June 1, 2013 PDI Newsletter
Greetings to all PDI and DCI Warriors,
Welcome to this June 2013 PD Institute newsletter. Let’s hope this cool spring weather we are enjoying means a pleasant summer ahead for everyone.
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This newsletter will once again use the familiar and popular format of presenting a simple exchange and blending of emails from one of the many people I communicate with, and my discussion addressing their their questions and problems. 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 doing for your DC.
Read this series of seven email exchanges like the back-and-forth of 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 MMXXXXX and the text in red is from me.
As you will soon read, MMXXXXXX is a loving wife and concerned partner who is very worried about helping her husband. In addition to the ravages of his Peyronie’s disease, they are also dealing with the sobering problem of her husband’s lung cancer while he continues to work.
Reading between the lines it is fairly obvious MMXXXXXXX is apprehensive that she is not using his PDI treatment plan correctly, and so she asks for help at different times about things that are not often a question for most folks. In these emails she reveals that she lacks the necessary confidence that would make her feel comfortable about what she is doing, but perhaps more so in her case. For this reason she questions basic points of care, and even asks for help and reassurance about topics and procedures that are explained in the many instructions that come with every order our customers receive from us.
In many ways MMXXXX is like most people who start DCI or PDI treatment – just a bit more. This is such a unique and scary thing that we do when we begin to try to help our body’s repair better than they are currently doing. We are not accustomed to being in charge of self-treatment; we are accustomed to submitting to medical care which for most people primarily involves doing what we are told to do. It is no wonder that MMXXXXX feels overwhelmed by the process; the fact is, most all people feel like this, but MMXXXX does more about it.
What is perhaps different about MMXXXX is that she takes the time and puts out the effort to get all the answers she needs to do a good job. MMXXXXX is trying to do all that she can for her husband and needs frequent assurance she is not making mistakes. She has assumed the role of a care giver for her husband. I respect her earnest effort to do the right thing. I work with many men whose wives abandon them because of their Peyronie’s disease. They are alone to face the recovery process and do not have the help of a loving woman. MMXXXXX’s husband is a lucky man to have such a concerned, dedicated and loving wife working for his welfare.
It is because she is trying so hard to understand the suggestions and ideas I present to her that I know she will help him do well. However, as you will soon learn, I am forced to explain to her that she and her husband must work together to make all Alternative Medicine treatment decisions, since in my role in DCI and PDI I am not anyone’s doctor; I do not make direct treatment decisions; I can only suggest and inform so each reader can decide what is best in each situation.
I believe this exchange of emails is so important because it not only presents basic treatment ideas, but because it stresses the pressing need for individual responsibility. Most of you have come to realize that current medical treatment of Peyronie’s disease (and Dupuytren’s contracture) leaves a lot to be desired. The medical profession does not place a high priority on treatment of both of these problems because they are fraught with drawbacks and problems at every turn. So many people are rushed out of doctor‘s office because doctors do not like to deal with the problems and frustrations that PD and DC present to them. For this reason so many people eventually look to Alternative Medicine methods to help themselves heal these problems to the best of their ability.
Sent: Friday, March 15, 2013 11:10 AM
Subject: Regarding PMD DMSO and the topicals
Dear Dr. Herazy:
During the time my husband is applying these topical serums and oils it is O.K. to still have sexual relations?
Please let me know about this.
Yes, your sexual relations can continue during the time he is using DMSO. However, to be doubly safe:
- He must be especially careful about washing off all residue of gel with soap and water after each DMSO treatment application
- Wait at least 30 minutes after the gel has been removed to begin sex
- On the outside chance of encountering extreme vaginal sensitivity in which irritation or swelling occurs, stop all sexual contact and contact me for further instructions.
In a little over 11 years of doing this work I have not had one case of DMSO sensitivity reported to me in which a sexual partner had any problem from DMSO being transferred. Once the DMSO has been applied to the shaft it is pretty much gone after 6-7 minutes, and there is none remaining to irritate the internal walls of the partner.
Theodore Herazy, DC, LAc
Sent: Tuesday, March 19, 2013 11:50 AM
Subject: Another question
We have started the program, but because of my husband’s surgery for lung cancer, and his terrible reaction to the chemo therapy, I have started him on the lowest dose of everything, including the enzymes for the first week.
When I increase the two enzymes, would it be O.K. if after he eats his breakfast, which consists of oatmeal/bran mixed with granola, a very small amount, can I then give him his first four tablets of the two enzymes. I cannot think of another time, when he can take them during the day on an empty stomach.
Will it make that much of a difference in his recovery if he takes it directly after he eats his first meal? I usually give him the second dose before he goes to bed on an empty stomach.
By your question I take it that your husband is eating frequently throughout the day, is that correct? If so, then I believe what you propose will have to suffice under his unusual situation. I wish he could use these products in the more standard way since he would likely get better results if he waited a few hours. But it is better that he does it this way – even though it is not ideal – than not at all.
Please see below for comments…
Sent: Thursday, April 04, 2013 11:37 AM
Subject: An update
Hi Dr. Herazy:
I ordered, for my husband the medium plan and started him on all March 20th, 2013. Because of his sensitivity to EVERYTHING, I began all supplements at one per day and have worked them up to the recommended dosage, except for the Scar X which he puts on once per day and the Nattokinase, which he now takes twice per day. I am wondering how I am going to get him to take it 3x per day. I have no special comment about this, except to offer that if you approach the increase on a slow and consistent basis you should eventually bring dosage up where it needs to be to support his ability to reduce or eliminate his PD scars. If his gut sensitivity dictates that he works more slowly than the average man then that will be the factor that determines his slower than average rate of progression, and there will not be much that any of us can do about his reduced pace.
We are now in the second week. Any suggestions as to how I can increase the enzyme to 3 times per day, as he works and will not remember to take it. He must make a decision. He must take responsibility for himself to participate in his own recovery. If you are asking me how I can do something to help him remember to take his therapy, while he is not willing to help himself, then he will likely fail. Can I increase the amount to 3/twice a day. Yes, you can consider increasing his dosage in this way, but even at that it is a very low therapeutic dose and will likely have to go higher than that in time. Will that be O.K.
ALso, what do you recommend we increase next week, being that there are no changes in his condition. At this lower dosage that you have started with, there is little chance of any positive change occurring. You two will have to discuss how to increase his plan. Please read the instructions you received with the 1st order to know how to proceed. He still has quite a bend, NO PAIN at all. He did have sensitivity at the site of the plaque, but sometimes now I cannot even feel the little pea shape thing and his sensitivity is going away. Great. This might be an early indicator he is making some positive changes, even at this early stage of treatment.
Do you suggest we begin the massage? Yes. Need some help here. What help do you need? If you sit and listen to the one hour program you will have everything explained to you in great detail. We are getting a little impatient. You have just started and you have decided to use a dosage lower than recommended, so your husband’s situation will naturally be slower to respond. I know we have to be patient. Can you give us some hope. Please read the testimonial page http://peyronies-disease-help.com/testimonials-peyronies-disease-institute/ to see what other men have been able to accomplish when they follow the plan aggressively.
PS: Also, I think I am beginning to run low on the enzymes. How much in advance should I place an additional order. Do they come promptly? I would order at least a week ahead of the time you will be needing any therapy product. I find that we send out 99.5% of orders the same day they are received; rarely does an order sit for a day before being filled. We use the USPS system which tends to be less expensive than other carriers and gets orders on either the east or west coast usually in three days and faster if you are closer to the middle of the U.S. TRH
Sent: Friday, April 19, 2013 7:48 AM
Subject: Can you please email back when you have time
Dear Dr. Herazy:
We are now in the third week of our Medium Plan. We are aggressively following everything as recommended. We are interesting in increasing something, but do not know which of the supplements to increase.
Can you email back and let us know, what your recommendation would be on what to increase and by how much. We are very patient and know this will take time, but need some advice at this time.
Thank you so much.
I am currently on vacation for the last few days; not returning until next week. Because I know you are very concerned, even though I am away from the office I will answer you briefly.
I suggest you might increase either the Fibrozym or the Nattokinase (one of the two enzyme products) by one capsule daily and increase the Fundamental Sulfur by one capsule daily. That should be a sufficient increase for your first time around expanding the therapy plan, if that is what you want to do.
Do you have a clear and detailed description of the size, shape, density and surface features of his PD scar to serve as a baseline to compare against? If not, you and your husband must develop a very clear and detailed description of his scar so you have a good guideline by which you will be able to judge his progress. Remember, his progress – or lack of it – is what ultimately determines if and when you increase his therapy dosage.
Please see below for comments…
Sent: Wednesday, May 01, 2013 12:04 PM
Subject: Need to know what to do next
Hi Dr. Herazy:
On April 19, you instructed me to increase Fibrozyn and Sulfur by one pill. On May 2, it will be 14 days since we increased. We do not feel any difference in the pea like nodule at the top of his shaft. Sometimes it feels flat and sometimes it is hard, but really no change. This last sentence makes it sound like you are dealing with a variable nodule structure, is this true? You cannot really say, “Sometimes it feels flat and sometimes it is hard, but really no change,” because that is change. I think you might be expecting the changes to be permanent in this early phase of care, when often they are only temporary. Variable and temporary progress is common when people begin treating Peyronie’s disease. After a time the changes become more permanent. Can you please describe the changes the nodule makes during an average week? What have you done to define the size and shape of the nodule? When you say “hard” what do you mean? What part of the nodule is flat? When you feel this flatness you mention, does it feel polished and very slippery, or dull, or rough?
Do you have any recommendation for another increase? Please advise. What is the overall plan you are following, so I have a good idea of your current effort in regard to dosage and frequency? TRH
It has been not even two months on the Medium plan.
I will await your reply.
Thank you so much.
Sent: Wednesday, May 01, 2013 1:19 PM
To: Dr. T. Herazy
Subject: RE: Need to know what to do next
Yes, to define what I am saying, sometimes, we feel it and it feels like a little pea sized, round and hard (meaning when you touch it, it is not soft, you cannot push it in, not pliable.) During the week, we feel it and we can hardly feel it. Sometimes it feels like it’s not even there, sometimes it feels flat, not shiny, maybe like you are describing rough and flat.
We are following the Medium Plan to the recommended instructions and then you increased on April 19 the Sulfur (x1 more) and Fibrozyn x1 more.
So it has been two weeks now, and we felt it yesterday, it was round again, pea size, no change in the size.
Should we feel it every day?
That’s the best I can describe it. There is no pain associated with this, even when he is erect and hard. We cannot feel any other plaque anywhere else. Of course he has a bend, but no discomfort.
What to do now? Increase or add something else.
I think you do not appreciate the volume of emails I must answer each day to keep my head above water. You need to directly and clearly answer my questions so I can tell you what you need to know, based on your feedback. I have asked you a few questions and you have not directly answered them, so I do not know how to help you.
I cannot be put in the position of telling you out right what to do each step of the way, as you appear to want. That would put me in the uncomfortable position of treating your husband through emails without ever examining him. That would create a dangerous doctor-patient relationship that cannot exist. All of the literature I have sent to you tells you what you should be doing for him to treat his own problem using Alt Med. I can give you suggestions and answer your questions about what you decide to do, but I cannot tell you what to do.
If you ask me, “My husband wants to increase Neprinol dosage from 3/day to 4/day, what do you think?” I can answer that question. I can tell you that is a reasonable idea.
When you ask me “What to do now?” I cannot answer that question because it puts me in a bad position I cannot tolerate. And I cannot tell you he should increase his dosage of a therapy from 3/day to 4/day without putting myself in jeopardy. In the past I have always made suggestions to you, and you have taken them as though I was telling you what to do. And I have not told you what to do.
Further, when I ask you to describe the dosage of his current plan and you tell me “he is following the Medium Plan to the recommended instructions” I have no idea what that means. I need direct answers from you so I can quickly look at what you are doing and make suggestions and offer you ideas for what you can consider to do.
Lastly, when you say something is “hard” that is an adjective that is much too open-ended for me to understand what is going on with your husband. Worse yet, “hard” does not adequately or clearly tell you or your husband enough about the density of his pea-sized nodule. You see, a pebble is “hard,” a pencil eraser is “hard,” and an overcooked egg is “hard.” All of these can describe the density of a PD scar, but they are all different. If you use the word “hard” it can mean so many things to different people (pebble, pencil eraser, or over-cooked egg) that we could be talking about totally different things. In this example all three of these uses of the word hard indicate different densities. I want to know – so you can know – what do you mean by “hard.” “Hard” like what? If you tell me his pea-sized nodule is hard like a diamond, that tells me one thing. If you tell me his pea-sized nodule is hard like a raw kernel of corn, that tells me something entirely different. More to the point: if you can be more descriptive about the state of hardness you both feel you would have a guideline or tool to use to judge his progress or lack of progress simply by defining what you mean by “hard.” You can abundantly use this clear definition of the hard density of his nodule as time goes by to track his progress MUCH more specifically and accurately. You can watch it go from being hard like a pebble on the beach, to hard like a lump of dense wooden mulch, to hard like a piece of wax, to a bit softer like an undercooked lima bean, to even softer like a perfectly cooked lima bean, to softer still like an over cooked lima bean, to even softer like a lump of soft soap, to… and so on down the line until it is gone. You cannot use words like “really hard” or “really soft” because they cannot be graded in any meaningful way. If you do not define the density of his scar in the way I am describing, then we not have a way to communicate. But worse of all, you have no way to know if your husband is actually making progress. Please do not tell me, “Oh, I will know if his scar changes. I will remember what that nasty little booger feels like. Nonsense. Everyone thinks they will recognize changes to the PD tissue, but no one remembers these subtle things unless they put powerful word-images on them. You must do it this way because I have found in over 11 years of doing this work that this is how it works best.
By the length and detail of this letter I want you to know I am here to assist you and your husband in his effort to get well by giving you my ideas and insights, but you must be willing to be in control of your situation by making the necessary decisions. I can only suggest; you must decide. Please be careful to read what I am writing, and answer the questions I ask so I can help you. I cannot spend this much time answering everyone’s questions as I have devoted to you.
So, read the papers that were given to you with your 1st order that explains how to increase dosage. Then tell me what you think you should do at this point of his care. I will let you know what I think about your idea, and then you can decide. OK?
Greetings once again MMXXXXX,
Please see below for comments…
Theodore Herazy, DC, LAc
Sent: Thursday, May 02, 2013 7:42 AM
To: Dr. T. Herazy
Subject: RE: Need to know what to do next
Sorry Dr. Herazy for taking up so much of your time. I do not mind spending this time with you, but I want it to be productive. I want you to know you must be in command of this situation, since I can only offer ideas and suggestions to you. Either you or your husband must grow into this role. In the future, I will try to just give you an email every 14 days with my recommendation and see if that is agreeable to you. I did not realize that this is the way the program works. I understand completely now that it is up to us to consider the changes and then just check with you.
Sorry for the misunderstanding. People go to the doctor and are told what to do. This Alternative Medicine approach is different. No one can tell you what to do. You must decide for yourself what you want to do. I can offer you help along the way in this new role.
Our current program is the following: Medium Plan was ordered. He is taking at present:
1. Nattokinase 2 tablets 3 times per day Most men eventually reach 9/day of Nattokinase and Fibrozym before seeing results; something to keep in mind. It is not a race to get to these levels; consider adding 1/day more every 7-10 days. Always evaluate size, shape, density and surface features to know if any dosage increase is necessary.
2. Fibrozym 2 tablets 3 times per day (we increased by 1 tablet on April 19th to 6 total)
3. Sulfur 1 tablet 4 times per day (we increased by 1 tab on APril 19 to 4)
4. Copper and DMSO twice daily Please consider using moist heat for 5-10 minutes to the area prior to DMSO application
5. Vitamin E, once daily
6. Vitamin C once daily How many mg of vitamin C is total amount? Most men use 2-4 grams of vitamin C daily
7. Papa 1 tablet 3 times per day Consider slowly bringing PABA up into 6/day range over time; not all at once, but perhaps taking several cycles to reach that level.
The description of the pea sized nodule feels like the hardness of a jellybean. THat is what I think, when I say hardness. Good. Now we both know and can exactly recall the density of the scar a week, a month or a year from now without any hesitation. Once the density is no longer like a jellybean, you must redefine the new density in a meaningful and accurate way so that the new density description becomes your standard. Without these descriptors you would only be guessing about progress. Also, both you and your husband should run you fingertip gently over the surface of the scar(s) to determine the surface feature description. You recall I asked if the scar felt slippery like a wet bar of soap, or slick like an ice cube, or smooth like a dinner plate, or slightly bumpy like a cotton sheet, etc. From my experience scar density and surface features will change 90% of the time before the size and shape will change. This is why you must use all these physical descriptions and structural features to catalog the attributes of each scar. You and I have no idea what kind of early changes his scar will make, so you must be watching all possible features of the scar to be alert for any changes that might take place. I have written this description down so that I can compare that description in another week to see if it feels like that hardness has changed in any way. I actually write all changes down on paper. Exactly. That is the way it should be done. I am reminded of watching the expert chefs on the cooking channel tasting a recipe. They are very critical of what they are doing and might add a few grains of salt or a few leaves of an herb to huge 3 gallons pot of food. When they taste and assess the cooking food in front of them they are “splitting hairs” when they evaluate their dish and what they must do to improve it. You must do the same. When you test the density of the scar that feels like a jellybean, you must ask yourself, “What does this remind me of?” You must open your imagination and capture the first mental image that comes to mind, no matter how farfetched or silly; just so long as it accurately depicts what you are feeling. Does it still feel like a jellybean only, or does it now feel like a jellybean that has soften a little in the sun, or a jellybean that has been kept in your back pocket for a while and is now less dense? Has it stopped feeling like a jellybean altogether, and now feels softer like a raw clove of garlic, or perhaps even softer like the egg white of a hardboiled egg? All of these things are dense or hard in their own way, but still demonstrate different degrees of the word “hard.”
Can we increase the Nattokinase by one tablet? What do you think about it? That seems reasonable to me, if that is what you two think you should do. Jumping up his dosage by two tablets would be perhaps too fast. If you find that a one tablet increase every 7-10 days is too much for your husband, you could think about approaching it from a slightly different direction:
Either increase by ½ a tablet every 7-10 days, or increase by one tablet every 14-21 days. Just something to think about. TRH
Well there you have the little discussion between MMXXXX and me. I hope you 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 about your problem, or questions about treatment, please send an email at firstname.lastname@example.org
Regards, Theodore R. Herazy, DC, LAc