June 1, 2016 PDI Newsletter
Greetings PD and DC Warriors,
Welcome to this June 2016 PD Institute Newsletter. I trust everyone is doing well and working diligently.
The subject of this month’s newsletter will be the early tissue changes that are observed in people who are using Alternative Medicine therapy for either Peyronie’s disease or Dupuytren contracture.
An interesting and important question comes up frequently during at least half of my telephone consultation with people – both PD and DC sufferers – who need help starting their therapy plan. Whether they are starting a large plan or small plan or their own version of what they think will work best, the problem is question is always something like, “I know we are all different and respond differently, but what usually happens with the dense fibrous tissue when the treatment starts to work?”
When the fibrous tissue of PD or DC finally begins to respond, most often there will be a small and temporary change in the density and surface features of the tissue that slowly becomes greater and permanent over time. Occasionally I hear a report of the first observable change being an alteration of the size or shape of the plaque for PD (or hand nodule or cord for DC) formation; but, usually the first change is the dense fibrous tissue will feel softer and it will feel different along its surface when a finger is rubbed across the surface of the tissue mass. Also, it is a rather consistent finding that at the beginning of improvement the tissue change will be so small that it makes the person wonder if it is actually happening – if it is real or not. This is why it is so very important that everyone has a really good definition of the size, shape, density and surface features of the targeted foreign tissue you are trying to eliminate. If you are not confident about the details of these structural aspects of this tissue you will never know for sure if the small changes you notice are actually occurring or not.
As the density and surface features continue to make positive changes, reduction of the size and smoothing or evening of the shape of the scar will then usually follow (square edges and angled corners of the tissue mass will become rounded or gradually slope or taper down until they cannot be followed and are lost).. Over a few months all these changes come together as the plaque, or hand nodule, begins to gradually disappear and becomes increasingly difficult to locate. Eventually you should be unable to find the foreign tissue mass.
By being absolutely certain the fibrous tissue is changing or not, only then will you be able to correctly decide if you should continue with your current plan or increase your plan in some way. No treatment plan should be continued for weeks and months on end, hoping that something good will eventually happen; that is like walking north when you really want to be walking south. The PDI and DCI concept of treatment is not based on hope or wishing; it is based on demanding of yourself that you can locate small and consistent tissue changes when you support the natural healing process by following the suggestions provided to you. These PDI and DCI plans are intended to be actively worked and modified every 7-10 days while the target tissue is monitored for structural change. If no change is noted after 7-10 days of using a plan, then you should change some part of that plan until you notice a change in the size, shape, density or surface features of the fibrous tissue.
It is a terrible waste of time, effort, money and the opportunity to recover when someone follows a plan that is not working, or changes a plan that is working. Either of these situations can occur when the condition of the fibrous tissue mass is unknown. This unfortunate problem can be avoided by knowing exactly all of the important features of your target fibrous tissue. If you have no doubt about the size, shape, density and surface features of your plaque (palm lump or cord) you will always be in control of your treatment, you will not waste time following a plan that is not working, and you will know you are exactly following a plan that is working, firmly keeping you in the best position to recover from your problem.
Usually the dense fibrous tissue will clearly show signs of change long before there is a noticeable improvement in the penile curvature or the ability to develop an erection, (or move the fingers). While the tissue change usually takes place during the 3rd to 5th month for most people, it can start even sooner for those who follow a very aggressive plan. Fast tissue change is the exception, and not the rule, so do not plan on that kind of fast response although it does happen. It is important to keep in mind that tissue changes usually occur during the 3rd to 5th month for people who are correctly changing and increasing their plans every 7-10 days, not just simply continuing to follow the same ineffective plan for 3-5 months. There is no easy way to do this. You have to work at it to get good results.
Tissue change being temporary sometimes happens during the early phase of the recovery pattern. The initial improvement in the fibrous tissue will not last very long, maybe just a few days or so, and then it will tend to go back to how it was before it showed any improvement. People report to me various patterns, but it often happens that their fibrous tissue makes some progress, looses it for a few days, makes some progress again, looses a portion of that progress, then finally makes even stronger progress that does not slip away any more and continues on to recovery. The pattern is never exactly the same, but it generally has a series and ups and down and then finally improves. I know this happened to me and many others who have reported to me over the years. A variable pattern soon develops in which there is tissue improvement, regression, improvement, regression, back and forth, etc. However, over time you will likely notice this pattern will slowly change. The amount of improvement will be greater than the amount of regression, and the time the improvement will last will become longer than the time the regression lasts. As you successfully guide your plan you will see the variation pattern shifting slowly in favor of improvement; the degree of improvement and the time the improvement lasts will be greater and longer than the regression. I wish I could say why this happens – it just does. Just like the stock market – it goes up and it goes down, but the general trend and pattern is that it slowly goes up over time. This is how I have seen most every case of PD and DC improve.
As soon as someone sends me an email about his scar or her palm nodule reduction, I will advise that it will not initially last very long and that he should be prepared to see the fibrous material fluctuate between improvement and regression for a few cycles over a few weeks or months. I can almost guarantee this pattern. Come to expect it; count on it. Temporary and slight regression is just the way it goes, so do not be discouraged or disappointed when it happens. Ii shows that you are on the right pathway.
As the positive changes in the foreign tissue become more stable, it is also very common to next see an improvement or reversal of the structural changes that were caused in the shaft or hand; meaning as the PD scar changes the curvature may change and in DC the finger range of motion will be improved. In Dupuytren contracture the improved finger and hand movement is rather straightforward and direct; finger and hand movement tends to slowly and consistently return to normal. However, for Peyronie’s disease the initial change in the curve is not always improvement. My curve worsened just after my plaque showed some real progress for the first time. The reason for the possibility that the PD curve sometimes (not always) gets a little worse before it gets better is an interesting process that makes sense once the reason is explained.
Ever play “pick-up sticks” as a kid? The object of the game is to remove one stick at a time from a pile of sticks in such a way the other sticks do not move. The challenge of the game is based on the complex interplay of many sticks lying across each other. Removing one stick from the pile usually makes three or four other sticks shift a bit. Sometimes just a slightly moving one stick can result in major shifts and moves in many other sticks – sometimes in ways that are completely unexpected and very unpredictable. This unpredictability of how things shift and move and respond in pick-up-sticks also happens when PD scar material is reduces and disappears during the healing process.
How many scars do you have? If you have only one scar (very unusual) that single scar could be influencing 2-3-4 different layers of interconnected tissue within the corpora cavernosa of the shaft to which the scar is attached. If you have more than one scar or plaque the dynamics of what happens to all those scars and interconnected tissue layers internally becomes complicated and impossible to predict as the scars get thinner, weaker and smaller. It is easy to understand that if a part of a scar, or one scar out of group of scars, becomes weaker, softer or smaller, that this will cause change of the internal tensions and angles of pull within the shaft, and change in the distortion of the shaft that you can see. Internal plaque or scar tissue continues to control the curve even as they become smaller and weaker.
As one or more scars DECREASES or INCREASES in size it could easily cause a change in the curve – to make it INITIALLY better or worse. This is why some men who have multiple Peyronie’s plaque formation can be perfectly straight; they happen to be fortunate to have their internal pull and tension balanced and equal, causing no curvature or distortion. And this is why I continue to remind my PD Warriors that the curvature might get your attention and drive you crazy, but the real problem is the Peyronie’s plaque and not the curve.
Once you understand this, then you know that an increase in your curve should only be seen as a bad thing if you know for a fact that your scar(s) are increasing in size, shape or density. But over time, as the scars continue to weaken, soften and reduce in size as you treat yourself, and as the internal pull and tension created by these weaker scars begins to balance internally, the curve will eventually straighten. Continue monitoring your scar size, shape, density and surface features as you work aggressively, and you should see this positive pattern of recovery play out for you.
A smaller scar can create a larger curve if it is in the wrong place or is pulling or pushing in some strange way. It might make you feel sick to see your curve get worse, but ignore the curve and keep checking the condition of the scars.
If you have trouble locating your plaque let me know and I will do my best to help you, or just read Chapter 4 of “Peyronie’s Disease Handbook.” I would be happy to explain what I can to you. Just send an email to me; I would like to help you.
This concludes our discussion for this issue of the newsletter. I hope everyone found this issue of the PDI Newsletter interesting and informative so you can do a better job of helping your own PD or DC condition.
If you want to contact me with a question, please do so through the “Ask Dr. Herazy” Q & A section of either website at Peyronies Disease Institute or Dupuytren Contracture Institute.
Enjoy the warmer weather coming our way as spring becomes summer. Stay focused on your treatment plan.
Theodore R. Herazy, DC, LAc