Welcome to this November 2012 PD Institute newsletter.
My wife and I went up to northern Wisconsin two weeks ago. Every year we travel north to soak in the annual spectacle of the hardwood trees changing color. What a simple and yet majestic display. Mother Nature is capable of doing some fantastic things, eh? And this thought gets us back to assisting this process of natural recovery.
This newsletter will present something that has never before been mentioned by the Peyronie’s Disease Institute or the Dupuytren’s Contracture Institute as a way to assist recovery from these two problems – ultrasound therapy. Over the last 10 years I have had perhaps a dozen people tell me they are using a small ultrasound machine at home for their PD or DC problem. As luck would have it, two people in just the last six weeks have asked me about using an ultrasound machine to help their Dupuytrens nodules and cords. And now you will read an email from someone with PD who is using an ultrasound machine along with his PDI treatment plan to eliminate his Peyronie’s plaque. I must be in an ultrasound cycle.
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This newsletter will use the popular format of reproducing an exchange of emails concerning PD or DC treatment so that everyone can benefit from the thoughts and information that have been expressed. In this newsletter we will hear from TXXXX who has written an email in which he mentions that in addition to using a Large Alternative Peyronie’s treatment plan he also bought a small home model ultrasound machine to use specifically for his Peyronie’s disease.
Apparently there is some level of interest in ultrasound as a potential tool to eliminate fibrous material from the body. Anyone who is interested in getting an ultrasound machine for either PD or DC, please let me know and I will put you in contract with a supplier for a very good price on an excellent unit.
This November newsletter will also discuss a very important topic that is of concern to both the people dealing with Peyronie’s disease as well as those with Dupuytren’s contracture. This topic concerns the critical need to clearly define and as much as possible measure the soft tissue lesion that is created in PD and DC.
In the case of Peyronie’s disease it is important to know the size, shape, density and surface features of the internal Peyronie fibrous plaque or scar. In the case of Dupuytren’s contracture it is important to not only know the size, shape, density and surface features of the nodule on the surface of the palm and the cord below the skin of the palm, but also to know two other aspects of this problem: the degree of fixation or adhesion of the lumps to the deep layers of the palm, as well as a measurement of reduced finger and hand movement.
How to actually locate the internal Peyronie’s plaque or scar is explained in considerable detail specifically for Peyronie’s disease in this email exchange with TXXXXX, who started his treatment plan just a month or two earlier. For those of you who are part of our DCI readership, please simply apply the ideas expressed here about PD treatment and dosage to what you are currently doing for your DC.
Read this series of combined emails like the back-and-forth exchange between two people talking while one occasionally interrupts the other to make an important point or answer a question. To understand the flow of the conversation, keep in mind that the text in black is from TXXXXX and the text in red is from me.
Because we all use SPAM filters on our emails, I had to edit the content of this email from TXXXXX. Both he and I naturally and appropriately use the word P_ _ _ S several times in our emails to discuss that part of the male anatomy. If I used the word P_ _ _ S in this newsletter as often as we do in our private emails no one would receive the newsletter because it would be dumped as a rejected email in your SPAM or JUNK folders. To avoid this problem I have substituted the word SHAFT for this other word so that no one will have a problem receiving this issue of the newsletter.
Remember my comments are written in red text and TXXXX has his comments in black text:
See below for comments…
Theodore Herazy, DC, LAc
Sent: Friday, October 19, 2012 11:23 AM
Subject: Re: Cannot find the scar
Dr. Herazy-Thanks so much for the time you spent with me on the phone this morning. After the experience with my urologist who did not even do a complete physical examination on me, I have been very encouraged by the products on your site as well as the time you would take just to talk and make sure I understand what is going on and how to prepare my treatment plan.As per our conversation, I am sending this email to you because I am having great difficulty finding the PD scar, which I know I need to locate in order to verify the existence of PD and accurately measure as I make progress with my treatment. You said that you had a stock email response you would send me, which I would greatly appreciate.
Here is the universal response I have developed over the years to help men know how to locate the elusive PD scar. This detailed description has grown in size as new ideas and additional concepts come to mind to help people do a better job of scar location. I have been told many times it has made all the difference in the world with finding the scar, so read it carefully and be patient with yourself as you learn this new skill:
“It is all too common for men to have difficulty locating their PD scar; even MDs often cannot locate it easily or at all. Knowing where your scar is located – although not always easy or obvious – is essential to PD treatment. Finding and describing the PD scar is not a matter of curiosity; you MUST know about the scar in as great detail as possible in order to know if you are making actual progress or not. If you do not know whether you scar is or is not responding to care, you are guessing. Guessing leads to poor or no progress against the enemy that is the Peyronie’s scar. You must not guess, you must know.
Before I go into this subject in some detail, I must remind you that the PD scar is best located while the shaft is soft or flaccid – meaning not erect. This will be true 99% of the time, so don’t bother to look unless you are flaccid.
While some men have PD nodules that are best described as “beans’ or “peas,” these are seldom difficult to locate and not the subject of this discussion. You see, not all PD scar shapes are this dense and well-defined; many tend to be flat, soft and often larger than what is expected and these tend to pose the greatest problem to locate. So for this reason if you are having a problem locating your penile scar, it is probably a good idea to shift your thinking and anticipation in this direction: You probably should be not be looking for a “pea,” which is small but has height; instead you might be better served looking for a “postage stamp” – maybe even a large postage stamp – which is flat and has margins that are sometimes difficult to locate. Changing the mental image of what you are looking for sometimes makes all the difference in the world in locating this tissue.
PD “scars” or plaques are quiet variable. Some men have an obvious scar and others cannot find one if their life depended on it. Often, when a scar is not found, but there is still pain and bending or any kind of recent penile distortion, a diagnosis of PD can still be made. This is so, because the scar that is causing the pain or bending is either:
1. So small – it cannot be found
2. So very soft – it blends into the other tissue and cannot be detected
3. So deep – it cannot be reached or felt easily
4. So large and flat – that the edges are not easily determined, almost like trying to find the edge of a roll of plastic wrap. When it is a large scar – as many of them are – it is something that is so close to you that you do not see it because you are looking far away and cannot see what is under your nose
5. So greatly different than what you think it is going to feel like that you miss it only because it does not meet your image of what it will be like
6. The doctor’s lack of ability, experience or concern when he does the scar examination – that he simply misses what is actually there if he was better at this kind of thing – yes, I know, it is difficult to imagine but it is true.
Usually, when a scar is NEVER found it is because of a combination of two or more of these factors – deep and small, or soft, large and flat, or deep, soft and doctor error, and so on. From my experience with those who have an extremely difficult time locating their scar, it seems that #4 (so large and flat) or #5 (so different than what you expect) are the reasons for failure to locate the scar. Keep this in mind when you search your landscape trying to locate the scar.
Big hint: Your primary scar will be located at the lowest or deepest point of the bend, curve or distortion you have. It will be found at or near the deepest or most curved area of your bend or dent formation or bottle neck or hour-glass deformity. It will be on the CONCAVE side of the bend or in the deepest part of whatever type of distortion you might have. The CONCAVE side of the bend is the side that is folded or bent over, or you might say it is the lower or bottom side of the rainbow. The opposite of the concave side is the CONVEX side. The CONVEX side of the bend is the side that is arched over or curved up, or you might say it is the upper or top side of the rainbow.
Ultimately, if you have PD you must begin the search with the attitude the scar is there, and it is only waiting to be found. Do not start with a negative attitude; you want to have a sense of high anticipation that it will be found within the next few seconds – this will help keep your senses alert. You should use as many different tactics as you can to find your scar(s) because having a good knowledge of your scar situation will help your treatment effort. The CONCAVE side is where the primary scar is located. If you have any scar located away from the concave side, it is not your current primary scar. For the most part you will want to evaluate all scars you can locate for changes in the size, shape, density and surface features, but when you work to stretch a scar using the PDI gentle manual shaft stretching method it is more efficient and effective to only work with the primary scar found at the concavity of the distortion. So when you are looking around to locate you scar you really should be looking only in that small area that is at the concavity of the bend when you are erect. Once you have that one located it will easier to find others if they are also present.
Hint: It seems to be more common for a man to have multiple scars, than just one. Men have told me they have found 6-8 internal scars. I had 3-4 scars when I treated my own PD problem. So when you find the 1st one, continue looking for more and you will probably find them.
Hint: Although I mentioned looking for a postage stamp sized scar earlier, PD scars are not regular or evenly shaped; they often do not have straight sides or 90 degree corners. They are usually very irregular and odd shaped. Think of the shape of the state of Florida or Idaho or Maine – not like Colorado or Wyoming,
Hint: Try to think in terms of your scar being much larger than you have previously imagined. Allow yourself to mentally expand the size of the scar you are looking for. Meaning, if you were looking for a “pea” before, start looking for a “peanut” size structure or even larger like a postage stamp. This changes your methods and your outlook about what you can detect.
It seems that lately I have many men reporting that their scars are as large as the length of the shaft, and some are narrow while others are wider. Image your scar is that large. If you are looking for a pea-sized scar it will prevent you from easily finding something much larger like a postage stamp.
Do not be discouraged if the scar you have is large since it does not seem that the size has much to do with difficulty or time required to eliminate it. Larger scars can take just as long as smaller scars to treat.
Try this: forget about finding a “scar.” Just try to find something – anything – within the mass of erectile tissue that feels unlike the other tissue. Find something that is unlike the rest of your shaft. When you find it, mark its location with a marker pen or something that will stay on the tissue for a day or two. Go back each day to that area and re-think what you are feeling. You are trying to see if it becomes easier to make sense of it. It could be that you have an unreasonable expectation of what a “scar” should feel like, and you are missing what is really rather obvious only because your expectation is wrong. Really, how could you know what a PD scar feels like if you have never had to do this before? Trouble locating the scar is a common problem.
PDI has much success with the methods we present to you. Just because your doctor could not locate your scar does not mean it is not there. And it definitely does not mean that you cannot find it just because he can’t. As so many men with PD finally come to understand, you must take control of your situation and begin to get well on your own. A large part of being in control of your treatment is to have a vivid image of the scar physical qualities in your mind.
I have worked with well over a thousand men with PD, some mild and some severe cases, some just a few months and several that were more than 10 years old. I had a pretty bad PD problem until I cured my condition using the procedures found in the book I wrote and the same Alternative Medicine ideas as on the website. You will not feel like a victim once you start working to improve your health and immune response against the presence of this foreign tissue.”
I thought I'd give you a little more background on my condition, which sounds very much like PD. The fact that your MD did not touch you during your office visit to locate your scar and determine if you have Peyronie’s disease is a fairly common situation. Many cases of PD are diagnosed without being physically touched; many men are given a definite diagnosis just on the basis of their history. These MDs do not like dealing with PD and they really do not go out of their way to make the patient happy. They are apparently bored treating this problem even though it ruins so many lives. Since your description and history is so strongly suggestive of PD it apparently convinced your doctor that you have Peyronie’s disease. It occurred about 14 months ago during vigorous intercourse with my partner. I did not hear a pop, or completely lose my erection, but something obviously went wrong. There was no discoloration or outward sign of trauma, but my shaft hurt the next couple of days. During my next erection, I noticed about a 30 degree downward direction, as opposed to my normally 10-15% upward curvature. The erection also appeared shortened by about 1/2", and on the underside the shaft seemed softer, as if it was not completely erect. What you are describing is an extremely rapid series of physical changes that are quite typical of PD, except that they often take many weeks or even a few months to develop. What is so different about your story is how fast those physical changes happened. I would have assumed that because of your injury that you might not have been able to have an erection for at least 10-14 days or so. If yours was only limited for a few day, that is much faster than average. I have communicated with men who have noticed a small bump in the shaft soon after penile injury, but they did not have reduction of their length and such a marked curvature so soon after injury . Everyone seems to respond differently. I am 39 years old and otherwise in excellent health. No drinking, drugs, no alcohol. Very healthy diet. I also am very physically active in martial arts, weight lifting, and running. Being in great shape does not prevent you from developing Peyronie’s disease, no more than being in great shape and hitting your thumb with a hammer would prevent you from injuring yourself. Not knowing what happened, I went to have an STD test, which in hindsight was unnecessary (and came back negative) as my girlfriend and I have been together for nearly 5 years. After a couple of months of the curvature not really changing, the pain was lessening, but I went to see a urologist. I described the problem to him, and with no physical exam he said it was PD. He gave me a recommendation of 400 IU of vitamin E daily and said to check back with him in 6-12 months. What a waste of time and vitamin E that would be. There is nothing wrong with using vitamin E as a PD therapy – I recommend it highly – but taking it in such a low dose and by itself is a waste of time and money. I doubt that anyone has ever benefitted from this kind of treatment, yet the average MD tells this to every poor guy with Peyronie’s disease who stands in front of them like a deer in the headlights. Makes you think they really do not care about anything other than selling the idea of Peyronie’s surgery. Needless to say, I have not contacted him again.I started doing some research on the internet and began to use some Wobenzym In my opinion is not nearly as good or effective as Neprinol for this particular purpose of reducing the PD fibrous scar. and bromelain/quercitin, as well as increasing my vitamin E intake. I found your site, and in late August I purchased the large Alternative Plan and have begun to incorporate the techniques, recommended dietary changes, and supplementation. I also purchased an ultrasound device and began to use the last couple of weeks. It has a setting for Dupuytren's Contracture, and have been using that several times per week on my shaft to help get rid of my PD. I am interested in this. Over the years I have explored the idea of using ultrasound therapy for both PD and DC, but the equipment often leaves something to be desired for use by the layperson. Could you please let me know the name of the manufacturer and model of the ultrasound machine you are using? I have been thinking for some time about doing a PDI research project with 10-20 men and information about your machine might be helpful to get that research going. I have been slowly increasing the dosages of the enzymes and trying to be consistent with all other techniques and recommendations, but have not seen marked improvement yet. That is because you are relating only to the degree of shaft curvature, and this is not the way to evaluate your progress or lack of progress. I would not be surprised that there are positive changes going on with the scar even though you have not been able to notice curvature changes. The scar changes early and rather rapidly when an effective dosage level is finally reached, but curvature changes are different. It might take two months or more of your scar making positive changes in size and density for your curve to change enough to be noticed at all. This is why I stress to everyone to focus on the details of the scar structure and try to ignore what the shaft looks like. There has been a return of the deep, dull pain that initially was felt with the onset of my condition. Actually, a recurrence of pain is not an altogether bad thing for you to be feeling at this time. I, and many other men who I have worked with over the years, have correlated pain in the shaft with positive changes in the shaft as the fibrous scar material begins to diminish and get softer. My theory on this relationship of return of pain and actual scar reduction is that as the scar is being reabsorbed and is getting smaller it causes physical changes in the tunica albuginea (the deep layer of tissue the scar is connected to and intertwined with). As the scar gets smaller it can be disruptive to the tunica albuginea where the scar is located and this can result in pain. When I was treating my own PD many years ago I made this connection between the feeling of a deep dull ache in the shaft whenever the scar was going through a phase when it was getting smaller or softer. I came to learn that this dull ache was a good sign that things were getting better. For me this went on for maybe 4-5 months as the internal Peyronies scars got smaller and softer. I am taking that as a positive sign that the PD is in an active phase, and that I am doing something to help heal this condition, as opposed to the stable phase where no change was taking place.If you have any other recommendations, I would also greatly appreciate it. First, let’s be sure you can identify the PD scar. Let me know if I can help you in that regard. TRH
So there you have it. This is a very instructive email exchange between TXXXXX and me. I really hope the message gets across that you simply have to keep your focus on how your PD scar (or DC palm nodule and cord) is responding to your therapy. If you are approaching your treatment plan in any other way, you are playing the foolish game of hoping and guessing that something good will eventually happen to you. With this PDI treatment concept you will not have to hope, you will know and you will be in control of your treatment. You will feel confident and less stressed about your Peyronie’s disease – or Dupuytren contracture – for the first time in a long time.
Again, if anyone is interested in investigating the idea of adding ultrasound therapy to what you are currently doing for your shaft or hand problem, send me an email and I will get that information out to you right away.
See you next month. By then the snow could be falling where you are, so stay warm and stay focused on your treatment.
Please send your treatment questions to me so I can give you helpful ideas and information to work with.