that same tissue or SAME BODY AREA again. Some people have PD in so many isolated areas of the shaft, or have DC in isolated areas of two hands, that they can treat one area for 10 minutes, let the machine cool off for 10 minutes, and then go to an ENTIRELY DIFFERENT AREA of the shaft or hand to do another 10 minute treatment to a DIFFERENT BODY AREA. The purpose for the proviso to stop treatment between 10 minute treatment applications is to cool the machine, as you first treat one area before treating another totally different area. Never treat the same area twice in the same day or in a few days. If you have only one lesion and you treat it once with ultrasound for 10 minutes, then you are done for the day or even a few days with that area. This, of course, assumes that you have treated your problem for a while without change of the tissue and have made the conscious decision to up your plan to an 11 minute application. OK? If I have muddied the water for you in this area of treatment, please let me know and I will take another stab at it.
Should the intervals be spaced out throughout the day (morning, afternnon and night) or all at once (with 10 minutes between each session)? No; see above. A few hours interval is not sufficient time between treatments for the tissue – but it is enough to cool the machine. We have two considerations going on at the same time when we are talking about US treatment: 1. Giving the tissue enough time to rest and respond (usually several days), and 2. Giving the US crystal enough time to cool off (at least 10 minutes or more). Obviously we have to be concerned with both, however I am sure we all agree the condition and safety of the tissue always being the most important.
Keep me posted on your progress. TRH
Thanks. JXXXXXXXXX