Provider Application (Physicians & Physician Extenders)
Edited Transcript of the above Podcast about Penis Pumps...
Penis Pump
Penis Pump Theory
An erection can be modeled (in a physics way) as a water balloon. A balloon grows to a size to where the inside pressure equals the outside pressure. A balloon with no air pressure collapses because there's no pressure on the inside to make it expand the balloon to match atmospheric pressure so the ballon collapses. When you blow into the balloon, then the balloon expands to a place to where the inside pressure matches the outside atmospheric pressure. Then it stops expanding.
There's another pressure that affects the balloon size that’s not immediately obvious—the tension or elasticity of the wall of the balloon. When you blow up a balloon, you can feel that tension and that it limits the size of the balloon and can feel that it’s the tension in the wall that makes it difficult to blow up the ballon.
What can you do make it easier to blow up a balloon?
Anyone who's ever blown up a balloon for a kid's birthday party knows that by stretching the balloon a few times, then when you blow into it the balloon is easier to expand.
So, in regards to the penis, pressure provided by blood flowing into the penis (with venous return back to the heart being impeded so that there's a one way valve) supplies the pressure that inflates the penis inflates. In addition, even though the penis is filled with tissue and not air, connective tissue, skin, & collagen all resist expansion, so that tension limits how big the penis can grow in the same way that the tension of the wall of a balloon limits it’s expansion.
So, the size of ballon will be determined by where intra-penile arterial pressure equals the sum of the atmospheric pressure plus the tensile pressure of the penile tissue.
Two forces contract the penis… (1) atmospheric pressure and (2) tension on the wall of the penis. One force expands the penis—the blood pressure within the penis.
This blood pressure will be increased by increased arterial pressure and decreased by a venous leak. In this course, we’ll describe multiple ways to do these two things. You can't do much about atmospheric pressure and that pressure contributes very little to the pressure forces on the penis, so the only other way legitimate way to decrease the forces that contract the penis is to decrease the penile tissue tension (PTT).
Four Reasons for Using a Penis Pump
There's four reasons for using the pump: (1)you raise penile oxygen levels, (2)you avoid contraction, (3) you can stretch out the bent places and (4) you can get an erection with it.
Always Stretch a Balloon Before Blowing it Up
Studies show that a pump or a traction device will both decrease that tension including the increased tension in scarred areas that cause Peyronie’s, therefore allowing the penis to become straighter, harder, & sometimes larger. So, a pump is now accepted as part of the protocol for rehabilitating the penis post prostate surgery, improving erection quality and for treating Peyronie's Disease.
Stretch the Tight Places
One study published in the British Journal of Neurology showed that when men who had Peyronie's disease sufficient to cause curvature of the penis for which they wanted surgery were put on a pumping protocol, 51% of them canceled the surgery because they were pleased with the results after only 12 weeks of pumping. Along with that improvement, there was an increase in the size of the penis.
Is Your Penis Holding It’s Breath?
The flaccid penis is starving for oxygen. Not so much as when you put a tourniquet around your finger and it turns blue. Obviously, your penis doesn't become necrotic just sitting around the house, but the flaccid penis has lower oxygen saturation that other parts of the body. So, the health of the penis partly depends on occasional erections which feed more oxygen to the penis. This is one of the reason for nocturnal erections, because that extra blood feeds oxygen to the penis.
This penile oxygen saturation can be measured.
When I managed a wound care center at a hospital, we had a hyperbaric chamber that would force extremely high levels of oxygen into the bloodstream (so much oxygen that a person could live without red blood cells from just the oxygen in the plasma). We used this method to help save the feet and legs of people with diabetes and poor circulation who suffered with ulcers—forcing oxygen-filled blood into the tissue to help heal wounds. Often, the circulation can be so poor that even hyperbaric oxygen does not help because there’s not enough blood flow. One of the ways you can figure out if the hyperbaric oxygen will help is by applying a stick-on sensor to the skin (similar to what you might see if you had an EKG) except that instead of measuring electrical current, it measures oxygen levels at the skin. It's called trans-cutaneous oxygen saturation. Using that we would decide where we could save the leg and, if the person needed an amputation, where the surgeon might amputate so that he saves as much of the leg as possible but takes off the part where blood flow is inadequate.
Back to penises…that same instrument can be used to measure the oxygen on the skin of the penis and then extrapolating get an idea about blood flow and oxygen levels inside the penis—penile trans-cutaneous oxygen levels (PTCO). Research showed that men who use a penis pump daily feed their penis oxygen. Even during other parts of the day (when they're not using the pump), the their PTCO goes up!
Researchers showed that Cialis works better if the man uses a penis pump. The improvement with the Cialis (the man can go down on the dose) might be from both the better oxygen flow and by stretching out the tissue so that the expansion needs less force due to less PTT.
Pump Makes Erection
Another benefit from the pump is the erection from the pump! A pump achieves an erection even without arousal and even in men who are not able to have an erection at all due to severe vascular disease or due to spinal cord injury. Before we had Viagra, a pump was an old-fashioned way of achieving erection in men who had suffered from severe vascular and erectile dysfunction. You put the vacuum pump onto the penis and then apply vacuum. When the penis is inflated with blood, a constrictor band is placed at the base of the penis, and that is enough tumescence enjoy penetration and sexual relations with a spouse.
Now, hopefully you can, with this course, avoid having to use the pump to achieve the erection. Some people think they are going to damage their penis by using a pump, so I tell you about past uses of the pump so you know that like many therapies whether it's beneficial or damaging depends on the intelligence of how the therapy is used.
You can lift weights and achieve strength, or you can lift weights too frequently or with too much weight and cause injury. The same thing applies to the pump.
Reasons you would not use a penis pump
We just mentioned you could have too much pressure and damage the penis, and we'll talk about how to avoid that later. Here’s the things that you may not be able to avoid: skin darkening, swelling, pain,
Darker Penis
One thing that often occurs is that the color of the penis can darken. This is not an immediate effect, but if you use the penis pump daily, and especially if you use it at higher pressures, whatever your natural skin color is, you will see that become darker in the area of penis. Most, if not all of that, will reverse and go back to your natural skin color if you stop using the pump, or use it less frequently. This is a known side effect of using the pump every day.
Swelling
The other thing that can occur is immediately after using the pump, there can be some edema, or swelling. The fluid from inside the penis can extrapolate out of the intravascular space, and when you take the pump off, not in the erect state, but when the penis becomes flaccid again, then you'll see some puffiness. This is a normal thing and does not mean that you've damaged your penis, and it will go away usually within a few hours. Interestingly while it's there, if you have another erection, the penis will be somewhat larger than your normal erection because of that edema that lives partly just under the skin. That gives a nice little extra ... Not a lot, but somewhat larger erection. Again, that's short lived and not permanent, but it could happen to some extent almost daily if you're using higher pressures.
Penis Pain
Another reason that you may not want to use the pump is that it can hurt. The way you avoid this is ... We'll talk about in more detail about the specific protocols, but one of the ways to avoid it, I'll tell you right now, is just to use a lower pressure in the beginning, just like if you were stretching for yoga or something. You would start with a little bit of a stretch, and then as your muscles relax, you would increase the intensity. Basically everything that I'm going to tell you about how to do this should avoid the pain.
Decreased Function
Some people call this "turtling." Your penis says, "Nope, I need to take a break." Your penis may feel rubbery, or puffy, and seem like it's tired. The answer is to give it a rest. Don't use the pump for a week. If you can, avoid ejaculation for 2 weeks. Let your penis recover. You can over train the muscles. You can over train the penis. With any training there is danger of damage. With any training. Some would make the case that when you lift weights you cause damage, then when the muscles heal, they heal back stronger. To a certain extent, this is what happens when you use the penis pump. So, if erections, seem to become less firm, or if sensation seems to go down, this would be like over training with weights and the answer is to take a break. When you recover back to your baseline/normal function, then you can go back to pumping (with your doctor's permission) at a lower pressure and/or lower frequency or time in the pump.
The good news is that when you follow the entire Priapus Shot® procedure the PRP should help your penis recover just like PRP can help muscles and tendon and collage and nerve recover in other parts of the body.
A Date with Your Penis
Another reason that many people resist using a penis pump is that it just takes time. We have time just making time to eat one some days, and having an appointment with a pump for 10, 15, 20, 30 minutes a day seems like a big deal. I'll tell you right now, the chances are you won't do it on a daily basis unless you do this along with something else. If there's a trigger. For example, if you watch the news every night and you make it a point to use the penis pump while you watch the news, then you're much more likely to use it than if you just think you're going to have a 30 minute appointment with your penis everyday.
Some people are motivated enough to do that, but even when it comes to something as simple as walking, where we know it saves us from death, most people don't make time to do it on a daily basis, even though they know it helps prevent heart disease and helps with sex and intelligence and depression and many other things, bone mass. Most people won't make time to do it because they're rushed for time. They aren't sleeping enough, they're working too much, their family needs them. I would advise you that if you want to see benefit from a penis pump, that you make it triggered ... Your appointment to do this triggered by something else. It's the thing you do right before you go to sleep while you read a book, or it's the thing you do when you take a bath every night, or right before you take a shower, something like that.
Caught with Your Penis
Another reason for not doing is just embarrassment. Many people are ... This idea of using contraption, people knowing that they might somehow want to make their penis work better or bigger. You would think there would be something that you would be proud of, and some men are. Just like they are proud that they workout everyday, they are proud that they use their pump everyday. Most men are not. It's something that's private and it's definitely something you don't do like you would with friends around the television watching the Super Bowl, for example. Most neighbors don't come around and sit around the living room and pump their penis. There is a certain mystery and there's some sacred ... It's a sacred subject, sex is. It's the thing that you do behind the closed doors, including taking care of your sexual parts.
I don't mean to imply that this is something you broadcast on Facebook tomorrow, but the idea that you should be so embarrassed by it that you feel shamed if your lover knows that you do this is perhaps something that's worth reconsidering. If you could have an honest discussion with your lover that goes something like the following dialogue then you can leave the shame where it belongs, which is out of your life.
Here's the possible conversation…
I want to let you know that I've been reading ... I don't want you to think something freaky is going on. I've been reading about ways to keep my body healthy, not just my brain and my muscles and my heart and my digestion, but my sexual organs. One thing that's been noted is that using a penis pump can help with erectile function and blood flow and help a straight, functioning penis throughout my life if it's done intelligently, and just wanted to let you know that this is something that I'll be doing for a few minutes everyday. Don't want you to feel threatened by it, it doesn't mean that I have developed some real fetish and in love with this device more than I am with you, but it's just something that I do. Sort of like stretching out before I do a 100 yard dash.
If your lover has a problem with that, then there may be some relationship problems that are much more serious than the idea of pumping your penis.
Wasting Time?
Another reason for not using the penis pump—“What if I do all of this and it doesn't work?”
When people say I did the Priapus Shot® and it didn't work, or I used the penis pump and it didn't work, then my next wondering is how did you define working? Did you expect to grow your penis three inches longer? Were you trying to correct Peyronie's Disease and get the angle of the bend in your penis to a place where it's usable? Were you expecting to become arrow straight and like it was when you were 16 years old?
The truth is that nothing works all the time—even antibiotics. You may think our antibiotics are so amazing that no one dies from infection. The real statistics are that people who have pneumonia severe enough to go into the hospital, 1 in 5 of them (20%) die in the hospital because our antibiotics “don't work.”
But, because 20% of people in the hospital die with pneumonia die, no one says, “antibiotics don’t work.” Antibiotics do kill bacteria and most of the people who would have died from pneumonia 100 years ago now get well and go home. But in some people, other factors cause the person to die from the pneumonia even with the antibiotics: maybe their nutrition is low or they have lung disease or they have decreased immune function or problems with their heart, or maybe the bacteria is especially virulent. Many factors could prevent a person from recovering from their pneumonia, but that does not mean that antibiotics don't work. Antibiotics kill bacteria, but not everybody who takes antibiotics for pneumonia gets well.
In the same way, the penis pump “works” in the people who use it; most of the time, men see changes. It's not going to take a man who has type two diabetes and severe atherosclerosis in the iliac arteries to the point that there's no blood flow getting to his penis, you can't then use a penis pump and somehow force blood flow into the penis and clean out his iliac arteries. In other words, there's a dam upstream from the penis.
One of the reasons for not using the pump is the idea, well maybe with me it may not achieve my desired results. All I can say is that you're right, it may not, but whatever results you achieve are going to be your best penis. Just like I know I can lift weights all day long and I'm never going to have the muscles of Arnold Schwarzenegger. Even when I was younger, I did not have that genetics, in the same way I'm not going to grow a 14 inch penis. I don't have that genetics. I have been able to put an inch and a half onto my penis with these therapies, and at that point, it was sufficient and I just maintained what I did.
The thing is, we live in South and Bo Jackson is a big football hero here. Won the Heisman Trophy and just ran over people in football and knocked the ball crazy in baseball. In high school, he did pushups. He had such an amazing genetic physique, he just did a bunch of pushups. In the same way, it's easier for some people to see the benefits and taking any one part of this course in how to straighten your penis and deciding that's the one magic thing and if it doesn't work then it's all hokey-ness is just not considering the whole picture.
Fires Explain Healing
I think another analogy to consider is the analogy of a fire. If someone tells you you can start a fire by using a match and you go out in the street in front of your house and you strike a match and throw it down, you get a little flame and it's gone. You think well, I guess I had a fire but not much really. Since you've never seen a fire, you go to ask another person and they say oh, you should cut down a bunch of wood and stack it up. That makes a good fire. You go chop down a tree and you chop it up and you split it and you make a big pile of wood in the street in front of your house, but no fire. You think well wood doesn't help a fire. Someone else tells you oh, you can put some lighter fluid, that makes a fire. You get lighter fluid and you squirt that in the street, nothing happens.
You get my point, obviously. If someone comes along and says oh, to make a fire what you really do is you make the wood in a stack, then you put the lighter fluid, and you strike a match. You do that and now you have a fire. If someone says oh, wood, that's worthless, that's hokey, that's a big scam, wood doesn't make a fire. What they're really saying is I'm looking at a little sliver of it and I haven't figured out about my particular body what's missing that I'm not getting what it is I'm trying to do, or are my expectations out of reach and I'm thinking I'm going to start this blazing Dante's inferno with a match and a few twigs. Hopefully that helps you understand whatever results you achieve, that's going to be your best penis, and your best penis and your best health, mental, physically, spiritual, and penile health is all going to be achieved when you consider the whole picture. When you're not getting the results that you desire, don't be like the guy who decides firewood doesn't work because he's trying it as a stand alone, say well this didn't work the way I'm using it, what else do I need to do about how I'm using it and what else I'm doing to make it work?
Now let's get to the how. First the equipment that you're going to need. You're going to need something that creates a vacuum. There are electric pumps, and there are hand pumps. If you got the privacy, an electric pump is better because you can just set it and forget it. You set it, it takes a minute or two to get things situated, you set the pressure where you want it, and you watch the news or you read your book or you listen to your podcast.
The hand pump, I think you pump it up to the pressure you desire and forget about it, but unfortunately there's hardly ever a perfect seal, so you have to pump it now and then periodically, about every few seconds usually. It's a distraction to doing something else. It's nice in that they're more portable and a hand pump is quiet, so it's something you can throw in your bag when you travel and something you can do in the restroom without someone wondering what's the motor in there while you're taking a shower. With this, you can be quiet about it.
Anyway, you're probably going to want both, an electric pump and a hand pump. For the ... By the way, if embarrassment is a thing and you just don't want to have a discussion about this, then a hand pump that you put under a towel and take with you to the restroom is a nice way to get around that. Most people are not going to bother you on the john. Even if you don't want to take a shower, if you just get to the stall or your private place where you go to the restroom and you lock the door and use your pump, they may just think you have constipation that day because you're in there for 15 minutes.
Next you need the tubing and the cylinder. The cylinder, there are two ways you can think about. One, sort of a one size fits all with a phalange at the base of the cylinder that expands and contracts based on the size of the penis. Your penis will change size as you use the pump, so that expands. I find those to be the least comfortable, that expansion puts pressure on the base, like a rubber band around the base of your penis. I find that to be the least comfortable but many people like them and get nice results. What I like better is a cylinder that's sized for the penis so that it starts off somewhat larger from your flacid penis, but then when your penis is expanded by the pump, it comes close to being the same size as the cylinder, and at full expansion your penis basically fills the cylinder. You can change the size of that cylinder as your penis might grow.
You have a cylinder, you have a pump, you have the tubing between the two. I prefer a tubing that you can disconnect that has an actual valve on it, but that's not necessary. It's interesting, one of the dentists who came to see me went to the auto repair store and bought a brake repair kit, used the pump on that because it's very substantial, and connected that to the tubing that goes to the cylinder.
The lubrication that you use, that can be petroleum based like a KY jelly. People are all into it has to be water soluble. Why? I don't know that it needs to be water soluble, you just wash out the tubing. I prefer a vegetable based, there are some creams that are made that are based on coconut oil or Vitamin E. If you want just get you some coconut oil in the cream type consistency at the grocery store.
Then another nice tip that one of my patients taught me who achieved wonderful results is just taking some water, not very much, a tablespoon or two, warm water, putting that in the cylinder, and then pressing the cylinder against your body. That holds the water in, and you keep the tubing elevated above the water. The water sort of acts both as a lubrication and a warming agent that is really nice. It gives, I think, a little better seal, but it's a little sloppy so you have to have a towel or something there. It's going to drip everywhere if you don't.
Then what else. Let's talk about how you do this thing. We've talked about the equipment, so how do you do this. First, it helps if you're semi-erect, but you don't have to be. It helps if you know you're not going to be disturbed. It's a little bit awkward to suddenly have to take the pump off because someone walks in the room or whatever that you don't want them to be shocked by what you're doing. So a locked door, and then you want to put the tubing firmly against your body, the tube that your penis goes into, and aim it more horizontal. If you aim it up, which is normally how your erection would go, it makes the seal break and your testicles can be pulled up into the tubing. The tube that your penis goes into should be at a right angle to your body. Pull your testicles down out of the way. You have whatever lubricant you've chosen there, and then you start pumping.
Pump to the place where you feel a mild pull, maybe a very mild discomfort but not pain. Most people when they first put their penis into the pump, that happens somewhere around minus five inches of mercury. On the penis pumps, it's usually the scale on the outside, and it will be the greater pressures. There's usually two scales, there's millimeters and there's inches. The inches will be at a greater pressure. It's usually about, on most penis pumps, it's about a fourth of a way on the scale. I have some people who look at the wrong scale and they're just not going up high enough. It's minus five inches of mercury. If it starts to feel tight to you at three or four it doesn't really matter, just whatever that is.
Then set a timer and keep it there, you'll notice that it starts to feel less tension, just like if you were stretching your leg or something. Then as you go, just increase the pressure. The goal is to make to at least seven, preferably up closer to ten by the time you reach the end of the session. Preferably for the last five minutes of a 10-15 minute session you're up closer to ten. I think it's better if you keep it at ten or less. Some of the old school people tell me they would go to 15. One of the guys that got really nice results with me went minus 15 twice a day. He only did that three times a week, so he used a higher intensity with a less frequency. Sounds like a workout routine, doesn't it. You do three sets of five everyday, or you do heavy duty hard weights twice a week. All sorts of theories about how to lift weights. It's the same principle isn't it. You put physical stress on the tissue, and then you allow recovery, which is why the Priapus shot helps so well, because just like Priapus helps with recovery of muscles, it can help with what you're doing for the penis.
I think it's worth saying here that combining the two, there is some synergy. Was Arnold Schwarzenegger big because he lift weights or because he did steroids? In Arnold's day, you could go to the pharmacist and he would just give you testosterone and the anabolic steroids were like antibiotics. There were not laws passed against them, the pharmacists would just give it to you if you just asked them for it. The veterinarians would give you all these veterinarian medicines. Arnold doesn't try to hide it, back in the day that's just what they did. They also lifted weights like gladiators. Had he lifted weights without the steroids, he would have been in amazing physique, but doing the two together so he could lift like a gladiator and then recover enough to lift the next day, that's exactly the principle we're applying. Some people will say well a penis grew an inch with the Priapus shot, but was it from the pump or was the from the PRP? Well, was Arnold big from lifting weights or from taking steroids? If you want to be a purist, just use the pump, but if you want to have your best penis, use the pump combined with the Priapus shot. That's just how it goes.
Back to how to do this thing. You put the cylinder there, you apply pressure, you try to work it up to minus seven to ten, and you want a total of 10 minutes. Take a five minute break where you let your penis recover, sort of massage it, get the blood flow back into it, try to avoid masturbating, you want to try to keep your hormones high. At least try to avoid having an ejaculation because those hormones are going to help you grow your penis. I'm not saying you can never ejaculate, but try to make penis pumping about growing your penis and avoid ejaculating if you can.
Take a five minute break, and then you apply the pump again for another 10-15 minutes. That's it. Take the pump off, or the cylinder off. If you want, you can have a band that goes around the top of your penis and the under side of your testicles to help hold the blood in your penis for the next hour or so.
Let's see, what else can I tell you? That's how you use the thing. I think that's enough for now. I hope this is helpful to you. Penis pumping is almost like weights were back in the 50s and 60s. I came up, I was born in 1960 and had an uncle, my mom's brother, he had an amazing physique. He would train at the YMCA. There were no gyms like ... In those towns like Birmingham where I grew up, there were no fancy weight training gyms. You had the YMCA, which was sort of like a mission. It was started as a Christian mission for people who didn't have another place to live. There were rooms there. People who just got out of prison would go stay there, like the Salvation Army or whatever homeless mission you have in your town. It was part of the United Way, and then they became the weight training part of it became more prominent, and the place to stay part of it because eventually phased out, which may be unfortunate.
Anyway, that was where you trained. That's where you lifted weights. The coaches, many of them, most of them actually thought that lifting weights made you muscle bound and clumsy. Even the doctors thought that the weightlifting body builders were just bloated from the steroids, they weren't really stronger. Amazingly it wasn't until the late 1980s that the research came out showing that anabolic steroids actually make you stronger. All that to say, there was this underground about lifting weights. When I at 15 in 1975 went to a huge bookstore in Birmingham looking for a book on weight training, there were only two. One by Arnold Schwarzenegger called Education of a Body Builder, and another by Frank O'Clumbo who was one of his training partners and a friend from Italy. That was it. There's whole shelves of weight training books now, right? The muscle and fitness magazines were little black and white things.
All that to say, it could be, just maybe, that penis pumps are something similar. The people doing it are ahead of the physicians by a long way, and the research over the next few years will catch up with what the people are noticing that are using a pump. I don't think, in my experience, you can take someone with a three inch erection and grow it into a ten inch erection. Maybe that's possible, I don't know. Maybe that's a full time job to do something like that. I'm less inclined to think that sort of thing is possible. I think it's more of a percentage thing. In that same way that Bo Jackson and Arnold grew in proportion to their genetics, I think the same thing applies to the penis. In my experience of seeing it easier for a man with a seven inch penis to grow it to eight, it's actually fairly routine if he's using the pump and a Priapus shot, or for five and a half to grow to seven. It's more difficult for three to grow to four, or four to grow to five. Although it can happen, I think it's more difficult.
The interesting this is that even in the guy with the seven inch penis, it's not 100%. That is the most frustrating part of this. When I talk with people who are doing other things with tissue regeneration, for example I recently did a lecture in Venice and shared the podium with one of the world experts in hair regrowth. We talked after his lecture, because in his lecture he said that he was not able to predict who would grow hair and who would not consistently. He could do blood tests and try to perdit. In other words, he wasn't sure what the complete formula was for making the fire in everybody. Maybe there are ingredients that are missing in some people that we don't yet know how to identify.
Believe me, I am thinking about this a lot. I'm researching it, I'm reading about it, I'm going to classes trying to see what people are talking about. I think that you're going to see great strides made. I'm giving you in this course what I think works best for helping the best formula for growing a harder, straighter, bigger penis. I think you'll see that science change. I'm grateful and honored that you're interested in these ideas. I encourage you to read and study and stay in contact with me, and contact me by email. You can post things, it's really a better way to post to the blogs. Contact the doctors that provide the Priapus shot. They're being updated by me on a regular basis on the science. We have amazing, phenomenal, amazing urologists in our group doing research in this arena. Much of what they're finding scientifically is not in the research yet. Usually what happens is people notice things, they might talk about it, they may not, they publish it in the research literature like the New England Journal and Journal of Sexual Medicine.
